The first half of the book contains birth story after birth story and if you’re anything like me then you will love reading them. While I was pregnant I read hundreds of birth stories, mostly to encourage me that my body was made to give birth. I had a lot of fears and even knew first hand from friends how quickly things can go array. All of the birth stories take place at Ina May’s farm in rural Tennessee. Sounds a little hippy, a little fairy-tale, a little poetic, but very real all the same. Reading the birth stories even after I’d had Logan has been just as encouraging for me to continue my slow road to midwifery.
The second half of her book is very technical. She talks about each stage of labor, how you can manage pain, what and how our bodies are designed to give birth and general stats. The stats are overwhelming and almost dated at this point, but interesting nonetheless. As I recommend this book to expecting moms I also want to encourage you to take certain things with a grain of salt. Ina is a little out there (aka: birth being sexual?! gasp!!) BUT there are very concrete explanations behind her theories.
As a way to make a note for myself and to highlight pieces worth sharing I am listing below what I find useful. I love that my Kindel has this highlight/bookmark feature! As a way of saving me some extra work I think it goes without saying that everything is a direct quote from Ina May’s Guide to Childbirth and that I am giving credit to her and her alone.
Our rule of thumb in guiding women through labor is to let the mother choose her own way of giving birth.
Thin women don’t seem to have the muscle mass to resist what labor is trying to do that sturdier women have. Of course there are always exceptions.
I learned that true words spoken can sometimes relax pelvic muscles by discharging emotions that effectively block further progress in labor.
All women are sensitive. Some women are extraordinarily so. We learned this truth by observing many labors stop or slow down when someone entered the birth room who was not intimate with the laboring mother’s feelings. If that person then left the room, labor usually returned to its former pace or intensity.
Remember this, for it is as true as true gets: Your body is not a lemon. You are not a machine. The Creator is not a careless mechanic. Human female bodies have the same potential to give birth well as aardvarks, lions, rhinoceros, elephants, moose, and water buffalo. Even if it has not been your habit throughout life so far, I recommend that you learn to think positively about your body.
During the last few days of pregnancy, hormones called prostaglandins cause the thick cervical muscle to begin to soften and thin in readiness for labor. This process is called ripening.
Prostaglandins, oxytocin, adrenaline, and endorphins are some of the most important natural chemical combinations produced within the woman’s body during labor and birth.
French physician Michel Odent calls my sister’s experience an example of the fetal ejection reflex-a sudden rise in adrenaline gives us the surge of power necessary to complete the job of birth.
We need to always remember that mothers who are afraid tend to secrete the hormones that delay or inhibit birth. This is true of all mammals and is part of natures design.
‘Don’t worry’ I’ll say. ‘I’ve never seen anyone explode or tear in half.’ Relief is usually instant and complete. ‘Only the baby will come out,’ I’ll go on if I notice my words are having a calming effect. ‘Your body is very wise. It only pushes out what needs to come out.’
They usually aren’t aware of the extent to which you can ease your own tense reaction by declining to think in terms of ‘uterine contractions’ and thinking instead of ‘interesting sensations that require all of your attention.’
One of the most meaningless diagnoses in obstetrics is cephalo-pelvic disproportion (CPD), a term based upon the Three Ps theory-the baby being too big to fit through the maternal pelvis. The rate of CPD varies widely from hospital to hospital, as well as from country to country. My partners and I have attended successful vaginal births for many women who were previously diagnosed with CPD.
To qualify as a law of obstetrics, a description of a biological truth ought to be true all of the time, not just occasionally.
The neocortex-the newer, rational part of the brain, which plays a role in abstract thought-and the primitive brain, which governs instincts. The primitive brain, or brain stem, is also considered to be a gland that releases hormones. All female mammals, including humans, release a certain number of hormones such as oxytocin, endorphins, and prolactin in the process of giving birth. Stimulation of the neocortex, on the other hand, can actually interfere with the birth process by inhibiting the action of the primitive brain in hormone release.
If it becomes necessary to gain entrance to a vaginal, cervical, or anal sphincter, it is a much less unpleasant experience when certain principles are kept in mind: (summarized) permission must be asked, place finger gently on rim of sphincter and hold for 4-5 seconds, move inside slowly and gently.
Out of these very different conceptions of women’s bodies and the meaning of birth have come two separate models of maternity care: the midwifery or humanistic model of care and the techno-medical model of care.
The midwifery model of care recognizes the essential oneness of mind and body and the power of women in the creation of new life. The midwifery model of care conceives of pregnancy and birth as inherently healthy processes and of each mother and baby as an inseparable unit.
Chorionic villus sampling (CVS) is an invasive technique for testing for chromosomal abnormalities. It is done before twelve weeks. It’s main advantage is that it can be done earlier in pregnancy than an amniocentesis.
The glucometer is a finger-poker that measure the sugar levels in a drop of blood. We use it when we notice several of the following symptoms at twenty-eight weeks or thereafter: (summarized) fast weight gain, feeling ‘funny’ or ‘dizzy’ after meals, constant thirst, craving for sugar, family history, previous large baby.
Certain situations are associated with a higher risk of infection in the baby. These include: (summarized) low birth weight or premature babies, membranes ruptured for more than 18 hours before birth, long labors, interventions, fast fetal heart rates, mother developing fever, high beta strep colonization in vaginal culture, and babies who need resuscitation at birth.
Inform yourself about what you will and will not accept. US courts have accepted the idea that you give your implied consent to procedures if you have not actively objected to various procedures by simply refusing them, firing your caregiver, or discharging yourself from the hospital against medical advice.
It may help to know that labor often starts and stops a time or two before it becomes powerful enough to complete the birth process.
There are legitimate medical reasons for induction. These include cancer, hypertension, diabetes, kidney disease, a small-for-dates baby, a decrease in the amount of amniotic fluid or an intrauterine death followed by a long wait for labor to begin (we’re talking weeks, not days).
The most common medical methods used to induce labor are breaking the waters (amniotomy), and various chemical methods: Pitocin IV drip and the administration of various prostaglandins (Cervadil, Prepidil, and Cytotec).
Given this history, it is not an exaggeration to call the supine position an invention of the industrial revolution.
Shaking the large muscles of the mother’s bottom or thighs is an effective way of helping some women relax during labor.
The technique, called the ‘pelvic press,’ involves putting pressure on the upper part of the woman’s hips (the upper iliac crest) while she pushes. This pressure pinches her hip bones closer together at the top while opening them a corresponding amount at the bottom, thus freeing the stuck head.
The hula and other hip-swinging dances of the Pacific island nations, Middle Eastern belly dancing, and rhythmic butt-shaking dances of Africa are all examples of dances that strengthen the pelvic muscles.
Episiotomies: cause pain that lasts for week or months, increase blood loss, cause more serious tears, often become infected, damage to pelvic floor muscles, and prevent women from breastfeeding due to pain.
Studies have shown that delayed cord-clamping allows between twenty and fifty percent of the baby’s blood volume to flow into the baby. Early cord-clamping also results in lower hjematocrit or hemoglobin values in the newborn (fewer red blood cells). Midwives agree that premature babies especially benefit from later cord-clamping.
At some point we will apply antiseptic to the baby’s cord stump and inspect the baby, but all this can happen at the convenience of the mother and baby. They are doing something more important just by being together. They are falling in love.
Step one to preventing postpartum depression (PPD) is to find time to sleep after giving birth, no matter how euphoric you feel. Try to sleep as much as you can when your baby sleeps.
See resources for a video documentary about Mrs. Smith, which aired on TV in 2002.