Ina May’s Guide to Childbirth- Ina May Gaskin

I am hoping to have a natural childbirth and this book came highly recommended from my doula and from a friend of mine who has given birth naturally.  If you are curious at all about natural childbirth, this is a good place to start.  Ina May Gaskin is probably the most famous midwife in the US and she has attended tons and tons of births at The Farm, an intentional community in Tennessee.

The first section of the book is dozens of birth stories of women who have given birth on The Farm or who have some other connection to Ina May.  The idea is that these stories show what childbirth can be when it is done naturally and to show that many of the common complications resulting in medical interventions can be handled by less invasive techniques (changing position in the case of shoulder dystocia, for example).  If all these ordinary women from a variety of circumstances can give birth without medical interventions, then surely you (and most other women) can.  The stories get to be kind of much after a while– there are A LOT of them, but they are interesting and contrast pretty strongly with the stories I’ve heard from many of my friends, who’ve been induced or who have had multiple c-sections.  I really envy the freedom that the women on The Farm get during labor.  They get to walk in the woods during labor or take baths and feel comfortable enough to assume whatever positions might work or to make noise while in labor.  It’s quite a different scenario than being hooked up to a fetal monitor in the hospital with strangers (nurses) coming and going throughout your labor.  That said, it was REALLY important to my husband that we have a hospital childbirth, so we are going to make the best of the situation.

The second section of the book is the actual childbirth guide and there are lots of helpful and interesting tidbits here.  I particularly enjoyed the chapter about “sphincter law” in which Ina May compares the cervix to other sphincters… it is difficult to urinate or defecate when you are feeling anxious or “watched” so it makes sense that similar conditions could slow or reverse the dilation of the cervix.  I also liked her response to the question “how does something that big fit through such a small opening?”  Ina May reminds readers that the penis expands and contracts without causing irreversible damage… and so can vaginal tissue!  (This post is going to attract all sorts of spam, but it’s hard to talk about childbirth without using the word “vagina” so I guess that’s unavoidable.)  What I wasn’t all that impressed with was the section on orgasmic childbirth.  I’m sure that exists, but I am skeptical that it is even remotely common and well, I’ll admit that I’m not perfectly comfortable with Ina May’s argument that childbirth is a sexual experience.  I think I am very much a product of the culture that has erased the connection between sex and childbirth, so it was hard for me to think outside of that.  I also had some quibbles with some of her data– there is some out of date medical info in here (mercury is not being used as a preservative in most vaccines any more and I’m pretty sure no one is using Cytotec to induce labor either ETA: I was wrong, apparently Cytotec is still being used by some docs to ripen the cervix and induce labor.) and there is a whole chapter talking about maternal mortality statistics.  She criticizes the US statistics for being incomplete, while also using them to support her argument that maternal mortality has stayed at the same rate for 30 years, indicating that the US is failing mothers in comparison to other developed countries where rates have improved.  My husband pointed out to me that she can’t have it both ways– if the data is inaccurate and incomplete, then it isn’t really responsible to use that data to support your argument.

What I find most personally troublesome is the antagonistic tone that we see here (and in most all literature about natural childbirth).  Being that natural childbirth and midwifery are the not the norms in the US, there is a lot of negativity towards doctors, hospitals, and the medicalization of childbirth.  While I fall much more into the natural childbirth camp, I really don’t like the tension between the two systems.  We need both doctors and midwives, both c-sections and unmedicated vaginal births.  There shouldn’t be opposing systems, there should be complementary systems.  Unfortunately, there’s historically been tough competition between midwives and doctors in this country and doctors pretty much ran midwives out of business by the 1950s.  Things are getting a little better, with there being midwives in doctors’ offices, but still I don’t think the antagonism between more extreme sides helps us move in the cooperative direction, though.

Ok, off my soapbox.  I think this is a book worth reading if you are curious at all about natural childbirth or even just childbirth… there’s a lot to learn from someone who has witnessed hundreds of natural births.  Take it with a grain of salt and supplement this with more up-to-date readings, of course, but overall this was a worthwhile read.

P.S. If you want to read a great birth story about a natural birth in a hospital, read Michelle’s story here!