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Easy Labor: Every Woman's Guide to Choosing Less Pain and More Joy During Childbirth Paperback – January 31, 2006

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Editorial Reviews


A superb book that gives anyone who is pregnant a great understanding of the choices and rationale for those options that make birth easier.
~Dr Michael Roizen, MD, co-author of New York Times #1 bestseller, YOU: The Owner’s Manual

Gives pregnant women a comprehensive overview of all their options for making labor more comfortable.
~ Newsweek

"Down-to-earth prose provides compelling descriptions of labor from moms, doctors, and midwives. A “Great Read”."
–FitPregnancy Magazine

"Provides a road map through the thorny thicket of labor — no matter what path you choose."
–ePregnancy Magazine editor’s book pick

“Best Bet” for labor literature!"
–Pregnancy Magazine

"A thoughtful and thorough look at epidurals, narcotics, hypnosis, acupuncture, and other traditional and nontraditional methods of pain relief, so your choices can be well informed. The authors believe that knowledge is power — in this case, the power to choose pain-relief methods that reflect one’s own values, priorities, and preferences. They deliver the facts and options in a meaningful and easy-to-understand way, while acknowledging feelings and providing reassurance."
–National Parenting Publications Gold Medal Award

“A common sense, down-to-earth approach to discussing pain-relief options during childbirth . . . a must for women wanting the straight scoop on what to expect during delivery!”
–Joy Hawkins, M.D., director of Obstetric Anesthesia and professor of anesthesiology, at the University of Colorado

“Reassuring and informative . . . a detailed and readable presentation of maternal stress, fear, and pain during childbirth.”
–Penny Simkin, co-founder of Doulas of North America International, and author of The Birth Partner

Excerpt. © Reprinted by permission. All rights reserved.

One Choosing the Best Birth Environment for You

Your choice of birth environment is the first decision you make that determines your pain-relief options. If you know you want to use modern medical pain-relief methods, you will need to select a birth environment that can accommodate these preferences. If you are leaning more toward a natural childbirth, but would like to keep your options open, you may want to be in a birth environment that offers not only nonmedical forms of pain relief but also allows accessibility to medical pain relief, should you change your mind during labor. If you are committed to using no medical pain-relief options and do not want to be in an environment where they are frequently used, you will need to choose a birth environment that has both the physical amenities and supportive caregivers you will need to successfully give birth free of any medications, using complementary and alternative pain-management techniques.

The staff of caregivers available to you during labor and birth can also directly impact your pain-relief options. For instance, if you think you prefer to use an epidural but are in a hospital where the only anesthesiologist is on another unit at the time when you are in need of pain relief, this can significantly impact your birth experience. Conversely, if you prefer to delay or avoid the use of medications, a busy hospital with a high percentage of epidural usage may not be the ideal environment for you to achieve this goal.

Pharmacologic methods (medications) should never replace personal attention and tender loving care of the woman in labor.1

Your birth environment and the people caring for you during your labor and delivery can dramatically impact how you will perceive your childbirth experience. By choosing the type of birth environment best for you, you are more likely to feel relaxed and comfortable when you arrive and throughout the rest of your labor and birth. If you are giving birth in the setting you desire, surrounded by people who are able to meet your needs, including your pain-management needs, you are more likely to have a satisfying “birth day.”

In this chapter we:

•List the most common birth environments.

•Describe what each has to offer with regard to pain-relief options.

•Provide a description of the various professionals who may (or may not) be with you during labor and birth.

•Provide an at-a-glance comparison between hospitals and birth centers.


Most women in the United States (approximately 98 percent) give birth in a hospital. But all hospitals are not alike, and maternity units vary greatly from hospital to hospital. In addition, the size of the hospital and its maternity unit can impact the type of birth experience you have.

Reasons You May Want to Have Your Baby in a Hospital

•You want to be in a place where all or most medical pain-relief options will be available to you.

•You want to give birth in a setting that has equipment and staff ready to deal with an unlikely emergency.

•You feel more confident in a birth environment surrounded by a variety of medical professionals.

•You want a two- to four-day recovery period before returning home with your new baby.

Larger hospitals typically offer more medical pain-management options than are found in smaller (community) hospitals. Larger hospitals are more likely to have an in-house, around-the-clock anesthesiology staff readily available if you are in need of an epidural. Often, these larger hospitals have anesthesiologists who are assigned specifically to the maternity unit. This reduces the likelihood of delays for women in need of pain relief that must be given by the anesthesiologist.

Smaller hospitals may not have as many medical pain-relief options and may not offer epidurals twenty-four hours a day, seven days a week. If they have a limited anesthesia staff, some smaller hospitals may not offer epidurals at all. On the other hand, many of these small hospitals, as a result of not having as much “high-tech” pain relief to offer, often have staff and equipment that can successfully support the mom who prefers to use fewer or no medications throughout labor and birth. So, depending upon your own preferences, either of these settings may be right for you. But, clearly, if you desire the full-throttle pain relief of an epidural, you are more likely to find this type of pain management taking place in larger hospitals with busier maternity units.

Size of Hospital Maternity Unit and Their Epidural and Combined Spinal-Epidural Rates:

•In hospitals that deliver fifteen hundred or more babies per year, 69% of women use an epidural or a combined spinal-epidural.

•In hospitals that deliver five hundred to fifteen hundred babies per year, 50% of women use an epidural or a combined spinal-epidural.

•In hospitals that deliver less than five hundred babies per year, 40% of women use an epidural or combined spinal-epidral.2

Hospitals of all sizes are increasingly responding to women’s requests for more pain-management options, including baths, showers, the use of birth balls, and the promotion of movement and positioning during labor and birth. More hospitals are encouraging, or at the very least accepting, women’s choice to use doulas (described in this chapter) as their primary support people during their labor and birth.

Many hospitals throughout the country have made their birthing rooms more appealing and homelike, with the goal of helping women feel relaxed and comfortable in the unfamiliar and sometimes intimidating surroundings of a clinical setting. Even with these changes, the hospital stay (which, for most women, is their very first hospital stay) can make you feel like, well, like you’re in a hospital! Many caregivers recommend you bring your own homelike objects of comfort that will promote a sense of familiarity and relaxation in an otherwise unfamiliar setting. You may want to bring your favorite pillow, fragrance, photos, and a radio or CD player to listen to your favorite music. If you feel more comfy in your own clothing, let the hospital staff know you would like to wear your own threads instead of their hospital gown.

Two more factors may also determine where you ultimately give birth: your insurance coverage, which may or may not cover your care at your preferred hospital, and your obstetrician’s hospital affiliation. The hospital in which your obste- trician or midwife works will be the hospital where you will have your baby. If you like your obstetrician or midwife, but do not like the hospital with which he or she is affiliated, you may find you will need to switch to a doctor or midwife who works in the hospital where you want to have your baby.

Are Women Who Have Their Babies in Hospitals Satisfied with Their Experience?

According to a survey of sixteen hundred women across the country:

Ninety-six percent said they were satisfied with the health care they received.

Ninety-four percent felt they were treated with kindness and understanding.

Eighty-seven percent said they were free to make their own decisions.3

The Birth Center

Birth centers grew popular in the 1970s as an alternative to the hospital birth experience. Birth centers may also be called alternative birth centers (ABCs) or childbearing centers. According to the National Association of Childbearing Centers, “birth centers are guided by principles of prevention, sensitivity, safety, appropriate medical intervention, and cost effectiveness.”4 Birth centers, unlike hospitals, do not exist in many communities across the country and, depending on where you live, may not be an option available to you.

Reasons You May Want to Have Your Baby in a Birth Center

•You are committed to giving birth without pain-relief medications.

•You do not feel relaxed in a medical setting and prefer a nonmedical type of atmosphere.

•You feel more confident in a birth setting surrounded by your family and being cared for by staff (and equipment) that is geared toward supporting a labor experience using coping strategies instead of medical pain-relief strategies.

•You may want to return home as soon as possible after giving birth.

Birth centers are often operated by midwives, or midwives and physicians together. The prospect of giving birth in a birth center is usually most appealing to women who want a birth environment where there will be as few medical interventions (including pain-relief interventions) as possible during labor and birth. The birth center is a good option for women who do not want to have their baby in a hospital but also do not want to give birth at home.

There are some in-hospital birth centers that provide a homey family-centered birth environment; they are attached to the hospital or are located on their campus. The in-hospital birth center is a distinct facility, separate from the hospital’s labor and delivery unit. Typically, epidurals are not offered in these centers. Depending on your preferences, this type of environment may also be a perfectly suitable option for you. A birth center within a hospital, however, may not operate in the same way an out-of-hospital birth center does, and its care practices and staffing may be more like hospital care than birth center care.

If you choose to have your baby in a birth center, a certified nurse-midwife (CNM) will most likely be your primary caregiver. Although in birth centers midwives and obstetricians work together, it is the midwife who will likely attend to the birth of your baby, unless the obstetrician is needed due to a complication. Your health care provider must determine that you are healthy a woman with a low-risk pregnancy in order for you to give birth to your baby in a birth center. Birth centers provide care to women throughout their pregnancy, labor and birth, and postpartum.

The birth center itself is characterized by a homelike atmosphere that is less high tech in appearance than a typical hospital maternity unit. If you are laboring in a birth center and at some point need emergency medical intervention, you will be transferred to a hospital.

Around 15 percent of women who begin their labor in a birth center need to transfer to a hospital. Of these women, only 2 percent transfer due to an emergency. The remainder are transported to the hospital primarily due to slow progress or because
the mom requests anesthesia.

Birth centers promote a relaxed, privte, nonclinical environment in which a variety of nonmedical pain-mainagement approached can be accommodated. Birth centers do not offer epidurals, and they ususally (although not always) do not offer narcoticinjections. Birth centers are ot equipped to perform cesarean section deliveries. In fact, the cesarian section rate for women who began their labor in birth centers is around 4 percent.

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Product Details

  • Paperback: 336 pages
  • Publisher: Ballantine Books; 1 edition (January 31, 2006)
  • Language: English
  • ISBN-10: 0345476638
  • ISBN-13: 978-0345476630
  • Product Dimensions: 5.2 x 0.7 x 8 inches
  • Shipping Weight: 6.4 ounces (View shipping rates and policies)
  • Average Customer Review: 4.4 out of 5 stars  See all reviews (39 customer reviews)
  • Amazon Best Sellers Rank: #485,306 in Books (See Top 100 in Books)

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Customer Reviews

Top Customer Reviews

Format: Paperback
I'm 4 months pregnant and have started reading about various labor options and philosophies. I'm pretty middle-of-the-road and have no issue with medical pain intervention. I'd also like to have some alternative methods in my back pocket, too. The information on pain management is useful. However, the pages and pages detailing the incredible pain of labor were not exactly comforting. I read this right after reading a book on hypnobirthing, which had the opposite philosophy, so perhaps the contrast was even greater. For me, the idea that the pain is "horrible, terrifying and excruciating" is not what I want to focus on for the next five months. I am using this book for the factual parts, which is useful. Then I'm looking elsewhere to help me manage my own fears and nerves about having my first baby. If this were the only book I'd looked at, I would be VERY scared about having this baby. Luckily, there are some books that are more reassuring and confidence-building that I'm reading as well. It's good to have info, it's not great to be terrified for months on end.
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As a childbirth educator and founder of Hypnobabies, I very much enjoyed seeing the authors provide us all such a nicely balanced collection of ideas for being more confident and comfortable during childbirth. I always love to see expectant moms research their choices for childbirth and this book has many. Easy Labor starts out with excellent information on choosing your birthing environment and caregivers, addressing childbirth fears and concerns, and giving wonderful resources.

The next section is all about epidurals and medications for birthing, with the information women need about the benefits, risks and side effects for each one as well as how and when they are administered, and how a birth partner can help if meds are chosen. Especially helpful are the comments from caregivers and mothers who have experienced using these medications for childbirth. There is even a chapter on medication for Cesarean births that answers many questions for women.

Of course the part of the book I am most impressed with is the section on Complementary and Alternative Approaches to Labor-Pain Relief. The authors very sensitively and concisely researched various forms of "CAMS" (complimentary and alternative medicine) from natural childbirth classes and waterbirthing to using hypnosis, acupuncture, aromatherapy and labor support. Resources are given throughout and the information is very comprehensive.

Incredibly fascinating are the chapters on the history of pain relief in childbirth and the birth stories from medical caregivers - their own birth stories! Doulas, OBs, nurses and midwives tell what they experienced, learned, and found helpful for their own baby's births. They also share perspectives on how their own attitudes impact their patient's childbirth experience. Great book. Get it, read it!

Kerry Tuschhoff, Hypnobabies
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This book is an excellent survey of labor options and pain relief methods. It seems fairly un-biased - not pulling either to home birth or to hospital birth. It is explains different medications and alternative methods and has quotes from mothers and practitioners on their experiences. It emphasizes the need to think ahead, to be flexible, and to be prepared for the unexpected turns that labor and delivery can take. I am on the brink of my third delivery and I agree with the authors that all expectant mothers should be "armed" with information about both natural and medical pain relief because labor does not always go according to your plan. Even if you plan on getting an epidural, you should know some comfort measures, in case you can't get that epidural right away.

One thing to note however is that this book will not really "teach" you much about breathing or relaxation. It will give you an idea of where to turn to find out more about a given method. I was hoping it would have more specific instruction on calming techniques. I recommend perhaps starting with this book earlier in your pregnancy so that you have time to research some of the methods that appeal to you in more detail. (For example, Bradley method takes 12 weeks of instruction and HypnoBirth techniques can take months to learn! And you need to find an instructor.)

But overall, it is a good practical guide to options.
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I am hoping to have a natural childbirth, but bought this book to better understand options in pain relief. Unfortunately, I didn't feel the book was very supportive of that at all. Lots of information on how excruciating childbirth is, how many women are not in any way prepared for it, how it will be a pain like one you have never experienced and cannot comprehend, etc. I don't mind a medically-oriented approach, but if you're planning to try to have a natural childbirth, this book is a bit scary! Good overview of medication options.
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I felt compelled to add another dissenting voice to the chorus of praise for this book. Although the book makes overtures towards balance, it is really (as some other reviewers have commented) heavily in favor of the epidural as the be-all end-all of labor pain management. The stories related by women and doctors imply a few things: 1. Women who want to give birth naturally, including experiencing pain, have a hero complex. 2. Women who do not do what their doctors say when they say to do it (which always seems to mean Pitocin or an epidural) are "difficult." 3. This one really surprised me! Women who do not choose high-tech pain relief are in fact going against the gains made by feminists who fought for the right to have less pain during labor via anesthetic.

I read this book after reading Ricki Lake's _Your Best Birth_, which is heavily biased in the other direction. But both books had the same effect of making me terrified to have my baby in the hospital, which is Lake's intention but clearly not Dr. Camann's.

The two stars are because I valued the clear layout of information on different types of epidurals and labor techniques, even though I would not trust the assessments of risks and benefits.

I learned something valuable from this book, though, which I can talk to my doctor about: I had no idea that people even thought women wanted to do without medication because they suffered from some delusional, macho denial of the reality of labor pain. Now I know!
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