Customer Reviews

Giving Birth: A Journey Into the World of Mothers and Midwives

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If you are part of the 99% of American women who choose to give birth in a hospital, attended by a physician, because you think that is the safest way to go, this book may well change your mind, or at least get you thinking about the possible benefits of a more natural, midwife-attended delivery. The author is decidedly pro-midwife; she weaves numerous statistics and stories into the text that underscore the decline of healthy delivery commensurate with the "medicalization" of delivery. For example, the US has the highest rate of hospital/medical deliveries but ranks 22nd in the world in maternal health / infant mortality -- well behind other countries, primarily western European, where home delivery and birth center deliveries are much more common. Other surprises -- according to the author, the World Health Organization recommends home deliveries and birthing center deliveries over hospital deliveries. The rates of C-sections and episiotomies are much, much lower for midwife-attended deliveries. Midwifes generally treat childbirth as something the female body is fully capable of doing on its own, rather than as a medical condition or disability to be treated. And the midwifes interviewed for the book seem to be very respectful of their clients -- assisting the client in her own birth experience rather than making the birth something the midwife choreographs & directs. The author writes about the history of childbirth & delivery and the practice of midwifery, interviews numerous midwifes, and even participates in home births attended by midwifes. At the same time, she discusses her own pregnancy (that is progressing while she is conducting the research for the book) and she trains to become a doula, or birth assistant. The book is gripping and easy to read; it reads fast like a novel -- and the discussions of home births she has attended are page-turners -- but it is also full of factual information and would serve to help prepare a woman for childbirth. In her interviews with midwifes, she discusses the risks to the profession -- insurance company's reluctance to cover home births and midwife fees, even though they're statisfically safer and less expensive than OB-attended hospital births, midwife's difficulty in getting insurance coverage for their practices, pressure on midwifes working in hospital settings to spend less & less time with their clients and to introduce more medications (Pitocin) -- to conform more to the medical model.

I read this book when I was about 4 months pregnant for the first time. After reading this book I had a much better idea of what I was looking for.

This book was wonderful to read, helped me really examine what I wanted for my own pregnancy and birth, and gave me insight if I ever decide to go into the childbirth field as a doula or childbirth educator.

This book illustrates the incredible knowledge that midwives have of the female, birthing body.

I had a beautiful, empowering, healing first birth that I will cherish for the rest of my life.

For my second birth I gave birth at home and it was a life changing experience. I would definitely recommend finding a way to have a home birth with a trained midwife.

I recommend this thoughtful, empowering book to all women and people working in pregnancy, labor and childbirth.

I'm a practicing homebirth midwife, so went right to the 'homebirth' chapter, thinking, "I'll just read this one chapter and then go the beginning of the book and read it 'properly'".
Well, I just kept on reading-did not put the book down! Read to the end and then started at the beginning and read thru to where I started in the middle! Loved the insight, the attention to detail, introduced accurate statistical information in a way that didn't make my brain glaze over and included all the other issues that face a pregnant woman today. Catherine Taylor covers a lot of the concerns, real and fleeting, that most woman have, but never really get to verbalize or talk to anyone about, or at least anyone with unbiased answers! This book helps balance all the fear-mongering, mis-communications and half-truths that surround birthing, will change your presective on how birth is now and what is truly possible; for yourself and in the 'bigger picture'.
Get a copy for yourself and one to give away-you'll grin and nod throughout the whole book.

Ms. Taylor,

I was one month along in my first pregnancy and, without much real thought, I bought your book "Giving Birth." I think I liked the tasteful cover and that it didn't seem to be a dry catalog of what to expect during pregnancy.

I read your book twice during my pregnancy, and it completely changed the way I approached my medical care and how I wanted to give birth. Before reading "Giving Birth," I had just assumed that I would trust the doctor and do whatever he said while I was in the hospital. I naively trusted his and the hospital's authority. But because your writing style is so vivid and thoughtful, I learned a tremendous amount about labor and delivery (going far beyond the mechanics of the process) without even realizing it. I feel like I entered the larger conversation about how best to give birth, and that I acquired a real voice of my own.

My doctor wanted me to shut up and let him do what he thought was best. I switched providers at 37 weeks after realizing that I couldn't just wish him into being the doctor I wanted. (He patted my head at one point and told me that I couldn't possibly know what labor was going to be like, so I shouldn't even plan on trying for an unmedicated birth.) Through a series of comedy of errors with my insurance provider, and the fact that I went into labor at 38 weeks, I wasn't able to switch to the birthing center in time. My original doctor still caught the baby. But I did everything else as I had hoped, with no medical interventions and the majority of my labor at home. (I gave birth thirty minutes after my arrival.)

I gave birth almost six months ago and I have always thought I should find a way to write and thank you. As cheesy as it sounds, your book truly changed my life!

I had a wonderful recovery and I honestly can't wait to give birth again.

Finally a book that tells the truth about what really happens when a woman has her baby in the hospital with a certified nurse-midwife, CNM. Ivy-league-educated author Catherine Taylor, writes about her own experience as a nurse-midwifery patient as well as stories of many births she attended as an observer or doula.

What is most amazing about the stories of birth that are retold is the author's realization that the certified nurse-midwives that the pregnant women trust are agents of the medical institutions. In story after story, the CNM patients are mislead about what to expect of their birth experiences.

Taylor shadowed a number of CNM's during their usual workdays at their hospitals. The CNM care frequently mirrored physician-nurse care as busy CNMs left their clients in very active labor. Claims one CNM, "We try to compensate by having a nurse attend them." Yet while a number of CNMs expressed a longing to be more actively involved with the women they care for, none actually provided the women with hands-on, continuous care during their labors and births. Taylor points out hospital-based CNMs frequently provide inadequate midwifery care, failing to provide even a modicum of "human presence" which is a core competency of the ACNM (American College of Nurse Midwives).

In birth story after birth story the reader is made aware of the inability of the CNM to prepare women for a drug-free, empowering birth. Woman after woman believed the slick hospital promotions that shows the beaming new mom and dad holding their little one with the ever-present staff hovering nearby. The rude reality is that for most of the women, this was a fantasy.

The midwifery clients were unprepared for the pain of labor and what to do about it. The midwives were too busy running from patient to patient to do more than stick their head in a room long enough to don a glove and check dilation and make lame suggestions for dealing with pain. The nurses also had no time to provide one on one support--that left the women and their partners to go it alone, without having been educated about what to do.

One theme that is played out in many of these stories is the power the hospital has over the CNMs. Whatever their personal beliefs may have been, they inevitably acquiesced to the hospital administration or physicians if there was friction between what a client/patient wanted. A few of the examples given include handing out "goodie" bags loaded with formula while theoretically promoting breastfeeding; telling a woman she needs pitocin when it is actually being given to speed up labor for the staff's benefit; and breaking a water bag for the physician's convenience.

Many CNMs seem to relish their role as mini physicians. IVs, rupturing membranes, ordering antibiotics, pitocin and epidurals, cutting episiotomies and dragging babies out by suction vacuum are daily activities for hospital-based CNMs. Yet the ACNM claims that one of the primary characteristics of a midwife is as an advocate "of non-intervention in the absence of complications." With the widespread use of routine interventions by CNMs, one has to wonder whether any of the ACNM publications can be trusted. Said one CNM to a VBAC client, "With the next baby, if the baby starts to look big, my preference is to induce a week early. You're so tiny you might have to have a c-section for all your babies."

Do CNMs educate their clients better than physicians so that when interventions are offered, they are able to make fully informed decisions? Taylor wonders about this too and asks, "Can parents in the middle of the unfamiliar and often disorienting experience of labor make good decisions?" Can parents really be fully informed when a CNM has to please her collaborating or supervising physician or comply with hospital protocol in order to keep her job? Too often it seems, they side with those who sign their paychecks.

Some women have been able to hire doulas to provide the emotional support and unbiased information about hospital interventions. Sadly this is not always what they thought they were getting either. As Taylor points out, doulas are trained to never be critical. This means that if a woman suddenly decides she wants drugs during her labor, the doula supports her. Like CNMs, doulas frequently find they must walk a fine line to be welcome in a hospital. Sometimes this may mean not advocating 100% for the woman but rather guiding her to comply with some unnecessary intervention that will soothe the staff and keep the doula in their good graces.

Taylor discovered that at one hospital, the majority of CNMs had homebirths. She attended a number of homebirths while researching this book as well as at Elizabeth Gilmore's birth center in New Mexico. Taylor chose to have her second child born at home. After her less than satisfactory first birth, Taylor explains that at home the woman's ability to birth is protected rather than controlled. This is what Taylor wants. This is, I believe, the primary reason women in America choose to have a homebirth.

Taylor's emotional process of going from a hospital birth to a homebirth is somewhat detailed in this book. Those of us who have had home births know exactly what she is dealing with when explaining her homebirth decision to those who only believe in hospital birth. She writes, "I realized my friend's viscerally negative reaction to homebirth was probably not based on some piece of knowledge or information, but rather on ungrounded fears."

While an ideal arrangement for birth is to have supportive medical care at the ready in case of an emergency, most homebirth families and midwives find this very difficult to obtain. Unlike a great many American women, Taylor had insurance while pregnant with her second baby and utilized that insurance to buy back-up medical care her CNM was unable to provide. While physicians decry those who plan homebirths without medical back-up, these physicians increase the dangers of homebirth by refusing to provide the very care they believe is essential for safety. Like Taylor, who pretended to plan a hospital birth in order to have emergency medical care readily available, those with money can buy a safety net. The rest cross their fingers or pray.

Taylor's praises Elizabeth Gilmore's Taos, New Mexico free-standing birth center. The practice employs obstetricians who provide built-in back up for the midwifery clients. Clients can choose to birth at home or the birth center. Although seemingly idyllic, the birth center has been a labor of love for Gilmore who has worked ceaselessly to keep it viable. The politics of birth are everywhere an endless war.

This book was written because Catherine Taylor had to write about her birth experience. Like so many of The Complete Mother subscribers, her homebirth transformed her into a strong, self-assured mother and woman. Those of us who have been there and done that will smile that knowing smile while reading of her metamorphosis. It's the secret knowledge that's suddenly discovered that we had the power all along, but didn't know it.

Taylor recognizes that the road to self-discovery is frequently full of pain and vomit and body fluids. "Yet it was one of the most vital and powerful moments of my life...my midwife did not just attend the birth of my baby; she attended the birth of a new, powerful, confident and loving part of myself." Amen.

Reviewed at The Compleat Mother website

Reviewed by Susan Hodges, President, Citizens for Midwifery, a national grassroots organization advocating for the Midwives Model of Care.
Review first appeared in the Citizens for Midwifery News, Fall, 2002.

Catherine Taylor has beautifully crafted a tapestry of birth stories, birth facts, midwives and midwifery, the needs of mothers, and maternity care realities. I highly recommend this eminently readable book to anyone who wants to learn more about pregnancy, the realities of maternity care in the U.S. and the midwife/birth setting choices that may be available.

Like several other recent autobiographical books about pregnancy and birth, Catherine Taylor's Giving Birth is organized around the sequence of pregnancy and giving birth, but there the resemblance stops. This book is a wonderfully readable narration of the author's research and learning about birth and midwifery over the time of her own second pregnancy and birth, at the same time personal and informative, but neither didactic nor judgmental.

A writer and editor, Catherine Taylor undertook to write about childbirth and midwifery, "for both personal and professional reasons." Already a mother of a seven-year-old, and wanting another child, she set out to explore and understand midwives and midwifery, not by just reading or through interviews alone, but by actually spending days with a variety of individual midwives as they went about their work. The process eventually led her to undertake doula training, and to spend time with both hospital-based nurse-midwives and direct entry midwives. In addition, the author researched her topic thoroughly, and her factual statements are referenced in "Notes" at the end of the book.

Written in the first person (and sometimes in the present tense), she reports her observations and experiences with an intimate and conversational style. In a very natural way, she has interwoven research and facts, related to the narrative by her own observations or subsequent knowledge: "At the time, I knew nothing about..." or "I later learned...." or "Now I know that...."

Taylor started out following midwives that were part of an HMO hospital where 80% of deliveries were with nurse-midwives. Along with her, we discover how individual each midwife is and their differences in practice, as she observes the midwives at work with women who permitted Taylor's presence. We learn about the frustrations, politics, pressures and compromises involved with practicing midwifery in the hospital. And Taylor is not passive in her thoughts. "I am a bit surprised by...." Or "I don't understand why..." pop up frequently. In addition, Taylor draws the midwives out with questions, getting them to talk about how they practice and about the political/professional aspects of their work. The result is a broad-spectrum picture of "nurse-midwives," including their relationships with their "patients" and with each other, and their vulnerability in the hospital system. In addition, the reader can't help but get an understanding of why, even though the nurse-midwives are doing their best, mothers frequently get shortchanged when giving birth in the hospital, even when attended by nurse-midwives. Because Taylor is observing as neither "patient" nor midwife, she notes when, for example, the supervising doctor makes a decision, but the midwife persuades the mother on a course of action (intervention) without letting her know that the doctor, not the midwife, actually made the decision.

Recognizing that one of the problems is that nurse-midwives in the hospital often simply cannot be with a woman during labor (a situation she experienced in her first labor), Taylor not only read about doulas, she completed doula training with Pam England (author of Birthing From Within). By this time Taylor was happy to be pregnant, and she also continued to follow midwives around and be at births. In addition, she became interested in home birth as a possibility, and observed several home births with different direct entry midwives. Does the setting affect childbirth? The stories and information in Giving Birth makes a strong case that it does.

If there is a weak part of this book, it is the brief conclusion. The issues and problems are well summarized, with emphasis on the need for respectful treatment of mothers, birth as a normal process, and attention to the spiritual, transformative and empowering aspects of giving birth. However, less than a page is devoted to "what can we do to change the system." Unlike the rest of her book, this section reveals a lack of understanding about the political and economic challenges involved, with rather vague "we can support" suggestions and no mention of the need to coordinate efforts if we are to effectively change maternity care in the US. She does, however, include a useful "resources" section, with lists of books, publications and organizations (including Citizens for Midwifery). To be fair, "what can be done" is not the focus of her book, and she has otherwise addressed birth and midwifery admirably.

I loved this book. I read it straight through, then turned to the beginning and started again. Catherine Taylor has a very flowing and readable style. She weaves hard facts with storytelling in a way that is interesting and entertaining.

I also really connected with Taylor's personality and experiences. I felt that "this could be me". She states that, since she was pregnant, she conducted her research looking for her "perfect birth". I bought and read this book with an eye towards my next birth. I came to the same conclusion Taylor did - if possible, I will have my next baby at home.

I truly believe that if every pregnant woman in America reads this book we will encounter a serious midwife shortage. I have nothing against obstetricians, they have a very important place in medicine. However, after reading this and other books and doing a lot of research on the internet, I don't think they have any place in a normal low risk pregnancy.

I cannot recommend "Giving Birth" enough. I will ask anyone that questions my decision to have a home birth to read this exceptionally well researched book so that we can have an intelligent conversation on the subject.

My number one title to give to women. Easy to read and chock full of truth telling about birthing babies in America today. Delightfully debunks the myths surrounding midwifery with hard facts and a fascinating story.

I believed that just having a midwife rather than a doctor would bring along with it a certain set of assumptions and practices.

This book helped me understand some of the constraints placed on midwives practicing in hospitals, the ways that doctors can make decisions for your care anyway without you even meeting them, and the different kinds of midwives and midwifery practiced in America.

It was well-researched and well-written with an honest, truthful and inquiring spirit. I highly recommend it.

This is the personal journey of the author into discovering her path to empowerment through childbirth. She becomes a doula and a homebirth mother along the way. The book offers real insight into the world of midwives and mothers.