Customer Reviews

Ina May's Guide to Childbirth

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One of the very few stipulations my wife made after we learned we were going to have a child is that I read this book by the doyenne of natural childbirth in the U.S. While the tone of the book is much too touchy-feely/hippyish for me, I have to admit that it is well worth reading regardless of whether you're planning a natural childbirth or a fully tech'ed out hospital one. That said, it would be very easy to read it as gospel and get swept up in its giddy repudiation of modern medicine, so one should approach it with, if not a skeptical eye, at least with one's critical faculties fully engaged. There is also the potential that readers who are fully committed to a hospital birth may come away from this book feeling scolded, or as if their decision is somehow "wrong".

The author is a superstar in the field of natural childbirth, largely as a result of her 35+ years work at "The Farm", a kind of birthing commune in Tennessee. The first half of the book is a compilation of natural childbirth stories written by mothers who've either done it at The Farm, or somehow in conjunction with the author. While these are certainly useful as illustrative examples of how it all goes down, they tend to get rather repetitive and could certainly stand to be scaled back a bit. And for those who know little about the birthing process, some of the terminology can be unclear. Finally, for those who might want to read this book on the subway (like me), be forewarned that there are some pretty graphic photos of childbirthing in this section.

The second half of the book walks the reader through the entire process, mostly with the aim of explaining why modern medical childbirthing procedures are not based on the mother's health and needs, but are designed for convenience of the medical establishment. Stuff like epidurals, amnios, fetal monitoring, pitocin, forceps, vacuum extractors, etc. all come under sustained assault. Gaskin makes a convincing case for most of her criticism, with plenty of good examples from historical texts and anthropological research. Perhaps the most striking and compelling examples come from studies of childbirthing in modern Scandinavia. Sometimes Gaskin stretches a little to far in her attempt to debunk every single medical procedure and doesn't always have the most current data. For example, Rhogham does not have any mercury whatsoever any more, and the danger from amniocentesis is vastly overstated. However, simply in terms of the debate over natural childbirth vs. hospital birth, it's awfully hard to argue with the data she's gathered from thousands of natural childbirths.

Ultimately the reality is that every mother's experience is different, and there's no technique, approach, or solution that works for everyone. That said, the book did a pretty good job of convincing me that the mother's mental approach to childbirthing and expectations for the experience are the single most important indicator of how it will all go.

I'm 17 weeks pregnant, and while I'm overjoyed to be pregnant...I've always been afraid of the pain I'll experience during childbirth. Reading Ina May's book, and the birth stories of the women in it, has changed all of that. I feel that I can handle labor now...and am even toying with the idea of not using drugs. (Prior to this, I used to say that I'd like an epidural plus any other drug they'd give me.) Even if I end up using some pain meds, I know I'll be entering the labor process without the level of fear I had before. That is priceless. This is a must-read for any pregnant woman and her husband...whether or not she wants to have a medicated or non-medicated birth. Bravo Ina May! Just wish I lived closer to TN so that I could use her services.

Anyone associated with the childbirth genre knows of Ina May, and her many devotees have been waiting a long time for this book. It couldn't have come at a better time, as legions of today's women voluntarily turn to the tricks of modern obstetrics, notably epidemic epidurals.
I'm a retired midwife (and author of Baby Catcher, a modern midwifery memoir), and feel I learned a good bit of my craft by listening to Gaskin speak, visiting The Farm a bazillion years ago, and reading and rereading and rereading Spiritual Midwifery. But much in obstetrics has changed since Spir. Mid. was published; at that time, natural childbirth was all the vogue, and Ina May was sort of preaching to the choir. Now, oh lordy, now things are very, very different. Cesarean rates hover around 25-30% in some hospitals, and the epidural rate is twice that. What are these women thinking??
It was by studying Ina May's 'style' that I realized the power of teaching by parable: the power of story-telling. Women's eyes glaze over when they're lectured to, but their attention is rivited by birth stories. In this Guide to Childbirth, Gaskin deals with the changes in modern OB and offers ways to get around the routines. But she once again relies on her story-telling techniques for getting across her central message: If you're surrounded by people who believe you can do it and who support your own belief that you can do it, then guess what? You can do it.

I am related by marriage to a midwife, so I have heard the gospel of homebirth for years. But the books she lent me had publication dates from my grade school and junior high years, so I often sneakily wondered--is it still really that bad? Then I started prenatal visits for my own first baby, and yes, it pretty much is. I am going to a doctor to keep an eye out for conditions that would call for the resources of a hospital--but if there aren't any, I'm staying home to have this baby. Read this book and you may decide the same thing.

Without scare tactics, and with plenty of solid data to back her up, Ina May provides a timely antidote for the overly mechanical, overly pharmaceutical way of childbirth that is still the conventional wisdom in most U.S. hospitals. She makes the chilling point that a lot of so-called necessary medical procedures--procedures that can increase the stress and dangers of childbirth--are based on modern physicians' ignorance of how birth really works. Ina May quotes from medical texts written before many of the drugs and procedures now used in "routine" hospital births were invented. The doctors who wrote those old books did something most modern obstetricians have never done: they observed normal births, over and over and over. They took for granted things that have been forgotten by modern medical schools. Ina May combines this old medical model of childbirth with her own vast experience in midwifery to guide you through what really happens during labor and what you (you plural--Mom *and* Dad) really can and should do.

Ina May will steer you safely between the artificial terrors of modern obstetrics and the artificial transcendentalism of many pregnancy handbooks. Her common-sense advice will help you sleep at night and click on a lot of light bulbs over your head. You will close the book feeling the truth of Ina May's pungent closing line: "Your body is not a lemon!"

UPDATE--JULY 2006: I've given birth twice since I wrote the above review and I still stand by every word. Whether you plan to give birth at home, in a birthing center, or at a hospital, take a childbirth education class for the basic details of the birth process--but read this book to fill in the inevitable gaps.

I bought this book based on all the glowing reviews. Since I plan to give birth naturally, I was looking for a book that would help me manage the labor and childbirth process in whatever environment I plan to give birth in. Needless to say, I was very disappointed in this book. I'll just do the review section by section to make this easier to follow.

Part 1: Birth Stories- Most of the birth stories are from the 70s, 80s, and 90s. There were about 4 or 5 from this decade. I think childbirth has changed a lot since the 70s and would have preferred to read more up to date stories. All the stories are from people who have given birth on "The Farm". This gives the book a myopic view and makes many of the stories hard to relate to. I am sure they're intended to be empowering but firstly, giving birth on "The Farm" is not an option for me and many other women. In Georgia, midwives can only deliver babies in hospitals and I am not comfortable with the idea of an unassisted home birth. So, a hospital birth with a midwife is essentially my best option.

Secondly, I am not the type of person that needs external validation or empowerment. I really felt that dedicating so much of the book (pages 3 through 125) to birth stories- especially birth stories that only reflected one type of birth experience- was a waste of space. A few varied birth stories would have been a lot more helpful and relevant.

Part 2: The Essentials of Birth- This was probably the most disappointing part of the book. Ina May starts the chapter by trying to make the birth stories relevant to any birth situation without ever really saying HOW you can do that. She falls back on the experiences of women who give birth at the "Farm" as her proof that the same birth experience is possible in every environment. She also compares the "Farm's" birth statistics to those of the medical community at large. Again, if you're not giving birth at the "Farm", how is this relevant?

There is a too short chapter on labor where the only advice she really gives on managing the pain of labor is the "mind/body" connection and how certain mental blocks can keep labor from progressing. While this may be true, this is not practical advice on how to cope with labor especially for a first time mother who has never been through labor before. She dedicates a full 7 pages to "What Happens in Labor". This is the whole reason why I bought the book and all I get is 7 pages of things that I already know. Not to mention the inordinate amount of space spent explaining the functions of the related body parts and what they do. If you didn't know what the uterus or the cervix was before reading this chapter, you'll get an overly-detailed description.

The chapter called "The Pain/Pleasure Riddle" is essentially a lecture on how society has trained us to view the pain of childbirth. No practical advice...just quoting studies and comparing the birth experience of American women to those from other countries. We also learn in this chapter that women perceive pain differently (gasp!). Then she went on to discuss painless birth and orgasmic birth..all of which is apparently controlled by our minds. So, essentially, it hurts because we think it hurts. She then goes on to contradict herself by saying in the very next chapter that "the women from the Farm know that birth usually hurts--at least the first time you do it..." She follows with the most useful advice in the book by saying that despite the pain, the best thing to do is to relax into the pain rather than resist it. Finally, something I can use while I'm giving birth. The chapter on relaxing the sphincter muscles was also somewhat helpful.

There is a chapter that attempts to explain the different screenings a pregnant woman may encounter during her prenatal care. I really think this kind of information is too little too late in a book that is supposed to be about the actual childbirth. The chapter entitled "Going into Labor" (19 pages) is essentially a comparison of how the midwives at the "Farm" handle labor and how hospitals handle labor. It tells you what procedures to refuse at the hospital (pubic shave, enema, routine IVs, etc...) Other than how necessary it is to eat and drink during labor to keep your energy up, there is no practical advice in this chapter either. The next few chapters briefly discuss pain medications traditionally given in hospitals during labor and some alternatives to those medications as well as episiotomies. The next chapters are basically more lectures, quoted studies, a 10 page section on VBACs, and very little practical advice.

I honestly wanted to like this book but realized by the time I got to the end that it just was not written for the typical woman who is about to give birth. Ina May touts the virtues of giving birth on the "Farm" so much that by the end, I honestly felt that was the only way to have the birth experience she describes. I think one chapter dedicated to discussing the "Farm" would have been much more appropriate than mentioning it in just about every chapter. I also think the book would be better as a reference for midwives than as a book offering advice to mothers-to-be. There just is not a lot of practical advice for the person that actual has to go through the laboring process. I don't necessarily disagree with much of what Ina May wrote and I appreciate her efforts to back up her positions with factual information but it is pure overkill. She digresses way too much and comes off as though she has an ax to grind.

This book helped me change my life.

After the necessary c-section birth of my son 5 years ago (I had pre-eclampsia), our new insurance company labled me as "high risk" and refused me maternity coverage. Since my husband and I wanted more children, I started considering a home birth with a midwife as a viable alternative. Needless to say my first birth experience put me emotionally on guard about my body's capability.

As I was researching the safety of VABCs (vaginal birth after cesarean) and home-births, I came across Gaskin's 1970s book, Spiritual Midwifery. Its language was amusingly "hippy-ish," but the inclusion of positive birth stories was refreshing and inspiring. After reading most of it, I went in search of similar, more updated books.

I found Ina May's Guide to Childbirth at a mainstream bookstore (being suprised at the lack of variety of birth experience offered on the shelf - is she the only person writing about homebirth nowadays?) Buying and reading this book new was one of the best emotional investments I have ever made in my life.

The experience and knowledge I gained reading this book is similar to many of the sentiments expressed in these other reviews. It really gave me courage to welcome and joyfully (if a little nervously) anticipate the birth of my daughter in March of 2005.

As for my labor, I would not call the sensations of the contractions "pain," I would call them "very heavy pressure." I credit this perspective to this book. Ina May (and her clients) helped me put contractions, transition, etc., into perspective. For example: Yes, I felt contractions every two minutes lasting about two minutes. No, it wasn't comfortable, and I had to concentrate and breathe through them with my eyes closed, hanging on to a door jamb. After two minutes the pressure went away for a while, during which I could laugh at my husband's jokes. Nature is pretty smart, giving women short "rest periods," as this book tells (reminds) us!

Reading about other women's experiences of physical sensations during their labors gave me a range of ideas as to what to expect, so as my own birth story was unfolding, it wasn't so scary or mysterious.

I am so grateful for the VBAC home-birth experience I had - thanks in many ways to this book's writer and contributors - I was beaming for days afterward! It was the hardest, most challenging thing I've ever done (notice I did NOT say "painful" or "scary"), and I was so proud of the outcome. My husband is still in awe of the power of my body!

An armload of gratitude to Ina May and her colleagues, the work they do, and the brave women who seek her out and share their experiences. I look forward someday to the home birth of my third child, knowing I am as strong and capable as the women who share their stories and wisdom in this book.

I'm currently 29 weeks pregnant with my first child, and I've read a lot of the "bestselling" pregnancy and labor books on the market (i.e. "What to Expect", the Dr. Sears books, etc) but this one blew the rest out of the water when it comes to labor and delivery! Ina May's book explains the importance of psychological readiness for labor and delivery, as well as awesome techniques to overcome the "obstacles" of labor naturally. The first half of the book consists of very inspirational natural birth stories which made me feel prepared and even EXCITED about natural childbirth before I even read the second half of the book.

After reading this book, I decided to switch from using my OBGYN to a midwife instead. My OBGYN is supportive of my decision to try a "natural" childbirth, but her definition of the concept doesn't go beyond "patient doesn't want an epidural". She is totally untrained and unprepared to help me naturally deal with stalled labor, avoiding an episiotomy, delivering a "stuck" baby, etc. I know she would give me drugs or wheel me in for a C-section long before a midwife despite her "supportiveness".

You CAN try the ideas in Ina May's book on your own during labor, without the doctor knowing a thing about natural childbirth, as long as the OB isn't going to argue with what you want to try in the middle of delivery! For example, if baby's shoulders are stuck, most OB's will want to do an immediate C-section; Ina May's book tells you that if you simply turn over on your hands and knees, the baby will most likely slide right out!

Ina May's informal approach to the topic of natural childbirth enables the reader to access detailed and empowering information about the physical, mental, and emotional process of giving birth. The first half of the book includes birth stories from many women who have experienced both medical and natural births. Their personal stories help the reader understand the impact of both approaches and make a more informed decision. This section of the book would be especially helpful to women with few friends/family from which to seek advice, or those who have heard primarily "horror stories" about birth. The second half of the book is a guide to achieving a natural birth in many different settings, from home to hospital. The book is easy to read, informative and empowering because you come away with so much knowledge. I also appreciated the fact that the author avoids using "hippy speak", or a dialect that everyone can understand. Some natural childbirth guides use more slang. Definitely read this book if you are pregnant or planning to become pregnant!

Finding myself unexpectantly pregnant, I was terrified of labor and delivery. I was scared of what everyone always said was overwhelming pain, and of the hospital process itself. Every hospital experience I have had in the past (due to my mother's battle with illness) has been overwhelmingly negative.

However, after reading this book I feel much more confident about the birth process. I know what I want and what I don't want, I have articulated my birthing preferences to my midwives (who will convey it to the hospital staff). I feel ready and almost excited about the process. Thanks to Ina May's book, I now feel that this is a challenge that not only can I handle, but a challenge in which I can take joy. I cannot express how much this book has calmed my fears. I highly recommend this book to any mom and/or dad to be.

EPILOUGE: Giving birth was the most exhilerating experience of my life (although I will admit that it hurt and wasn't the most fun I've ever had). I kept the stories from and principles in Ina May's book in mind and it really helped. I was also able to keep in mind that chldbirth is a natural process and nothing to be scared of. I did wind up getting an epidural after 24 hours of labor (total time: 33 hours) and can still confidently recommend this book to women who plan to have pain relieving drugs because the I was still able to keep Ina May's principles in mind and also because it truly did relieve my fear of childbirth.

I highly, highly, highly recommend this book.

Reading "Ina May's Guide to Childbirth" is like cracking an ancient code etched in my DNA. As Ina May's words unfold, they bring to modern consciousness information that is essential and visionary, articulating and applying the ancient wisdom of childbirth in the language and culture of the present time. In this information age, this book is creating a "new" birth culture. Like "Spiritual Midwifery" in its time, "Ina May's Guide to Childbirth" is a pioneer and an instant classic, a significant and inspiring milestone in the evolution of human culture. This book is intelligent and lovely. I plan to order it by the case and give one to each of my prenatal ladies. (I am an obstetrician/gynecologist.)