Birth: The Surprising History of How We Are Born (Paperback)

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Key Phrases: birth centers, cesarean rates, painless childbirth, New York, United States, Twilight Sleep (more...)

Editorial Reviews

From Publishers Weekly

Anyone who has taken a prenatal education class in the last decade can detail much of what Boston Globe reporter Cassidy documents about birthing battles in her enjoyable new book. What she so cogently adds is a history of Western practices and attitudes surrounding birth, from the "God-sibs" (or "gossips") who sat by a woman's bed in Europe and early America to the scheduled cesarean of today. The book is well written and will be an important eye-opener to many. Cassidy works hard to remain neutral, but a preference for the discourse of "natural" birth creeps in. She looks nostalgically back at times when most women gave birth at home with female midwives in attendance. This leads to some problematic moments, as when she wants to argue that, historically, birth was not the danger to women's lives that many today assume. But then she has to admit that pioneer women wrote their wills before giving birth and that most women who die in childbirth today are in the non-Western world, where they lack access to hospitals. This is, by Cassidy's admission, the work of a woman disappointed by her own birthing experience. But that, too, is a product of our time—the idea that we "deserve" a certain experience as we give birth. (Oct.)
Copyright © Reed Business Information, a division of Reed Elsevier Inc. All rights reserved. --This text refers to an out of print or unavailable edition of this title.

From The Washington Post

Blame it on the pelvis. The awkward shape and size of that bony structure makes childbirth both difficult and dangerous. As a result, humans are the only mammals who need help to deliver their children, notes Tina Cassidy in Birth. Other animals have a straight shot through the birth canal, but our babies have to twist and turn to get out of that darn pelvis -- or, as I came to imagine it during my own pregnancy, to squeeze themselves like a basketball through a Pringles can.

But infrastructure is only the first problem. Human interference can make things much worse. In this breezy popular history, Cassidy, a former Boston Globe reporter and editor, surveys centuries of terrible childbirths around the world, attended by doctors, nurses and midwives with strange theories and, in more than a few cases, deeply sadistic streaks. Tirelessly wide-eyed, Cassidy details how laboring women have been strapped down and shackled, drugged into oblivion and ripped open with a macabre array of tools more suited to taxidermy than obstetrics. It's amazing anyone got out of the womb alive.

Childbirth fads and customs in Western cultures swing from one extreme to another and back again, Cassidy writes. First there were midwives, who were then replaced by doctors, recently unseated by a returning vogue for midwives. For centuries, babies were born at home, then women opted for hospitals; now, those hospitals are trying to make their delivery wards more "homey." Mothers breastfed for thousands of years, then they were told that formula was better. Now it's back to nursing. Painkillers are in, then they're out. And so it goes, literally ad nauseam.

It's not surprising that childbirth would be the focus of such ambivalence and anxiety. Throughout history, the making of children has been at once a low-odds proposition and a high-stakes affair -- not the joyful experience it is advertised as today but a matter of dowries, alliances and staffing up the farm. Maternal and neonatal death rates ran high at all levels of society. In male-dominated cultures, the fact that women were solely responsible for gestation and delivery must have been an affront. No wonder, then, that the attending women were eventually supplanted by male doctors.

Those doctors -- as early as the 16th century in Europe -- had startlingly little training and a severe distrust of the more experienced midwives. They were taught on makeshift mannequins and many hadn't even seen a live birth before they began to perform deliveries -- sometimes with their hands covered by a sheet, too embarrassed (or concerned for their patients' modesty) to look directly at the body parts they were working on.

Then came the hospitals. Cassidy points out that, for most of human history, the majority of women have given birth in or around their homes. Those who first delivered at American hospitals, starting in the 18th century, may have been at far greater risk of injury and death than their mothers. Doctors regularly moved from autopsies to live patients without ensuring sterile conditions -- or even washing their hands. They didn't know they had to. Some blamed the women themselves for the resulting infections, citing tight petticoats, loose morals and anxious "fretting" as causes. Even after germ theory became generally known, infant deaths from birth injuries in the United States jumped a shocking 50 percent between 1915 and 1929, Cassidy writes, because more women were giving birth in overcrowded, vermin-infested hospitals, where hand-washing still wasn't standard procedure and staff engaged in "aggressive" obstetrics that amounted to brutally wrenching the child out of its mother.

In contrast, women today seek out the best "birth experience," whether it's the "give me the epidural in the hospital parking lot" approach or multi-week Lamaze classes. But these so-called choices mask a less certain reality. Childbirth is unpredictable, and the best-laid birth plans are no guarantee. We are still ambivalent about this business, decrying the medicalization of childbirth but embracing its ability to get that newborn out safely if we hit a rough patch.

Cassidy has put together a concise survey, with more breadth than depth. Some of the material won't be all that surprising to anyone who has prepared for childbirth or at least paged through What To Expect When You're Expecting. But there's plenty of new gore for those who want it.

Oh, and there's more about that pelvis: It makes things hard in the months after birth, too. Over millennia, as human forebears got smarter and their brains grew larger, evolution found a balance: Since the pelvic opening can't grow any wider and still allow us to walk on two legs, babies' heads can't grow any bigger. This is why, Cassidy writes, our infants are born "altricial": With their brains still developing, they are helpless and in need of extended parental care. A shivering newborn calf can stumble to its feet within an hour after birth, but a human doesn't walk for about a year. Anatomy is destiny, in this case: Even after they make it through childbirth, parents are in for a long -- and bumpy -- ride.

Reviewed by Sara Sklaroff
Copyright 2006, The Washington Post. All Rights Reserved. --This text refers to an out of print or unavailable edition of this title.

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Product Details

• Paperback: 320 pages
• Publisher: Grove Press (September 10, 2007)
• Language: English
• ISBN-10: 0802143245
• ISBN-13: 978-0802143242
• Product Dimensions: 8.9 x 5.9 x 0.9 inches
• Shipping Weight: 10.4 ounces (View shipping rates and policies)
• Average Customer Review: 4.3 out of 5 stars  See all reviews (35 customer reviews)
• Amazon.com Sales Rank: #139,014 in Books (See Bestsellers in Books)

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Customer Reviews

Most Helpful Customer Reviews

18 of 18 people found the following review helpful:

5.0 out of 5 stars Superb coverage of a complex topic, February 4, 2007

By	Kathryn J. Alexander "Co-Author; Easy Labor, ... (North Carolina) - See all my reviews

This review is from: Birth: The Surprising History of How We Are Born (Hardcover)

Birth: The Surprising History of How We Are Born, is a comprehensive tour through the (yes, appropriately titled, sometimes surprising!) history of how we are born. The impetus for the book was the author's mother and grandmother's birth stories, combined with Cassidy's own personal experience of a high-tech, modern-day birth that included all the bells and whistles typical of a modern visit from the stork. After her pitocin-augmented, epiduralized, cesarean birth, Tina Cassidy began asking herself, and others, if what she had just undergone was, really, the best for her and her baby.

It soon became clear to the author that apparently straight-forward questions revealed unforeseen levels of complexity. Using the investigative curiosity of a seasoned newspaper reporter and editor, Cassidy soon found out that childbirth today, and childbirth throughout history, are complex matters involving religious overtones, societal mores, historical reflections, passionate beliefs, economic incentives, medical advances, political agendas, and polarized opinions on all sides. Some of the questions addressed in this book include - Is childbirth really better today than it was a decade, or a century, or a millennia, ago? Are you better off giving birth at home or in a hospital? Are you better off with an obstetrician or a midwife? Is cesarean section really just another "lifestyle choice" or should it be reserved for truly life-threatening circumstances? Should everyone (or anyone) get an epidural? What - really - is the function of pain in labor? Should everyone (or anyone) be induced? And did you know that raw placenta makes a mighty fine cocktail ingredient? (P. 219 has the full recipe. Cheers.)

The answers reflect the remarkably complex nature of maternity, now and historically. However, Birth does not give the answers to these questions - because these are questions for which there is not one correct answer for all women. But Birth does frame the issues so the reader can understand why an essential act that is required for the propagation of our species has become mired in controversy at virtually every turn. Extensively referenced, historically accurate, full of fascinating gems, and drawing on the wisdom and insight of a wide assortment of authoritative figures in today's childbirth arena, Birth is a must-read for those interested in, as the title says - the surprising history of how we are born.

26 of 28 people found the following review helpful:

5.0 out of 5 stars Wonderful, I just hope people read it!, October 25, 2006

By	Kassandra Bradberry "mom2sol" (Tacoma, WA United States) - See all my reviews (REAL NAME)

This review is from: Birth: The Surprising History of How We Are Born (Hardcover)

I think one of the reviewers of this book is confused about this book and the difference between the midwifery model of care for a normal, low risk birth and the medical model of care. The author is not idealizing midwives she is simply biased towards the midwifery model of care because of her experience with the medical model. I know of many women who have had similar experiences with the medical model. There simply isn't enough personal attention and support, especially for a first time mom giving birth with this model of care. From my own experience, (with a midwife and a doula as well as my wonderful partner) my first birth was very similar to many of the stories I hear, except I had the support of a patient midwife and doula who were willing to sit back and wait. After pushing for a few hours my midwife suggested a different position to try and with the help of my partner, doula and midwife I pushed out my 9-pound baby boy without a tear. We discovered that his head was molding off to one side or asynclitic, he was essentially "stuck". I very much believe that if I had been under the medical model of care with a nurse coming in offering an epidural every half an hour my son would have been born by cesarean. Instead I had one of the most empowering experiences of my life. One of the first things I said to my husband was that pushing was so difficult and that I really had to focus my energy on one specific area, which my midwife was kind enough to point out to me. I would not have been able to push him out if I wasn't able to feel that area! So there you go. Yes, perhaps some of us are biased towards the midwifery model of care but for good reason! I'd also just like to say that there's a pretty big difference between a healthy American woman getting regular prenatal care and a woman in the third world. I don't know of any one who doesn't appreciate that hospitals and surgeons are available to us, we just want to use them when they are actually needed!
Any way just read the book for yourself and come to your own conclusions!

8 of 8 people found the following review helpful:

5.0 out of 5 stars Interesting read, March 8, 2007

By	K. Rasmussen (Stratford, WI USA) - See all my reviews (REAL NAME)

This review is from: Birth: The Surprising History of How We Are Born (Hardcover)

I really enjoyed this book and had a hard time putting it down. My original intent was to save it for a plane ride, but I finished it before we left for the airport. It is a history of birth in America (primarily, though it does touch on different cultures and parts of the world). I should forewarn though that I am a pregnant woman who works in obstetrics, so I had a pretty strong pre-existing interest in this area. While it is clear that the author has a bias toward the "natural" birth, it was still primarily fact-based, and I found it to be quite interesting. I have recommended it to many of my friends and colleagues.