Ina May’s Guide to Childbirth

Since I’ve been reading so much on birth and parenting in the past six months, I thought I would share some of my findings. Ina May Gaskin is one of the “greats” of contemporary North American midwifery, and her Spiritual Midwifery has become a classic.

As the title suggests, the primary concern of her Guide is the culmination of pregnancy, but the sections about nutrition, choosing a practitioner, and ultrasound and other prenatal tests make it valuable reading in early pregnancy, as well. A practitioner’s approach–midwifery or “techno-medical”–will affect a woman’s prenatal care, as well as her birth.

Gaskin endorses a philosophy that recognizes pregnancy and birth as natural processes that are the domain of the woman within whose body they occur, rather than medical conditions that require a doctor’s intervention. She works to dispel the negative associations with birth that propel many women to choose a medicated birth (or elective cesarean) long before their due date arrives.

“Part I: Birth Stories” serves that very purpose–to reshape women’s image of childbirth through positive stories. These first 130 pages (nearly half the book) consist of brief stories, ranging in length from one page to several, written by women who describe their experiences with natural childbirth. As I approached my first birth, I found this to be the most empowering aspect of the book. My mother, grandmother, and maternal aunt had all given birth by C-section, so while growing up, I only heard about medicalized births. It was also good to receive affirmation that my birthing experience didn’t have to repeat the grueling 48-hour ordeal of my mother, laboring alone (with my father) through the night in a hospital bed, wondering what was happening to her.

In Part II Gaskin discusses natural pain relief techniques, as well as the medical options available and some of the risks associated with them. Practical chapters include one on episiotomy (“Is it really necessary?”), vaginal birth after cesarean, and the third stage of labor (everything after birth)–cutting the cord, delivering the placenta, bonding with baby, preventing postpartum depression. Throughout the book and in some dedicated chapters, such as “A Vision for Midwifery and Mothers in the Twenty-First Century,” she discusses the state of childbirth in the US and other hi-tech societies and where she believes we should go from here.

The chapters don’t always seem to proceed in logical order, but this seems a minor issue and does not interfere with comprehension. Gaskin supports her arguments with extensive endnotes at the close of most chapters. Ina May’s Guide is recommended reading for mothers, midwives, and anyone interested in birth.

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