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I recently read Born in the USA by Marsden Wagner, who is the former director of women and children’s health for the World Health Organization. He made a great observation on the essential difference between midwives and the majority of doctors when it comes to childbirth.

Doctors view birth as something that happens to a woman.

Midwives see birth as something a woman does.

Seemingly a minor difference, but it means everything for how women in labor are treated.

Midwives assist a laboring woman give birth. Everything they do is to provide support for the woman while she works to birth her baby, and they are there in case something should go wrong. Women are considered “clients,” not “patients” because they are not sick. They are simply pregnant.

On the other hand, doctors deliver a baby. They see women as patients with a condition that must be fixed. Namely, she is pregnant and she should not be pregnant anymore. The goal is to get the baby out as quickly as possible, generally through medical methods and by their own expertise. It is rare to see a doctor who is willing to allow a healthy labor to happen naturally without attempting to meddle. Doctors are expert meddlers. It’s really all about control. But labor cannot be controlled, and when doctors (or nurse-midwives) attempt to control the uncontrollable, they tend to end up doing things that are not necessary or beneficial for the mother or her baby.

Doctors should be backup for when a woman actually does need assistance, not the default option for every woman in every birth. We need support during pregnancy and birth. Not always a medical degree.

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In preparation for the birth of our third baby, I have been rereading all of the birth books I found helpful during my first pregnancy, as well as others I didn’t manage to get to at that time. It’s been a few years since I read them, and especially after a difficult labor with my second daughter, I’ve been needing a little reassurance and guidance this time around.

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Since I’ve read several childbirth books in a relatively short period of time, I’d like to give you a little review of what I would consider to be the best natural childbirth book for women who only have time to read one book.

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Although I have discovered invaluable information in each book I’ve read, the winner has to be… drumroll… Ina May’s Guide to Childbirth by Ina May Gaskin.

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Here’s why:

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Most childbirth books tend to focus on one of two things: either the feelings of the birth experience and how to achieve a gentle birth through relaxation, or, instead, on the medical establishment and all of the interventions routinely performed on women. The first approach can leave a woman unprepared and uneducated in the face of a different birth than planned. Especially when complications arise. The second can unnecessarily frighten her and make her completely averse to doctors even in a true life-threatening situation, or it can train her to become an acquiescent patient in a hospital.

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Ina May’s book leans to neither extreme. She addresses both aspects thoroughly.

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Considered the nation’s leading midwife, Ina May Gaskin began her midwifery career in the hippie days, when everyone wanted a homebirth away from the “establishment.” She attended countless births over the years. Her wealth of knowledge and experience is truly incredible, and she has witnessed natural births that most traditionally-trained medical doctors and nurses have never seen or conceived of.

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The first part of the book is birth stories from many mothers who had natural births. This may not seem important, but in our culture of labor as a “medical emergency” and childbirth as “the worst pain you’ve ever experienced,” I think it is so important that pregnant women hear (or read, in this case) accounts of what a normal birth can look like. Each woman’s experience is different, but all of them fly in the face of the horror stories that everyone – from the media to veteran mothers – likes to inflict on a pregnant woman.

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In Part 2, Ms. Gaskin explains some history of birth in the last several thousand years, and how our society ended up with such a skewed perception of what giving birth is all about. She then talks about the process of labor, what’s happening in the body and mind, and even discusses nearly unheard of “orgasmic” or “pain free” birth. (Side note, there are unedited photographs of vaginas and women laboring or giving birth throughout the book, just so you know). Ina May explains how laboring in an unfamiliar place with unfamiliar people can lengthen or completely stop labor, and why an intimate setting with people you trust is the best place to bring new life into the world. She talks about this from both a biological and emotional standpoint. I should note that she discusses birth in both home and hospital settings.

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In the second part Ms. Gaskin also covers a myriad of tests and interventions normally performed or offered during pregnancy or labor, as well as VBAC (vaginal birth after cesarean) and tips for choosing a traditional caregiver, midwife, or doula. She also talks about birthing positions around the world, and has drawings of women in each.

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Throughout the book Ina May remains true to her earthy roots. She writes frankly and insightfully about birth and about the labor process. She is engaging and down-to-earth, and provides an incredible amount of information. This book now holds a permanent place on my shelf.  If I could only give one book about childbirth to any pregnant woman, Ina May’s Guide to Childbirth is the one I would choose.

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