The Thinking Woman's Guide To A Better Birth by Henci Goer

This book is great! The author is right on, and the book contains a wealth of information. If you’re looking for a book that will tell you the truth about childcare in our nation, then you’ve come to the right place. Over a third of the book lists the author’s references, so rest assured, this book is well researched.

The book starts out with exactly what is wrong with obstetric management. The author points out that there is a gap between current obstetric practice and what current medical research suggests. The author asserts this is because obstetricians are basing their practices on a set of predetermined beliefs and an incorrect training. Obstetricians are taught to view birth as a series of potential problems. In reality, the author says this is often a self fulfilling prophecy, and without it, childbirth is no more dangerous than digestion.

Despite the calamities of childbirth in the hospital, there is another option. The midwifery model of care fits within the realities of childbirth and is founded on the belief that labor can be trusted to go right most of the time. The author quotes Michel Odent as saying, “One cannot help an involuntary process. The point is not to disturb it.”

The book goes on to discuss the Cesarean epidemic. There is one part of this section that I loved, which are the rationales for the grossly high Cesarean rate in our country. Here they are:
We don’t really know what the Cesarean rate should be
Babies have gotten bigger
My Cesarean rate is right on the national average
Our hospital handles more high risk cases
Women have the right to choose a Cesarean even when it isn’t medically indicated
Having personally worked in a labor and delivery ward, I can attest that this is the exact thinking held by most of the hospital staff.
So why do we have such a large Cesarean rate? The author answers that as well. Money, impatience, convenience, hospital culture and peer pressure, and defensive medicine.

Next, the book covers breech deliveries. The author asserts that Cesarean is not the only way to deliver these babies, and she supports her case well. Baically, the thinking is that breech is too dangerous to do vaginally and a Cesarean will solve all the problems. The author points out exactly why this isn’t so. There are many research physicians that have noted if an obstetrician doesn’t know how to do a vaginal breech delivery, then they son’t know how to do a Cesarean breech delivery either. Delivering a breech baby through the cut in the abdomen can pose the same problems as potentially during a vaginal delivery. The truth is though that most breech deliveries do just fine. This is another case of defensive medicine and a lack of skill. Breech deliveries is quickly becoming a lost art as physicians aren’t even allowed to learn how to do this anymore due to hospital constraints. Midwives, however, are still skilled in this area. The author also gives information on how to get a breech baby to turn.

Inductions are covered next under the heading: Mother Nature Knows Best. There are many things discussed in this section, but I’ll highlight the part I like best. The author recommends ways to avoid an unnecessary induction.
Refuse an elective induction for convenience
Choose a care provider carefully (the author gives question to ask)
Refuse an ultrasound to estimate fetal weight
Refuse an induction for a suspected large baby
Don’t permit your due date to be changed based on a later sonogram
If you know when you got pregnant, refuse a sonogram solely for the purpose of estimating your due date
Consider refusing routine tests of fetal well being (high rate of false positives), consider repeating tests if they come back unfavorable
Drink plenty of water before an ultrasound to measure the amount of amniotic fluid

Next follows a great chapter on IV’s. The author discusses why nothing by mouth during labor is foolish. She points out exactly why eating and drinking during labor is perfectly acceptible. The rationale behind not eating and drinking is the risk of aspiration if a woman needs to be put under general anesthesia. The risk of aspiration has more to do with an incompetent anesthesiologist than it does with what a woman eats or drinks. Narcotics can also play a role in the risk of aspiration, yet these are not limited in use whatsoever. It is pointed out that the risks of epidurals are often glossed over, while women are still denied food and water. The dangerousness of routine IV’s is also covered. There are no benefits of a routine IV or denial of food and drink during labor.

There are plenty more topics covered in this book, making it a truly worthwhile read. If you’re having a baby or thinking about having a baby, this is a book you absolutely must read. It is so important to be educated in this area. The author writes so eloquently. She is down to the point and easy to read and understand. The book reads quickly and is an excellent resource. Don’t just walk, run to the store to get your copy today.