Review: Ina May’s Guide to Childbirth

Although this book contains much factual information about pregnancy and childbirth, Ina May’s Guide to Childbirth by midwife Ina May Gaskin is just as much a book on childbirth philosophy as it is a book about the process of birthing a baby.

The heart of the book is a number of birth stories, sometimes in the words of the women who gave birth and sometimes in the words of Ina May. While some of the women further toward new age woo than I think is quite reasonable, for the most part, these are powerful stories of women finding in their bodies and minds the power to give birth in a way that doesn’t treat birth as a medical problem to be fixed. One thing I appreciate about these stories is that they don’t exclusively describe normal, uncomplicated births. A good handful of the stories contain births that were difficult.

One thing Gaskin does well is demonstrate how many of the birth interventions that are sold as conveniences can hamper birth and lead to further interventions that the woman did not originally want. For example, the labor inducing drug Pitocin (synthetic oxytocin) can force the body into labor before the pelvic region has finished preparing for birth which, in turn, leads to higher levels of cesarean sections. This isn’t to say cesarean sections are bad. The point is that a woman may choose one intervention — induced labor — and end up with another which she may not have personally wanted — a cesarean section. Another example is epidurals to kill the pain of birth can lead to higher levels of perineum tears because the woman giving birth is unable to feel when she is pushing too hard or too fast.

Because of this, Gaskin advocates letting women’s bodies do their work and turn to interventions only as needed. The medical interventions that doctors have available to them today are wonderful lifesavers, but by treating them as conveniences that can standardize birth, we start down a chain of interventions in way that are not always desirable.

Beyond the philosophy, this book also contains a lot of information about the birth process that emphasizes how to let the process of birth happen in its own way: let the birth take time; stand up and move around to help the baby into the right position and let gravity help you push it out; laugh or let your partner sexually stimulate you to relax you and help to loosen your muscles; etc. These aren’t magical incantations to make the birth process pain free and fast, but they are ways of working with the birth process rather than against it.

You shouldn’t read this book expecting a neutral presentation of non-medical birth, but you should read it if you want a book that focuses on birth as a normal process not something to be medicated away.