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Conscious Empowered Birth
book review

Ina May's Guide to Childbirth by Ina May Gaskin
Reviewed by Cristin Tighe

It is wonderful that Ina May Gaskin published a more modern book after Spiritual Midwifery.  That book was and still is immensely useful, and the compilations of positive birth stories in both books are wonderful.  Two things she says about these stories stand out.  She writes: “Stories teach us in ways we can remember.”  (p.4)  She also states - “There is an extraordinary psychological benefit to belonging to a group of women who have positive stories to tell about their birth experiences.” (p. 3) It is surprising that this simple idea of the power of telling and hearing stories, of sharing experiences is not well understood for birth.  It is good the book provides stories of value, given the influence of U.S. culture and the media to over-dramatize the negative by showing births that are not calm, peaceful and empowering, but emergency-oriented, over-dramatized births where women are not supported or honored for their birthing power.  It is surprising, that there are so few published stories and so few gatherings where pregnant women can listen to these positive stories… which is so important since most women in Western cultures do not witness births before their own.  It sadly makes sense that women’s birth experiences are often negative and disempowering, since most have no experience of observation and often little experience even of stories.  Both creating sharing groups for women, encouraging women to write down their stories, can be very powerful for healing, change and empowerment.

In addition to more birth stories, this book really brings together Ina May Gaskin’s advocacy for women’s power to birth with evidence-based data: “The purpose of this book is to point you toward the best information currently available about women’s real capacities in labor and birth and to show you how these can mesh with the most effective use of modern birth technology.” (p. xi)  This book gives the feeling that the disempowerment of women -- the isolation and control over our grandmothers’ births and the rage of disempowerment through the shift toward cesarean birth and discouraging VBAC -- can now be overcome through a wise, mature, academic and intuitive approach to considering all that is possible for women through birth.  It is excellent that this book attempts to bridge the duality of past discussion - taking both the power and utility of women birthing naturally as well as recognition of the valuable technologies available for those infrequent births with complications. This concept of bridging duality and making connections are themes that run through the book.  Ina May teaches us that we need to embrace all options and find the connection between the black and white.  Being empowered around birth requires understanding both sides.  There are many areas where she points this out:

  • “The Power Mind/Body Connection” (chapter 1) that mental attitudes and emotions – “… interfere with the ability to give birth far more than is generally understood.” (p. 130)  This means women can be empowered to birth while pregnant by educating themselves, practicing relaxation and breathing, and visualizing positive outcomes.  That positive people (p. 138) and verbal support is key, and allowing women to “discharge emotions” (p. 135) is an overlooked tool to help labor progress, as is positive self-talk (p. 142).  So women who can connect mind and body, not allowing modern technology to take over body and stifle mind, can powerfully birth. It also means that obstacles to labor and birth are often the responsibility of the woman, which is not the easiest lesson.
  • The powerful synergy of male/female energy for birth possibilities (p. 137)
  • “The Pain/Pleasure Riddle” (chapter 3) that birth is painful and orgasmic – “…women… know that labor can be painful, but many of them know that as well as labor and birth can be ecstatic – even orgasmic.” (p. xiii)  Our cultural influence strongly determines our pain perception (p. 151), and changing attitude “… can alter our perception of it.” (p. 152)
  • “Birth Pain is different from other pain.” (p. 161) – that the natural survival instinct to run or fight is not what you need in birth.  Birth requires relaxing, letting go and surrendering, not protecting self or running away. (p. 161-162)  Ironically, many interventions cause pain after birth, which is not often considered (p. 165).
  • “Sphincter Law” (chapter 4) – that these muscles including the cervix and vagina must release to let go, and in birth is the most extreme relaxation of these two sphincters.  Understanding the power of feeling safe, laughter and positive thinking, breathing to help with relaxation, and the connection between the cervix and the cervical spine/throat/mouth can all aid in labor.  Cultural and medical practices that discourage thinking or encourage disassociation with these parts of the body cut our connection between body and mind, in these areas, and can impede progress.  So this understanding and connections is key.
  • Domino effect of interventions & “synergistic acceleration” – We know that (complications aside) each intervention carries one risk that it will lead to the next intervention, all having some negative impact on the birth process and the health of mom and baby.  Ina May points out the significance of seeing this the other way, “...the more things you do that are right, the more synergetic they become” (p. 130).  She mentions that there are many things “to do” in birth and that they can be done right or wrong (e.g. “…Turn birth over to women? Feed them? Just let them sleep?  Wait for them to go into labor? Don’t scare them?” (p. 130)  These synergistic steps, as statistics in the book show, lead “…to relaxed, happy, enthusiastic mothers and healthy babies” (p. 130).
  • Doctor/hospital/medical institution driven-birth & “women-centered style” of maternity care.  Ina May Gaskin calls these “the midwifery or humanistic model of care and the techno-medical model of care” (p. 183) - The first is female-centered, sees birth as a healthy process, values emotions and labors natural rhythms.  ( p. 184)  The second is male-derived, seeing human body as a machine, pregnancy and labor as illness, and encourages mind-body separation.  (p. 185)

This book overall is a wonderful contribution, to both the spiritual writing on birth and the academic.  The chapters on labor, vaginal powers, what least to expect, VBAC and choosing a caregiver are valuable contributions.  They are academically based, well written, easy-to-read and to the point.  Also, they summarize a lot of valuable information that many women before would have to read multiple books to understand.  Ina May Gaskin’s Vision for Midwifery and Mothers in the Twenty-First Century is a wonderful list… it will be amazing to see her, or others as intelligent and motivated, to lobby on Capitol Hill or get into the mass media, so women can hear this side, realize they are pulled and pushed by the medical model of care, and take back power so births can be wonderfully women-centered again.



 

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