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midwifery textbooks

post #1 of 47
Thread Starter 
As part of preparing for UC, many women feel the need to learn what is normal and what to do in case of complications. Personally, I think instinct and intuition go a long way, but I understand the desire also to intellectually understand what is going on, because I will never be working from a totally instinctive place, the mind is already there, so I at least want to give it the right information to work with. For instance, although thousands of years ago women may have instinctively eaten their placentas after birth, I know I never would have before I read about its benefits. So for me, the value in learning has been primarily in dispelling myths and misconceptions about birth that were lurking in the back of my head and filling in the gap that an unfully-accessed instinct leaves. Unfortunately, a lot of the information out there perpetuates myths and misconceptions about birth, or (while suggesting that it's comprehensive) leaves important things out.

Two of the most popular books people recommend to help prepare are Emergency Childbirth by Gregory White MD and Heart & Hands by Elizabeth Davis. Spiritual Midwifery comes in quite a bit too, and I throw in Special Delivery by Rahima Baldwin once in a while. I'd like this thread to be a critical look at these books to balance out the approval implicit in recommending them, and a place to ask questions about the information contained in them.

I'll start. The thing that I think bothers me most about Heart & Hands is that there is never any mention of the role of the mother's instinct and intuition in labor, only a very clinical step-by-step guide to what the mother ought to do and what the midwife ought to do to her, based on the midwife's observations, measurements, and notions about what normal labor looks like. As a midwifery text, I feel it is irresponsibly lacking in this way, as it has helped train a whole generation of midwives to manage birth rather than allow it to be spontaneous and trust in the instinctive process. For those using it to midwife themselves, I feel it's potentially dangerous to consult as an authority, as it may lead the mother to second-guess her own natural urges in favor of "expert" pronouncements about what is normal and what is best for the laboring woman to be doing at each point of labor, and it is pretty heavy on the "necessity" of managing the birth, especially second stage and the emergence of the baby. I disagree strongly with about 90% of what she has to say about this (and I'll come back to this.)

I also really dislike her (rather condescending and presumptive, I think,) focus on psychologically-based dysfunction of labor having to do with flaws of the mother, such as an "inability to surrender control", relationship issues with her partner, or fear of becoming a parent, as opposed to having environmental-induced disturbances such as inhibition, distraction, and passivity (which she doesn't talk about at all.)
post #2 of 47
Somewhat playing Devil's Advocate here:

First, I don't think that any woman who is going the UC route is in danger of allowing a book to usurp her authority or interfere with her instinctual process. If she's looking to a book for information, I think it's more likely that she feels the need to validate something that is already resonating for her. By its nature, a book is an "authority." Even those books that preach mothers to trust their instincts (I'm thinking of Deepak Chopra's book off the top of my head--Magical Beginnings, Enchanted Lives) are going to be a sort of authority voice, simply because that's why you look to a book. How can you have a book tell you how to trust your instincts?

And while I wholeheartedly believe that instinctual knowledge is an awesome thing, there are so many things that can and do interfere with that. We all have baggage (some of us have matching Samsonite, I know I do) that we bring into all relationships, even birth. When you have interfering forces within your own mind, how do you always know that your intuition is really that--your intuition--versus a sock come loose from your baggage? (I've been going through that very situation lately with the whole protein/BP/post dates thing. How much is really intuition that something may be wrong, vs I just want this baby out?)

Personally, I love Heart and Hands, simply because it is so straight forward and pretty much a checklist of birth. I don't think that it's the cause that so many midwives medically manage birth. If that's their only textbook or source for information, their education is incredibly lacking. Same thing for a mom planning to UC--I hope that she gets more than one source of information. Heck, that goes without saying for just about any topic, not just birth.

The fact is that these books are written for people who are childbirth attendants of some sort, not for women who are planning UC. A childbirth attendant is in a completely different headspace from a laboring/delivering mom. Certainly a laboring/delivering mom isn't going to be asking for an intuitive assessment from her attendant, nor is that person likely to be able to tap into the mom's intuition, YKWIM?

Even a book written specifically for women planning to UC would be an authority text. Anything/anyone that you look to for guidance is an authority, whether it's a person, a book, a website, etc.

Did that make sense?
post #3 of 47
I ordered Heart and Hands and was SO excited to be getting it. I am not going completely UC, but am doing a lot of my own prenatal (my midwife lives over 2 hours from me and I'll be relocating before the birth), and intend on a very natural, hopefully hands-off birth.

Anyway, I REALLY dislike the fact that she presents the typical medical mindset nonsense about twin pregnancy that dominates obstetrics. While a mo/mo pregnancy is much more high risk, a typical twin pregnancy with 2 placentas is REALLY not that much more high risk than any other birth. Rather than giving any necessary disclaimers about some of the risks, and then discussing in minor detail the importance of nutrition, role between presentation and type of birth, etc., she just sounds like twins are out of the reach of ANY midwife, like twin mamas who want an out-of-hospital birth are SOL, and then moves on.

I was so disappointed after reading the twin section that I put the book down for a few weeks. I was just too ticked off that she promoted the same nonsense I read on (insert name of medical discussion board here) all the time as if it were fact. BS
post #4 of 47
I own Dr. White's book, and Spiritual Midwifery, and they just confirmed my beliefs. Birth is a natural, bodily function.
I really like Ina May, but, her books gave me nightmares. I initially purchased her books thinking they would give me the boost to look for a midwife, and they did the opposite. Ironically, I would love to be a midwife in 10-15 years.
Now, I wasn't looking for birth info, though, so my opinion may not matter. I had too many childbirth education classes and already knew too much.
The newborn info, to me, was more important than learning about birth. I mean, birth happens. It's the baby that needs attention.
post #5 of 47
I have Spirtual Midwfifery and while it was good it bothered me. It seemed like it was trying so hard to attain the "hippies having babies in the fields" vibe that it ruined a lot of it. Granted that has to do with the fact that it was in the 70's and they were hippies but it seemed to forced.

My biggest pet peeve though (and I stopped reaing it about half way through the birth stories) was a lot of the.......disregard for human life. I had to stop reading after one story because of the alcohol content. I have no problems with drinking but the mother herself wrote that she was drunk until she had the baby. The midwives were ok with it and even told her to have a drink (she had preterm labour). It seemed overboard. A good portion of the stories were like that and in mind only perpetuated the myth that homebirth is for deliquents. Like a PP said her books (that one at least...I don't think I'll read another) are mightmare worthy. I would not consider a midwife if that was my first go round. She doesn't seem to trust birth despite her actions/words. She also comes across as very bossy and the women who had the babies? Sound totally brainwashed! The love they have for Ina May and her DH rubbed me the wrong way. I don't think it did the homebirthing community justice...I can see it doing more harm. It gives off a cult like vibe that just doesn't work. I can see it making a UCing woman second guess herself (a newbie...I don't think a seasoned pro could be swayed by Ina ).
post #6 of 47
Thread Starter 
For the most part I agree with you Kate. What you say can be true and it can still be worthwhile to have a critical/questioning discussion about these books.
post #7 of 47
I agree with you, fourlittlebirds, about Heart and Hands.

I actually just finished writing a critique of this book (3rd edition) for an assignment for school, and it was a great learning expereince to look critically at this book. This was one of the first books I ever read about midwifery 6 or so years ago, and it had been a while since I had really revisited it. Now that my own ideas on birth have really come into their own, it was very frustrating to read though Heart and Hands. From a midwife's perspective, I found it to be so very "hands-on" (like all her talk of pelvimetry and "protecting the perineum"), and some statements really got me, like "don't forget the importance of vaginal exams" : .

Spiritual Midwifery, I understand, has it's place historically among midwifery books....but....wow, all those pictures of mamas birthing right on their sacrum (semi-sitting), with all the hands on her maneuvering the baby's head out.: But, I even had a hard time reading Ina May's newer book. It just felt like most of the birth stories in there were full of vaginal exams and "the midwife said I could/should".
post #8 of 47
Quote:
Originally Posted by Lennon View Post
Spiritual Midwifery, I understand, has it's place historically among midwifery books....but....wow, all those pictures of mamas birthing right on their sacrum (semi-sitting), with all the hands on her maneuvering the baby's head out.: But, I even had a hard time reading Ina May's newer book. It just felt like most of the birth stories in there were full of vaginal exams and "the midwife said I could/should".
Seems most who dislike this book think that. In the beginning I could see why someone would want to use her but she very quickly got more hands on. After a few stories I called my sister to ask why so many people loved/adored/worshipped her. It didn't make sense to me...yeah she did a great thing as far as promoting the homebirthing community but in my opinion she promoted a great deal of co-dependence as well.

After I posted I sat here trying to think of why this book bothered me. Don't get me wrong...as far as clinical information and inspirational moments it was great. I still plan on finishing it. Her language seemed so crass though. I have a mouth like a sailor and some of her comments made me blush. It seemed that while she was striving to be appear to be so open and free she was degrading the act of childbirth at the same time. It really bothered me how sexual some of the stories were from HER point of view. I understand birth can be very sexual and I can't imagine the feelins a midwife goes through being able to witness it all. Her focus seemed to much on her and her "trip". I wouldn't recommend this to most people- uc or not. It just seems....I don't know. I hate to be repetative but it was so cliche in the whole "tripping love fest of two unharnessed and free spirits".

Ok, I'm off my hippy soapbox.
post #9 of 47
On a slightly different note: White's book, while reassuring, is also outdated in many places, especially in the area of resuscitation. CPR and the Heimlich have come a long way since that book was published. Also, White suggests fundal pressure for prolonged shoulder dystocia, while later studies found that fundal pressure may impact the shoulder further and is entirely contraindicated.

I'd love to find an Emergency Childbirth - style text that incorporates modern resuscitation methods, the Gaskin maneuver, and the McRoberts maneuver rather than outdated and potentially harmful advice.
post #10 of 47

bs"d

Re: Emergency Childbirth by Gregory White MD

I've posted this before, but this thread reminded me, so I'll repeat myself. Overall, I found Emergency Childbirth to be reassuring. Obviously, UCers don't subscribe to the notion that normal birth is an "emergency", however, since his book is intended for individuals likely to assist with "emergency childbirth" who are not birth attendants, such as paramedics, he makes many statements about how everything goes well the vast majority of the time. There are a lot of instructions that are unnecessary (and possibly harmful), but the worst are his directives to baptize babies that might not make it.
post #11 of 47

Emergency Childbirth

Yeah, I'm glad I already knew infant cpr, because those outdated pictures frightened me!
I love the book, but, can't they revise it?
post #12 of 47
I LOVE this thread. I have to say that I personally like more clinical books even if they don't talk about the mother's intuition at all just because I can add it to my thought process, but if the book already has a little of it I find myself forgetting to add more. I also like knowing *exactly* what is happening to the tissues, cells, etc. which a lot of the more midwifery centered books seem to gloss over. It seems for me if I know what is happening microscopically I have a better sense of myself when I experience it.
Don't get me wrong, I've learned plenty from those books and others (like the ones by Polly Block--which basicly offer the same stuff Spiritual Midwifery offers, but without the hippy stuff and foul language)

What this thread tells me is that a book about the nuts and bolts (technical aspects) of homebirth FOR UCers is needed.
post #13 of 47
Thread Starter 
I have a love/hate relationship with Spiritual Midwifery. It played a huge role in the beginning of the modern homebirth movement in this country, and is a fantastic historical record. I love the back-to-nature DIY mentality of the people at the Farm. Many of the pictures are just beautiful, and there is such a feeling of joy and such simple, lovely language expressed in many of the stories. Now, part of this undoubtedly is because they were all high. And my love for it probably has something to do with the fact that I am a child of the '80's who wishes she grew up in the '70's with hippies for parents. All that's neither here nor there as far as the purpose of the thread, I always just feel compelled to put in that disclaimer.

The "Instructions to Midwives" takes up a good third of the book, and a lot of UCers refer to it. There's a lot of good information in it about anatomy, but the section about management of labor and especially second stage is typical obstetric-midwifery fare. She's big on frequent vaginal checks and coaching breathing and sounds. Here's a gem: "The semi-sitting position is best for delivering the baby's head, so that you can have eye contact with the mother and slow the delivery of the head." Here's another:

Quote:
When you can see that birth is a few minutes away, slide a sterile sheet under the mother. Wash your hands and her puss again [with antiseptic soap]. Have your assistant wash her hands and be ready for the hemostat and scissors, in case you need to cut a cord or give a lady a snip; and the ear syringe, for suctioning out mucus from the baby's nose and throat. You should rupture the membranes when you see the water bag if it looks like the baby will be out soon.
And,

Quote:
Coach the mother about how much and how hard to push. Support the mother's taint [perineum] with your hand during rushes [contractions]. It helps the mother to relax around her puss if you massage there [...]. Sometimes touching her very gently on or around her button (clitoris) will enable her to relax even more. I keep both hands right there and busy all the time [...]. It's really important at the time of crowning that hte mother doesn't complain at all [...].
She recommends that if the perineum turns white during pushing, the mother needs an episiotomy. (The episiotomy rate at the Farm was 20%.) She recommends also checking for the cord and slipping it over the head before the baby is born and cutting if it can't be slipped over, routine suctioning on the perineum, putting pressure on the baby's head to keep the mother from birthing too fast, traction on the baby's head to help deliver it, and uterine massage before the placenta has separated from the uterus.

Not that this has anything to do with whether the technical advice in general in SM is correct or not, but on a personal note, I cannot stand Ina May's attitude toward the laboring mother and her husband as their spiritual and psychological advisor. Example here. Another thing that irritates me is Ina May's unpleasant bias toward fat women. According to Ina May, fat women tend to be lazy and have to be made to do something to get the labor going.
post #14 of 47
again, I say, I really don't understand Ina May often being suggested reading, even on UC lists. What about Jeanine Parvati Baker? Admittedly, I've only read things she wrote on the internet, I have yet to read her books, but I get the feeling from my limited exposure she would be more in tune with a "UC mindset" if there is such a thing.....how do you women who have read her books feel about it? (And may I borrow them from you?)

Kat
post #15 of 47
Quote:
Originally Posted by rajahkat View Post
again, I say, I really don't understand Ina May often being suggested reading, even on UC lists. What about Jeanine Parvati Baker? Admittedly, I've only read things she wrote on the internet, I have yet to read her books, but I get the feeling from my limited exposure she would be more in tune with a "UC mindset" if there is such a thing.....how do you women who have read her books feel about it? (And may I borrow them from you?)

Kat
I have her prenatal yoga and natural birth (at least I think that's what it's called). You are welcome to borrow it if you want. Just shoot me a PM.

I like the book. It doesn't offer any practical advice or information on birth. It, obviously, has lots of yoga moves but the best part about it are the beautiful birth stories. She is a bit more "out there" than I am, but she does have the right attitude toward birth, IMO.
post #16 of 47
Quote:
Originally Posted by fourlittlebirds View Post
I also really dislike her (rather condescending and presumptive, I think,) focus on psychologically-based dysfunction of labor having to do with flaws of the mother, such as an "inability to surrender control", relationship issues with her partner, or fear of becoming a parent, as opposed to having environmental-induced disturbances such as inhibition, distraction, and passivity (which she doesn't talk about at all.)
This is a criticism of mine as well.
post #17 of 47
Quote:
Originally Posted by christyc View Post
Anyway, I REALLY dislike the fact that she presents the typical medical mindset nonsense about twin pregnancy that dominates obstetrics. While a mo/mo pregnancy is much more high risk, a typical twin pregnancy with 2 placentas is REALLY not that much more high risk than any other birth. Rather than giving any necessary disclaimers about some of the risks, and then discussing in minor detail the importance of nutrition, role between presentation and type of birth, etc., she just sounds like twins are out of the reach of ANY midwife, like twin mamas who want an out-of-hospital birth are SOL, and then moves on.
I felt the same way. As soon as I found out we were having twins I went directly to Heart and Hands to see what she said. Total shock! Huh? Here's what I don't get. Her book is also intended to be a resource for midwives in other countries w/out much education, backing, etc.. So what do those midwives do when they encounter twins/breech?

I have the 4th edition and don't like her comments on UC in the preface. *Usually* the women who choose UC do it because of dissastisfaction with the medical system. I think she's implying that less women would UC if they found better midwives? Not sure how to see it from what she's saying.

As someone who does not have access to midwives AT ALL, I am happy that at least books like this are available, but at the same time, I use my intuition and common sense to know which sections are just "hooey" (that would be about 3/4 of Spiritual Midwifery)
post #18 of 47
I have Heart and Hands and I actually love it and referred to it quite often during pregnancy and post-partum. With that said, I did find some of it undesirable, but I just skipped over the parts I found condescending, unhelpful, etc. It did have a lot of good technical information, though and it helped me to feel more prepared for the birth.

Emergency Childbirth wasn't as helpful as I thought it was going to be. I didn't like the weird pictures, either, but the overall message is good---childbirth usually turns out fine! I bought it for my husband, but he never did end up reading it!

I haven't read Spiritual Midwifery, but I did read most of Ina May's Guide to Childbirth. I also found it to be surprisingly annoying in some parts. It did seem a little bit like she wanted to be too involved in the birth process. I think the biggest thing I found a little off-putting was that she believes birth is a sexual event, yet she seems to be directing the sexual action and being involved! Now THAT would be majorly inhibiting to me "Kiss your husband passionately! Make low, sexy moans!" Yeah, right lady!!

My favorite, though is Heart and Hands by far.
post #19 of 47
Quote:
Originally Posted by MamaRabbit View Post
Her book is also intended to be a resource for midwives in other countries w/out much education, backing, etc.. So what do those midwives do when they encounter twins/breech?

Your post made me remember a textbook that's focus is purely on how to give care in countries without much development. I wish I could remember what it's called. I'll have to ask my friend who has it. It has really neat stuff like testing urine for sugar by leaving it out to see if ants are attracted to it. I bet it has all sorts of useful stuff for UCers.
post #20 of 47
A Book For Midwives: A Manual for Traditional Birth Attendants and Community Midwives ?????
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