Meredith's Reviews > Ina May's Guide to Childbirth

Ina May's Guide to Childbirth by Ina May Gaskin
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's review
Apr 27, 11

bookshelves: nonfiction, pregnancy, midwifery
Recommended to Meredith by: my doula
Recommended for: women seeking natural childbirth
Read in April, 2011

Written by Ina May Gaskin, the most famous and most respected midwife in the United States, who is responsible for reclaiming the almost extinct practice of midwifery during the mid-20th Century, Ina May's Guide to Childbirth advocates a non-medical, woman-centered approach to birth and emphasizes the mind/body, physical/mental/spiritual connection. Ina May's Guide to Childbirth is a good read for any woman interested in natural childbirth.

Ina May's views are at odds with the Industrial-Medical Complex currently dominating health care in the USA, which lobbies for what she terms "the techno-medical model" of maternity care. She defines the techno-medical model as the mindset that ". . . some medical intervention is considered necessary for every birth, and birth is safe only in retrospect. According to this model, once labor starts, birth must take place within twenty-four hours . . . women who give birth vaginally generally labor in bed hooked up to electronic fetal monitors, intravenous tubes, and pressure-reading devices. Eating and drinking in labor is not permitted. Labor pain within this model is seen as unacceptable, so analgesia and anesthesia are encouraged . . . Instead of being the central actor in the birth drama, the woman becomes a passive, almost inert object -- representing a barrier to the baby's eventual passage to the outside world" (185 -- 186).

The first 125 pages are devoted to birth stories. Most are told by mothers who gave birth at The Farm Midwifery Center at the author's hippie commune, but some take place at hospitals. The second half of the Ina May's Guide to Childbirth goes into Ina May Gaskin's philosophy of childbirth and prenatal care, the mind/body connection, the current models of maternity care in America, the history of how the practice of midwifery almost disappeared in the United States, the hidden dangers of medical pain relief and medical interventions, and the possibilities of VBAC as well as birth positions and labor practices.

During her discussion of cesarean section, Ina May brings up the trend begun in the 1990's of sewing up the uterine incision with a single layer of stitches rather than in two layers because it saves the surgeon five to ten minutes of his time. Because this type of wound repair increases the risks of uterine rupture, placenta accreta, placenta percreta, and placenta previa in future pregnancies, she recommends that women request double layer suturing if they're having a cesarean. Oddly enough, the type of suturing used to close cesarean sections either weren't mentioned at all or just mentioned in passing in the other childbirth books I'd read.

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