Not wanting to infringe on the woman's own wishes for her baby's birthday, I try to avoid placing my own personal biases into advice that might not be relevant to her. My best advice to any woman that's planning a birth is just to trust your body. In 99% of all pregnancies, there is no reason to assume something is going to go horribly awry. I do believe that women and their families should put a "worst case scenario" segment into their birth plans, but after that's said and done with, I'd recommend they leave it behind and not think about it again unless something happens. Even if she is planning on having an epidural ahead of time, I want her to know that her body is likely still fully capable of dilating, effacing, contracting, and birthing on its own (it may take a little longer, and pushing might be a little less effective, but it's far from impossible). I know of too many moms who underwent a cesarean surgery for "failure to progress" after only a few hours of active labor. The act of simply trusting oneself and trusting the age-old process of childbirth means a woman will be more attuned to her body (even if she can't feel anything from the waist down) and will be more trusting of her decision to utilize any number of medical interventions, including cesarean surgery.
That being said, two of the suggestions I would give any pregnant couple are not so open-ended: avoid Pitocin like the plague, and steer clear of What To Expect When You're Expecting.
What gives me the right, you might ask, to say that after proclaiming your dedication to not infringing on the family's wishes? Well, I don't have the right. But I do have the knowledge to know that Pitocin does more harm than good if its use is not medically indicated (which it rarely is before the postpartum period). As for the What To Expect books, well, that is the subject of today's blog entry.
In short, What To Expect When You're Expecting encourages the opposite of trusting one's own body. The book paints a frightening picture of the birthing process, leads readers to expect that something will go horribly wrong, and blatantly encourages the routine use of medical interventions that might in fact impede the body's ability to progress normally.
Amazon.com contains conflicting reviews on the book itself, with most reviewers either giving it 5 or 1 stars. The positive reviews contain language like "everything you want to know about pregnacny [sic]" and "lots of great information." Another still gives the book five stars even though "a LOT of it may not pertain to you because it discusses a LOT of complications that you can have ... It can make you a little paranoid..."
The negative reviews go a bit more in-depth:
"This book assumes that pregnant women are idiots, and talks to them accordingly. It's full of cutsey [sic] language, puns, and linguistic tics that drove this English major up a wall. In terms of content, it contributes to our culture's position of "better safe than sorry" when it comes to kids - kids and pregnant women must be protected from anything and everything that might be the slightest bit upsetting. It does not provide any information on the research behind their advice, assuming that the pregnant woman is too stupid or lacking in self-control to make an informed decision for herself upon being presented with the facts, relying instead on making across the board recommendations on all kinds of things for which there is no scientific basis."A father writes a review warning of the paranoia the book caused him and his family during his wife's pregnancy:
"...this will be the worst book that your significant other can read and will make your life utterly miserable for the next nine months. It's been over four years since I had to deal with this serie's [sic] 3rd edition and I still can't stand the sight of it.Reading complaints about What to Expect being paternalistic didn't surprise me. The first time I picked up a copy at Ed McKay's, I recall thinking it seemed more like an instruction manual than an informative text. Which is odd, because surely anyone that knows a thing about the process knows that no one pregnancy is the same, that there is no standard way to own one's body, and that there are infinite variations of normalcy in any given healthy mom-to-be.
"It may have been intended as a self-help guide, but its alarmist tone and condescending attitude leads this to act more as a bible for every worst-case scenario imaginable. After spending a few hours perusing this book's contents, your wife, girlfriend, whomever will become so overworked and paranoid that every little ache, pain, and irritation will become a sign of the baby being born with a forked tongue and three heads. The diet your partner will be instructed to keep is impossible for any human being alive to follow. She will be told to try and avoid ... damn near everything it seems like."
What To Expect is likely on the shit list of a wide range of birth professionals, be they obstetricians, midwifes, doulas, nurses, etc. I chalk its popularity up to its undeserved good reputation and great marketing. Still, great marketing doesn't mean great product.
Okay, so What to Expect is evil. What, you might ask, should we read instead? Glad you asked! :)
It all depends on what kind of information you're looking for. If you just want to replace What To Expect with another plain-English book minus all the fear mongering, I'd recommend either:
In its recently-released 4th edition, this book contains basically all the information contained in What To Expect without all the fear, guilt, and negative outlook on the childbearing year. The language is plain-English and easy to read. It contains diagrams, illustrations, and charts for quick reference. Contrary to popular belief, this is not just a book for women planning a natural birth. There are whole sections dedicated to laying out the benefits and risks of each medical intervention, laboring in bed, effective laboring and bearing down with an epidural, and induction methods. PC&N informs instead of instructs and offers a wealth of suggestions on how to be an active and informed participant in the birth of your child no matter the circumstance.
I can feel your eyes rolling. I don't know how, but somewhere along the way the Our Bodies, Ourselves series became synonymous with overly-crunchy man-hating feminists. Or, for many women in my generation, the book brings people to laugh, "That's that health book my mom had!"
And it's fair enough. OBO is, indeed, written from a feminist and self-aware perspective. My question to you is, why is that a bad thing? OBO is truly the antithesis of What To Expect: it encourages women to take ownership of their own bodies instead of being told what to do/not do, it offers suggestions for a variety of different scenarios and needs, it takes into account issues of race, class, income, gender identity, physical ability, and it's outlook on the functions of the female body are genuinely positive. Plus, like PC&N, Our Bodies, Ourselves: Pregnancy and Birth contains just about everything you need to know about the childbearing year, empowering the reader to make informed decisions about her body. What's so bad about that?
If you are planning a natural birth, avoiding What To Expect is even more important! The best reads I can recommend for those even considering an unmedicated birth are:
People tend to associate Lamaze with the ubiquitous breathing technique: "Hee-hee-hee-hoooo!" In actuality, the Lamaze technique no longer encourages patterned breathing as part of contraction rituals unless it helps mom. Leave your biases at the door and pick this baby up... it's a wonderful read.
This book can be summed up in one phrase: childbirth is normal, it is not a disease. Encouraging women and their partners to embrace the single most normal thing in the universe, the book offers tips and tricks to handling the challenges of labor and encourages families to choose natural childbirth for the better health of the mother and the baby. Easy to read, written in plain-English.
Full disclosure: this book is crunchy! A long-time lay midwife and generally badass lady, Ina May Gaskin is a natural childbirth guru that wants to change the way we think about birth. With all the horror stories about birth that we see day in and day out in books, movies, TV shows, and newspapers, the positive birth stories told throughout the text are a welcome change. Additionally, contrary to popular belief, she is not 100% anti-medicine. There is a whole section of Guide to Childbirth that details moments where advances in medical science and hospital births have been positive. She leaves that section to the end, however, since she still ascribes to the belief that birth is normal and, most of the time, it is safe to allow it to happen on its own.
For more in-depth, research-based information on pregnancy and childbirth options, I recommend:
This book is not unbiased, and it doesn't pretend to be. Goer is a natural childbirth advocate who wants her readers to know what they're getting into before they utilize a medical intervention. Using up-do-date research and statistics, Goer breaks down pregnancy myth after pregnancy myth to bring us a comprehensive look into the American childbirth industry. She challenges the notion of "necessary intervention" in complicated labors, the "perils" of home birth, and perhaps most notably, restrictive hospital policies that usually do more harm than good to the health of the mother and baby alike (such as restricting food intake). What's most notable, she does it all without being overly accusatory of women who make the informed decision to have a medicated birth. Informative and a good read, but a bit cut-and-dry in the language department. Highly recommended for women who want to learn more about all that stuff they do to you while you're in labor.
What about the mens, you ask! There are plenty of great books for them. Dads and partners are fast becoming active participants in the births of their children, leading more families to report heightened satisfaction with the pregnancy and childbirth process, increased dad-baby bonding, and a sense of accomplishment that is shared between the whole family. While any of the above books are great read-alongs for expectant couples, anyone planning on supporting a woman throughout childbirth has got to get his/her hands on...
I cannot speak more highly of this book! It includes all the "basics" on each stage of pregnancy and childbirth including interventions, plus a number of things dads/partners/doulas can do to support mom through the whole process. The book's format is easy to navigate, with each pregnancy/childbirth scenario having its own section with different sub-sections: "How the mother may feel, "How you may feel," "How you can help," "What does the caregiver do?" and "What does the doula do?" Awesome tips and tricks for partners to be active and informed (including how to give awesome foot rubs, ladies! cha-ching!).
3 comments:
Right on! I am also sick of all those hyper-alarmist baby books out there. Although, I think we might crave being scared ... it is a bit like watching a horror movie.
Half way through my pregnancy I altogether stopped reading "What to Expect", I didn't so much find it terrifying as much as I did useless. I ended up having pitocin during my labor (water broke but not in labor), and I'm certainly glad I hadn't read the article linked in your entry. I was already freaked about it enough, because of the rumored horrific contractions that come with pitocin. Anywho... I know better now :)
Spontaneous rupture of membranes without labor contractions are indeed a medically-indicated reason to use Pitocin, if the mother is GBS+. Otherwise, there's no real reason to hurry unless it's been a few days and the fluid levels are dangerously low and there are signs of fetal distress (which does happen given enough time, though the amniotic fluid can replenish itself).
Basically, any medical intervention involved with childbirth (or any kind of health care!) needs a close look at benefits vs. risks. There are great reasons to use Pit to induce labor, and so long as safety precautions are taken, it's not as dangerous as leaving an emergency situation to "work itself out." The problem is, far too often a doctor or nurse (or midwife) will come in and say, "We need to start Pitocin." The mother hears "need" and rightly assumes it's a medical need, not a need based on the doctor/midwife needing to be home for dinner that night. ;)
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