For those who do not already know, I read a lot of birth books. Like a lot. Not just birth but all things women’s health, pregnancy, birth, postpartum, parenting, the works!
If you have seen my Amazon wishlist, you’d realize I have no shortage of books in this particular genre and field of study to read. The habit began when I worked through my DONA Doula certifications and will continue throughout my Midwifery studies through the Ancient Art Midwifery Studies Program.
As someone embarking on a Life Long Learning Journey, I figured I would share as I go!
Henci Goer’s The Thinking Woman’s Guide to a Better Birth was the most recent read I have finished so I’ll be starting here (I’ll add from previous reads later on as well, just need to start somewhere!).
Henci Goer
“Award winning medical writer and birth activist Henci Goer gives clear, concise information based on the latest medical studies.
Goer will help you compare and contrast your various options and show you how to avoid unnecessary procedures, drugs, restrictions, and tests.”
About the Book
Right off the bat, this book covers an extensive list of options for an expecting parent to consider when it comes to their childbirth experience.
The Book Covers:
Cesareans
Breech Babies
Inducing Labor
IVs
Electronic Fetal Monitoring
Rupturing Membranes
Coping With Slow Labor
Pain Medication
Episiotomy
Vaginal Birth After a Cesarean
Doulas
Deciding on a Doctor or Midwife
Choosing Where to Have Your baby
And much more
As a doula, these are the topics I like to go over with my clients to prepare them for birth. Like I mentioned in my What is a Doula Series | Knowing Your Options; having a solid foundation of knowledge to work with is HUGE in having the birth experience you want.
Motivated to educate and reduce the overwhelming number of cesarean births (and their resulting complications) Goer is upfront in her desire to reduce this epidemic by providing the resources for the expecting parent to navigate what options are best for them.
While initially the idea of going through each option and intervention may seem overwhelming; Goer breaks them down into manageable bites.
Each chapter has the same pattern for presenting you the information:
Beginning with an overview and critique of mainstream belief and practices. Again, she does not hide that she typically disagrees with standard practice because the research she shares has shown that standard practice is not supported by the evidence.
A description of the procedure or intervention is provided to give you more context. For a lot of first time birthers, this is really helpful! Oftentimes care providers function from this “assumption of knowledge” mindset from being experts in their field that they can forget to meet you where you are at and provide information that you might not have even realized you needed. This description can help to demystify these aspects of birth interventions.
Next is “The Bottom Line,” where you will find the pros and cons of each approach or intervention as well as strategies to help you avoid a potentially unnecessary intervention. These are presented in an easy to understand and approachable way.
Closing with “Gleanings from the Medical Literature,” Goer makes a point to reference evidence based studies to support her Bottom Line comparisons of each procedure. Here she summarizes those points that are taken directly from the medical literature she has drawn from.
Appendices - Literature Summaries
As a bonus, Goer provides literature summaries of the medical literature and studies she reviewed and drew from as well as a complete list of references so you can go and review the full study on your own if you’re so inclined.
My Thoughts on The Thinking Woman’s Guide to a Better Birth
The format is again, very approachable, and backed up with the research she has done. I really appreciate that while this is essentially a summary of medical procedures, studies, and academic writing; it has been written for those who may not have an academic background.
A common misconception is that someone who is a “thinker” has to be an “academic” minded person. This is simply not true! Anyone who takes the time to learn what they can before making a decision is a “thinker.”
While this book was published in 1999, it is still exceedingly relevant today. Which is honestly upsetting. Goer was reviewing research done in the 80’s and 90’s, aware of this increasing crisis of cesarean rates, maternal deaths and injuries, and overall traumatic birth experiences rising.
Sadly, these interventions and their “justifications” and high rates should not be relevant today, but they are. There are still hospitals in 2021 that go down this list of interventions not supported by the medical literature, checking each one off like it’s still 1999.
So while this publication is older, and does not currently have a more recent edition available; it is still relevant.
I would recommend this book to expecting parents that would like some foundational knowledge in the types of interventions as well as some options for a different type of birth experience.
Many people are not familiar with out of hospital options such as birth centers or home births as well as the benefits of having a doula present (regardless of where you birth). Goer does not just provide you a road map to navigate hospital birth, but the option to birth with a provider in a location that supports your values and vision for birth.
I particularly enjoyed how her research debunks a lot of myths that providers may use as justification for interventions such as:
“We’re a high risk hospital, so our cesarean rates are going to be higher.” National hospital statistics show the rates to be wildly inconsistent with whether the hospital is considered high risk or not.
“My cesarean rate is right on the national average.” Her responding sass that this argument amounts to “All the other kids are doing it,” was highly satisfying. Because yes, your rate may be at the national average (currently 31.7% as of 2019 compared to when this book was published at 21.2%) but the World Health Organization, the international healthcare community, and the Mother-Friendly Childbirth Initiative recommend getting cesarean rates down to 10-15%.
All in all, I appreciate the frank approach to discussing these interventions. Some have a purpose and can be life saving. The issue arises from the widespread use for every birthing parent. Disregarding your individualized health factors and your birth journey as more than a comparison to a skewed “average,” is what perpetuates this birth culture that thinks we need to “Save the Baby” from its mother’s body.
For those in the back, your baby does NOT need to be saved from your Body!
More often than not: you, your body, and your baby are more than capable of birthing when interventions are kept to a minimum and you are allowed to move through that process of birth at your own pace.
More about the Author
Henci Goer
If you would like to learn more about Henci Goer and her works please visit her website http://www.hencigoer.com/
Henci Goer, award-winning medical writer and internationally known speaker, is an acknowledged expert on evidence-based maternity care. Her first book, Obstetric Myths Versus Research Realities, was a valued resource for childbirth professionals. Its successor, Optimal Care in Childbirth: The Case for a Physiologic Approach, won the American College of Nurse-Midwives “Best Book of the Year” award. Goer has also written The Thinking Woman's Guide to a Better Birth, which gives pregnant women access to the research evidence, as well as consumer education pamphlets and articles for trade, consumer, and academic periodicals; and she guest posts on Lamaze International’s Science & Sensibility. Goer is founder, director, and faculty member of Childbirth U, a website offering narrated slide lectures at modest cost to help pregnant women make informed decisions and obtain optimal care for themselves and their babies.
This concludes our first book review! What did you think? Would The Thinking Woman’s Guide to a Better Birth be something you would be interested in reading as you prepare for your birth?
As a birth worker I think this is also a valuable book. A great reference to use when reviewing interventions and the concise Risks and Benefits to share with clients. As well as a poignant reminder that even in 2021 we still have a lot of work to do to achieve that Mother-Friendly Childbirth Initiative and Midwifery Model of Care to reduce the rates of cesarean births, interventions, maternal injuries and death, and instances of traumatic birth experiences.
Birth Matters. So understanding what an intervention is, why it’s recommended, if it’s supported by evidence, and when it is necessary and when it is not: these are all crucial to being able to make informed decisions regarding birth and supporting our clients during this process.