auguries of innocence

After seeing someone in a Natural Childbirth group on Facebook quote something by Henci Goer, I immediately went & looked her up. I wanted to share a little bit with you from her book, The Thinking Woman’s Guide to a Better Birth:

Obstetricians treat women laboring slowly the way Peter Pan treated the Lost Boys. He expected everyone to adapt to his ideas of the way things should be. If they didn’t, Peter saw to it that they did. For example, the boys entered the Neverland underground home through hollow trees. If a boy didn’t fit his tree, James Barrie writes, Peter “did something” to the boy. So too with obstetric management. Obstetricians have inflexible ideas of how labor ought to go. If your labor doesn’t conform to that pattern, typical doctors “do something” to you to make you fit. There are, as you may gather, a number of drawbacks to this myopic approach.

Doctors set the cutoff defining “abnormal” progress in dilation at 12 hours for first-time mothers and 6 hours for women with previous births because, according to the standard-setting studies, only 5% of women will take longer than this. However, the new study found that average duration in first-time mothers was 7 1/2 hours, not 6, and the threshold for abnormal, fell at 19 1/2 hours, not 12, in first-time mothers and over 13 1/2 hours, not 6, in women with prior births. The standard also stipulates smooth, linear progress. More than a relatively brief halt is thought to require action. However, averaging many labors together evens out the variations. Individual labors often don’t work this way.

As a result of obstetric impatience and injudicious management, in 1995, about one in five U.S. women who began labor on their own had oxytocin stimulation (augmentation), and nearly 176,000 women had cesareans for failure to progress, prolonged labor, labor dystocia (dysfunctional labor), or cephalopelvic disproportion (the baby didn’t fit). These diagnoses are all ways of saying the baby didn’t come out within somebody’s idea of a reasonable time, but “reasonable” is primarily a matter of philosophy, not physiology, as the enormous variation in the rates of oxytocin use and instrumental and cesarean delivery among caregivers attests. As one editorialist all too aptly put it, “Unfortunately, we have spent the last 25 years managing labor without knowing what we do.”

I’m definitely going to be picking up a copy of this book! It looks really informative. Even though I’ve already given birth once and I know what I want this time, I don’t think it hurts to be well read. There are so many good resources out there - I definitely think we should take advantage of them. What book did you find most informative regarding childbirth?

EDIT: I updated this post because I’m an idiot! Had a bit of pregnancy brain and wrote the wrong title for the book. It’s actually “The Thinking Woman’s Guide to a Better Birth“. Sorry about that!