The Thinking Woman's Guide to a Better Birth
Book by Henci Goer
An Introduction —
Obstetric Management: What's Wrong with this Picture?
"You’re expecting a baby or planning to become pregnant. Congratulations, you are embarking on a challenging and potentially highly rewarding journey. Without question, you want to have a safe and satisfying birth experience. I want that for you too, and I wrote this book because achieving that goal isn’t as straightforward as it ought to be. Over the past 30 years, obstetric management has converted what should, in most cases, be a healthy, normal process into a high-tech event. Without anybody intending it to happen and with little recognition that it has happened, things have gone terribly wrong with maternity care in this country. Consider the following:
Cesarean section is the most common major surgery performed in this country. Every year in the U.S. one in five–nearly one million– pregnant women have a cesarean section despite the health risks, pain, recovery time, and expense. The consensus of the medical literature is that half of these operations were not needed.
Doctors now use electronic fetal monitoring, a machine that records the baby’s heart rate in conjunction with the mother’s contractions, on four out of five laboring women. The percentage has risen steadily in the face of a stream of studies showing its use doesn’t improve babies’ health. In fact, its routine use threatens the mother’s health by increasing the odds of forceps or vacuum extraction deliveries and cesarean section.
At some hospitals, almost every laboring woman has an epidural. Meanwhile, studies document a host of epidural complications affecting mother, baby, or both.
Half of women giving birth vaginally still have an episiotomy, a snip at the bottom of the vaginal opening. The research proves up, down, and sideways that, with rare exceptions, this procedure does no good and often does harm–sometimes serious and permanent harm."
Good obstetricians, family practitioners, and midwives:
- Believe childbearing to be a fundamentally healthy and normal part of a woman’s life.
- Treat women holistically, taking into consideration their thoughts, feelings, concerns, and priorities.
- Respect the right of women to make informed decisions for themselves and their babies.
- Respect labor as an experience with its own lessons and rewards.
- Offer supportive rather than interventive care.
- Evaluate individually and do not treat by rule.
- Start small when intervention becomes necessary.
- Keep abreast of the medical literature.
Excerpts taken with permission from Henci Goer's website: The Thinking Woman's Guide to a Better Birth