Book Review: Spiritual Midwifery

Today's book review: Spiritual Midwifery, the classic by Ina May Gaskin!

I really got a kick out of this book. When I was a little girl, I wished that I had been born in the 50s or 60s so that I could be a hippie, but my idea of "being a hippie" pretty much entailed having long hair and flashing peace signs. Maybe because of that, I very much enjoyed getting to read the accounts of hippie living. I certainly learned a lot. The first edition was written in the early 1970s and it really shows!

Roughly the first 200 pages of the book contain nothing but birth stories. Lots and lots of birth stories, mostly very positive, natural, out-of-hospital births. There's a section on instructions to the pregnant couple on nutrition and exercise in pregnancy, mentally preparing for birth, supporting and caring for each other during pregnancy, etc., that I thought was very nice. Then there's a large section on "instructions to midwives" and technical/medical advice, ranging from supporting a woman during labor to suturing perineal tears.

For the most part, the birth stories are great. Reviewers on Amazon love them. I can see how a pregnant woman would love this compilation of birth stories. Most of them are positive. There are at least two deaths (one premature, one anencephalic baby), a few premature births, at least one C-section (I didn't read all the stories), and a few with complications, but most of them are smooth, at-home births. The hippie language pervades the birth stories, and to be honest, I had a little bit of a hard time taking it seriously at first. All this talk of "we were totally getting high on the energy in the room, man" and "being telepathic with each other" and sharing energy, switching bodies, "psychedelic," "tripping," "far-out"... I did like the term "rushes" for contractions. It's concise and nice. I've heard of "pressure waves" as a term - I think they use it in hypnobirthing - but I like "rushes."

I think that one of the best things about these birth stories is the focus on the mental state and spiritual health of the mother. I think that reading at least some of these stories is a good idea for both parents-to-be so that they can keep in mind how their mental states can affect the birthing, and so that the birth partner can understand that getting in tune with the birthing woman's emotions and encouraging her to express emotions can be very helpful. There are also good ideas on coping with labor and helping it progress contained in the stories.

For the most part, the instructions and medical advice were good, too. There were a few things that I felt might be a little outdated - some of the instructions didn't seem as conservative about giving episiotomies as I expected, for example, and most of the photos showed women giving birth in sort of half-sitting-half-lying-down positions. But there's a lot of great information - for example, the sections on pelvic anatomy, fetal positioning, and suturing tears were great. I wouldn't treat this book as an infallible Bible but it is a terrific source of information.

I do think that there are some cautionary tales in this book, too. It seemed to me that early on in the history of the Farm and Caravan, they had quite a few premature babies born out-of-hospital, and they didn't really seem to consider going to the hospital. Most of the babies survived and thrived but at least one of them died. There was also a case of near-death where no one present knew anything about neonatal resuscitation. Personally, I feel that this underscores how important it is to have a trained birth attendant, and how important going to the hospital can be when the need is there. Of course those women had a right to make their choices, and they were willing to accept the outcomes of the choices. And, luckily, there are many more trained homebirth attendants around nowadays, so more women have more choices available to them now!