Monday, June 6, 2011

Book Review: The Thinking Woman's Guide to a Better Birth

Whew, getting back on track! I've been reading, but updating. Whoops.

I recently read The Thinking Woman's Guide to a Better Birth by Henci Goer. This book seems to be very well-regarded, and for good reason. Goer does a great job of laying out the findings of a whole lot of research in a way that's easily readable and accessible to someone without a medical background.

She does have a strong bias towards natural birth, as she explains in the introduction. I appreciate that she acknowledges her biases and she is honest about them with the reader. This sometimes translates into a bit of bias that is a bit... not anti-OB, I don't want to say, and not quite hostile, but certainly suspicious.

However, this book is really well-researched, and written very clearly. I think that people who come into reading this, feeling pretty down with medicalized hospital birth but curious about the other side, can overlook the occasional anti-OB comment and appreciate the really solid research in this book. There's a ton of tremendously useful and educational stats in here.

I had a few little quibbles with the book. There were a few little inconsistencies - saying in one chapter that EFM is basically pointless, because it increases interventions without improving outcomes, but then saying in the VBAC chapter that EFM was recommended, without elaborating more on why that should be. I also disliked the style of citing sources. The main body of the text contains explanations for laypeople without citations. Then, there is an appendix at the end of the book for each chapter that summarizes the literature sources, so that you can link a specific assertion with its source. For me, as a scientist, it bothered me to not to be able to link a statement with a citation! But, maybe it is more comfortable for the general reader to read chapters uncluttered by citations and journal article titles, so maybe that is a strength of the book.

One interesting new medical thing I learned from this book - okay, two: (1) Women are given a big bolus of IV fluid, on the order of at least a liter (4 cups), when they get an epidural or before a C-section. This is to raise blood pressure, to counteract the blood pressure-lowering effect of an epidural. (2) That's a ton of water all at once, and it may be (at least partially) responsible for the problem of increased fluid in the lungs and respiratory issues in C-section babies.

Another post coming up soon on some more specific thoughts!

P.S. Can anyone tell me how to pronounce "Henci Goer"? I have no clue and it really bothers me. Hensy? Henchi? 'Ensy? Gore? Go-er?

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