Concerning Birth and Fear and Doctors and Fear and Pain and Fear and…Plumbing?

I keep reading fearful posts from mothers-to-be on a closed group page for a natural birth community. Women are saying things that start, “my doctor won’t let me,” or one asked, “what do contractions feel like…I’m scared,” and another posted “what if I get to 40w and nothing has happened?” These woman are all fans of an amazing birth blog and community, Birth Without Fear. So when I read these posts that emanate fear, I want to help. I originally posted some of what follows on that closed group page. Lots of the members “liked” that post – and several commented that I should turn it into a blog post that they could share. To those women I say, “okay.”

In response to “my doctor won’t let me:” obstetricians can’t dictate what you decide to do. Your doctor can make recommendations based on his/her experience. Your doctor may even strongly suggest that you follow a particular course of action – and some may “threaten” to discontinue care if you don’t do as s/he says (it’s rare, but it happens.) In no other realm of healthcare do we commonly hear things like “my doctor won’t let me.” Doesn’t happen. But of their obstetricians, I hear women say with alarming regularity things like “my doctor won’t let me.” There’s a long history for why this happens – and sure, I’ll go there in a bit – but it’s still kind of odd. Ultimately, your doctor simply can’t dictate your decisions. In fact, you have to allow them to do so.

Originally posted on The Unnecesarean

Originally posted on The Unnecesarean

A doctor – obstetrician, internist, dentist, podiatrist, whatever – is really no different than any other specialist you might hire to solve a problem you aren’t comfortable solving on your own. Sink dripping into your cabinet and you can’t fix it? Hire a plumber. Roof leaning and you have the carpentry skills of a rabid beaver? Hire a roofer. Fertilized egg implants in your womb and baby starts growing in your belly? Hire an obstetrician. Or – just as in all those other cases – don’t. No one tells you that you must not try to fix your sink or repair your roof. Lots of people will tell you it’s a terrible idea for you to try, but no one can tell you that you must hire a specialist. Sure, there’s cases where you might need a licensed, bonded plumber – because the problem might wind up being much bigger than a leaky gasket. In fact, you may discover that all your pipes are made with lead and you’re going to need to rebuild the system. It’s time to call in the big guns. So it’s probably a good idea to bring in a specialist. But guess what? Odds are good, unfortunately, that if you call in the specialist right away – before you even explore what might be going on – that what may have been a leaky gasket that needed the turn of a wrench, turns into a huge operation involving other parts, cutting things, replacing things, repairing things (that only got broken when the cutting started…) In other words, it gets really involved, really fast – and really expensive – really fast.  Why does that happen? Because you didn’t check it out. You didn’t google “my sink is leaking” and read about what might cause that. You didn’t call up other people with sinks and ask their opinion. You didn’t educate yourself about the problem – so when the specialist arrives and sees that 1. there’s a problem and 2. you’re clueless, that specialist has an opportunity to do what he or she went into business to do…and it’s probably really naive to think the answer to that is “help people.” That doesn’t mean all plumbers are dishonest – of course not. They have experience. They recognize symptoms of things that, in their experience, led to larger problems later. Sometimes much later. Sometimes those symptoms didn’t actually lead to a larger problem later, but one time it did, and that one time was a very, very bad time – so now whenever that plumber sees that same condition, s/he goes ahead and treats it just like s/he wishes had been done the one time that things went very, very badly to potentially prevent that same thing happening again (not that it would have, but it might have…)

(Wait, am I still talking about plumbing? And wtf, am I really building an overwrought metaphor for prenatal care and birth around a plumbing example? I think I’m offending myself…)

Here’s the deal – obstetricians have totally seen some completely horrific things. Every worst-case scenario you can imagine has at one time or another landed at the feet of an obstetrician. Were I in that position, I’d certainly be tempted to do everything in my power to prevent those worst-case scenarios. Witnessing one maternal death would be too many. One baby that didn’t make it. That would be enough. I’d be out. That’s why I’m not an obstetrician. It’s why I’m not a midwife. Obstetricians are trained surgeons – and for an OB, there’s an illusion of control about surgery that just doesn’t exist with vaginal delivery. For whatever reason, the fact remains that America has an enormous cesarean section rate. The CDC calculated the 2010 section rate at 32.8% – but when I go to that link and do the math on vaginal delivery vs cesarean delivery, I get 48%…so not sure what I’m missing there.

Wait – go back a second. Read those last few lines again. I’ll wait.

It sort of doesn’t matter if the number is 32.8 or if it’s 48 (FORTY EIGHT!!) it’s too high. Way too high. Did women suddenly develop defective hips? Are our vaginas busted? What the hell people? Sorry – I’m sidetracked in mid-blog, but that just upset me a great deal. I’m going to need a minute.


Click here for additional angst

I don’t need to go down this path. Other people have gone down this path – and there’s no need for me to reinvent this wheel. Go visit The Unnecesarean and do some research if you’d like. There’s an epidemic. This is not new information in the natural birth community. If it’s new information to you, please, please go read about it.

What I’m saying is that when your obstetrician says that he or she won’t “let” you go beyond 40 weeks, or won’t “let” you give your birth a trial of labor, the unspoken “threat” there is cesarean section. Whether or not you view that as a threat is none of my business. I see it as a threat. Sure, the early stages will include inducing labor – might be as simple as sweeping membranes – but either way, once the first intervention is allowed (by you,) you’ve made a turn down the path that leads in many, many cases to a cesarean delivery. If you don’t want that for yourself, don’t start down the path. Nobody can tell you that you must. And it doesn’t matter that one time out of 100,000 a really, really bad thing happened to a woman who didn’t have “x” done. You know who it matters to? The industry whose entire business model is built on calculated risk. Insurance companies. Malpractice and health insurance companies. They’re the only ones who care about 1 in 100,000. So who needs to be making healthcare choices for you? A board of directors (many of whom have never given birth)?

Oh, and fascinating information right here – most obstetricians have never had the opportunity to attend a home or natural delivery outside of a hospital. I once had an awesome conversation with a young female obstetrician on a flight from Chicago to Atlanta where we talked birth, I told her my birth story, she told me several of her own (she has no children yet, but has already attended hundreds of births.) She had never talked to a woman who had given birth under a CPM’s care at home. She was fascinated. She ordered Ina May’s Guide to Childbirth while we were on the plane. I like to think I may have started a ball rolling there that would end in some very happy birth outcomes for patients of her practice. She’s in Illinois, where homebirth illegal – but was going to try to hook up with some midwives to “sneak” and attend a natural birth. When your OB looks at you like you’re nuts for wanting to birth at home – try to remember that what you’re talking about is completely and entirely outside that person’s realm of experience.

If you haven't read this, go buy it now. I'll wait.

If you haven’t read this, go buy it now. I’ll wait.

By the way, I don’t mean to imply that your only option is hire an obstetrician or go it alone. All I mean is that there are other options – always other options – for your healthcare. Pregnancy is not a medical condition. Birth is not a medical procedure. It can be – because sometimes problems happen – but it’s not necessarily medical. Plenty of us have had low-risk pregnancies and have given birth without intervention or medical assistance. Sometimes we’ve hired a midwife. Sometimes we’ve had an awesome obstetrician who helped us deliver naturally. Some women have had an unassisted birth. My point is the options are there – but don’t expect “the plumber” to tell you to hire someone else. That’s not his job. Delivering as many babies in as little time as possible, with the best number of average outcomes – that’s the obstetricians job – and how s/he makes the most money. Are you comfortable being a statistic? Or do you suffer under the radical notion that women are people?

Next question:

“What do contractions feel like?” Generally followed by, “I’m scared.” I’m going to take that a step further and boil it down to: is there pain in giving birth? If you’ve gotten this far in your life or in your pregnancy without realizing that…oh honey. I have read where women say they felt no pain – and I have read about (and seen) agony in child birth. Here’s the thing to remember – pain is perception. It’s not “real” – pain only happens insofar as your brain interprets the signals it gets from the nerve endings in your body. And guess who is in control of your brain? The same person who is in control of what your doctor allows you to do. YOU. It’s overwhelming if you let it be. There’s one thing to remember – the perception of pain in childbirth is nothing more than your body can handle. Your conscious mind may have trouble with it – and I’ve heard women say they passed out (trust me, there’s usually something else going on with these ladies…anxiety, other neurological disorders, etc.) But your mind deciding “nope, can’t deal” isn’t the same as your body not being able to deal. It can. More importantly, it will – if you allow it. Are there plenty of drugs available to deaden the pain? Sure. But just remember what I said above – any intervention (and anything foreign introduced into your body while laboring is an intervention) starts you down the path that more likely ends in cesarean than the path where there are no interventions. Comfortable with that? Cool – go for the drugs. Walking is overrated anyway.

“What if I get to 40w and nothing has happened?” First, what does “40w” mean? The average gestation for a human being is 40 weeks. To borrow a phrase from one of the other group members, that means that just as many women give birth at 38 weeks as do at 42 weeks. The average is 40. So when you say that you’ve gotten to 40 weeks and nothing has happened, I’m reminded of a line from one of my favorite plays (Tom Stoppard’s Rosencrantz & Guildenstern Are Dead) – where Guildenstern asks Rosencrantz what he’d think if the same coin were flipped 85 times in a row and came down tails each time. Rosencrantz says, “I’d have a good look at your coins, for a start.” So, you get to 40w and nothing has happened – how do you know it’s 40 weeks? Do you know your conception date? I know – Last Menstrual Period, blah blah blah – still, there’s a few days where an egg can be fertilized…a few…and it takes time to implant…so even under the most “known” conditions – your “due date” could be off by a few days in either direction. And how many of us really know? RELAX. Release the fear. The ‘E’ in EDD is not ‘Expiration’. It’s an Estimate. It’s a ballpark figure. You’re at about 40 weeks, give or take a day. And if nothing has happened? So what? It’s not time – that’s all. And no amount of walking, bouncing, evening primrose oil, artificial rupture of membranes (having your water broken), or anything else is going to make baby come – and baby is the one who initiates labor, not you. Not your cervix. Not your doctor (again, unless you let them – and even then, all they can do is arbitrarily cause your uterus to contract – not make the baby start moving down.) As my first CPM always told me – no matter what, that baby is coming out. LET IT COME. Release. The. Fear. If it’s your “due date” and baby hasn’t come yet – give it time. You’ve already waited 40 weeks – what’s another few days? Or go ahead and let your OB talk you into artificially ripening your cervix. Let them “sweep” your membranes or break your water. Guess what? If baby isn’t ready, your cervix can soften, your water can break, and you’ll be lying there, not “allowed” to walk, with a monitor shoved up in your hoo-ha, and no baby. Guess what happens next? ‘They’ tell you that it’s been too long – your baby is “dry” (nevermind that your body keeps making amniotic fluid – and a tear in the sac can absolutely repair itself.) They tell you it’s time for pitocin. Now you’re lying there, on your back, with a thing shoved up in your hoo-ha (and probably a catheter by now because you can’t get up to pee) and NOW you’re having horrible, artificial, earth-shattering fake contractions caused by a drug – and wow, those hurt. Here, let’s give you something for pain. Maybe something to calm your nerves – deaden your senses. Then guess what – no baby – and it’s time for a shift change – and wow, that monitor shows baby’s heart rate keeps dipping (wonder why?) and yeah, your baby is in distress, your body is broken, you couldn’t do this after all – sign this form and off to the operating theatre we go. Think I’m being an extremist? Really? Talk to the women you know who’ve wound up with a cesarean they never wanted. Ask them how it all started. Ask them where the pressure started. Ask them if their doctor decided that since nothing had happened at 40 weeks, s/he wasn’t going to let them go overdue, so they decided to sweep membranes and pop in some cervidil. I’m not pulling this stuff out of my rear end.

So if there are so many of us “in the know” – if there are so many women out there who have started to educate themselves – then why is that section rate so darned high? Why do so many women continue to hire obstetricians right off the bat? Why is “natural” childbirth considered something that happens in a hospital room with an IV in your arm, pitocin in your veins, and a team of nurses standing by to whisk the baby off to be weighed, bathed and wrapped before it’s even handed to you? Why is having a baby at home, in a birthing pool or in the privacy of your own bed, considered “unnatural?”

Now *that’s* a loaded question.

There has been a movement – oh, since the dawn of time, really – to remove the concept of self-control from women’s experience of the world. We’re “hysterics,” we’re the “weaker sex,” we’re “pussies” (could write a book about that last…many have.) “Acting like a girl” means acting weak, weepy, or whiny. It’s enormously prevalent, it always has been, and the entire medical system was built around the concept that women (and men) do not know what’s best for themselves. Before men interjected themselves into the birth process, women helped women give birth. Period. And they were fine. We used birth stools and midwives and the men stayed OUTSIDE. Did more women die in childbirth back then? Arguably, yes. But more people died of the common cold back then, too. More people died of everything back then. Knowledge didn’t get around as easily as it does today. People couldn’t read. People couldn’t share information. Men came into the birthing room, and women were suddenly put in submissive posture – on our backs – and given drugs to dull our senses. Heard of twilight sleep? Go read about that happy crappy from the same people who later brought us eugenics. Babies were pulled from our bodies, handed off to other people before they were handed to us (because we were unconscious) – all of this came about when men decided they needed to be involved. Because we’re too weak. Too frail. Too stupid. It persists to this day. Even female OB’s are products of a system that is based on the lie that women simply can’t give birth without a patriarchal system of regulation. It’s so deeply entrenched in our subconscious and group consciousness, we’ve gotten to the point that there are women who actually believe their breasts are for men’s pleasure, not for babies, and that using them for their sole and intended purpose is “gross and, like, incestous.” There are women who report photos in closed birth groups on social media sites that show other women using their bodies to nurture and give birth to their babies – because they think it’s inappropriate and gross (on a birth page – seriously.) That’s how deep this particular bit of nonsense goes. Birth is something that’s icky – and breastfeeding is something that should be hidden away behind closed doors – even when it’s being celebrated within a birth community. 


Indeed, Captain. In-freaking-deed.

So what? What’s the big deal? Lots of women have cesarean sections and are fine. Lots of babies are born while Mom is flat on her back, steeped in drugs and drooling out one corner of her mouth, and those babies are fine. Because that’s what’s important, right? The goal is to have a healthy baby. As long as we achieve healthy baby, who cares about the mother’s experience, right?

Yeah, because that’s what we hear every day, in every corner, about every possible topic. It’s not about the journey – it’s the destination that matters.

No, wait…

Okay, well then, in this one thing, it’s the destination that matters. Just this one. Because ultimately, who cares about a woman’s experience? Who cares about her journey? The BABY is what matters.

Want to know who cares? I care. My fellow mothers care. Yes, we’d rather everything bad that might ever happen to our children would happen instead to us – of course we would – but we matter. Our experience of the world matters. Who we are, what we feel, what we do matters. And for all you women reading this, on the cusp of your 40 week “due date” with your low-risk, perfectly “normal” pregnancy, unsure about what to say to your doctor when you go in for your final prenatal visit later this week, knowing you’ve already been told that once you hit 40 weeks, it’ll be time to “get things started” – I’m going to give you three words of advice. You’ve heard them before. Or heck, I’m pretty old, maybe you haven’t heard them before. Here goes: just say “no.” No, I don’t care to have my membranes swept. And by the way, s/he may not ask – sometimes they just do it as a matter of procedure without even bothering to ask you first. Whether or not that constitutes rape for you is up to you, but I know what I call it when someone sticks something into my body that I didn’t tell them was okay… Your best bet is to say “no” to any internal exam. No, they don’t need to “check you.” It’s not necessary. It’s not. You are probably dilated a couple of centimeters. Even if you’re not, you probably will be soon – so say “no.” Say “no” to stretching and sweeping. Say “no” to a scheduled induction just because it’s 40 weeks and nothing has happened yet. Say “no” to “getting things started.” It’s not up to your doctor to start your labor. It’s not even up to you. Baby will come – when all else fails, that baby is coming out. There’s no need to fear – there’s no need to allow anyone to feed you their fear. There’s no need to assume that the one in 100,000 case will be your case.

Trust your body. Trust your baby. Trust birth. Release. The. Fear.

Courtesy of Shara Rivers, with my thanks

Courtesy of Shara Rivers, with my thanks

**Obviously, every decision about a healthy birth is ultimately up to the pregnant woman and her chosen care provider. I’m not giving you medical advice – I’m giving you advice based on my own birth experience and that of hundreds of other women I know who have given birth naturally and without medical issue. If you have concerns, discuss them with your provider. If you’re not sure what’s going on, ask questions. If you aren’t happy with the answers you get, seek a second opinion. You wouldn’t agree to a complete rebuild of your car engine without seeking a second opinion, would you? And that’s just your CAR!

15 Comments (+add yours?)

  1. Shara Rivers
    May 15, 2013 @ 02:05:53

    Wow! Great post! And I totally agree. I have had a hospital birth, a birth center/water birth, a fast birth attended by paramedics, and an unassisted birth and I can say I agree with every word in your post. We as women need to take responsibility for our births, no matter who we hire (or don’t) to attend them.


  2. Becky
    May 16, 2013 @ 15:46:47

    I find posts like this really annoying. Pain is perception? So I choose to feel pain? I don’t think so.
    I went into childbirth without fear, TWICE. Both times I endured hours of unbearable agony that made me wish for death.
    I did not choose to or want to feel that pain. Now, facing a third delivery, I am afraid, and for good reason. I am happy for women that have little pain or even no pain during birth. I have had friends with births like that. But for many women it is extreme pain and posts like this only make women feel worse. My pain was real and valid. I’m tired of having to defend it.


    • Shine On, You Crazy Mama
      May 16, 2013 @ 23:30:03

      I don’t mean to invalidate your experience. The fact is, pain is indeed a perception – and this is a scientific observation, not an opinion. Here’s some documentation: and another one:

      In no way do I provide those links as a way of saying, “it’s all in your head.” It’s not. And I’ll be the first to hop up and say I experienced what I can only describe as agony giving birth. In addition to the actual pain of giving birth, I also experienced a retained placenta that had to be manually extracted by my midwife within a few short minutes of giving birth. To give you an idea, gloves on, betadine up to her elbow, and INTO the cervix she went – after I just pushed a baby out of it. The feeling of her hand scraping the inside of my uterus…ah. Yes. Not at all in my head and not at all painless. Shrieking is probably the best description I have for the sounds I made.

      So – not slinging stones at you, cause if I were, it would be from firmly inside a glass house. No need to defend your experience of pain. Pain is real. It’s just also manageable – and different people have different thresholds of manageability. Some would prefer to use artificial means. Others would prefer to reduce the risk of further complications and bad outcomes for the babies by avoiding those artificial means. I would never presume to make that choice for another person.


  3. Hannah Avery
    May 16, 2013 @ 16:05:00

    Great post! I have had both of my children at home. They both went well. During my second pregnancy I read “Ina May Gaskins Guide to Natural Childbirth” and I totally loved it. I think it really helped me to not fear the coming labor and birth, and the second labor was better than the first, partly because the baby was not posterior, and partly because I understood what was going on with my body, and could mentally deal with it well. My husband even delivered the baby, as my midwife, was just a tad to late (my fault there). I see what you described above happen all the time to my friends ( starting with induction, and ending with cesarian). And then everyone thinks I’m some kind of saint for having mine at home, but I see what happens to them, and don’t want it to happen to me.



    • Shine On, You Crazy Mama
      May 17, 2013 @ 00:34:25

      Isn’t Ina May incredible? I remember reading Spiritual Midwifery for the first time before assisting at my friend’s first birth (also at home) and thinking…”What?? Rushes? Are you kidding?” But it’s amazing now that I’ve been there how attitude can affect every aspect of birth.


  4. Erin
    May 16, 2013 @ 17:00:58

    I love this! When the mother’s experience is right – empowered by knowledge and full responsibility in her choices – it is ultimately BETTER for the baby, too! So those who claim that the woman’s desire to do things in a more natural way, or her right to refuse certain interventions, is selfish – they are the ones who claim “it’s about the health of the baby!”, don’t see the irony in the fact that a natural, unhindered birth is really the best for BOTH parties. The destination is bettered by a beautiful journey.


  5. beckie
    May 16, 2013 @ 19:20:36

    Your post is delicious. Thank you for putting it out there!!!
    I had my first in a hospital with very little intervention because she came too fast, one induced w/ epidural because I was too stupid to know better, two in a birth center with very medical minded midwives who I suspect used cervidil …oh and let me tell you sweeping the membranes and massaging the cervix is the same stinkin thing! just say NO!!, and one at home water birth.
    Oh how I wish they had all been at home. Such an amazing difference!!
    My last three births were 42+ weeks. Well done, fat and sassy.
    I am currently training my children about the beauty of non-interference in birth. I intend to interrogate…ummm…enlighten their future loved ones on this same subject.

    you can read my last birth story here if you like that sort of thing.


  6. Kim
    May 17, 2013 @ 13:16:41

    Just read your blog post, and it’s great, but one thing concerns me – sometimes, very bad things DO happen during childbirth. When my oldest daughter was born, no one knew that I had a condition that would actually complicate childbirth. My daughter and I both nearly died. You’re teetering on the edge of telling women to dismiss what their OB says. I had to have an emergency caesarean. Just something to consider – if I had chosen to not hire an OB, and had attempted a home-birth, I wouldn’t be here to tell about it. And my beautiful 17-year-old daughter wouldn’t be here either.


    • Shine On, You Crazy Mama
      May 28, 2013 @ 22:17:47

      I’m glad you brought this up. I know many woman who have decided (or wound up) having an unassisted home delivery. If that’s a choice a woman is comfortable making – or is at least able to handle when it just happens – then that’s awesome. I generally advocate for midwife or doctor assisted birth. I don’t intend – anywhere in this post – to advocate for uneducated or unattended birth. In my own experience and that of my closest friends, our prenatal care with a midwife was superior to the care we received from an obstetrician. My own midwife was a CPM working in practice with a CNM – who was also a Nurse Practitioner. I spent at least an hour a month in consult with these women, and my CPM was well-qualified to recognize complications with labor and delivery. In fact, I experienced a third-stage complication that may well have led to my demise had she not acted very quickly, calmly, and effectively. As it was, she was well-trained and did exactly what needed to be done – and I didn’t die of a hemorrhage.
      I don’t say to disregard an obstetrician’s advice. I say to educate yourself about every aspect of your pregnancy, labor and birth options. Seek second (or third or fourth) opinions, and don’t take at face-value everything a doctor throws your way. They are not always acting in your best interest, particularly when they are contractually obligated to a hospital and to a malpractice policy.
      I’m glad you – and your daughter – are with us :)


  7. Trackback: No more tears, this fountain dry | Shine On, You Crazy Mama
  8. Jeff
    Sep 02, 2013 @ 14:03:27

    No doctor could write such words and not have her license suspended…

    Would you hire this midwife?

    Don’t let the head suddenly explode from the mother’s puss. Coach the mother about how much and how hard to push. Support the mother’s taint with your hand during rushes. It helps the mother to relax around her puss if you massage her there using a liberal amount of baby oil to lubricate the skin. Sometimes touching her very gently on or around her button (clitoris) will enable her to relax even more. I keep both hands there and busy all the time while crowning … doing whatever seems most necessary.


    Sometimes I see that a husband is afraid to touch his wife’s tits because of the midwife’s presence, so I touch them, get in there and squeeze them, talk about how nice they are, and make him welcome.


    I might want to have a cunt one day and a twat the next. On the third day I might decide that pussy is my favorite word.

    Would you hire this midwife?

    Her quotes make her sound immature, foul mouthed, and sexually inappropriate.

    Plenty of women have hired her. Her name is …

    Ina May Gaskin.
    The quotes come from Spiritual Midwifery, 3rd and 4th Editions


    • Shine On, You Crazy Mama
      Sep 02, 2013 @ 21:06:19

      Jeff, it sounds like you probably aren’t aware of the midwifery model of care and how it differs from the obstetrical model. Start here:

      That’s some “nuts and bolts” for you.

      Midwives don’t suddenly spring the kind of hands-on approach that takes into account both how a woman’s body functions and how a woman may perceive the things done and said to her on their clients. Women who hire midwives may be more comfortable with a plain-talking care provider who uses “familiar” language and who isn’t afraid of touching a client in ways that may not be considered typical in a hospital setting.

      Having said that, you seem to take particular exception to the idea that women HAVE hired midwives like Ina May for years. We want a midwife who knows that one of the most powerful and natural ways to induce or enhance contractions is to stimulate the body’s natural production of oxytocin. Nipple stimulation is the easiest way to do this. So is any kind of vaginal/clitoral stimulation – and oxytocin releases cause the body to relax. A tensed up cervix cannot dilate enough to allow passage of a baby. If a woman is comfortable with her care provider, and that care provider gives her options during labor for how to relax, which might include nipple, vaginal or clitoral stimulation, then it’s that woman’s choice to accept her suggestions. It shouldn’t be up to anyone other than the woman herself.

      Ina May isn’t unlike many other midwives in that she provides evidence-based, knowledgable care to a laboring woman. Fortunately, it isn’t really FOR you to understand, as its highly unlikely that you would ever be a pregnant woman in need of a care provider. I decided to approve your comment, which many might consider ill-thought and ignorant, precisely because one of the many callings I have in life is to educate people about womancentric childbearing and delivery.

      I applaud you for taking time to read at least excerpts from one of the seminal works on modern midwifery in print today. Not many men have done that. I encourage you to open yourself further and read more. Ask more questions. Try to put aside what you may know or think of modern medicine as it applies to birth and instead put yourself in the place of a woman who is embarking on a journey that is at times terrifying, uncomfortable, painful, joyous, and ecstatic (even orgasmic, as odd as that may seem to you as an outsider.)

      Thank you for your challenging questions. And yes, I would hire Ina May. In part, to paraphrase the comedian Jim Gaffigan, “because I want my baby to live.” But also because I want my birth experience to be as fulfilling and “real” as it can possibly be, while at the same time remaining wholly within my own control and on my own terms. That’s what midwives offer us that most obstetricians just do not.


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