Book Review: Your Best Birth

Book Review of Your Best Birth By Ricki Lake and Abby Epstein (New York: Wellness Central) 2009 

In a stroke of good luck, the publishers of Your Best Birth sent me an extra copy. I could pass it along to my sister who has not yet caught my passion for home birth and is not fully sold on midwives as it thoroughly explains the differences between home, hospital and birth center birth as well as the differences between midwives and OBs.  I could mail it to my sister-in-law whose friends rave about the epidural; this book is written for the hip American birthing woman and emphasizes informed birth without being pushy about natural birth.  I could share it with a doula friend to lend to clients, and I bet at least one would find the road to birthing with midwives (maybe even at home or in a birth center).  Perhaps I will just keep it for myself, my lending library could use two copies of this book.

There are some excellent childbirth books out there, but I think this is the first childbirth book I've read that speaks to all pregnant women.  It encourages the reader to seek a birth that is truly best for mom and baby while acknowledging that mom must be empowered by the process as well. Your Best Birth embraces both the potential homebirther as well as the mom strongly leaning towards an epidural. It is also probably the first birth book I've read that simply and clearly addresses the disconnection between the birth you want and the birth you will actually have unless you choose your provider very carefully. 

This book is an easy read!  I have very little time when I don't have at least one child clamoring "Mommy, mommy" and yet I finished this book in a week and a half!  There is something to be said, in today's busy world, for a book that can be read while eating breakfast with your three kids and whose information can be retained even when half asleep from a night up with a teething baby. 

Your Best Birth has easy to read, useful lists that will help you navigate the path towards an informed birth. 

• The Birth Inventory (to will help you find and remove birthing fears)
• A list of things to ask on the hospital tour  
• Questions for your doula 
• Questions to ask before being induced  
• And More! 

Ricki and Abby include a lot of things that every pregnant woman should know but often isn't told. For example, they strongly recommend only inviting people you trust completely and who you don't mind seeing you naked, to your birth.  They tell you what to do when your partner is "Freaking out about your birth plan."  They also talk about patient to staff ratios and what that means for your birth (great tip!). Ricki and Abby emphasize that you have a CHOICE when it comes to how/where you will birth and spend a lot of time giving you the information you need to make the best choice.  This book is jam packed with information, from exploring VBACs to healing from sexual abuse.  

There are a lot of random things I love about Your Best Birth.  They mention craniosacral therapy, an excellent way to help babies recover from a traumatic birth. I LOVE Dr. Mortiz's quote on electronic fetal monitors "The EFM has been studied extensively and the results are clear. It does not prevent poor fetal outcomes....What it does is lessen the need for one-on-one nursing and raise the rate of C-sections. If I monitored your heart for twenty-four hours beat for beat, trust me I would find something wrong." (140) The section titles are catchy; "Not your Mamma's Birth Plan," "A Doula for Youla."  And as an organizer, I appreciate Ricki and Abby's strong call to action, their call to take back your birth.  I have the feeling that many women who read this book, will do just that and that makes me hopeful.

Admittedly I wish the book had advocated a little bit more for normal birth.  Over the course of reading the book I had a few moments where I thought, uh oh, they are looking through the medical model lens...  I would have taken VBAC and "older age" off the high risk list on page 13, though to their credit, the authors acknowledge that the term high risk is loaded. The list "Questions for the Hospital Tour" (44), is missing "what will you do if my water breaks before I go into labor?" (an event that happens to about 10% of pregnant women and the truthful answers to that question are often not very pretty).  I sighed again when I read: "If you are high risk, a home birth is not for you." (59) Readers are referred back to the "high risk" list  on page 13 (wait a minute, home birth is definitely for VBACers.) As a VBACer myself, I am sensitive to statements that discourage VBACing and in general, I really think we need to be careful with the term high risk.  There are conditions that are truly high risk (placenta previa for example) and then there are conditions where you might need to do a bit more preparation and choose a provider with experience but are not necessarily high risk. For example,  VBACing with one low-horizontal incision is no higher risk then any other unforseen complication during birth such as cord prolapse or placental rupture. And I recently read that if a VBACer plans on having more children, it is safer for her to attempt a VBAC at home. Birth, as with all activities in life, is never "risk-free."  

As a student midwife who is studying to be a Certified Professional Midwife (CPM), I am required to bring attention to the following sentence: "Requiring CPMs to pass a national license exam, continue their education on an ongoing basis, and be subject to peer review and state regulation would enhance consumer confidence in that profession." (83)  CPMs are already required to pass an extensive exam to receive certification. They must fulfill continuing education requirements to keep their CPM certification AND they are already subject to peer review.  So the suggested system is already in place (The North American Registry of Midwives), we just need states to recognize the existing system.

And I just can't let them off the hook for including low amniotic fluid on the list of "Good Reasons to Induce."  While it is true that some caregivers think this is a valid reason, the EVIDENCE says it is not. It is so important to get evidence-based facts out there.

I will now step down from my soap box.

Your Best Birth ends with some really great birth stories and a section that explains how a gentle birth, where baby goes straight to mom, maximizes bonding.  There is a resource section for further research as well.

There are a lot of things I LOVE LOVE LOVE about this book.  In the books defense, most of us in the U.S. grew up immersed in the medical model of birth and even with a growing awareness of normal birth, we may continue to view birth through the lens of the medical model.  This book is meant to reach mainstream America and if it had completely debunked the medical model, it wouldn't speak to all women.  If you are pregnant, planning, or thinking about planning a pregnancy, I think that watching the Business of Being Born and reading Your Best Birth should be at the top of your to-do list. I am also incredibly grateful for all of the incredible advocacy that Ricki and Abby do for Birth as it should be, EMPOWERING. 

Comments

[rachel]

This book doesn't say all the things I'd like it to say in the way I'd like to say it, BUT it is a book that I can give to the friends of mine who won't talk to me about home birth. It includes "everyone" and is a book that I feel wouldn't make my "you're crazy for having a home birth!" friends uncomfortable. I love that it tells the risks of things such as epidurals and of course c-sections. :) At least with this book perhaps some more women will go into labor more informed about their options!

[Kat]

I know what you mean! I would love my sister-in-law to read Ina May's Guide to Childbirth but the reality is she probably won't. I will definitely recommend "Your Best Birth" and I am pretty certain she will read that one.

[Molly]

Thanks for the thorough review! I requested a review copy of this book, but have not yet received one.

Re: what you said here" It is also probably the first birth book I've read that simply and clearly addresses the disconnection between the birth you want and the birth you will actually have unless you choose your provider very carefully."

Perhaps it isn't simple and clear, but the book Mother's Intention: How Belief Shapes Birth addresses the disconnection between the birth you want and the birth you will actually have--I love how up front she is about it ("buy the hospital ticket, take the hospital ride" types of things). She also has a great section on why you DON'T want "balanced" information when it comes to birth, because you can't balance two things that *aren't equal.* Anyway, it is a good, not well-known book and I wanted to mention it!

Molly

[Kat]

Molly,
Your welcome! I have not heard of the book "Mother's Intention: How Belief Shapes BIrth" but it sounds fantastic and I will have to get it. I have a copy of "The Doula Guide to Birth that I need to read as well. And I agree that you can't have "balanced" info. Some reviewers have felt that "Your Best Birth" was biased. I don't agree. Yes you come away with the feeling that physiological birth is best for mom and baby but then again, it is!
Kat