Why yet another natural birth book?...

There is no shortage of natural birth books. I should know. My bookshelves are full of them and, as an obstetrician who cares for a large number of women wanting natural births, is my business to know what is in them. I definitely have my favorites and regularly refer my patients to one book or another, depending on their needs. However, as I worked to build support for naturally laboring moms within my delivering hospitals and tried to offer my patients better options and techniques for working through their unmedicated births, I found the supply of books and information about natural birth lacking. Here are some of the main challenges I discovered:

1. Religious-Type Devotion to Natural Birth: Many of the natural birth books available to women offer incredibly inspiring natural birth stories and useful tools and strategies for working through an unmedicated birth. Unfortunately, this is often presented in an overzealous fashion, that exaggerates the benefits of natural birth and describes birth and the woman's body with terminology usually reserved for the divine. Birth is presented as something to be "believed in" or "trusted." Naturally laboring women are referred to as goddesses. While I fully support efforts to normalize a physiologic birth process and give women confidence that it is something they can achieve, such biased views of natural birth create unrealistic expectations for women and their partners as they embark on their birthing journey and set women up for disappointment, guilt, and even depression if their own birth does not happen in such a heavenly fashion. This bias also rings very untrue for those who work within the medical community, who each day have experiences with birth that make it extremely difficult to trust. When natural birth is presented with such fervor, doctors, nurses, and even some midwives are less inclined to hear the valuable information contained within natural birth texts or take the women desiring a natural birth seriously.
2. Fear-Mongering: While the medical community is frequently accused by natural birth proponents of fear-mongering or "playing the dead baby card" in order to get women to consent to medical interventions, there is quite a bit of fear-mongering on the other side as well. In most natural birth texts, articles, and blogs, medical intervention is painted with a broad stroke of negativity. For example, women are often told that epidurals definitively increase their chances of a cesarean, drug their babies, and lead to more difficulty breastfeeding, when there is surprisingly little evidence for these supposed facts. Doctors are described as scalpel-wielding villains, without the philosophy or even knowledge to care for women laboring in a natural fashion. Women are told to avoid the hospital for as long as possible in order to help reduce their chance of unnecessary intervention.  It is no wonder that women planning a natural birth feel frightened of their care providers and write multi-page birth plans.
3. Lack of in-depth information about common natural birth requests and strategies: Many natural birth books present overly simplistic explanations of common natural birth techniques. For example, women are encouraged to walk or ambulate, because it "promotes gravity" or is what our hunter-gathering ancestors did and any efforts to restrict movement in labor are reduced to paternalistic holdovers of old-fashioned delivery techniques that kept the physician in control of the process. While these explanations may be partially true, they do not go nearly far enough in helping women and their care providers understand why ambulation is important and the barriers that are currently in place in many maternity units that prevent women from moving as freely as they would wish. This understanding is necessary in order for women and their care providers to work together to achieve this portion of a woman's labor plan. Another thing that is necessary is broader knowledge of the science that actually exists regarding natural birth requests and strategies. For example, most nurses and doctors are unaware of the studies suggesting that a labor tub may speed up labor and aid in correcting a malpositioned baby or the studies showing the impact of a doula or the hospital environment on the labor process. Due to the abundance of misinformation readily provided everywhere from the internet to the supermarket checkout line, pregnant woman may also be more concerned about the impact of certain medical interventions on their birth process than is warranted by the actual science. Women and healthcare providers alike need better information about natural birth in order to make informed choices.

So, I spent two years reading hundreds of studies about natural birth and writing the book I wish I had, both when I was pregnant with my second child and when I was a young attending working with naturally laboring mothers. It is a natural birth book that is not trying to convince anyone to have a natural birth or pick any one magical method of preparing for a natural birth. The only case this book tries to make is that natural birth plan requests are reasonable and can be met without abandoning good and safe care and women have the right to make those requests and the medical community has the obligation to respect them. By adding a little science to natural labor, women and their providers can embrace what has been shown to work, let go of the fear and distrust that too often taints provider-patient relationships, and find that elusive middle ground where women can be both safe and heard.