OUR BODIES, OURSELVES: Pregnancy and birth
Publication Date: March 2008
Pregnancy and birth are as ordinary and extraordinary as breathing, thinking or loving. But as soon as you announce you’re expecting, you may be bombarded with advice from every angle — well-meaning friends, relatives, medical professionals, even strangers want to weigh in on what you should or shouldn’t do, and it’s easy to feel overwhelmed by conflicting recommendations.
“Our Bodies, Ourselves: Pregnancy and Birth” will help you sort fact from fiction, giving you the most accurate research, up-to-date information, and the firsthand experiences of numerous women who have been exactly where you are today.
You’ll get the tools you need to take care of yourself and your baby during and after your pregnancy, from tips on eating well during pregnancy to strategies for coping with stress and depression. Learn everything you need to know about:
- Choosing a good health care provider
- Selecting a place of birth
- Understanding prenatal testing
- Coping with labor pain
- Speeding your physical recovery
- Adjusting to life as a new mother
“Our Bodies, Ourselves: Pregnancy and Birth” is an essential resource that will guide you through the many decisions ahead.
Q&A with Our Bodies Ourselves Co-Founder Judy Norsigian
What makes Our Bodies, Ourselves: Pregnancy and Birth different from all the other childbirth books on the shelves?
JN: This book challenges the status quo of maternity care when it is not serving the best interests of women, babies, and families. We present the best available evidence about the advantages and disadvantages of a range of practices, from epidurals to episiotomies. And we include the important warning that some common procedures are not consistently helpful to women in good health and might be better avoided in some cases, while other practices that have been shown to improve birth outcomes are not offered widely.
Which practices are overused and which are not offered enough?
JN: When used appropriately, maternity care interventions such as artificial induction of labor, episiotomies (cutting the opening to the vagina), epidurals, and cesarean sections can improve health outcomes and even save lives. Yet far too often, these interventions are used routinely on healthy women, despite clear scientific evidence that they are unnecessary, ineffective, and/or can cause harm.
The widespread routine use of medical interventions during labor and birth has failed to improve the safety of childbirth for women who are at low risk for medical complications. In addition, these interventions can disrupt the natural rhythms of labor, undermine womens confidence in our capacity to give birth, and decrease our satisfaction with our birth experiences.
At the same time that such procedures are overused, practices that have been shown to improve birth outcomes as well as womens satisfaction with the experience of giving birthare widely underused. These practices include receiving continuous one-on-one support from a skilled, experienced caregiver during labor; being able to change positions, get out of bed, and walk during labor; and using comfort measures such as massage, warm baths, and birthing balls.
What is the difference between what you call a climate of confidence and a climate of doubt?
JN: Pregnancy and birth are normal, healthy processes for most women, the vast majority of whom have healthy pregnancies and babies. Yet childbirth is often seen as an unbearably painful, risky process to be managed in a hospital with the use of many tests, drugs, and procedures. The high-tech medical care that is essential for a small proportion of women and babies has become the norm for almost everyone. Some advocates for childbearing women describe this as a climate of doubt that increases women’s anxiety and fear.
In contrast, a climate of confidence focuses on our bodies capacity to give birth and on our capabilities and strengths. Such a climate reinforces womens power and minimizes fear. Factors that create a climate of confidence include caregivers who listen to you and respect the birthing process; friends and family who provide support; and a birthing environment in which you feel comfortable.
What can a woman or a couple do in advance to increase the chances of a positive birth experience?
First of all, there are no guarantees: Birth is unpredictable and beyond our control. Expectant parents should be aware of that. Staying flexible is much better than having a fixed idea of how you want your birth to go and then feeling like a failure if something else happens. That said, if a woman is healthy and has no medical complications that call for a high-risk approach to her care during pregnancy, labor, and birth, she can increase her chances of having a safe and satisfying vaginal birth by:
- Finding a doctor or midwife with low rates of intervention.
- Choosing a birth setting with low overall rates of intervention.
- Considering her preferences for birth and discussing them with her caregivers.
- Arranging for continuous labor support from someone with experience.
- Exploring options for pain relief.
- Avoiding continuous electronic fetal monitoring when possible.
- Avoiding routine use of other medical interventions when possible.
Almost 40 years after publishing the original “Our Bodies, Ourselves,” you say there’s more of a need for this kind of information than ever. Why is that?
There is so much misinformation out there, it is often hard to know what to believe. We help people sort fact from fiction by writing clearly and accurately, using language that ordinary people can understand. We also provide excellent guidance on how to use the internet effectively to get high-quality information.
Who wrote “Our Bodies, Ourselves: Pregnancy and Birth”?
This book was written by dozens of people, including midwives, doctors, mothers, and public health experts. Our editorial advisors included Tekoa King, CNM, MPH, a certified nurse-midwife and editor-in-chief of the Journal of Midwifery & Women’s Health, and Cornelia (Kea) van der Ziel, M.D., an obstetrician-gynecologist and co-author of “Big, Beautiful and Pregnant.” The lead author of the chapter on choosing a provider and birth setting, Leah Diskin, is the daughter of one of the founders of Our Bodies Ourselves and a mother of two herself. This book continues our tradition of learning from women’s lived experiences as well as from the latest research findings.
PRAISE FOR pregnancy and birth
From Publishers Weekly:
“In this third spin-off of ‘Our Bodies, Ourselves,’ the self-described women’s health ‘bible’ first published in the 1970s, the Boston Women’s Health Book Collective focuses on pregnancy, birth and recovery. This book will help women make confident and informed choices about the birth process as they negotiate the healthcare system and balance their options.
“The chapters are arranged chronologically along the journey into motherhood, with useful sections on the physical and emotional changes of each trimester, fetal development and prenatal testing. Other topics include choosing a healthcare provider, prenatal testing, labor, pain management, recovery, breastfeeding, emotional ups and downs and many other issues.
“The text is interspersed with pertinent personal narratives, as well as with more than 70 black and white photos and illustrations; the emphasis is on up-to-date information, probing the use-and overuse-of various practices and medical interventions. ‘Informing yourself about these practices and their alternatives,’ the editors write, ‘is an essential step toward creating a better birth experience for yourself and your baby.’ This comprehensive guide is sure to take its rightful place among its sister titles, empowering a new generation of expectant mothers.”
“Our Bodies, Ourselves: Pregnancy and Birth contains a treasure trove of information you won’t find in other books on pregnancy and birth. The advice is balanced, honest, medically up-to-date and beautifully presented. If you read only one book in preparing to deliver your new baby, this should be it.
— Sandra Blakeslee, co-author of “The Body Has a Mind of Its Own”
“As a new mother myself, I appreciated all the scientific evidence that was used to back up recommendations or to question standard practices. And yet this book manages to be a smart, readable guide that is not preachy — a rarity for pregnancy books.”
— Tina Cassidy, author of “Birth: The Surprising History of How We Are Born”
“The trusted Boston Women’s Health Book Collective has written a comprehensive, accessible, and up-to-date book for expectant mothers. It balances important facts, scientific data, and evidence with the voice of the “wise woman”; and it provides questions to ask, issues to think about, and options to consider and discuss. This is the #1 book I am going to recommend to my patients.”
— Timothy Johnson, MD, FACOG, Bates Professor and Chair of Obstetrics and Gynecology and Professor of Women’s Studies, University of Michigan
* In the spring of 2008, the University of Michigan Health System in Ann Arbor purchased 4,000 copies of “Our Bodies, Ourselves: Pregnancy and Birth” for all of its patients seeking prenatal care.
“Once again, OBOS is the voice of reason and sound evidence in what has become a fear-based culture of childbirth in America, where medical technologies abound but often increase risks to mothers and babies unnecessarily. This book is an essential resource for women who want to make informed decisions about who will attend them at birth, where they give birth, and how they will manage the pain of labor.”
— Lorrie Kaplan, Executive Director, The American College of Nurse-Midwives
“Too much current maternity care overuses technological and surgical interventions in normal pregnancies, often detracting from the joy and optimal mother and baby outcomes that are possible. This book is a clarion call for more sanity in our maternity care system.”
— Charles S. Mahan, MD, FACOG and Professor Emeritus of Public Health and Obstetrics and Gynecology, USF, Tampa
TABLE OF CONTENTS
The Journey to Parenthood
1. Approaching Birth with Confidence
2. Choosing Your Health Care Provider and Birth Setting
3. Preparing for Childbirth
4. Your Developing Pregnancy and Prenatal Care
5. Taking Care of Yourself
6. Relationships, Sex and Emotional Support
7. Prenatal Testing
8. Special Concerns During Pregnancy
9. Childbearing Losses
10. Labor and Birth”
11. Coping with Pain
12. Special Concerns During Labor and Birth
13. Cesarean Births
Becoming a Mother
14. Your Physical Recovery and Your Newborn
15. Feeding Your Baby
16. Life as a New Mother
Knowledge is Power
17. Advocating for Better Maternity Care
18. Advocating for Mothers and Families