My birth book recommendations

I have a bunch of friends who are expecting babies soon, inspiring me to write about some of my favorite books on the topic of childbirth.

I read alot when I was pregnant. Mostly the fear mongering stuff, like What to Expect When You're Expecting. In the end, it didn't serve me as well as I would have liked. Which is why I wrote Birth: The Surprising History of How We Are Born, to put the whole process into historical and cultural context.

Still, there are many more books that I wish I could have availed myself to. They include: Your Best Birth, By Ricki Lake and Abby Epstein, the names behind the excellent film The Business of Born; Baby Catcher: Chronicles of a Modern Midwife; The Doula Guide to Birth, by my friend Rachel Zimmerman and her doula, Ananda Lowe; and The Birth House, by Ami McKay (the only novel in the bunch.)

A birth, a boy and a book

Eight years ago today, on a sub-zero morning of a full moon, my son was born by unexpected c-section. He was fine. I was upset. My husband, then a journalist, shell-shocked from witnessing the cutting, cauterizing, puking, shaking and stitching, wondered if any of it had been necessary and defaulted to skeptical reporter mode, asking the obstetrician a question when I had finally been wheeled into recovery.

"What," he asked her, "would you have done in this situation 500 years ago?"

I was groggy but overheard the gruesome answer that she delivered to him at the foot of my bed.

Her response generated more questions and my resolve to find out if what she said was true. I spent many therapeutic and enlightening hours in the rare books department at various libaries, pulled shifts in hospital maternity units, and devoted a great deal of time interviewing academics, midwives, doulas, nurses and parents, processing information for myself and what would become my book, Birth: The Surprising History of How We Are Born.


For these last eight years, Jan. 10 has been a day of reflection for me on becoming a mom and an author -- simultaneously. This year, I am noticing that my son is no longer a baby and the c-section scar, a thick keloid that looked like a frown when viewed from above, is almost imperceptible.

Finally.

A birthday thanks

Today is Harrison's birthday. Four years ago, he was born in a pool of water (chronicled here) in his bedroom at our home in Boston, a VBAC attended by an amazing midwife, Deborah. As I do every year on this day, I say thank you to her for guiding me through one of the most amazing experiences of my life. This is a poem I wrote about her.

More Business of Being Born

I wanted to pass along the brand new trailer for More Business of Being Born from Executive Producer Ricki Lake and Filmmaker Abby Epstein. This release follows their landmark documentary, The Business of Being Born, with a four part DVD series that continues their provocative and entertaining exploration of the modern maternity care system. More Business of Being Born, available November 8th, offers a practical look at birthing options as well as poignant celebrity birth stories from stars including Alanis Morissette, Gisele Bundchen, Christy Turlington-Burns, Cindy Crawford, Molly Ringwald, Laila Ali, Kimberly Williams-Paisley and Melissa Joan Hart. Part 4: The VBAC Dilemma is currently available for rental on demand. You can watch a trailer here.

As part of the cast of the first film, I was excited to go to its debut at the Tribeca Film Festival, unexpectedly pregnant. The film confirmed my decision -- and my husband's decision -- to have a home birth. Here's what I wrote about some of the reviews of the original film.

An amazing birth-artifact

This is an amazing image for two reasons: First, it was found by a man who is legally blind. Second, it shows a common position women gave birth -- standing up, supported by ropes or vines -- before doctors determined it was more convenient for women do to deliver on their backs. Which, it turns out, is the worst possible position because it is more difficult for both baby and mother. Thanks to Carey Goldberg at the CommonHealth Blog for pointing it out to me.

Carla Bruni-Sarkozy gives birth -- without the president there

Carla Bruni-Sarkozy gave birth this week to a girl, but her husband wasn't there -- he was busy jetting off to Germany to meet Angela Merkel on important business. Fair enough. Or is it? I quickly received a couple calls from journalists asking what I thought.

Throughout all of human history in almost every culture, until the last 30-50 years, men never witnessed the births of their babies. They didn't want to see it and the mothers didn't see the upside of having them there. Before birth moved from the home to the hospital in the early 20th Century, moms typically had a gaggle of other women and a midwife to support her through labor. Men were considered useless and it was not their place. This changed when birth moved to the hospital because suddenly women were often left to labor alone -- with the obstetrician stepping into the room at the last minute. This trend made women crave support -- and fathers, being family, were the only ones hospitals would allow, even if it took lawsuits to open the gates. (P.S. If the mother and father weren't married, hospitals initially refused to allow him to witness the birth. Lawsuits changed this practice, too.)

Despite that history, men are now expected to attend the births of their babies. Which is great, if they want to be there and the mother wants them to be.

But there are many dads who are squeamish, fight with staff, or freak out the mother. If the mother has other support -- and she always should -- and if she doesn't mind him not being there, fine. It may be best for everyone.

As for Sarkozy, he's left with a public perception problem. Is Angele Merkel more important than your wife? Did this birth seem less important than those with your previous wives? At the very least, when he did show up at the clinic, he should have brought flowers.

Regulating midwives

Below is the written testimony I provided today during a hearing for a bill that would essentially sanction home birth midwives in Massachusetts -- some home birth midwives.

Good morning. My name is Tina Cassidy. Some of you may recall that I spent many years here in this building as a member of the Boston Globe’s State House Bureau, covering many of these sorts of hearings. If I learned anything from that experience relevant to the task before me today – it’s do your research, keep it brief, and make your case clearly. So stop me if I fail on any of those points.

First, I wholeheartedly support the concept of what you are trying to achieve with House Bill 2368. Anything that promotes midwifery care – especially out of hospital midwifery care -- is good for women’s health, and the health care system, because better care can be provided for much less. Numerous rigorous studies prove this to be true.

I also support this bill’s mandate that out-of-hospital births be covered by insurance for the reasons stated above. In the UK, the government is actually encouraging more women to give birth at home as part of the National Health System because they, too, understand the benefits of home birth, not just for women but for all of society – and the public coffers.

However, I am dismayed that in an attempt to “allow” homebirths, this bill prevents women from choosing a lay midwife, a person who could have more experience and more knowledge than those who are regulated. That is something I viscerally oppose.

At a minimum, this bill prevents many worthy and wise women from practicing an ancient tradition – a deeply respectable and important tradition as old as human history – a tradition that stopped about 100 years ago when medical colleges in the US began churning out “educated” doctors ready to deliver babies without having ever seen an actual birth. But those male doctors were regulated. The midwives, with millennia of hands-on practice, were not, and they were forced to the brink of extinction, with mothers paying the consequences when that continuum of knowledge passed on from generation to generation was all but lost. Want to know how to naturally deliver a breech baby? Ask a midwife.

I urge you today, please don’t have this bill be referendum on one lawsuit, or one midwife, or one story about a birth that went awry. Sadly, bad outcomes happen with even the best doctors with years of practice and all the technology money can buy. There are fantastic doctors in this room who have said, it’s not whether, it’s when.

When women choose a lay midwife, they often do it with far more research than a woman choosing an obstetrician. I say this from experience – as someone who was a first-time pregnant busy journalist who blindly chose the first OB with an opening for an appointment – and ended up a statistic in America’s unabiding cesarean epidemic, attended by a doctor whose definition of “normal birth” becomes more constricted every year, due to increasingly onerous guidelines and rising malpractice premiums.

For my second birth, I would have been blessed to have any of the certified professional midwives in this room attend the home birth. But the midwife I choose was a lay practitioner, someone I deeply trusted and connected with. She supported me emotionally and physically during an amazing and gentle experience, as well as in the weeks postpartum. It was blue chip care that I was willing to pay for out of my own not very deep pockets.

As she supported me, I am here to support her and others like her. In an effort to allow greater access to midwifery care, please don’t limit it.

Doing such will only drive underground those practitioners who are not CPMs and lead to the persecution of women who choose them.

Finally, please accept this additional written testimony – a chapter on the history of midwifery – from my book, Birth: The Surprising History of How We Are Born. It tells the story of the role that Massachusetts played in the near-final crusade against midwives. I believe if we don’t understand history we are doomed to repeat it.

Thank you so much for your hard work on this important issue.

Tina Cassidy