Unassisted Childbirth.

Laura (and David) gave birth to four children at home unassisted starting in the mid 1970's through the early 1980's. The book gives a brief description of obstetrical technology and procedures, the disadvantages of which are presented clearly & succinctly.

This is a good book to use in IH/IBP classes since she examines the role of belief and cultural messages on our childbirth experiences, refferring to other cultures where the belief about childbirth is such that it allows women to have painless childbirth. She also discusses cultures where women give birth alone.

There's a section of birth stories - unassisted homebirths - which express the joy and intimacy and promote developing trust in the natural process.

Shanley describes her own four unassisted births, including one footling breech and a 5 week premature birth where the baby dies (which she says was a manifestation of her desire to miscarry). The others were healthy babies and normal births.

My concern about this book is that Shanley did not have any prenatal care. She says she ate whatever she wanted, including fruit, M&M's, vegetables, but it does not appear that she had any blood work, nutritional counseling or any other prenatal evaluation (she could have done her own prenatal care if she didn't want to put her faith in an outside "expert").

I admire that she understands the role of her beliefs on her birth experiences, and that she was willing to take complete responsibility for her births, instead of giving her trust to someone (doctor or midwife) else. However, I have concern about her lack of prenatal screening to detect abnormalities or potential risks (which would allow her to be prepared at the birth for these problems). The breech birth concerned me because of the added risk of complications, such as a posterior position, cord prolapse or entrapment of the head. With a skilled attendant present, a baby who might have died or been seriously compromised could have been saved.

I admire Shanley's acceptance of the process - realizing death is a part of birth is a difficult thing to accept, even for a midwife, much less the expectant parent. Personally, however, I would want to know that "the expert" - the trained birth attendant - would do everything they knew to help my baby if there were a serious problem. Then, if the baby died, I would accept that there was nothing that anyone didn't do that caused it - since I would have taken all measures to ensure a healthy baby and the attendant would have done all she knew to bring my baby into the world safely.

Another reason to use a midwife is that I enjoy the companionship during pregnancy and labor. For me, it helps to have my midwife and friends there, even though I know ifs my work to do. Once the baby's out, there are friends to celebrate with!

I think this book is a good one for any IH/IBP teacher's library, since it promotes homebirth, developing trust in the birth process, and the impact of beliefs and cultural attitudes on childbirth. However, I wonder how many babies with problems born without an attendant would have lived if only a person with skill were there to help.