The Labor Progress Handbook, 2nd Edition

by Penny Simkin and Ruth Ancheta

Wow. This book is so useful, especially for someone like me whose mind works best in a linear, graphic way. Starting with definitions and moving from before labor through pre-labor, early labor, active labor, to second stage, the authors explore why and how labor can be dysfunctional and what to do to restore it to functionality. There are also sections with specific descriptions of maternal positions and movements, and comfort measures.

I do know, however, that in labor or when with a woman in labor, one doesn't necessarily use the information laid out here in such a linear A-B-C way. Intuition plays a big role, and communication, in deciding what to actually do in the moment when something is making a labor difficult and long. Oftentimes, though, I think birth attendants can feel just as "stuck" as the mom does when things are not going smoothly, and having the information in this book (or maybe even the book itself!) at hand to get some new ideas working could be a huge help at those times.

Wise Woman Herbal for the Childbearing Year

by Susun S. Weed

I loved this book. It really appealed to my emotional roots in the semi-counter-culture of the 80's, where I spent a lot of time as a child absorbing the cool differentness of my parents and their friends.

It's also actually a useful resource :-) It describes the properties and uses of a variety of herbs in a variety of forms for a variety of problems and/or needs during the time just before, during, and just after pregnancy. While I have read other books which include herbal remedies for childbearing, I felt this book gave me a better sense of herbs as medicine and how to use them as such in a way that respects their potency and potential for benefit . . . and harm. I also appreciated the detailed instructions on how to find, prepare, and store herbs for medicinal use.

One thing I did notice was that there is not a lot of explanation of why herbs work. That is a little off-putting to the scholar-huntress in me. I want to understand why and how things work, and I like it when people experiment and find empirical evidence for what they think and what they think works. That is not the place the author of this book is coming from. The herbalist tradition, at least as she presents it, is one of inherited wisdom which can be added to by an herbalist's personal experience, but which does not really need to be skeptically verified. I respect this perspective, but it's not one I choose for myself very often.

Pregnancy & Birth: The Best Evidence - Making Decisions that Are Right for You and Your Baby

by Joyce Barrett, MD, and Teresa Pitman

I think this would be a great book for libraries to have (mine didn't) and for me to have to share with parents I'm working with if they are the sort of parents who are very interested in research and making the "right" choice. Although since the book is almost 10 years old at this point, I might prefer to send people to a resource like The Cochrane Collaboration which is at least in theory updated regularly.

Many topics are unlikely to change over time, however - the risks and benefits of, say, episiotomy, aren't going to suddenly reverse in predominance. It's more the stuff that hadn't been researched 10 years ago that might be out of date.

The Birth Book: Everything You Need to Know to Have a Safe and Satisfying Birth

By William Sears, MD and Martha Sears, RN

This book is, of course, a classic, and I've read it a couple of times before.

What I noticed reading through (most of) it this time was the spirit of it: it's a spirit of fighting for what you want/believe is right, and of seeking for the information you need. And the Searses believe that they know what you should want/believe is right/information you need. That's not necessarily a bad thing, but I can see how it might feel judging to some people in some circumstances, which I'm not sure I've seen or understood before.

I was interested in the biochemical/mechanical explanation of why relaxation in labor is important to pain coping. It makes sense; and I still kind of wonder about the emphasis on relaxation. My personal experience tells me that no matter how relaxed I am, I'm still going to experience cervical stretching as painful, and that for me, more active pain coping practices will work better.

But I'm not the only kind of person in the world. And so I'm inspired to keep working to improve my ability to help women labor who need more active ways of laboring, and those who need my help or encouragement to relax.

The Complete Book of Pregnancy & Childbirth

I'm doing my doula reading . . .

The Complete Book of Pregnancy & Childbirth (4th Edition) by Sheila Kitzinger is beautifully written. It's innocent, poetic, and inspiring.

It also drove me kind of nuts.

Reading it reminded me of this scenario: imagine a parent teaching her teenage child to drive. She wants to be positive and encouraging, and so as her child is driving along she says something like this, "Oh, honey, I'm so excited that you're learning to drive! It's going to be so great for you to be able to get places on your own! You're getting so mature and WATCH OUT FOR THAT CURB!"

Much of the text is very problem focused. I like it better than, say, What to Expect When You're Expecting because the problems it's focused on are the problems I am personally biased to see as real, rather than those I see as iatrogenic. But I still feel more supported and nourished as a doula, mentor, and human being by authors who help me find solutions that work for me than by those who spend a lot of time pointing out all the things that can go wrong.

There is lots of good information in this book, though, and one particular section really surprised me by describing for the first time I've seen in print or on-line an exact scenario (involving 1st trimester bleeding) which I experienced in my first pregnancy but never really had explained or validated before.

Twelve Months to Your Ideal Private Practice: A Workbook

Twelve Months to Your Ideal Private Practice: A Workbook by Lynn Grodski was inspiring to me! I really want to dive in and start doing the exercises; unfortunately, I know deep inside that now is NOT the time to actually do that. I'm just coming out of my first trimester of pregnancy, and before I start ANYTHING new I need to reassemble my life to a state resembling functionality (you know, take my Christmas tree down - NO I AM NOT KIDDING!)

However, I do think I will use this book. It's practical (which appeals to me), has a lot of innovative ideas (at least to me, who knows very little about business), and offers some good metrics for how things should work in a small business (like percentages for expenses, time to work on "office" stuff, etc.) I think it will work for me. I wish I could convince some other small business people I know and love to work through it with me, but I know from past experience that you can't give away what others aren't looking for . . ..

A good read. (And if you are a small business person who would be interested in working through this book with me, let me know . . .)

Birthing From Within

This is the book that shares the roots of what we are doing as Birthing From Within Mentors, Doulas, and parents. Pam England co-wrote it with her husband, Rob Horowitz, and it is a wonderful guide, starting place, and reference for pregnant and new parents and those who work with them.

I taught my first childbirth education series of classes based primarily on what I had gleaned from this book about art and awakening to the possibilities of birth. My awakening was definitely furthered by the Birthing From Within training I took; but everything is there in kernel or root in the book. I have also shared it with friends who found different parts of it very helpful as they prepared for their births.

The warming attitude that comes across to me from this book is expressed in this slogan: "Labor is hard work; it hurts; and you can do it."

Go read it if you haven't!

Ina May's Guide to Childbirth

Ina May's Guide to Childbirth is the book I think everyone who is expecting a baby should read. Period.

Yes, even more so than Birthing From Within.

It is so accessible for so many different kinds of people who are going to want and choose all kinds of different things for their births. And it is so wise.

I can't be critical about it, really. I just love it so much. Even if all people read are the birth stories (which make up the first half of the book) they will learn so much about what is possible in birth. And then, Ina May Gaskin is just a truly Wise Woman. So the second half of the book, which is Ina May explaining why birth works the way it does and what your choices within and outside of the medical establishment are likely to be, is also wonderful and mind-eye-heart opening for anyone.

The Thinking Woman's Guide to a Better Birth

The Thinking Woman's Guide to a Better Birth by Henci Goer is one of the most commonly referenced books by people who are interested in natural birth and want to share that interest with someone else (i.e., "what book should I give my cousin who is pregnant and wants to learn about her options?") I can see why. It's an excellent resource, full of useful information, conveyed in a way that is very acceptable to highly educated, intelligent women. It appeals to me, as one of those women.

You can see the table of contents and some sample chapters here.

My one caveat is that it is very information focused. It's not about how to make decisions from the heart; it's about how and why to make decisions from the mind. This is very helpful for people who need to persuade their minds to follow what their hearts are telling them, or who need to persuade family members or friends to support them in following what they know with their minds or hearts to be right for them. It doesn't encourage delving deeper. But that's what Birthing From Within is for :-)

The Birthing From Within Keepsake Journal

There is still one opening in the December class listed below. If you're interested, please contact me ASAP!

If you register for this or any other class I mentor, you will receive a copy of Our Birthing From Within Keepsake Journal by Pam England. It's a kind of a workbook. We won't start on page one and work through it in class or anything - it's not meant to be a syllabus for Birthing From Within classes. But we'll use some part of it occasionally, and otherwise, it's a gift for you (and your partner if you have one) to explore as you have the time and energy. It asks you to journal, to learn a little bit, and to communicate with your baby and your partner.

I love the idea of the Journal and I love the content. I am not totally thrilled about the format, because I, personally, work much better with a blank page than with lines and decorative borders when I am trying to journal. But this is a very petty complaint. If you are like me, feel free to get yourself a nice blank book to use when actually doing the exercises in the book, or some nice art paper, and just treat the Journal itself as a guide.

The Four Agreements

"Dreaming is the main function of the mind, and the mind dreams twenty-four hours a day.

It dreams when the brain is awake, and it also dreams when the brain is asleep.

The difference is that when the brain is awake, there is a material frame that makes us perceive things in a linear way. When we go to sleep we do not have the frame, and the dream has the tendency to change constantly."

The Four Agreements: A Practical Guide to Personal Freedom by Don Miguel Ruiz fascinated me. It lays out the fundamental world view of the Toltec (intellectual/spiritual leaders in pre-Conquest South/Central America) as experienced by a modern inheritor of that tradition, and how Don Miguel believes that world view can help and heal all people. An "agreement" is a belief or choice we make about how we are going to live. The four agreements are healthy beliefs and choices: be impeccable with your word, don't take anything personally, don't make assumptions, and always do your best.

This book felt like a window into a spiritual tradition which is very different from (in some ways) but very compatible with (in other ways) my own. There were a few things that came up for me in reading it: one was the emphasis on control - I believe control is not desirable in most of life because it isn't truly possible. Ruiz posits control as a desired way of being in the world. Another was that while he talks a lot about the agreements we make within ourselves, and how they construct the way the whole world works, he doesn't talk about the agreements we make explicitly or implicitly with each other. I think those are very important, too. Finally, although I agree with some of what he says about how children experience agreements and become party to them, I don't agree with all of it. His veiwpoint falls into the "children are born innocent and are corrupted (forcibly) by the evil world" camp, and I'm just not sure that's a true view of reality. I think children are born with their own complex and not "innocent" spirits, and shape their families and communities as they shape the children.

But overall I did a lot of saying "right on" in my head while reading this book.

The Birth Partner

I actually had a hard time believing that I hadn't read this book before. It looked really familiar, but I realized as I delved into it that in fact, this was the first time I'd read this material.

The Birth Partner: Everything You Need to Know to Help a Woman Through Childbirth (2nd Edition) by Penny Simkin, P.T. is terrific. There's so much practical information packed into a very readable text! One thing I really like is the illustrations of different labor positions. I'm pretty familiar with them, but it is helpful to have pictures to look at with a mom instead of having to get into each one to demonstrate them all when time is short. There is a chart showing what medications are in which kinds of commonly offered anesthesia options, when these are usually administered in labor, and benefits and risks. Since I am not a medical professional, this is very helpful information for me when I ask "what kind of epidural are you offering my client?" and the doctor says "blah blah blah yadda yadda yadda " (i.e. names of medications I have no previous experience with.)

Probably the most interesting and challenging part of the book for me is the Pain Medications Preference Scale. This is a scale from 10 to -10: 10 means a mother would prefer not to feel any pain at all, getting anesthesia before labor begins. -10 means a mother would prefer to use of pain medications under any circumstances, even in the case of a cesarean birth. Both of these extremes being nearly impossible to put into practice, most women will fall somewhere in between. The Scale also shows what a birth partner needs to do to help a woman with this preference. The idea is for the mom and the birth partner to each identify their own preferences and support each other appropriately. That is the kicker for me. I know what my personal preference is and I know that many of the women I work with will have a different preference. So far I think I have done okay with that. I really don't feel any urge to judge any one's decision to (or not to) choose pharmaceutical pain relief when it is different than what I think I would decide for myself in a similar situation. But I find that I have sometimes reflexively justified a mother's choice as being one that I would make for myself in a similar situation. And although on the surface that may not cause a mother to feel judged or invalidated, on a deeper level, comparisons are odious. It doesn't matter what I would do if I were the mom. My judgement of that question is irrelevant to what is happening in the moment at a birth, and in the long run, I can see that it could be harmful to impose my judgement, offer my justification for her decision. It matters what I do do as one of her birth partners. My role is to validate her decision making process. What matters is for her to make a decision that is justified in her mind by her own values and preferences. It makes me so mad when a doctor or nurse says, "I would do this for myself/a family member, so it's the right thing to do." Just because it was right/would be right for you doesn't mean it's right for me. I don't want to say that - even subtly and subversively - to the women I am caring for.

The flip side of this is that Penny Simkin is one of the few birthy authors I have read who is really trying to be almost completely value neutral about the "big issues" in the birth world. In this book, at least, she is valuing caring support by a birth partner for a pregnant woman, but she is not expressing any kind of opinion herself about the birth industry and how it functions. While I think this is good in that it makes this book useful for a wider spectrum of people than many other books, I also think that I'm not sure value-neutral is where I want to or can be about the birth industry. Non-judgement of the people participating in the birth industry by having babies isn't the same as non-judgement of the system for me. I need to leave those judgments of the system aside when I enter the birthing space or even the educational space; but I (at least for now) think it's also important for me to recognize the judgements of the system I do hold as I lay them to the side when that's what's needed.

Okay, this one got long. Good stuff!

The Doula Advantage

I read this book, by the way, while labor-sitting with a wonderful couple who had a very long, very slow labor followed by a very fast 2nd stage and birth.

The Doula Advantage: Your Complete Guide to Having an Empowered and Positive Birth with the Help of a Professional Childbirth Assistant is by Rachel Gurevich. What I found most interesting about it is that it's written from a very different perspective than most "you should have a doula" books: that of the consumer. The author isn't a doula or a midwife or a childbirth educator. She's an editor at a mom-focused website - and a mother. So this is kind of a "consumer reports" version of why and how to have a doula.

I like that she lists a wide variety of doula certification organizations (including Birthing From Within) - so many sources just say "find somebody certfied by DONA". DONA is great, I'm sure, but I have no desire to certify through them. And I am learning a LOT through my certification process with Birthing From Within!

On the other hand, this seems like kind of a "lightweight" book to me. I guess because it's focused on ONLY doulas and why you might want one and how to get one. There is so much to learn and think about and experience around birth besides a doula that it felt strange to read a book that really doesn't address (in any depth) the kinds of choices and experiences a doula is supposed to help a woman negotiate.

One little thing that struck me as odd was her injunction against meeting with a doula you're thinking of hiring in your home. She really doesn't say why she thinks this is a bad idea, and honestly, I think it's a good idea assuming you've screened the person ahead of time (by talking to her over the phone, etc.). It's harder to have a conversation that's more than superficial in a public location, and I don't know that I'd want to hire or be hired based on a superficial conversation.

Would I recommend this book to clients? Maybe - I mean, it wouldn't go on a "waste of time" list like some other books I could (but won't) name - but it wouldn't be at the top of the "read this now" pile, either.

Homeopathy for Pregnancy, Bith, and Your Baby's First Year

I loved reading this book, and I'm so glad I couldn't find it through the library so that I have my own copy to keep. Miranda Castro, the author, is a homeopath who has worked extensively with women and children, including herself and her own, and her purpose in this book is to empower people to prescribe homeopathic treatments for non-critical conditions for themselves and their family members.

I learned a lot I didn't know about homeopathy. I've always been told, "well, there's nothing really in homeopathic remedies, so try it - it can't hurt you and it might help." And I've read the indications on the remedy bottles and guessed at something that might be appropriate. And sometimes, it's helped. Castro explains that in fact, using the right remedy for too long, or using the wrong remedy, CAN cause or exacerbate the symptoms you are trying to treat or other symptoms; that you should not take most remedies for more than a few days or doses at a time; that it is usually not a good idea to combine multiple remedies; and that a dose is a dose - it doesn't matter if you take 3 of those little granules or 5 of them.

She also explains in detail how to choose a remedy - when you have lots of time, or on the fly in an emergent (though not emergency) situation. The book includes a "materia medica" list of a wide variety of homeopathic remedies and what they are good for to help you in this task, something I've not encountered before. Although this sounds like it would be boring, it was actually pretty interesting reading, since each remedy is linked to certain emotional and character traits. I read it "looking" for myself and other family members - and I found us!

Today I looked up a remedy in this book for a doula client facing an induction next week. (This was simple as there is only one suggested remedy for labor not starting in a timely fashion.) I didn't prescribe it, of course - I think I'd need some formal training of some sort to feel at all comfortable prescribing even relatively benign homeopathic treatments to anyone outside of my immediate family - but I did share the information with my client. I have no idea if she'll use it - but I'm sure I'll use this book again with clients and for myself and my family.

Required Reading

I am going to be doing some required reading for my certification processes so I thought I'd post some reviews here for my own future reference . . . and yours!

First review: The Ultimate Breastfeeding Book of Answers by Jack Newman and Teresa Pitman.

This is an awesome book. I had to get it via interlibrary loan and I am appalled by this fact. It should be in EVERY library, several copies. This is vital information mothers and partners need when they are learning how to breastfeed and how to support breastfeeding. I have breastfed two children very successfully, attended LLL meetings regularly, and watched various friends and family members breastfeed successfully. I learned a lot from this book, including some information about some of the things I worked through with each of my sons that it would have been helpful to know at the time, rather than in retrospect.

Although I do think that there was value in our figuring things out ourselves. I mean, we didn't ever give up and we learned a lot about each other in the process of figuring out what worked and what didn't for us. I'm not sure but that we mightn't have missed something important if we had been given the "answers". On the other hand, a lot of people get to the point of giving up, or are encouraged to that point by ignorant care providers, so this is a very important book to have as a resource. I will be getting my own copy ASAP.

As much as I loved the informational aspect of this book, I also really loved the flavor of the writing. Wry, dry humor, and wit! Punchy, too. It was fun to read. Here is a representative quote:

"I think this question of guilt is an important one. We shouldn't be making mothers feel guilty for not breastfeeding, should we? We shouldn't be making mothers feel guilty for anything, actually. Most mothers are doing the best they can, sometimes under very difficult circumstances. . . . But we certainly make mothers feel bad about their choices in many other situations. If you are . . . pregnant, and you drink alcohol, even small amounts, you will probably leave your doctor's office with stern warnings ringing in your ears and guilt in your heart. . . . Obviously, the physician who says that we should not make mothers feel guilty for not breastfeeding doesn't believe that breastfeeding makes a difference. But there is lots of evidence that it does - for the mother, for the baby, and for society."

- pp. 35 - 36 The Ultimate Breastfeeding Book of Answers

P.S. - I bought myself a copy - this is such a useful book and I had a 30% off coupon from Borders . . . YAY!