By Rachel Rose
The statement, “If patient-centeredness defines midwifery, then no doubt any of us who attends birth—whatever our degree or relationship to technology—should be a midwife” is a provocative one, especially coming from an obstetrician who had all of her children via cesarean section. But this is exactly what makes Dr. Anne Lyerly’s book A Good Birth a standout. I wish that I’d had a copy of A Good Birth in the early stages of my first pregnancy, as I struggled with decision-making about where, how, and with whom in attendance to give birth. It was hard not to feel wistful as I delved into Dr. Lyerly’s research on what makes a good birth, drawn from interviews with the only people who can possibly know: women who have recently given birth. The experiences of mothers are central to Dr. Lyerly’s research, and inform both her practice and her thesis, which is that women can thrive under all kinds of birthing conditions, and feel that they’ve had a good birth even in adverse situations, provided they have agency.
Interviews with new mothers about what made their birth experiences good (or bad) is fascinating reading material for anyone who has ever created and birthed a baby. Somehow, medical professionals have divided into camps, with midwives pushing natural birth and obstetricians pushing medicalized hospital birth, and left it up to women to choose what they are most comfortable with (or least uncomfortable with). If I were pregnant now, I would only go to a maternity care provider who had read A Good Birth, or who had already incorporated the lessons from Dr. Lyerly’s book. Her epilogue “Common Ground: Notes to Maternity Care Providers” is worth the price of the book alone. She speaks passionately about the collateral damage in the birth wars: mothers.
“I can tell you that the birth wars have had an effect, though perhaps not the one advocates
may have hoped for. They have set the stage for guilt and self-doubt among childbearing
women who face stark and false choices among caricatured versions of birth rather than
the authentic and messy and uncertain options that birthing, wherever you do it, entails….”
Ideology—whether from the natural birth movement or the medicalized obstetrical movement—divides women, setting them up to judge other women and themselves as successes and failures for where and how they give birth. We as a society can do better, ensuring that all birthing women are able to feel connected with their care providers, are able to give birth in a way that fits their values and their circumstances, and are honored for the new life they are bringing forth.
Reading this book, I revisited that difficult hour when I was in recovery after my urgent C-section, alone, in pain, without a nurse (shift change) and not knowing how my baby was coping in the NICU. Yes, I had an obstetrically good outcome, in that my high-risk pregnancy ended well, but I did not have a good birth for my first child’s arrival, the point where I became a mother.
So many women can recount traumas and heartaches, and we are told to focus on our blessings, our living treasures, and never mind what we lost: an opportunity for sacred transformation. But even though my last birth was over ten years ago, I found Dr. Lyerly’s book provided a healing opportunity to review my birth experiences, to find meaning and beauty and pride in them, and also to mourn the areas where I felt abandoned. In this regard, Dr. Lyerly’s book is essential reading for those who give birth, as well as for those who attend births. In listening respectfully to pregnant and birthing women, both before and after their births, and in studying their collective wisdom like an anthropologist would, Dr. Lyerly’s reframing of what makes a successful birth experience is a gift to both mothers and birth attendants. This book serves as a wake-up call to care providers, whatever their ideological camp, to reconsider how they practice, and the impact their approach has on the women they serve. A Good Birth is a book I’ll be buying for my friends as they go through this transformative experience. For women who have yet to give birth, A Good Birth is critical reading, as it inspires them to consider the choices they make around birth, and also to ensure that their care providers are held accountable.
Women remember the day we bring new life into the world for the rest of our lives, for better or worse. There is nothing routine about it. It is a sacred day, and Dr. Lyery’s insistence on this truth is central to her message in A Good Birth.
Rachel Rose (http://www.rachelrose.ca) has won awards for her poetry, her fiction, and her non-fiction, including a recent Pushcart Prize. Her most recent book, Song and Spectacle won the 2013 Audre Lorde Poetry Prize in the U.S. and the Pat Lowther Award in Canada.
Want to read more thought-provoking essays? Subscribe to Brain, Child: The Magazine for Thinking Mothers and see why we’ve been receiving awards for literary excellence since 2000.