The Thinking Woman’s Guide to a Better Birth promotes evidence-based management of labor and birth. This is a book all about research. It provides summaries and explanations of everything scientific research has demonstrated about common labor interventions such as c-sections, induction, IV’s, epidurals and more. Everything, that is, until about 1997. That is the main problem with this book. Research becomes quickly outdated.
For anyone looking to read a discussion of statistical information and evidence-based best practice, I recommend Goer’s newer book, co-authored with Amy Romano, Optimal Care in Childbirth: The Case for a Physiological Approach. It does the same thing, review and discuss the research literature, but is even more comprehensive and up to date. Given that their new book is available, The Thinking Woman’s Guide to a Better Birth doesn’t really serve a purpose today beyond historical documentation. The rest of this review, my commentary on why or why not (or rather how) to read this book, can be applied to their new book as well.
I have found that The Thinking Woman’s Guide to a Better Birth impacts pregnant women in interesting ways, good and bad. (And their partners, at least in theory. Although I haven’t personally met any partners who dive into this book.) The beneficial impacts are as follows:
- The ability to think critically and ask good questions increases.
- They gain insight into how medical recommendations may or may not apply to them.
- They become comfortable advocating for their rights for informed consent and informed refusal.
- They gain some insight into the many factors that impact medical recommendations such as: research, tradition, liability, public health, and cost.
- They begin to understand that medicine is not one-size-fits-all or infallible, and that parents taking an active role is a good thing.
The Thinking Woman’s Guide to a Better Birth detrimental impacts to pregnant women (and/or partners) include the following:
- They sometimes become rigidly committed to an ideal of a zero-intervention birth to the point that when a great provider tries to explain how an intervention may benefit them, they are too skeptical to believe it.
- They become distrustful of medical routines and personnel.
- They become more focused on arming themselves with insight and education than on preparing their inner person to be a strong, loving, birthing woman or parent. Information is not the only aspect of preparation.
If you are a childbirth educator, doula, or care provider, Optimal Care in Childbirth is simply a must-have for your bookshelf. As an expectant family, it may not be. (Likewise for the outdated Thinking Woman’s Guide to a Better Birth.) My great hope is that you will be working with a care provider whom you can trust to be current in their evidence-based practice, and non-defensive and thorough in their explanations as they assist you while you make choices for your own family. That being said, informed consent and refusal practices are rarely what they should be.
Becoming educated in your own right is very powerful. While education about the things you can do to optimize your own health and help your birth go well is essential, The Thinking Woman’s Guide to a Better Birth doesn’t really aim to address that type of education and readiness. Instead, it offers a much more complex discussion about the institutionalized system of healthcare delivery and how that relates to obstetrical management. This may be very useful and empowering information for you, especially if it directly relates to a question or concern you are facing. If you have prepared yourself for labor and birth and would like to look further into benefit/risk analysis for many potential situations you will like this book. But it is certainly not a first-line basic book with which to start your preparation for birth.
For some people, The Thinking Woman’s Guide to a Better Birth will create more anxiety because of the problems it highlights. For others, it will feed the illusion that being super book-smart gives you control over the labor process and substitutes for inner readiness to open and surrender to birthing. For these reasons, I don’t think it is necessary for most birthing families to read this book, at least not cover to cover. Instead, turn to this book as a reference if needed, and also read one or two sections of it in order to illuminate the actual gap that exists between evidence and practice so that you learn how to watch for it.
Become well-educated about the information you have a right to, and practice asking excellent and detailed questions with your doctor or midwife. These skills, which can indeed be learned from The Thinking Woman’s Guide to a Better Birth, will empower you to gather the information you need in the moments you need it. Refraining from reading the whole thing will help you stay focused on more personal preparation. It will also free up a little reading time for walks, conversation, or being still – which are equally needed for birth preparation!
The Thinking Woman’s Guide to a Better Birth’s Author, Henci Goer
Henci Goer is a childbirth educator and doula, as well as an award-winning medical writer who specializes in childbirth. Amy Romano (if you are considering Optimal Care in Childbirth), is a nurse-midwife, research analyst, and educator. Both women are involved with maternity care system reform and advancing maternal and infant health.