Call The Midwife

I feel that this reading list requires a bit of my background story, so here goes:

I am a yoga teacher that specializes in Prenatal Yoga and Childbirth Education. I am also a Birth Doula. I got all the required trainings and read all of the recommended reading lists from DONA to Lamaze to the more "natural" Inspired Birth but I still felt my education was lacking and that there were some elemental facts that I was missing.

I also feel compelled to build a Yoga based labor pain management system and to build it I need better understanding. I envision a helpful practice--more yoga, more calm, more practical with proven simple labor tools that have strong physiological and yogic backgrounds.

BUT--something about this business of having babies was setting off alarm bells in my head-- I was/am continuing to notice what seems to be huge disconnects from what I was reading in various pregnancy/childbirth books and what I had learned during my trainings--to what I was seeing in the field as a Birth Doula and what tidbits I read about birth in various history books. I was very confused...I still am--so briefly:

Birth is a basic physiological function of the female body indeed it is the epitome of physiological functions. It is as natural as your heart beating and your lungs breathing. True enough but unless your heart and lungs develop "problems" it does not hurt to breathe or circulate blood through your body, healthy functioning hearts and lungs do not require medical intervention. Many, many, many childbirth education and natural birth books explain that childbirth isn't designed to be painful either. 

The reality I was seeing is that we have the medical world on one side claiming childbirth is a dangerous excruciating pathology that needs to be risk-managed with a multitude of medical interventions in order to keep mother pain-free and baby safe— And natural birth activists on the other side claiming that birth is a safe non-painful physiological bodily function that needs no outside intervention. One that is best accomplished in a sun dappled glen beside a baby deer--crunchy granola style. 

A bit of eclectic reading led directly to this next dichotomy: I was reading both HypnoBirthing by Marie Mongan and The Six Wives of Henry VIII by Antonia Fraser. The first book is of course all about using hypnosis to manage your labor and delivery and the second devoted a fair amount of space to the pregnancy travails of Henry's six wives as the primary duty of the Queen during Tudor times was after all to produce heirs to the throne. 

On the one side I read that Ms. Mongan considers birth done the Hypnobirthing way to be a perfectly “natural” pain free experience and she believes that women should take lessons about birth from her cat. On the other side, back in the day, when all birth was supposedly “natural”— none of Henry’s wives faired particularly well with Childbirth—they had numerous miscarriages, their babies died, and the 3rd, Jane Seymour, died because of birth complications, most likely childbed fever. Henry VIII’s legacy was one future King and two subsequent Queens out of six wives. Henry's sixth wife may have survived him but she also died after giving birth--again most likely from childbed fever.

Out of this a perfect storm of confusion was born.

Confusion One: Your heart doesn’t hurt when it beats, your lungs don't hurt when you breathe (unless, of course, there is a problem) so why-- if our bodies are designed to give birth do the majority of women find childbirth to be accompanied by the racking pain of contractions and why do they experience so much perineal tearing during delivery?

Confusion Two: Cats, albeit fairly stoic creatures, calmly release kittens, and chimpanzee babies often assist their own births—so why do we do it in hospitals surrounded doctors and hooked up to machines—as if we have not a baby to be born but a disease that needs to be excised and cured? Why is the medical community so convinced that human women “need” so much help?

Confusion Three: If childbirth is supposed to be a safe physiological human body function (like the beating of your heart)—why did so many women and babies die during and immediately after birth?

 I thought the appropriate place to start was learning more about the actual history of Childbirth and I freely admit that I started this project a while back. I'm not entirely sure what I expected to find but it sure wasn't what I found in these books...but if you want to follow my path start here--but I warn you once read them they can't be unread and these books will totally change your perspective:

  Pushed: The Painful Truth About Childbirth and Modern Maternity Care by Jennifer Block completed

 This book was published in 2007 and further down in this list you will find Ms. Block's follow up published in 2019. This was an eye-opening shocking book even when read through the eyes of a doula who has seen these truths in action as part of my profession. It is engrossing, well documented, and comprehensive. Be careful if you decide to read because you cannot un-read it. This book takes a look at childbirth in the age of machines, malpractice, and managed care in America. Ms. Block's investigation reveals that while emergency OB care is essential, we are overusing medical technology at the expense of women's and babies' health. Spoiler alert: It is no better in 2019.

 Get Me Out: A History of Childbirth from the Garden of Eden to the Sperm Bank Me Out by Randi Hutter Epstein, M.D. completed

The continuation of my eye opening peek into the history of childbirth and Epstein took me on a superficial journey through the history of childbirth--its fads, fables, superstitions, and the extraordinary. I went in to this reading arc expecting to find something totally different. It is a good read but I definitely preferred Ms. Cassidy's book. 

 Birth: The Surprising History of How We Are Born by Tina Cassidy completed

 This was the first book on the world history of childbirth to be published in 50 years, this was first published in 2006. From evolution through the epidural and beyond, it is intelligent, impeccably researched, and eye-opening. A must read if you want to look past the collective willful amnesia about actual childbirth--this book explores the physical, anthropological, political, and religious factors that have influenced and continue to influence how women give birth.

 

 Debunking the Bump: A Mathematician Mom Explodes Myths About Pregnancy by Daphne Adler completed

 I read the whole thing but I can imagine many pregnant women and new moms using this book as a go-to must-have reference book. It helped me to more completely understand various myths and beliefs that surround childbirth. I like to give up to accurate advice to women I teach and this book is at my side.

  Expecting Better: Why the Conventional Pregnancy Wisdom Is Wrong--and What You Really Need to Know by Emily Oster completed

 FYI this book has been updated to 2019 since my reading. There is a little controversy over the advice given about alcohol consumption. But for the very most part this book helps pregnant women to expect more out of their birth experience. It is a more conversational and readable than Ms. Adler's--Ms. Adler's is a for sure must have scientific reference and Ms. Oster's is all that and an entertaining read to boot.

 

I will admit that after reading these excellent books that I fled in dismay from the knowledge I had gained. Sometimes it pays to be very careful what you wish for...

Why did I run? Mostly because I have learned that Childbirth as it is practiced today is a mostly man-made catastrophe, particularly in the United States. I use the term "man-made" quite literally. So I stuffed this research project back into a corner of my mind. I instead shifted my focus away from that mess of wrong towards my little bubble where I could perhaps start writing about righting these wrongs.

A favorite altruism of mine: In a world of problems be a solution. So I decided I would go back to the comforts of "being a part of the solution."

This decision worked for a while and I wrote about all the stages and phases of Labor and how to use Yoga to help ease suffering. I wrote about using Movement as a Yoga-Based Birth Skill. This spate of writing helped ease me back into the reasoning that while I may not be able to change Birth in America as a whole--it is certainly in my wheelhouse to help each and every woman who walks through my door to have a calm positive birth experience if she so desires.

My bubble burst (I couldn't resist the pun) when I realized that I needed to write about Premature Rupture of Membranes (PROM) as it was mentioned as a complication numerous times in other of my posts. I started this writing project with the delusion that it would be an easy short factual post. Instead I found that this topic is a minefield of controversy and the post ended up being 20 some pages long. 

As a reward for sticking with such a messy complex topic and writing such a long read essay-- I allowed myself an expensive book purchase and read said book as I was going through the editing process. Odd book choice (unless you know me) as a reward-- I understand-- but a very interesting book that cleared up a lot of my wrong thinking about infection during childbirth and in instances of PROM.

   The Tragedy of Childbed Fever by Irvine Loudon completed 2/2019

FYI: This is an excellent book but incredibly pricey and for the record I paid $65 for a used copy from a London bookstore ($170 on Amazon). Was it worth what I paid for it--absolutely yes. It was worth it to me as I am a birth doula, a childbirth educator, a prenatal yoga teacher, I blog about childbirth, but more than anything I am a woman wondering what the heck has gone so wrong with birth in America today!

While I had certainly gained a lot of knowledge through the above research and reading I still didn't feel ready to write about it and I continued to wonder to what end would any writing that I did actually serve.

I haven't been writing for long but something I am coming to believe is in the power that lays hidden on the shelves of Umberto Eco's Anti-Library--#TBR- all of the knowledge contained in books etc. that you haven't read yet. It is my belief that some projects demand waiting for the right knowledge to appear. 

While the stack of books and internet research that I have completed since the above mentioned perfect storm have definitely strengthened my belief that we humans are a weird lot, that history is written by the victorious, and as a species doctors are extremely adverse to change, strongly clinging to beliefs long after they have been proven wrong, time after time--I still believe that my idea needs more time to develop before it comes to fruition. At the deepest level I feel that we are looking at something completely elemental in the wrong way and missing something that is right in front of our noses. 

Again I shelved this project for awhile and shifted my focus towards the creative endeavor of setting up a personal website where I could write about the things that interest me such as reading, yoga, cooking, and childbirth. It was time well spent as now I have this lovely website "Categorically Well Read" and a growing Twitter account @DebbieVignovic.

During this building process the universe swirled and tipped a book off the shelf that I would normally never consider reading and onto my radar in such a way that I finally caved and bought myself a used copy.

  The Black Swan: Second Edition: The Impact of the Highly Improbable by Nassim Nicholas Taleb completed 7/2019

According to the back cover: A Black Swan is an event, positive or negative, that is deemed improbable yet causes massive consequences...in this book NNT shows in a playful way that Black Swan events explain almost everything about our world, and yet we--especially the experts--are blind to them.

I found myself giving this book a long slow careful read and not just because of the math. Time and time again I marked passages that reminded me of things that had happened and are happening in Childbirth--so much so that I am pondering the need to take a virtual long slow walk with NNT through these passages--to what end I do not know--but enough so that I am calling my project "The Black Cygnet". Regardless, birth as done by homo sapiens seems to have been slammed by Black Swans since the moment we took the highly improbable notion of standing up on two feet.

I recently re-dusted off this project with the thinking that I still have reading to do. There are two contrasting views--one in which technology does it better and midwives are evil and one in which midwives rock and technology is evil. I suspect instead middle ground but I need to expand my base of knowledge especially where the practice of midwifery is involved. 

So the universe swirls and I find I have excellent timing as two new must read books have just been published. Both in their own ways confirm the fact that we live in a messy complex often toxic world nowadays and furthermore a world in which there are no easy answers to be found.

Welcome to two front line modern day versions of the state of women's health care:

 

  Hard Pushed: A Midwife’s Story by Leah Hazard completed 8/2019

A moving, compassionate, and intensely candid view of modern midwifery in the UK. A glimpse into what life is like on the NHS front line working within a system at the breaking point. Part of my research into the world and practice of real life midwifery and reading time well spent. This is a very engrossing read and works to dispel thoughts that I had about the NHS. 

 

 Everything Below the Waist: Why Health Care Needs a Feminist Revolution by Jennifer Block completed 8/2019

This is a badly needed and shocking book. A follow-up I have been waiting for ever since I read Ms. Block previous work "Pushed" (see above) which was published in 2007. While this book arrived just in time for my current round of research I was almost afraid to crack the cover and as it turns out rightfully so. This jaw-dropping investigation into the women's health care industry shows that indeed nothing has changed unless it was for the worse. As Melissa said in her review on Amazon: "A book about feminism's unfinished revolution in women's health. It is fascinating, informative, and appalling."

Now I am going to dip into the past and read the stories of two "turn of the century" midwives who both kept diaries documenting their midwifery practices. The first, Catharina Schrader practiced at the turn of 18th century in the Netherlands, and second, Martha Ballard who practiced in New England at the turn of the 19th century. Both woman practiced at moments in history in which men in the form of man-midwives and later as gynecologists and obstetricians where steadily infiltrating and usurping a profession that since time immemorial had been an almost exclusively the domain of women. 

 

 Mother and Child Were Saved: The Memoirs (1693-1740) of the Frisian Midwife Catharina Schrader (Nieuwe Nederlands Bijdragen Tot De Geschiedenis Der Geneeskunde En Der Natuurwetenschappen) Trans. by Hilary Marland with introductory essays by MJ van Lieburg and GJ Kloosterman completed 8/2019 (The first read through anyway)

Catharina Schrader's memoirs span 52 years and an estimated 4,000 deliveries, which she carefully documented throughout her life as a midwife. When she was 88 years old, 'Vrouw' Schrader recorded her last birth. On October 30, 1746, she died in her hometown of Dokkum. What makes this an unique opportunity is that Vrouw Schader kept meticulous written records for 3060 of her cases. For her memoir she hand picked 122 of her most complicated deliveries and this memoir is what has been translated into English.

How I wish I could read all of her 3060 cases because her complete diary is not just the complicated heavy births but it also contains the hidden invisible evidence of all the "normal labor, healthy child" deliveries that made up the vast majority of her work. This book was published in the 1980's and will set you back a pretty penny--for my line of work and research-- pennies well spent. 

  

  A Midwife's Tale: The Life of Martha Ballard, Based on Her Diary, 1785-1812 by Laurel Thatcher Ulrich completed 9/23/19

From the back cover: A Pulitzer prize winning portrayal of one woman's life in Early America. Ms. Ulrich is a historian of extraordinary persistence, skill, and empathy. Between 1785 and 1812 a midwife and healer named Martha Ballard kept a diary that recorded her arduous work (in 27 years she attended 816 births) as well as her domestic life in Hallowell, Maine. A very tumultuous time in the course of American history.

 

 ETERNAL EVE The History of Gynaecology & Obstetrics by Harvey Graham currently reading

This is a book first published in the 1950's by a famous obstetrician who published this work under the pseudonym of Harvey Graham. True this a title from the male perspective and as such traces a line through history to the wonderful accomplishments of men in the world of gynecology and obstetrics. I'm reading it anyway because thus far I have found it very difficult to find books that document birth before the 15th-16th centuries. So I have been trying to read between the lines a bit for the information I am interested in gleaning from the past. This book is almost 700 pages at which writing I have read about 200 pages. I experienced a bit of childbirth reading burnout by the fall of 2019 so this one continues on through 2020.

 

  The Midwife's Tale: An Oral History from Handywoman to Professional Midwife by Nicky Leap edited by Billie Hunter completed

Some female perspective on the history of midwifery and please take careful note of the word "oral" in the title as for much of history women did not read or write and/or where not allowed to learn how to read and write. It is why so much of actual birth history will remain cloaked in the realm of invisible evidence.

It took me a good while to finish this book not because it is not an excellent book it very much is...it is just very deflating to read what has been documented and written about childbirth. Like the authors of this book I also had somewhat romantic expectations about our midwifery heritage when I set about my own research and like them I expected to find a treasure trove of forgotten skills and writing about experiences that would enhance midwifery practice and inspire my faith in the physiological nature of childbirth. And like them I was shocked and disillusioned about the truths of the practice I found along the way. It took me a long time to read and it took them eight years to finish this book.

 

 Outback Midwife by Bet McRae completed 8/31/2019

The memoir of Beth McRae which details her 40 years spent as a midwife in Australia. The book takes you from a city hospital to the bush to her work with the Aboriginal community. This was reading time well spent although it did nothing to restore my faith in childbirth practices. She is an amazingly dedicated woman. 

 Call the Midwife Call by Jennifer Worth completed 1/20/2020

This book is about the real-life experiences of a young midwife serving in a convent in London's East End during the 1950's during chaos of the post war London docklands. This book is also the basis for the award winning TV show of the same name. It served as a nice companion piece to The Midwife's Tale which mostly centered on birth in England prior to the Second World War and this book covers women's birthing experiences immediately following WWII. She wrote not just her experiences as a midwife but about what life was like for all the inhabitants of East London. I hope my time expands to being able to read the rest of this series as well as to watch the TV show.

 

 The Last Midwife: A Novel by Sandra Dallas Will not be reading.

This is a fictional tale of murder, mystery and secrets, the story follows the travails of the only midwife in a small Colorado mining town in the 1880's. I found this while collecting books for the category: The Wives Between Us. I have decided that this fictional book about a late 19th century midwife is not for me. In her acknowledgments the author states that "I realized my book would not be about midwifery, but about a midwife...midwifery would not be a theme of the book but a part of it." She also states "...my editor suggested I write a book about a midwife. Oh, yuck, I thought. I don't want to write about the details of childbirth." I couldn't even make it through the first chapter and as I value a quiet mind--I put this book aside and went on to this fabulous fictional portrayal of midwifery.

 Midwives (Oprah's Book Club)  by Chris Bohjalian completed 9/2019

According to Amazon this novel chronicles the events leading up to the trial of Sibyl Danforth, a respected midwife in the small Vermont town of Reddington, on charges of manslaughter. It quickly becomes evident, however, that Sibyl is not the only one on trial--the prosecuting attorney and the state's medical community are all anxious to use this tragedy as ammunition against midwifery in general; Sybil, an ex-hippie who still evokes the best of the flower-power generation, she is an anachronism in 1981 and perfect fodder in this fight. It is about the continuing fight of the OB/Medical to wrest control of childbirth from midwifery care, it is also about family. I think it is because Mr. Bohjalian tells his story through the eyes of Sybil's daughter that he is able to tell the story that he does. This is a very good book and reading time well spent.

These are well written articles that are available online: 

Witches, Midwives, and Nurses: A History of Women Healers by Barbara Ehrenreich and Deirdre English

Birth and History by Deborah Gorham

Birth, Obstetrics and Human Evolution by Karen Rosenberg and Wenda Trevathan

I still have a lot to read about childbirth it will be an ongoing reading project but I don't think what I am looking for exists. We live in a world where the gory, horrific, shocking, tragic, heavy birth, complications, death, bad news...this is what sells books, this what keeps people reading...not the quiet roll call of "normal labor, healthy baby". Most women were accomplished amateur midwives by the time they were of middle age--they quietly sat with their fellow women and did the tasks that needed done. Without fuss or bother. The quiet completely invisible history of childbirth for billions of women from evolution forward. BUT they did not write the books--MEN wrote the books. The victorious version of history.

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Hi! I'm Debbie. Here at Categorically Well-Read I give an extra layer to the reading life. Learn more about me, check out my current category of books, submit your own suggestion, or check out my latest post.