The premise of this book is at once simple, terrifying, and profound:
"Women are even beginning to deny normal birth to themselves: If 'normal' means being induced, immobilized by wires and tubes, sped up with drugs, all the while knowing that there's a good chance of surgery, well, might as well just cut to the chase, so to speak. 'Just give me a cesarean,' some are saying. And who can blame them?"
Block's goal is to get women to be their own advocates and to be informed about how labor should progress. She blames the medical industry's penchant for turning medical advancements aimed at "treatment of abnormality" into "speeding up an ordering an unpredictable, at times tedious, process" for women being pushed into too-soon deliveries. She says that women are too often offered inductions, Pitocin to speed up in-progress labor, artificial rupture of the membranes, and even c-sections for convenience. She sees these practices as directly related to more tearing during delivery, a higher rate of c-sections (whether the patient wants one or not), and overall rushed, unhealthy deliveries.
Clearly, Block is a natural birth advocate. She goes so far as to frequently cite sources who believe no "normal" (complication-free) pregnancy should end in a hospital. She also has a large section of the book devoted to cataloging the daily activities of midwives, some of whom practice underground because the states they are in have made their careers illegal.
I enjoyed the read and agree (at least intellectually) with a lot of the conclusions and evidence.
As for what I took from it to personally apply to my pregnancy and intended birth, I'm less clear.
I like the idea of a natural birth, but I like a lot of ideas. I was in the room with my sister as her labor progressed (naturally, without any medication to speed it up), and she looked positively worn out before she asked for the epidural. (I left shortly after that, but I was there long enough to see her become much calmer). Even though the epidural provided her a much-needed relief, it also made her very--for lack of a better word--dopey. She also tore pretty badly during delivery, though I have no idea if that's connected to epidural use or not.
At first, I thought for sure I'd get the epidural. Then, I did research and decided that I would try to do it without one. The thing that made me change my mind was reading about how delivering flat on one's back is about the least logical way to do it. This made a lot of sense to me. I grew up in the country and watched a lot of animals give birth; I've never seen one do it with their legs straight up in the air. As I read about walking around to help with labor pains, different positions to push, birthing balls, and water therapy, it sounded good. Plus, I really, really don't want to feel drugged out.
But then I remembered my sister's face before the epidural, and she was only dialated to a 4 at the time.
So, I'm still on the fence.
As for Block's other concerns, I feel somewhat (perhaps naively) confident that I can be my own advocate in preventing early intervention. My doctor and the hospital I am using both strongly advocate natural birth. They provide birthing balls and two-person showers for laboring mothers. The hospital itself provided me a birth plan to fill out that included options about how much movement and control I wanted during the process. This could all, of course, be smoke and mirrors, but I feel comfortable there. In addition, my doctor's office is a combined practice, and the doctors share weekend and late night shifts. This means that I might not have my individual doctor present at delivery, but I feel like it also means that I'm less likely to be pressured to speed up a delivery to accommodate her schedule.