Informed Choices

In our studies, we’ve come across some interesting information about the evolution of birthing practices.

Here are some excerpts from “The Thinking Woman’s Guide to a Better Birth” by Henci Goer that may guide you in making more informed choices when it comes to your birthing experience.

Helen Sandler, an obstetrician in Whelming, North Carolina, resigned in June 2005 after hospital administrators told her to increase her cesarean rate, which was a modest 10%. “Quite a lot of C-sections are being done for so-called failure to progress in a couple of hours.”


Martin studies show that squatting, for instance, increases the diameter of the pelvic outlet and that an upright position, especially hands and knees, decreases the length of labor, shortens the pushing stage, increases the fetus’s blood oxygenation, and protects the perineum.

Roberto Caldeyro – Barica, a Uruguayan physician who studied birth positions in 1950 said except for being hung by your feet the spine position is the worst conceivable position for labor and delivery.


Oxytocin is an ancient hormone, present in all mammals. In addition to its star role of contracting the uterus during labor and birth, oxytocin is the hormone secreted in both men and women during ecstasy of orgasm, the feeling of emotional connection with a friend, the rush of being in love, and the literal rush of milk to a suckling infants. In the words of Ina May Gaskin, “ What gets the baby in, gets the baby out”, and gets the baby fed, too.


The duration of the normal upper limit to labor has been reduced from 36 hours in the 1950s to 24 hours in the 1960s to 12 hours in 1972 when active management was introduced.

Some obstetricians have inflexible ideas of how labor ought to go. If your labor doesn’t conform to that pattern, typically, “doctors do something” to you to make it fit.  As you may gather, there are a number of drawbacks to this myopic approach.


When William Camann, M.D, director of obstetric anesthesiology at Brigham and Women’s Hospital in Boston, was asked about the many grievances often brought against the epidural he cited that it lengthens labor, necessitates artificial oxytocin, increases the likelihood of a vaginal tear or episiotomy, ups the chance of a cesarean section, and this disrupts breastfeeding.

All have been associated with the epidural, he acknowledges, but the studies aren’t proving cause and effect. Use of epidural anesthesia and childbirth at large hospitals increased from 22 percent in 1981 to 66 percent in 1997, and is estimated to be 80 percent today.


A natural birth versus a medical birth.

A place called “The Village” is located in Southern Tennessee (widely known as The Farm) gives statistics of a medical birth versus a more natural guided birth. Ina May’s “Guide to Childbirth” writes,

Women in my village expect to give birth vaginally, for that is the way all but one or two out of every hundred have their babies. Yes, we do sometimes have to transport a woman to the hospital for a cesarean or instrumental delivery, but such interventions are comparatively rare for the woman who give birth at The Farm.

Our cesarean rate up to the year 2000 was 1.4 percent and our forceps- and vacuum- extraction rate was 0.05 percent. The US national cesarean rate for 2007 was 32.3 percent, and the instrumental delivery rate was about 10 percent.

Women at The Farm know that labor can be painful, but many of them know as well that labor and birth can be ecstatic — even orgasmic.

Above all, whether or not they experience labor as painful, to a woman, they found labor and birth a tremendously empowering passage.


Doulas can reduce the number of babies born in poor condition and the number who are admitted to special care nurseries, have prolonged hospital stays, or have elevations for infection.

Studies show that women, after their labor, feel that they coped better, have a higher appreciation of their bodies strength and performance and themselves as women, breastfeed longer, and experience less difficulty in mothering. They can have more positive feelings toward the baby, better self-esteem, a better relationship with the father, and less postpartum depression.

The fact that these studies took place in different countries, with different populations of women, under different circumstances, and constantly found benefits, further strengthens confidence in the validity of their results.

The author of an analysis of benefits and no known risks, stated “Every effort should be made by those close to them but also from especially trained caregivers. The support should include continuos presence, the provision of hands-on comfort, and encouragement. * referenced from…. (The Thinking Woman’s Guide to a Better Birth)