The Thinking Woman's Guide to a Better Birth

by Goer, Henci (Author)

• ISBN13: 9780399525179
• ISBN10: 0399525173
• Format: Paperback
• Copyright: 1999-10-01
• Publisher: Perigee Trade

Summary

As an intelligent woman, you are probably used to learning as much as you can before making major decisions. But when it comes to one of the most important decisions of your life--how you will give birth--it is hard to gather accurate, unbiased information. Surprisingly, much of the research does not support common medical opinion and practice. Birth activist Henci Goer gives clear, concise information based on the latest medical studies. The Thinking Woman's Guide to a Better Birth helps you compare and contrast your various options and shows you how to avoid unnecessary procedures, drugs, restrictions, and tests. The book covers: Cesareans Breech babies Inducing labor Electronic Fetal Monitoring Rupturing Membranes Coping with slow labor Pain medication Epistiotomy Vaginal birth after a Ceasarean Doulas Deciding on a doctor or midwife Choosing where to have your baby and much more . . .

Table of Contents

Introduction: Obstetric Management: What's Wrong with This Picture?	1	(10)
Why the Gap?	3	(2)
Why This Book?	5	(3)
About the Book	8	(3)
1. The Cesarean Epidemic: Obstetrics on the Cutting Edge	11	(20)
Myths and Realities Behind the Rise in Cesareans	12	(7)
What Determines Your Chance of Having a Cesarean and What Should the Odds Be?	19	(2)
The Cesarean Procedure	21	(1)
The Bottom Line	22	(9)
Benefits and Risks of Cesarean Section	22	(4)
How to Avoid an Unnecessary Cesarean	26	(1)
Making a Cesarean a Positive Experience	27	(4)
2. The Full-Term Breech Baby: Cesarean Section Is Not the Only Answer	31	(18)
What's the Problem with Breech Birth?	32	(2)
Turning the Baby Head Down	34	(3)
The Home Version	34	(2)
The High-Tech Version	36	(1)
Alternative-Medicine Versions	37	(1)
The Bottom Line on ECV	37	(3)
Controversies and Trade-Offs of ECV	37	(1)
Strategies for Improving the Odds of Success of ECV	38	(2)
The Bottom Line on Breech Birth	40	(7)
Trade-Offs of Cesarean vs. Vaginal Breech Birth	40	(2)
Controversies of Vaginal Breech Birth	42	(5)
Safety Factors in Vaginal Breech Birth	47	(1)
Gleanings from the Medical Literature	47	(2)
External Cephalic Version	47	(1)
Vaginal Breech Birth	48	(1)
3. Induction of Labor: Mother Nature Knows Best	49	(26)
Why Not Wait?	50	(7)
Convenience Inductions	51	(1)
Suspected Large Baby	51	(1)
Prelabor Rupture of Membranes in Full-Term Pregnancy	52	(3)
"Overdue" Pregnancy	55	(2)
Tests of Fetal Well-Being	57	(1)
Cervical Ripening and Induction Procedures	58	(2)
The Bottom Line on Labor Induction Generally	60	(7)
Avoiding an Unnecessary Induction	60	(2)
Pros and Cons of Techniques for Ripening the Cervix and/or Inducing Labor	62	(4)
General Advice on Induction	66	(1)
The Bottom Line on Labor with a Large Baby	67	(1)
Strategies to Avoid Unnecessary Intervention	67	(1)
The Bottom Line on Induction for Prelabor Rupture of Membranes	68	(4)
General Advice	68	(1)
Compare and Contrast Three Approaches to Prelabor Rupture of Membranes	69	(2)
Advice for Group B Carriers	71	(1)
Induction for Postdates Pregnancy	72	(1)
Compare and Contrast Three Postdates Options	72	(1)
Gleanings from the Medical Literature	73	(2)
4. IVs: "Water, Water Everywhere, Nor Any Drop to Drink"	75	(10)
The Illogic of "Nothing by Mouth"	76	(3)
The Bottom Line	79	(4)
Pros and Cons of Forbidding Food and Drink in Labor	79	(1)
Pros and Cons of Routine IVs	79	(2)
What Should You Eat or Drink During Labor?	81	(1)
Ways to Minimize the Chance of Aspiration	82	(1)
Gleanings from the Medical Literature	83	(2)
5. Electronic Fetal Monitoring and Cesarean for Fetal Distress: The Machine That Goes Ping!	85	(14)
How Did We Get into This Mess?	86	(4)
How EFM Is Done	90	(2)
External EFM	91	(1)
Internal EFM	91	(1)
The Bottom Line	92	(5)
Comparing External and Internal Monitoring	92	(2)
Situations When the Medical Literature Supports the Use of Continous EFM	94	(1)
Ways to Avoid the Drawbacks of EFM	94	(2)
Ways to Avoid Problems with the Baby	96	(1)
Gleanings from the Medical Literature	97	(2)
6. When Doctors Break the Membranes: If It Ain't Broke, Don't Break It	99	(8)
The Amniotomy Procedure	103	(1)
The Bottom Line	103	(3)
Pros and Cons of Routine Amniotomy	103	(1)
Pros and Cons of Amniotomy for Indication	104	(1)
Avoiding Amniotomy	105	(1)
Gleanings from the Medical Literature	106	(1)
7. Slow Labor: Patience Is a Virtue	107	(18)
Active Management of Labor	110	(4)
Procedures	114	(1)
The Bottom Line	115	(8)
Benefits and Risks of Techniques for Coping with Poor Progress	115	(4)
Strategies to Avoid the Need for IV Oxytocin, Instrumental Delivery, or Cesarean Section	119	(4)
Gleanings from the Medical Literature	123	(2)
8. Epidurals and Narcotics: A Shot in the Dark	125	(24)
Why You Don't Hear About the Downside of Epidurals	126	(3)
The Epidural Procedure	129	(3)
The Bottom Line	132	(14)
What an Epidural Does	132	(1)
The Trade-Offs of Epidurals	132	(3)
What an Injected Narcotic Does	135	(1)
The Trade-Offs of Injected Narcotics	135	(1)
The Trade-Offs of Natural Childbirth	136	(4)
Strategies to Avoid Pain Medication	140	(2)
Questions to Ask When Helping a Laboring Woman Decide Whether to Have Pain Medication	142	(1)
Strategies to Minimize the Risks and Side Effects of an Epidural or Spinal-Epidural	143	(3)
Gleanings from the Medical Literature	146	(3)
9. Episiotomy: The Unkindest Cut	149	(12)
Why Are Doctors Still Doing Routine Episiotomies?	152	(2)
What Is an Episiotomy?	154	(1)
The Bottom Line	155	(4)
Pros and Cons of Routine Episiotomy	155	(1)
Traditional Indications for Episiotomy	155	(1)
Strategies to Protect the Perineum	156	(3)
Gleanings from the Medical Literature	159	(2)
10. Elective Repeat Cesarean: Just Say No	161	(16)
So Why Hasn't VBAC Become Routine?	162	(4)
The Bottom Line	166	(9)
Pros and Cons of VBAC vs. Elective Repeat Cesarean	166	(3)
The Odds of VBAC	169	(1)
Factors That Exclude VBAC	169	(1)
Factors That Don't Exclude VBAC	170	(1)
Factors That Promote Safe Vaginal Birth	171	(2)
Factors That Promote a Positive Birth Experience	173	(2)
Gleanings from the Medical Literature	175	(2)
11. Professional Labor Support: Mothering the Mother	177	(10)
Do You Really Need Professional Labor Support?	178	(3)
What About the Father's Role?	181	(1)
The Bottom Line	182	(4)
Pros and Cons of Professional Labor Support	182	(2)
Comparison Between Labor Support from a Female Relative or Friend and a Doula	184	(1)
Comparison Between a Doula and a Monitrice	184	(1)
Choosing a Professional Labor Support Companion	185	(1)
Gleanings from the Medical Literature	186	(1)
12. Obstetricians, Midwives, and Family Practitioners: Someone to Watch over You	187	(14)
The Bottom Line	190	(10)
A Guide to the Qualifications of Birth Attendants	190	(1)
Pros and Cons of Various Classes of Birth Attendants	191	(2)
Interviewing a Caregiver	193	(4)
When Choice Is Limited	197	(3)
Gleanings from the Medical Literature	200	(1)
13. The Place of Birth: Location, Location, Location	201	(18)
History Reexamined and a Few Current Facts	202	(3)
The Safety of Hospital Births	205	(2)
A (Relatively) New Out-of-Hospital Option	207	(2)
The Bottom Line	209	(8)
Comparing Birth Sites	209	(3)
Comparing Direct-Entry Midwives and Nurse-Midwives	212	(1)
Interview Questions	213	(4)
Advice If You Decide on an Out-of-Hospital Birth	217	(1)
Gleanings from the Medical Literature	217	(2)
Appendices	219	(136)
Literature Summaries	219	(102)
Chapter 2	219	(8)
Chapter 3	227	(12)
Chapter 4	239	(5)
Chapter 5	244	(6)
Chapter 6	250	(4)
Chapter 7	254	(10)
Chapter 8	264	(12)
Chapter 9	276	(8)
Chapter 10	284	(7)
Chapter 11	291	(4)
Chapter 12	295	(12)
Chapter 13	307	(14)
Bibliography	321	(22)
The Mother-Friendly Childbirth Initiative	343	(12)
Resources	355	(4)
Index	359