Book Review: The Sacred Gift of Childbirth

The Sacred Gift of Childbirth: Making Empowered Choices for You and Your Baby

Many books teach and focus on the health and safety of giving birth, from comfort techniques to medical procedures.  But few delve into God or His principles and plan for women.  Childbirth offers a unique benefit from many divinely designed blessings–spiritual, emotional, and physical.  The Sacred Gift of Childbirth: Making Empowered Choices for You and Your Baby empowers women with valuable information that allows them to make informed decisions about birthing.

In this book, Marie-Ange Bigelow explores that spiritual connection and asserts several ways that she believes childbirth can bring women closer to God.  She argues that rather than being feared, childbirth is “an event that should be celebrated with gratitude” and an opportunity to partner with God and strengthen our relationship with our Heavenly Parents.  She first lays out “God’s Plan for birth,” then moves on to describe how birth has been increasingly medicalized within the U.S., offers factors to consider in making decisions for an upcoming birth, and then concludes with how a woman can best be supported before, during, and after her birth.


Our bloggers decided that this book needed more than one reviewer. Liz, a doula, hoped to find a uniquely Mormon take on childbirth. Libby, who had three medically-necessary cesareans, hoped to find an affirmation of the spirituality she felt in her decidedly non-traditional births.

Liz’s review

As a birth doula and Mormon woman, I have spent a lot of time pondering the spiritual aspects of childbirth. There were several sections in this book that I really liked.  I particularly the passages where she discussed how birth can be empowering: “Some of our greatest moments of pride and accomplishment come after we have worked hard for something.”  I think this can be applied not just to childbirth, but to any time women do hard things and emerge victorious, whether it’s giving birth to a baby, finalizing an adoption, defending a dissertation, and/or nailing that high-stakes presentation at work.  She highlights scriptures where birth is used as an analogy to Christ’s atonement, and how pain can be “one of life’s greatest teachers” if we let it.  She highlights the bonding that can happen between mother and baby, mother and partner, and mother and God during childbirth.  Her chapter on the role of husbands during birth was particularly helpful on this front; she spends several pages explaining how important it is for husbands to support–not manage–their wives during childbirth.  She even lightly touches on how men are culturally accustomed to presiding and making decisions in relationships, but that the most important thing they can do during childbirth is to encourage, assist, and believe in their laboring wife: “as spouses, being equally yoked is beneficial during birth.”  Having witnessed many births (including un-medicated, medicated, and cesarean births), I can add a hearty “amen” to the power of women being supported, encouraged, and empowered to make decisions during childbirth.

That said, I do have two critiques of the book, one minor and one major.  My minor critique is the author’s repeated emphasis on childbirth being The Divine Role of women on Earth, equating motherhood and priesthood in a way that I think is doctrinally inaccurate or incomplete.  I know many women whose bodies are unable to carry a pregnancy and/or give birth, and to dismiss them as simply aberrations to God’s plan with no capacity to fulfill their divine role is hurtful and causes many women to wonder if they have a place in God’s kingdom as a woman.  Additionally, I think suggesting that a woman’s principal role is motherhood is limiting, because there are plenty of women who don’t experience pregnancy, birth, or motherhood, and who participate in the building of Zion and doing good on Earth in a way that both glorifies God and shows divine nature and worth.  I wish the language in the book had been less prescriptive of all women fulfilling their divine role through motherhood.

My major critique of the book also has to do with prescriptive language: the author repeatedly prescribes natural birth as God’s plan and the “best” way to give birth.  While she does give the occasional carve out for requiring medical assistance (“the divine design of childbirth is perfect, but our bodies are not”), there is an overwhelming bias towards natural birth being the optimal way to experience childbirth.  She argues that if Eve can give birth naturally, so can you, and outright says that she “believe[s] in natural childbirth and encourage[s] all low-risk women to have this as a goal.” While I agree with the author that medical interventions are often pushed upon women without full education as to the risks/benefits, and that there is a predominant culture of fear surrounding birth that may affect a woman’s decision-making surrounding her birth, I am strongly opposed to suggesting that natural birth is the best way to give birth.  There is no validation given for women who simply want a pain-free or cesarean birth, but instead an insistence that God designed natural birth and that is the best way to grow spiritually during childbirth. Having witnessed many women who feel empowered, strengthened, and spiritually edified during and after medicated and/or cesarean births, I simply believe that natural birth can be one empowering way to connect with God, but definitely not the only way. I would also argue that just as God designed the human body to give birth, God also inspired scientists and obstetricians to perfect various interventions that, while generally overused in the American medical system today, have saved countless lives and are incredibly helpful to women who choose a medicated or cesarean birth.

Overall, I think this book can be incredibly helpful to women who have already made the decision to have a natural birth and are looking for affirmation and support.  I don’t fault women who choose this path: I chose it myself!  But I also think it’s crucial to carve out space for women to have a spiritually uplifting and empowering birth experience with the use of medical intervention, as well as space for women to experience spiritual connection through avenues other than pregnancy, childbirth, and/or motherhood.

Libby’s review

The title would seem to say it all. Marie-Ange Bigelow’s The Sacred Gift of Childbirth drives home the simple, and to her largely LDS audience, obvious, point that childbirth is important and transcendent, a gift of God to women. If you’ve had easy natural births, easy transitions into motherhood, and are looking for a book to confirm your convictions that childbirth is sacred and natural childbirth is the One Best Way to birth babies, you may find it uplifting.

The rest of us probably won’t.

Bigelow’s repeated insistence that natural childbirth is God’s plan for women is more than tedious; it creates false and dangerous expectations for Mormon women and their babies, effectively setting up many women to “fail” at childbirth or, worse, refuse life-saving medical care. Moreover, her invocation of LDS General Authorities’ opinions about gender roles and family planning allows for no variations from anything but the most idealized (and idolized) of Mormon families, which is likely to alienate many of the people she hopes to reach.

It’s difficult to know exactly what God’s plan is about many things, and childbirth certainly falls into that category. There’s little scriptural guidance aside from “be fruitful and multiply.” Digging into the history of childbirth further complicates things: in 1900, for example, the maternal mortality rate in the U. S. was somewhere between 600 to 900 per 100,000 births (with approximately 1 in 10 babies dying in their first year of life). After more than 100 years of significant public health initiatives and medical breakthroughs, that rate was down to about 28 per 100,000 births in 2014. Dare we make assumptions about which number better reflects God’s will?

Bigelow points out that the maternal mortality rate was even lower from the 1970s to the 1990s–just 6.6 in 1987–and links the rise since then to increased maternal choices about cesareans, epidurals, and inductions. Yet Priya Agarwal of the World Health Organization, looking at the same numbers, identifies three major risk factors. The first, she says, is that “[h]ospitals across the USA lack a standard approach to managing obstetric emergencies.” Second, poor health management and chronic health problems–an unfortunate byproduct of our failure to ensure accessible, affordable medical care to all citizens–mean that more women in the U. S. begin pregnancies with preexisting health problems. Third is a business management truism come to life: that which is measured improves; that which is not doesn’t. “Only half the USA’s states have maternal mortality review boards,” Agarwal writes, “and the data that are collected are not systematically used to guide changes that could reduce maternal mortality and morbidity.”

Are elective cesareans a problem? Certainly. But does that problem stem from individual women’s insistence on convenience? Likely not.

Bigelow also frowns on lesser forms of intervention. She links epidurals (correctly) to higher use of Pitocin, higher risk of breastfeeding problems, and decreased maternal satisfaction with the birthing process. Again, however, we should be wary of equating unmedicated birth with God’s plan, just as we would be leery of setting a broken bone or undergoing necessary surgery without the benefit of anesthetics. Bigelow counsels, “While we are now able to choose an optional intervention, we are never able to determine the consequence of that choice. And because all interventions carry potential risks, the only way to keep childbirth safe is to learn how to decipher when the benefits outweigh the risks.” Here, however, she declines to mention that a less painful childbirth might indeed be a benefit that outweighs the slight risks of complication. Instead, she tells mothers-to-be, “[I]f avoiding pain is the number one goal of your birth, you will not be satisfied with the recommendations I offer.” Guilt-trip induction complete.

Her general distrust of the medical profession brews throughout the book. Despite the extreme cautions that obstetrics researchers take (a policy that has actually slowed our understanding of some perinatal complications), Bigelow writes, “In between the implementation of new interventions and the completion of research to determine their effectiveness and safety, there will always be women experiencing unknown side effects. . . . Couples will put their trust in unproven methods, making these methods socially acceptable and approved of.” While she’s careful not to dismiss cases that legitimately require intervention, she clearly considers even accepting an epidural (something that 80 percent of women in the U. S. opt for, and which nearly all medical practitioners consider to be safe) to be a mere convenience that a truly enlightened mother would eschew: “When deciding if you desire an epidural, it is important to remember that the discomfort of labor is not a risk. Experiencing the pain of contractions actually makes your birth safer. However, for many women, the pain involved is a definite con. For this reason, I encourage women to weigh the benefits and risks, not the pros and cons.”

This is not to say that I’m anti-natural birth. When I was diagnosed with preeclampsia during my first pregnancy, landing in the hospital meant that I missed the last two weeks of natural childbirth class. I didn’t have a choice about interventions; cesareans saved my life and my babies, and while I’m grateful to be alive I mourn the childbirth experiences I might have had if things had been different. I think every woman should have the option of natural childbirth if it’s safe for her to do so. But I’ve also seen that pregnant women tend to consider their babies’ well-being before their own (hands up if you’ve gone off medication during pregnancy, lived through mandated bed rest, or downplayed your own medical concerns for fear they would trump your child’s), often to their detriment. By advocating solely for the ideal outcome for baby, Bigelow ignores the very real strides we’ve made in caring for mama. The story she relates of her sister, who was determined to breastfeed despite extreme pain, gives us the impression that bottle-feeding is somehow a less righteous choice, and fails to mention recent studies, controlled for parents’ socio-economic levels, that find little difference between breast-fed and bottle-fed babies. Her insistence that mothers sacrifice everything for their babies doesn’t allow for us to lean in to natural childbirth partway, nor does it acknowledge the scriptural caveat that “it is not requisite that a [woman] should run faster than [s]he has strength.”

The best chapter in the book by far is on post-partum depression. Bigelow gives us a very real look at the frequency and depth of PPD, and urges Mormon women to reach out for help rather than sticking it out on our own. If there is anything to take from this book, please remember this:

Many women with postpartum depression do not share their experiences with others. Imagine how difficult it would be for an LDS mother to admit that she does not enjoy being a mother. She may feel ashamed or worried that others will judge her. It is isolating to feel like the only woman who isn’t happy since she became a mother.

. . . I want to be clear in stating that Satan and sin are not the causes of postpartum depression, and all women are susceptible to this trial. Struggling with depression is not a sign of unrighteousness.

Well, thank goodness. Unfortunately, she spends much of the rest of the book shaming women who have made birth choices other than natural childbirth; just a few pages earlier, her disapproval shows through clearly as she attributes a mother’s disengagement with her child to the medical interventions involved in the birth:

I remember a particular birth in which the mom was so disengaged with her baby that when the nurse asked her if she wanted to hold her baby before they took him away to wipe him off and perform a newborn assessment, the mom said, ‘No, I just really want a milkshake.” . . . [T]hink about that: a woman who has carried a child for nine months, has anticipated his arrival, has wondered what he would look like and what color his hair and eyes would be, isn’t even interested when she finally gets to see him.

I’m concerned that Bigelow attributes this effect to medical intervention rather than exhaustion or depression. She’s prone to conflating the two, suggesting throughout that the higher instance of PPD rates among women who have medical interventions are the result of those interventions. But it just isn’t so: correlation does not equal causation, and there are alternative explanations that make more sense, beginning with the fact that medical intervention typically occurs when mothers are already under undue stress or babies’ lives are in danger, and including the observation of a nurse in the ante-natal unit at Brigham & Women’s Hospital, where I was placed on bed rest before the birth of my last child, that the most significant predictor of post-partum depression seemed to be ante-natal depression, which can be triggered by a high-risk or otherwise difficult pregnancy, itself in turn more likely to require medical intervention. Life–and giving life–is complex and difficult; telling us that we’re doing it wrong just makes it worse.

Liz

Liz is a reader, writer, wife, mother, gardener, social worker, story collector, cookie-maker, and hug-giver.

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19 Responses

  1. Emily U says:

    I read several books on natural childbirth and breastfeeding when I was pregnant for the first time. I was 100% sold on both. My son was born without medical intervention, but breastfeeding went extremely poorly. I seriously grieved that it didn’t work for us. Now, a little older and wiser, I believe in minimizing expectations and “should” as much as possible. It’s a hard balance to give information without employing “should.” Thanks for these heartfelt reviews.

  2. Amy says:

    Libby, honey, pre-e is NOT a medically necessary reason for a section. It’s a reason for induction sure. But it’s not an automatic section.

    • Libby says:

      Oh, I forgot that part. They tried inducing me, but my cervix just wouldn’t dilate. The cesarean became medically necessary when my blood pressure was just too high.

      Second pregnancy, my doctor was all for letting me do a VBAC…until an ultrasound two days after my due date showed low amniotic fluid (which, in retrospect, was probably also an indicator of preeclampsia). Dangerous. Since I’d previously had a cesarean, there was no question of inducing me, and no one was willing to let the baby’s head crush the umbilical cord with such low fluid, so there we were.

      With the third baby, I ended up with severe preeclampsia ten weeks before his due date.

      I’ve been highly involved in my medical care all the way through. And, as I noted earlier, I’m grateful I’m alive.

  3. Emily Butler says:

    The part of this book that resonated with me the most was the woman who admitted that she just wanted a milkshake after delivering . . .

    Such thoughtful, well-reasoned reviews. Really well done, Liz & Libby. I’m glad nobody tsk-tsk’d my decision to deliver via C-section. Holy cow, as if I needed one more reason to feel like I was doing it wrong . . .

    • Emily U says:

      Seriously, I can relate to the milkshake quote. Having just done the hardest physical thing of my life, holding baby asap wasn’t top of mind for me, either.

  4. Nancy Ross says:

    I appreciate both reviews. I think that natural childbirth is great for you if that is what you want, but we often don’t get to make a whole lot of choices in childbirth and assigning the label of “righteousness” to one set of choices/potential outcomes isn’t helpful. Mormon women really don’t need more guilt and shame.

  5. Descent says:

    I believe that the author was reporting what the research says about physiological birth in low-risk mothers and that she did so accurately. The consensus among researchers is that the safest mode to give birth is unmedicated and unhindered. We now have the science to explain what happens hormonally with and without medication and intervention. The biological norm is that undisturbed birth is safe and rewarding for women. The author made room for individual circumstances and emergency obstetric procedures for when the process deviates from that norm. I disagree with the reviewers saying that the author got caught up in the best/righteous dichotomy.

    It think it is also helpful to recognize that this book is primarily written for women preparing to give birth for the first time and likely have little exposure to childbirth, so by necessity the information needs to be digestible. The main thesis was that evidence based practices in birth align with the body’s innate design while also recognizing that adaptations and thoughtful decision making is necessary in a variety of situations. It’s easy for women who have already given birth to feel judged and slighted by anyone promoting the biological norm, especially if their experiences did not align with it. So much goes into every birth experience and it’s often not easy to rehash every detail to determine whether it something had a biological cause or an iatrogenic cause. Too often unfortunately, iatrogenic harms leave women feeling traumatized and dissatisfied. I see this book as an effort to prevent and protect LDS women from some of the harms that can come when the biological norm and respect for the individual are not care providers’ highest priority.

    • Violadiva says:

      Great points! Thanks for giving us another way to see the book. Knowing that her audience is first time moms rather than after-the-fact-moms is an important distinction.

    • Sue says:

      “The biological norm is that undisturbed birth is safe and rewarding for women.”

      The biological norm is that 830 women die every day from undisturbed pregnancy and childbirth. (http://www.who.int/mediacentre/factsheets/fs348/en/).

      “The consensus among researchers is that the safest mode to give birth is unmedicated and unhindered.”

      Please share citations. From MDs, not the chiropractors or public health specialists or cardiac nurses that Marie cites. And show consensus, not the work of one MD whose hypotheses have not been corroborated or even noted by scientists. Home birth, which is unmedicated and unhindered, is 4 times more deadly for babies than hospital birth. See the data at ishomebirthsafe.blogspot, compiled by an LDS mother and scientist.

      “I disagree with the reviewers saying that the author got caught up in the best/righteous dichotomy.”

      What else would you call it when the author tries to reassure readers that they “should feel no shame or remorse” over receiving a “legitimately required” induction? It’s a medical procedure, not a sin. And it appears that Marie is the arbitrator of whether it’s legitimately required (see her “Unproven Reasons to Be Induced”).

      “I see this book as an effort to prevent and protect LDS women from some of the harms that can come when the biological norm and respect for the individual are not care providers’ highest priority.”

      The safety of mother and child should be the highest priority. Harm comes to LDS women when they believe that accepting medical help contravenes God’s plan. Feelings of unworthiness come to them when they believe that women’s bodies were designed for childbirth, yet their bodies “failed.” The biological norm doesn’t merit our respect. LDS Charities’ Maternal and Newborn Care uses a substantial amount of funds and volunteers, including in the US, to help mothers who would otherwise have to give birth “unhindered” (https://www.ldscharities.org/news/new-maternal-and-newborn-care-program).

      • Descent says:

        Hi Sue, I would refer you to the work of Dr. Sarah J. Buckley and Dr. Michel Odent for discussions of what I am describing. One of the best resources for low-risk birth is Optimal Care in Childbirth by Henci Goer and Amy Romano. I would also caution you from conflating global stats with low-risk statistics from developed countries. The strength of Optimal Care in Childbirth is that is a review of the literature and it evaluates the strength and consistency of the methodology and conclusions. I believe it is important to understand how the physiological process of birth is designed to work and provide women with care that does not lose sight of that while adapting to individual circumstances and risk factors. I stand by that. We could research bash but it’s just as obnoxious as Bible bashing in religious communities so I will refrain from anything further.

      • Sue says:

        Dr. Buckley writes about the hormones of childbirth without the benefit of being an endocrinologist or even a researcher. Her theories have not been corroborated by scientists. At least she admits it: “There are no long-term studies of the effects of epidural analgesia on exposed human offspring” (“The Hidden Risks of Epidurals”). Dr. Odent said “For her, his [the baby’s father] presence is a hindrance, and a significant factor in why labours are longer, more painful and more likely to result in intervention than ever.” Somehow I don’t think he’s a guy you want to cite.

        I’m looking for scientific studies showing that “natural birth has the lowest instances of morbidity and mortality.” Of course births can be successful without medicine. But the figures that I cited above show that medical assistance improves mortality rates. Women should not be misled into rejecting safe preventive medical procedures because somebody said it contradicts God’s plan or it “harms birth.” Our goal should be a healthy baby and mother, not devotion to the idol of natural birth.

  6. Childbirth Educator says:

    I agree with Descent’s post. The author is certainly not trying to make women feel guilty for their birth experience–she’s just stating the facts and research which clearly indicate that natural birth is the safest option for low-risk mothers. Think of how many women don’t realize that, and how it would change the way they evaluate and make decisions during birth if they DID know. Do I shame women for getting an epidural or a C-section? No–but I do want them to be thoroughly educated on the benefits and risks before making those decisions. So does Marie. Much better to know what you’re getting into beforehand than going in blindly and having major regrets, and in many instances, trauma, after. That’s what I feel like the author was trying to portray. Yes, the book is in favor of natural birth, but for a good reason. She doesn’t shame other options if you are educated and have made informed decisions with the Holy Ghost on your side.

  7. As the author of the book, I guess I’ll chime in. 🙂 It clearly states on the first page of the book that this book is geared towards pregnant, low-risk women. The point isn’t to read it after you give birth, but before, so you can truly understand all of your options. While these reviewers believe that educating women on the well- proven data is shaming women, I have to disagree. We cannot purposefully without helpful information because it might hurt someone’s feelings. (Read more about that here: http://www.mariebigelow.com/educating-not-shaming/)

    I also have to point out that nowhere in the book do I ever say that there is a best way or more righteous way to give birth. Only a safest way to give birth. And despite the unpopularity of natural childbirth, it still remains the safest way for low-risk women to deliver. Just as educating and shaming are not synonyms, neither are best and safest.

    I know not everyone will like my book and that is totally ok! But what isn’t ok is using information that isn’t in the book to tell others not to like it. Most of the points these reviewers refer to are not direct quotes from the book, are modified to represent their personal interpretations, and are taken out of context.

    For women seeking an honest education about childbirth, my book will fit the bill. I am confident in that and confident in the research I present as it has all been extensively fact checked by myself, by midwives, obstetricians, and professional editors.

    • Sue says:

      I have questions about your research, Marie. In your book you claim that inductions triple the rate of cesarean section. As evidence you cite a Swedish study from 2011, which you call current. That study looked at the outcomes of 881 inductions.

      In your book you also cite the ACOG bulletin,“Safe Prevention of the Primary Cesarean Delivery,” 18 times. But that very same bulletin says this: “Studies that compare induction of labor to its actual alternative, expectant management awaiting spontaneous labor, have found either no difference or a decreased risk of cesarean delivery among women who are induced.”

      Question 1: If ACOG is a reliable source 18 times, why isn’t it a reliable source for this?

      Since that Swedish study, there have been numerous studies which informed ACOG’s consensus, including one that studied over 3 MILLION women, a somewhat higher-powered study than your 881 women (see http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3719843/; also http://www.nejm.org/doi/full/10.1056/NEJMoa1509117?query=TOC; http://www.ncbi.nlm.nih.gov/pubmed/21542808; http://www.ajog.org/article/S0002-9378%2814%2900221-X/abstract; http://www.cmaj.ca/content/early/2014/04/28/cmaj.130925; and http://onlinelibrary.wiley.com/doi/10.1111/1471-0528.12329/full#bjo12329-bib-0015.

      Question 2: Why didn’t you tell your readers about these newer, higher-powered studies?

      You also claim that inductions invite many risks into labor and birth. I can’t think of any risk worse than death. That first study I cited shows that “Delivery [induction] carries a greater mortality risk than expectant management [spontaneous labor] at 37 weeks of gestation, carries equivalent risk at 38 weeks of gestation, but becomes advantageous at 39 weeks of gestation and beyond.”

      This 2012 study of over one million women shows that between 37 and 41 weeks, inductions reduce neonatal mortality: http://www.bmj.com/content/344/bmj.e2838).

      A 2015 Danish study assessed the changes in perinatal outcomes in children born from 37 weeks gestation following induction. The author of that study said this: “We have seen significant reductions in newborn asphyxia, neonatal mortality, macrosomia and peripheral nerve injuries. Another similar study we conducted recently also demonstrated a halving of stillbirths following the implementation of proactive labour induction practice” (http://www.bjog.org/details/news/7500721/Proactive_labour_induction_can_improve_perinatal_outcomes.html).

      In your book you say that reaching 40 weeks gestation is not a proven reason to be induced—that a woman doesn’t need to be induced until 42 weeks. You provide no citations for those claims. In fact, the risk of stillbirth at 42 weeks is FIVE times that at 37 weeks.

      Question 3: Don’t you think this is an important, even lifesaving message to give to women?

      Concerning inductions, you also say “Pitocin makes contractions last longer, which can lead to fetal distress, brain damage, and, in rare cases, even death.” As evidence you cite another ACOG bulletin. A quick search of that bulletin shows that the terms “fetal distress” and “brain damage” don’t even appear in that bulletin.

      Question 4: How do you justify that?

      I hope you’ll answer my questions.

      • Sue,
        I applaud and thoroughly relate to your passion for truth regarding childbirth. It is something we have in common. However, I do not share your passion for online debates, and will have to set the healthy boundary of no longer participating in them. I’m assuming you are the same Sue who has posted similar argumentative questions on other reviews. Please correct me if I’m wrong. I will try to quickly respond to your questions this last time, but will not continue to do so in the future. Please feel free to reach out again if you would be interested in collaborating productively.

        I do not know everything about childbirth, nor do I claim to. I’m sure there is plenty of research I am unaware of. It would be humanly impossible to sift through it all. I can say with confidence that I have included sound research in my book, and I am happy to share with you my process of finding it.

        First of all, no research after May 2015 was included in the book. That is how long it takes to get a book ready for publication. I also do not include research that is too new to have been replicated (and several of the things you point out fall into that category.) All the research I include I was able to find at least 3 studies with similar results and findings that were conducted with sound science. It is easy to find “research” that supports anything you can think of. It is more difficult to find research that is unbiased and controlled. Everything I cite has multiple sound studies supporting it. When quoting statistics, I always chose the middle number to give a moderate viewpoint, instead of leaning either conservative or liberal.

        As of right now, there is no conclusive evidence showing that the routine use of interventions improves low risk births, but there is ample showing it harms it. This isn’t just supported in the data, but in our doctrine as well, with the belief that God loves us and created the human body. (Why would a loving God who desires us to have families, create childbirth to fail without medical intervention, knowing that modern medicine would not, and is still not, available to the majority of His daughters?) We also know that the Church cares deeply about childbirth outcomes, and trains doctors and midwives worldwide in the life-saving techniques of hygiene to prevent spread of disease, hemorrhage prevention, and neonatal resuscitation. It is good skills that improve low-risk births, not interventions. Different story for high risk births, but that is not my area of expertise, nor the focus of my book. As you know from reading my book, I believe strongly in treating low risk women as low risk, and treating high risk as high risk. That is what the data supports. This paradigm contributed to the extremely low mortality rates of the late 20th century.

        As Libby points out in her review, the mortality rates before the 1930s were atrocious. She implies that medical interventions are what changed this, but that isn’t correct. It was discovering the spread of disease, treating and stopping hemorrhage, and learning how to support newborn breathing that made the difference. These are now essential skills to all doctors, nurses, and midwives in the United States and are our best defense against maternal and newborn deaths. This was briefly discussed in my book, but isn’t critical to debate because there are no added risks to good care and competent provider skills. Only benefits.

        As for stillbirth rates and risks as weeks progress, new research has solidly confirmed that there is no medical basis for induction before 42 weeks. ACOG officially took that stand within the last 2 years. As you know, there is conflicting research, and there are some in ACOG who believe ALL women should be induced at 39 weeks. This was hotly debated within the last couple of weeks, showing there is no conclusive evidence at this time that shows that inducing without medical need improves outcomes. And the section you are referring to the ACOG article “Safe Prevention of the Primary Cesarean” has been largely questioned and been shown to have faulty statistics that have not been replicated.

        Evaluating still born risk is extremely complicated, and includes looking at relative risk and absolute risk. Since most studies look at relative risk, we can safely assume that numbers are inflated and researchers are skewing statistics in order to meet their hypotheses.
        And another risk that is not considered when just studying stillborn risk is maternal death, which has been proven to increase as we increase interventions. Trading in one death for another is hardly a medical achievement.

        At this time, for low risk women, the evidence is overwhelmingly siding with leaving birth alone, as unhindered birth is most likely to succeed. And until I see solid, repeated evidence stating otherwise, I will continue to believe this. You however, may believe and study whatever you’d like. Use your passion and knowledge to write your own book! I would love to read it.

      • Sue says:

        You asked me to correct you . . .

        I believe I posted one comment on one review, I didn’t ask a single question, and I’ll let the reader decide if I was argumentative: See “The Moments We Stand.”

        Apparently if someone disagrees with you, that means they have “a passion for online debates.” I have a passion for the truth. Many of your claims are inaccurate, and could mislead women. I’m not trying to change your mind; I just want anyone who might be reading your claims to know they’re “largely questioned.”

        In your book you say, “The routine use of intervention has contributed to America having the highest rate of maternal mortality in the industrialized world, and one of the highest infant mortality rates.” As evidence you cite Coeytaux et al but they say nothing about mortality in their section on interventions, and their citations show no such causality. And infant mortality is a measure of pediatric care and therefore irrelevant in a discussion on childbirth. Neonatal mortality is the pertinent measure, and America’s is among the lowest in the world and dropping.

        I can show you “solid, repeated evidence” that home birth, which is inherently unmedicated, has a neonatal mortality rate of at least triple that of hospital birth. See ishomebirthsafe at blogspot.

        Somehow all of your sources are valid and mine are “too new to have been replicated.” But you say, “New research has solidly confirmed that there is no medical basis for induction before 42 weeks.” I hope it’s not too new to have been replicated. In any case it seems to be a secret.

        “Why would a loving God create childbirth to fail without medical intervention?” He didn’t. But the natural maternal mortality rate, where nothing is done to avert death, is 10–15%. The day of a child’s birth is the most dangerous of her life, at least until she turns 92. Birth is risky. Why did God make it that way? I don’t know. Why did He design babies to be born vitamin K-deficient? But the real question is: Why would a loving God create a plan He wanted women to follow but make it impossible for some women?

        You use quotes about mothering to support your thesis, but parturition is not parenting. How we mother has eternal significance; how we give birth doesn’t. To say that hormones guide our maternal behavior denies the gospel principle of free will. To say those first few moments of bonding are critical to the mother-child relationship denies the power of the Atonement.

  8. Violadiva says:

    This sounds like a book I would have appreciated to read along with Ina May’s and Sheila’s when I was pregnant with my first. Three midwife assisted home births later, I’m grateful for the knowledge I actively sought out about pregnancy and childbirth well before getting pregnant. I think the research, reading and soul searching I did to prepare for birth empowered me to feel strong and unafraid of my body and what it could do. I took 20 hours of childbirth education before giving birth to my first, and even after all that felt surprised about what I didn’t know I didn’t know once the baby was here!
    Based on many of my personal friends’ birth experiences, we all researched and learned about birth in different ways, and we all had a variety of outcomes. I think for the couple who is searching, this would be a good book to put in their path. And even for the couples who aren’t searching 🙂 So the author has a very targeted audience, which we all can appreciate.
    But for everyone else, I can see what Libby is getting at: it’s not for them. It’s tough for C-section moms anytime they hear the message (intended or otherwise) “you did this the second best way”
    Although, I would say that a C-section birth is still a sacred gift, and there are ways to make empowered choices within that framework. (What kind of pain reliever to use, what kind of anesthetic, baby skin on skin with mom while she’s being closed and recovering, etc. )
    I’m sure the author can appreciate that this blog is for women of all walks and birth circumstances, only a small sliver of whom are her targeted audience. (Pregnant, low risk women)

  9. Rhonda says:

    I loved this book! After reading it, I felt empowered to make better choices for my birth, however it unfolded. I wish someone had told me all these things YEARS ago! I bought a few extra copies of this book to share with family and friends.

    I have had epidurals, inductions, and some all natural instinctual births. I am a mother of 7. I think this book is a great resource for women to prepare for childbirth, as they will need to make many decisions leading up to and during the birth.

    Many women and babies could be spared a lot of illness, pain, and unnecessary recovery time, if they better understood the risks of interventions, not just the benefits.

    I wish I would have known the risks of an induction before I’d chosen to have one. I wish I would have known that it would likely lead to an epidural, which would likely lead to me being on my back- compressing my tailbone, causing me terrible back pain for 6 months after. I wish I would have understood that laying on my back would likely make the pushing stage much harder and cause me to tear or be cut and need stitches- resulting in weeks of painful recovery. (And for many women- resuming sexual relations is delayed and painful.)

    Knowledge is power. I appreciate how the author empowers the reader with sound research that is proven in the incredible, healthy, empowering, fulfilling experiences of my last 3 births. And the quick recoveries following. 🙂

    If I am blessed with any more children, I will consult this book to help me make a birth plan. If I choose to have any interventions, I will understand better what I am getting into. That is a good thing. That is not shaming. I will know that I did the best for my unique situation. I thank Marie for writing this book, and sharing this information with the world, as this info can be hard to come by for some reason! I am excited to share this book with my daughters. I feel so blessed to be a woman, and to have the Lord’s help through pregnancy, childbirth, and raising these choice spirits!

  1. May 28, 2016

    […] Complete | Blue Bird’s Nest May 25: Vitamin C May 26: Laura Walker May 27: Jessica Poe | Libby Boss | Liz Johnson May 28: The Mommy Method May 29: She Teaches Fearlessly May 30: All About Baby | The […]

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