Your Best Birth: Know All Your Options, Discover the Natural Choices, and Take Back the Birth Experience, by Ricki Lake and Abby Epstein, is a book I would love to recommend to all of my pregnant friends–and I almost can.
Lake and Epstein, or, as they would probably prefer to be called given the “girlfriend” tone of the book, Ricki and Abby, set out to awaken the inner birth goddess in every pregnant woman, but more in the fabulous and fearless sense of goddess than in the crunchy or new-age meaning. They want you to have “YOUR best birth,” rather than THE best or the PERFECT birth, because there is no one-size-fits-all and they know that flexibility is key in childbirth.
Just like your best girlfriend, Ricki and Abby give it to you straight. And just like a close friend, they want you to feel supported no matter what path you choose. However, just like your friend, you can tell when they still do not quite approve. While Ricki and Abby want you to feel empowered even if you choose an elective cesarean or find yourself needing an emergency c-section, they make clear that they believe every woman with a normal pregnancy should try for a more natural birth.
And the evidence supports their opinion. Cesarean sections save lives when performed only as necessary, in approximately 5-10% of births. Once c-sections rise above 10-15% of births, outcomes are actually more negative for both the mother and baby. The c-section rate in the United States is above 30% and the rate of maternal death is among the highest in the developed world. Avoiding c-sections is more than a matter of catering to a mother’s “image” of her ideal birth, it is a genuine health issue with high-stakes consequences for both mother and baby.
Moms who are determined to go forward with an elective cesarean section or who have not come to terms with a previous cesarean section may find certain sections upsetting. However, for moms like author Abby Epstein who do require a c-section, the book does a great job of discussing how to maintain control and encourage the immediate postpartum bond between mother and child.
When describing medical procedures, Abby and Ricki also don’t stint on the unpleasant details. Although this is a very small part of the book, I found myself feeling faint while they described the epidural. The book does allow that sometimes an epidural makes it possible for a woman to regain focus during a long or hard labor but Abby and Ricki want us to have informed consent should we choose an epidural. While I agree, even as a mother who has chosen an epidural twice, that ideally a mother gives birth without an epidural to avoid the potential complications and make birthing the baby easier, I am not sure the graphic image would be helpful to a mom in labor. Perhaps more of a warning before launching into a description or placing the more graphic descriptions in an appendix might give pregnant woman a choice as to whether or not they wish to read those sections.
Overall, the message of the book is incredibly empowering. A must-read for almost every pregnant woman, Your Best Birth presents all the options from homebirth through hospital birth and helps you negotiate these complicated decisions. The authors believe, and I agree, that it is important to understand that the options presented to you (or the path given to you) by the hospital may be determined less by what is safest and healthiest for you and your baby than by what is least likely to result in the hospital getting successfully sued. After reading this book, you will be equipped to determine which path is right for you and your baby and how to stay flexible and responsive to the situation without losing your voice.
The emphasis throughout the book is on assembling a “birth team” that you trust completely and that will advocate for you so that no matter where and how you birth, you will have your best birth.
If you are pregnant and want a no-nonsense discussion of the options available to you, this book will help you find your way to your own best birth.