This is a book review by Pushpa Saraswati on “Birth with Confidence – Savvy Choices for Normal Birth” by Rhea Dempsey.
Birth with confidence – Savvy Choices for normal birth is written by Rhea Dempsey and published in 2013. Rhea is a renowned author, childbirth educator, speaker, counsellor and birth attendant with over 34 years of experience in her field. She has greatly contributed to countless pregnant women, their partners, birth attendants, doulas, midwives and medical professionals through sharing her knowledge and expertise in working with pain during childbirth and its importance and connection to normal physiological birth.
When it comes to labour and birth we commonly hear, “it’s not so important how you birthed and how your baby came earthside, all that matters is a healthy baby and mother which is a ‘good’ outcome right?” Of course all women want a healthy mother and baby. But how to go about that? How to achieve this can vary tremendously. In the book Rhea asks an important question, a simple yet fundamental question of: “do you want to be an active participate in the birth of your baby by working with your body and baby, and allowing the uninterrupted natural hormonal dance to unfold?” This is a telling question as it differentiates the willing women from the women who wish to hand over the “work” and essentially the delivery of their baby to caregivers and other active agents while the woman becomes an observer/bystander in her own birth.
Throughout this book you hear the term ‘normal physiological birth’, so what is it? Simply put, a normal physiological birth is initiated by baby’s readiness to be born and the mother’s readiness to birth. It is allowing the innate hormonal interaction between mother and baby to naturally happen and progress undisturbed. A labour which involves all the wonderful birth hormones that open the mother’s body and ignites love and deep bonding between mother and baby.
The sad truth of our current birth culture:
The author sheds light on the unfortunate truth of our current birth culture. The sad fact is the established institutions and systems gravitate more towards controlling and undermining the core innate body functions. Unfortunately we live in a culture which puts very little emphasis and value towards the birth process and how the experience affects mother and baby both physically and emotionally. In parts of the book it discusses various statistics which definitely put into perspective the obstacles and challenges for women to successfully have a normal physiological birth in this day and age. The overall attitude is the belief that the efforts of labour and birth have no importance nor intrinsic value. Due to this attitude a large number of women feel a sense of lost opportunity with their birth experience. They go into it believing birth is a normal process of a healthy body that women are designed to do and have the capacity to do. Yet throughout their pregnancy and birth their self trust, confidence and inner strength are slowly undermined. What becomes very clear is women are frequently coerced and expected to give away their trust and power to the institution, to the procedures/policies and to the medical authority. No wonder why women are left asking how did my birth experience unfold so differently to my expectations and potential. The birth experience affects women profoundly and many are left having to process their birth trauma. For these reasons the willing women must be even more proactive in protecting their birth potential.
In the book it mentions a term that was new to me, yet it is something that is all too common during labour and birth. ‘Acquiescence’ which means the reluctant acceptance of something without protest. This acceptance and submission occurs when faced with medical authority. For non experts in medical literacy it takes a lot more effort to refuse the routine protocol, to demand more information, and to seek an alternative option that better suits the individual’s needs and avoid unnecessary and unwanted interventions/procedures. The author emphasises the necessity for savvy and willing women to be equipped with confidence and understanding of patient autonomy, health literacy, informed refusal and informed consent.
Exploring the motivations for a normal physiological birth:
An essential part of the book explores the various reasons for what motivates willing women to decide to undertake the amazing challenge of a normal physiological birth. Usually the most common motivating factors are the health and wellbeing benefits to mother and baby, especially baby. However one-point Rhea discusses, which left a positive impression on me was the importance of undertaking the challenge of a physiological birth as a way of self-transformation and growth. By undertaking this challenge a woman is strengthening her inner resolve, she is building her resilience, determination, courage and endurance which are all fundamental characteristics of becoming a mother. There is power in birth for great emotional and spiritual development. This can be a motivating reason that can carry her through the challenging parts of birth. The willing woman needs to see and feel the value of the physical experience of labour itself, not only as a means to a benefit after the birth as this may not be enough when the going gets tough.
The kind of support team is pivotal to the birth experience & outcome:
In life we have all faced moments of self-doubt, loss of confidence, self-pity and wanting to throw in the towel and quit. In the heat of the moment we look for anything and anyone to confirm those negative beliefs. What did we need the most in those moments? Someone to agree and confirm those negative beliefs or someone to support and encourage us with self-determination and confidence? In all other aspects of life when we strive to accomplish achievements that push our physical and mental limits, our community and society sees the importance of cheering us on and dispelling any negative thoughts and moments of self-doubt. Yet this does not happen in birth. Women are looked at as needing to be saved and spared from the experience of birth, any trace of self-doubt and lack of confidence is validated.
The author puts strong emphasis on the importance of carefully selecting the birth place and the support team during labour and birth. However, more than just selecting helpful people to support her, it is more essential to focus on caregivers experienced in physiological birth and known carers that have been there throughout pregnancy and labour. As Rhea says in the book “trust comes from an established relationship and a shared philosophy.”
In our birth culture we undervalue and underestimate the importance of the support team during birth. It is not a luxury to have skilled support people, it’s a necessity; because when she encounters those crises of confidence that very support team will be an integral part in her success in accomplishing her birth goal. When anyone, especially birthing women are pushed to the very limit of their comfort zones, when she reaches that climax, it is then she will face a crisis of confidence, it’s not a matter of if, it’s a matter of when. And in that moment she will entirely depend on her support team to see her through and hold her to her intentions.
As you can see this book shares valuable information that are essential to confidently achieving the normal physiological birth all willing women deserve. Through understanding what it takes, what is involved and what obstacles a mother may face, only then can she truly be equipped with the tools, knowledge and choices in order to successfully take on a physiological birth. So for those savvy women who are willing and determined to have a normal physiological birth they would greatly benefit from reading this highly informative book.
My name is Pushpa Loverh and I am a Doula who has trained at the Doula Training Academy. If you would like to talk more about your birthing options, please contact me: