Book Review – Do Birth, A Gentle Guide to Labour and Childbirth

Book Review by Aynsley Rope
Do Birth, A Gentle Guide to Labour & Childbirth
Authored by Caroline Flint

Do Birth is an informative, easy to read birth-education book offering a basic overview on what to expect during pregnancy, birth and the postpartum period. It doesn’t go into a great deal of detail leaving you overwhelmed, it provides you with enough to start thinking about your options. Caroline is an avid believer in homebirths, which becomes evident in the first chapter. The information she provides can help guide women and their partners through a positive and gentle birth with little intervention where possible. She highlights that this can be achieved with the right education, environment, mindset and support.

I was interested in this book because of the extensive experience Caroline has in the birthing world. Not only has she been a practicing midwife and childbirth educator in the UK for 40+ years but has also published six books on childbirth and founded her own birthing center in London which she ran for 22 years. Personally, this book resonated with me because of her deep understanding and extensive knowledge on home birthing, which can sometimes be portrayed as dangerous or irresponsible. For women that are considering this option, this book usefully sheds some light around the many benefits of home birthing. Coming from a midwife’s perspective who has a ton of experience in this field Caroline’s perspectives give plenty of reassurance!

The seven chapters cover all of the themes that an expectant mother or partner would want to read about from the birth, preparation and what to expect to having a ‘homely’ birth in hospital, getting to know your baby, the postpartum period and Caroline’s hopes and dreams within the maternity system. There is also a Frequently Asked Questions (FAQ) for quick, easy reference to answers on those questions that we all ask.

The first chapter covers the options on where to birth – hospital, birthing suites or at home. Caroline promotes a homebirth where possible and talks about how taboo home birth has become despite the drop-in high-risk pregnancies in the last century, which is generally the reason why it is not recommended. In London (where Caroline is based) there is a push from the maternity system that a woman’s first child should be in hospital for her body to ‘prove’ that she is capable to birth with no difficulties. Only then a homebirth will be considered for the second pregnancy. Furthermore, a whopping 50% of those first time Mum’s who have hospital births end up having a caesareans, similar to Australia.

She talks about doctors and hospitals and the significant role they have in our modern-day society; their role is an important one and is specifically designed for those who are ill. But we need to remember they are not always well designed for a birthing woman. I particularly appreciated her insight on this issue, as she explained:

“Doctors are trained to think that childbirth is a dangerous time. They are men and women of action. We expect a doctor to do something when we are ill or need surgery ….. We expect doctors to act, which is why their care can be counter intuitive to child birthing. They are not trained to be patient, they are doers. So, they speed up slow labour’s and start up late ones… However, so many doctors find it impossible not to intervene…”.

Chapter 2 talks about the practical side of pregnancy and what you need to add to your to-do list regarding appointments, the ‘hospital bag’ and items to have at home for a home birth.

A birthing pool at a home birth (hire or purchase) is an excellent option, water can make such a huge difference in labour to help sooth muscles and increase relaxation which in turn makes the pain more manageable.

“The water also makes you more buoyant and able to take up the most extraordinary positions, thus opening your pelvis in a way that your never could on dry land.”

Chapter 3 is appropriately titled “The Baby is Coming!”. This covers some old tricks to help prime your uterus into labour including having sex (due to a large amount of the hormone prostaglandin found in semen), eating dates from 36 weeks and raspberry tea. If you end up overdue, from a home birth perspective, an issue you may have is midwives are pressured to encourage an induction which rules out the home birth all together. This is because monitoring is required in hospital. Some hospitals have policies around inducing if you reach a certain date. Caroline references ‘The Cochrane Review’, which is an up-to-date evidence-based and reliable online resource you can refer to so you know your options. https://www.cochrane.org/

She covers the stages of labour and the sensations felt with waters breaking, pain relief, positions you can get into to help the pain and ‘the secret ingredient’ – oxytocin! Oxytocin is the hormone that is released while having sex and is the same hormone to bring on surges in labour. I love how honest Caroline is on this subject.

“Now you may be embarrassed to hear it, but I’m not embarrassed to say that nipple stimulation is useful during labour and so is clitoral stimulation … You may want to rub up and down on your partner, be stroked, caressed – and all of these things you can do in your home. Its best if the midwife keeps away at this point to give you both privacy!”.

She talks about birthing the placenta and that in some cultures it is a sacred organ. Ingesting the placenta can have many benefits for your overall wellbeing in the postnatal period and can drastically improve a mother’s state of mind if she is prone to depression.

“I have cooked it before now for a new mother, served with mash potatoes and garlic!”

Chapter 4 is about creating a homely environment for a birth in hospital. This can be achieved by imagining you are checking into a hotel, get comfortable and create the space as your own and most importantly – no one enters without you allowing them to do so. What great advice! When I think of a hospital birth, I envision medical professions entering as they wish. Setting these boundaries can give you your desired privacy which is important to make you feel relaxed and the chance to become intimate with your partner to help release oxytocin.

If the progression is slow, you can often be coerced into some sort of intervention. Do what feels right for you. If the intervention is strongly suggested the below is a great mnemonic to remember – BRAN:

“What are the Benefits of this treatment?

What are the Risks of this treatment?

Are there any Alternatives to this treatment?

What if we do Nothing and just wait?

Chapter 5 –This chapter “Getting to know your baby” covers perhaps the overlooked part of giving birth… with so much of the focus on preparing for labour and birth over the 9 months. To be honest I was surprised to read that the bond between mother and baby doesn’t come as naturally to some and this is a perfectly normal, particularly after birth when you are feeling tired and deflated, with hormonal changes. There are simple things you can do to improve this like watching, smelling, talking to your baby and skin to skin time, this releases oxytocin.

Chapter 6 titled “Taking it Easy” explores the benefits of breastfeeding and gives a how to guide. Some women fear they are not producing enough and Caroline’s main piece of advice to overcome this is REST! Taking care of the nurturer is just as important as the baby as you are the food supply. Also, of course stay hydrated and eat as well as you can.

Visitors is a topic I hadn’t personally thought about and an important one to keep in mind. Keeping visitors to a minimum while you are settling into Mum life is more than OK. Work out a strategy prior to the baby arriving on what you feel comfortable with post birth. Setting boundaries will allow you to feel relaxed. Also consider that babies need to be in close proximity to their mother, so if they are being handed round and held, they could return to you feel disorientated or upset.

Chapter 7 is Caroline’s ‘dream’ for the current maternity system and the way women birth.

“In my dream, there would be delivery suites as there are now, where doctors can intervene if there is a medical reason to. However, there would be very few of them because if you have women alone to get on with their labour – like other mammals – they usually manage to give birth safely.”

Caroline’s book should be a go-to resource for all women giving birth, whatever their choice as she gives a lot of important insights whatever the setting. But most of all I would recommend this book to women striving for a physiological birth with little intervention or a home birth – they will reach the end of this book with more insight and feel more confident in their upcoming choices, as I know I did. So often women turn to the ‘experts’ for advice which usually implies medical professionals. I strongly believe that if this advice was based around what can go right instead of what can go wrong it would be a different maternity system. Of course, all possible scenarios and options need to be considered but if we regarded birth as a natural and physiological process in which it is, the way Caroline does, a woman’s birthing journey will be an empowering experience.