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Birth: The Surprising History of How We Are Born

Birth: The Surprising History of How We Are Born

3.9 8
by Tina Cassidy

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From evolution to the epidural and beyond, Tina Cassidy presents a lively, enlightening, and impeccably researched cultural history of how and why we are born the way we are. Women have been giving birth for millennia, so why is it that every culture--and every generation--seems to have its own ideas about the best way to get a baby born? Among the topics that Tina


From evolution to the epidural and beyond, Tina Cassidy presents a lively, enlightening, and impeccably researched cultural history of how and why we are born the way we are. Women have been giving birth for millennia, so why is it that every culture--and every generation--seems to have its own ideas about the best way to get a baby born? Among the topics that Tina Cassidy looks at are: why birth can be so difficult (blame our ability to walk on two legs, for instance), where women deliver, how the perception of midwives has changed (they were once burned as witches), the lives of some famous obstetricians, and the many ways childbirth has been deadly (lots of blame to go around). Birth is full of quirky details, startling facts, and tales both humorous and disturbing--from men disguised as women to get into delivery rooms to a news flash about a woman giving herself a C-section. From Jessica Mitford's seminal The American Way of Death to Mary Roach's Stiff, we've witnessed how millions of readers are fascinated by what happens at the end of life. Here is the riveting true story of how it begins.

Editorial Reviews

By good evidence, childbirth is a universal experience, but we all do it differently. Tina Cassidy's lively cultural history of birthing takes us into delivery rooms and deep into history to show how numerous factors have influenced how women bring babies into the world. Birth almost bursts with astonishing details and quirky stories about life's original delivery system; from Rio de Janeiro's remarkably high C-section rate to the science of fish-bladder vacuum extractors.
Alexandra Jacobs
Cassidy’s natal narrative hews closely to real-life events; a few literary examples (“Lawdy, Miz Scarlett!”) might have enriched it even further. And maybe it wasn’t strictly necessary to include a recipe for placenta pizza topping (from a 1983 issue of Mothering magazine). Still, there’s a collective, willful amnesia about birth — as if it’s an alien visitation, rather than the normal order of things — that has been begging for her clear-headed dissipation. We want it to be meaningful and we want it to be mercifully brief. This book is both.
— The New York Times
Sara Sklaroff
In this breezy popular history, Cassidy, a former Boston Globe reporter and editor, surveys centuries of terrible childbirths around the world, attended by doctors, nurses and midwives with strange theories and, in more than a few cases, deeply sadistic streaks. Tirelessly wide-eyed, Cassidy details how laboring women have been strapped down and shackled, drugged into oblivion and ripped open with a macabre array of tools more suited to taxidermy than obstetrics. It's amazing anyone got out of the womb alive.
— The Washington Post
Publishers Weekly
Anyone who has taken a prenatal education class in the last decade can detail much of what Boston Globe reporter Cassidy documents about birthing battles in her enjoyable new book. What she so cogently adds is a history of Western practices and attitudes surrounding birth, from the "God-sibs" (or "gossips") who sat by a woman's bed in Europe and early America to the scheduled cesarean of today. The book is well written and will be an important eye-opener to many. Cassidy works hard to remain neutral, but a preference for the discourse of "natural" birth creeps in. She looks nostalgically back at times when most women gave birth at home with female midwives in attendance. This leads to some problematic moments, as when she wants to argue that, historically, birth was not the danger to women's lives that many today assume. But then she has to admit that pioneer women wrote their wills before giving birth and that most women who die in childbirth today are in the non-Western world, where they lack access to hospitals. This is, by Cassidy's admission, the work of a woman disappointed by her own birthing experience. But that, too, is a product of our time the idea that we "deserve" a certain experience as we give birth. (Oct.) Copyright 2006 Reed Business Information.
Library Journal
Not What To Expect but how expecting has changed over the millennia--and how it hasn't. With a 15-city tour. Copyright 2006 Reed Business Information.
Kirkus Reviews
Former Boston Globe editor Cassidy explores the way childbirth has changed, from pre-history to the present. Women have always borne children, but how people have thought about the process is far from static. Cassidy got interested in the topic after realizing that three generations of women in her family had completely different expectations about what childbirth should be like. Here she considers the development of the epidural, the relationship between midwifery and obstetrics, the current trend toward conveniently scheduled C-sections and shifting ideas about the father's appropriate place: by the laboring woman's bedside, or in the waiting room? One of the more amusing sections here details the attempts of cultures around the world to induce labor. The Egyptian Siwa tried to scare tardy babies into entering the world by shooting two rifles near the expectant mother. Midwives in France's Auvergne region placed a chicken on the stomach of a pregnant woman, hoping the bird's claws would prompt labor. Other cultures have shaken pregnant women on blankets or hung them from trees. Cassidy doesn't limit herself to sociological or cultural changes. In her captivating first chapter, she addresses how evolution has affected childbirth. Most mammals have a much easier time giving birth than do humans, because their birth canals are roomier. Walking upright, as people do, requires a compact pelvis, and humans have bigger brains than any other mammal. In other words, the very combination of features that allow people their place at the top of the evolutionary heap, large heads and small pelvises, combine to make birth terrifically difficult. "If we had just one more inch of pelvic width," Cassidyexplains, "there might be no need for cesareans, forceps, vacuums, extraction hooks, and episiotomies." Fascinating, funny and occasionally shocking-should be at the top of every pregnant woman's reading list. First printing of 50,000; $50,000 ad/promo. Agent: Richard Abate/International Creative Management (ICM)

Product Details

Gale Group
Publication date:
Thorndike Nonfiction Ser.
Edition description:
Large Print Edition
Product dimensions:
5.40(w) x 8.50(h) x 0.80(d)

Read an Excerpt


The Surprising History of How We Are Born
By Tina Cassidy

Grove Atlantic, Inc.

Copyright © 2006 Tina Cassidy
All right reserved.

ISBN: 0-87113-938-3

Chapter One

IN THE BEGINNING After I had a baby in 2004, the women of my family gave me three things: newborn outfits, advice, and accounts of their own birth experiences. The last was the impetus for this book. My grandmother, Genevieve Damaschi, who bore three girls in the 1940s and '50s, explained how she was gassed during the birth of her first daughter, slipping in and out of consciousness on a stretcher in the hallway of Hartford Hospital. She screamed. The nurses told her to "shut up." She didn't see the baby for three days, per standard hospital infection-prevention policy. My grandfather was barred from the room while she labored. My mother, who had me in 1969, recounted in a ten-second sound bite an equally frightening story of her five-hour labor and delivery ordeal. "They shaved my pubic area. They gave me an enema. They made me walk around the room a couple of times. They gave me a shot. I woke up three hours later standing on the gurney in excruciating pain. The doctor came in, gave me another shot, and then the next thing I know, you were born." "Did they use forceps?" I asked. "I think that they did, because of the condition that your head was in." "You don't know if they used forceps?" "I'd like to getthose records," she said, sounding sort of dreamy, her mind stuck in the labor room where she, too, delivered alone, no husband or family allowed. "Scopolamine," she said. "It makes you not remember what happened. I pretty much slept through it." When she was about to have my brother in 1976, my mother skeptically attended Lamaze classes, which then were in vogue. There she learned how to breathe-hee hee huhhhh-and her husband was prepped to witness the birth, a relatively new idea at the time. Though her "natural" delivery of me should have been proof that she could deliver this second child vaginally, her doctor gave her an X-ray to determine if her petite pelvis could allow for my brother to pass through. The doctor said her pelvic width was borderline and after just a couple of hours of normal labor, suggested a cesarean section. Unhappy with her first birth experience, she leaped at the opportunity. Spouses were almost never allowed in the operating room then. So my mother delivered alone. Again. My youngest aunt had her first child in 1982, just as natural childbirth methods were peaking, a feminist backlash against the highly controlled births my mother and grandmother had gone through. Hers was the most unusual of all the Damaschi women's labors to date, because her husband witnessed the whole event. But the birth of her second child, in a Catholic hospital in 1989, did not go as well as the first. Because of long-held religious beliefs that it is a woman's station in life to suffer during labor-says so right there in the Bible-the facility did not allow for any pain relief. She was left alone in a room for hours, the baby facing backward in the birth canal, and she tore mightily at the end. Despite all, I had high hopes for how the birth of my son, at a major hospital in the medical mecca of Boston, would unfold. I purposely chose a female obstetrician. Armed with a birth plan, the latest fad in obstetrical empowerment, I knew I would sail through labor wearing my favorite black spaghetti-strap nightgown-no johnnie for me! The lights would be dim, an epidural anesthetic juicing my spine only if absolutely necessary. I had written down my instructions for the nurses to read so that even if I was in too much pain to explain it to them myself, my plan would be clear. An instructor at the hospital's prenatal class told us that the episiotomy, a cut to make the opening of the birth canal wider, was no longer routinely performed by their obstetricians because they now knew that the incisions often caused more problems than they solved. The doctors also had abandoned stirrups because they had learned that having women lie flat with their legs in the air negates the powerful force of gravity for pushing out the baby. They said they didn't routinely employ forceps anymore, which can injure the mother and child. And the doctors had stopped objecting to squatting, which opens the pelvis, an ancient practice that had been rediscovered after disappearing in the prudish Victorian era. My husband and I felt blessed to have the latest thinking at our disposal. But after ten hours of labor and another four hours of pushing, the very busy obstetrician making rounds that night told us matter-of-factly that our son had not rotated all the way, and was stuck. I asked to have a midwife come and offer suggestions to move my labor along, but the harried staff said she was unavailable. I asked them to shut off the epidural (yes, I had succumbed the fifth time the nurse asked me if I wanted one), so that I could try other labor positions. They obliged but only, I think, because they were annoyed and knew the pain would be so severe I wouldn't care what happened next. Indeed, that was true. My son's heart rate was fine, but things had dragged on too long, as far as the staff was concerned. The doctor insisted upon an emergency C-section-which was performed with the speed of a SWAT team-throughout which I vomited and shook violently, while my poor husband clung to my side of the operating curtain, careful not to glimpse my uterus, which rested outside my abdomen while the doctor stitched it. The next morning, my still-ashen spouse, grateful everyone was alive and the baby was perfect, cornered the doctor, wanting to know if the ordeal had really been necessary. "What did they do in that situation before there were C-sections?" he wanted to know. "The baby would have died in the birth canal," the doctor said. "They would have had to wait for it to disintegrate, or they would try to get it out some other way, drilling a hole in the fetal head, emptying the contents and collapsing the skull, before it started to poison the mother." Well, then. I caught this response as I shuffled out of the bathroom on my way back to bed. Too weak to react, I gingerly climbed beneath the blanket and filed a mental note to see if that was true. If I had lived five hundred years ago ... I drifted into a fitful, clammy, bloated sleep, my body pumped even larger with fluids than it had been before the birth, while little George, softer and sweeter than heaven, lay wrapped up like a burrito in the crook of my arm, where I longed to keep him forever. I was in a great deal of abdominal pain; it hurt more than I could endure to get in and out of bed. The doctor, following standard procedure, had cut through my taught belly skin, through a layer of fat, cauterizing along the way, until she reached the fascia, the glistening sheet, which looks like the filmy layer on a chicken breast, that undergirds the abdominal wall. She then nicked the fascia with the knife and extended the cut with scissors, pushing, not cutting, to tear the tissue like a sheet of wrapping paper. Once the fascia was peeled away, she pulled apart the muscles in the middle, poked a hole with her finger through a layer of tissue underneath, and stretched it hard. Using a clean knife, she cut ever so gently, and not too deep, into my uterus. She pulled apart the incision until it was big enough for the baby's head and reached in elbow deep for the baby's chin as an assistant pushed down hard from the top of the uterus. Someone, I'm not sure who, went between my legs and up inside my body to give him an extra boost before George popped out explosively, rather like a champagne cork. I may have been in the hospital for the obligatory four long days, but there was no time to be a patient. I may have been a mom who was completely in love with my son, awed by him and stunned by how he came into the world, but I was also the primary food source for this amazing little organism, whose needs were constant and exhausting. I was discharged for home feeling utterly drained, my hormones roiling, my body viciously assaulted. All the while a nasty germ was breeding in the incision, forcing a trip back to the hospital, where an obstetrician prodded me with a Q-tip-incredibly, inside the wound-before sending me home in tears with an antibiotic prescription. Next came mastitis, a breast infection typical among novice nursing women. So much for birth and nursing being "natural" processes. Surely, nature did not intend for any of this to be so difficult. If it did, how could the human race survive? Was I being a spoiled, wimpy modern woman? Was that why so many of my friends were having similar experiences? And if so, why were some women I know delighted by the whole affair, from first contraction to final push? Was my son too big? Was I too small? Were my boobs too sensitive? Should I not have succumbed to an epidural? I've been a journalist for half of my life. I've covered Super Bowls and fashion shows, presidential campaigns and inaugurations, mob trials, bank failures, housing bubbles, kidnappings, and terrorism. I tried to make sense of all of those crazy stories by doing research and asking questions, whether it was pressing John McCain on his agenda while riding the Straight Talk Express or interviewing Tom Ford on a rose petal-strewn Milan runway. Through the frigid, blurry January, weeks after George was born, I found myself suddenly housebound with time to ruminate-though not with the time to cook or take a shower. Still, when George was peaceful, my mind returned to that nagging question: Why is birth such a crapshoot after all this time? I realized that I needed to use my professional skills to understand women's bodies, the process of labor and birth, and the shockingly intense postpartum weeks. I needed to put into perspective my own experience. I needed to know what other women, in other cultures, in other times, had done. When, finally, my infections had cleared and my scar had hardened into a thick red keloid, I embarked on a mission that became this book. It began simply enough. Holding babe in arms, I awkwardly started to search the Internet. When I found little to satisfy my curiosity, I dragged myself to the library. At first I was disappointed to discover that the most recent comprehensive world history of birth had been written more than fifty years ago. Even that, Eternal Eve, a British classic by Harvey Graham, was hard to find and badly outdated. There were a couple more recent books that focused specifically on American childbirth history, and I found plenty of anticesarean, pro-breast-feeding polemics, feminist and academic histories of midwives, and surveys of male-dominated obstetrics, but I knew these didn't tell the whole story. Indeed, much of what lined the shelves were how-to birth and breast-feeding guides, which were even more annoying now than they had been the first time I read them. There was no single source for the information I wanted, and clearly I was not the only one seeking it. The chatter on baby blogs was anxious. Women everywhere wanted answers to the same questions, from what other cultures use for pain relief, to why so many Dutch women give birth safely at home, to whether all women one day will have cesareans. Continuing my quest, I descended into vault like library basements, where the rare book departments and the microfilm rooms always seem to be located. It was in one of these windowless places that I found proof that my doctor wasn't inventing that horrific tale of demise she told my husband: As early as the seventh century, desperate people were using hooks to perform craniotomies to extract a stuck child. Suddenly even more motivated, I paged through the brittle parchment of sixteenth-century midwifery books, as well as vintage obstetric texts and hundreds of old periodicals. Eventually, I visited hospitals and birth centers; inspected antique obstetrical instruments in museums; attended a HypnoBirthing class; interviewed mothers, fathers, doctors, midwives, childbirth educators, hospital administrators, lawyers, academics, public health activists, and anthropologists. I spent days with nurses and anesthesiologists, witnessed single and multiple births, natural and cesarean. And sought out the latest trends. All to try to understand what is supposed to be a natural-perhaps the most natural-physiological process. The more I learned, the more questions I had: How did midwives go from being burned as witches to vaunted by yuppies? Who let men in the room? Why would someone give birth in the ocean? What does the Titanic have to do with an ultrasound scan? Is there a link between Pitocin and autism? What did Queen Victoria have to do with epidurals? How is a woman's pelvis undermined by eating Big Macs? Were cesarean sections really named after Julius Caesar? Could it possibly be true that even in early twentieth-century America, women delivering in hospitals were more likely to die there than if they had given birth at home? That poor women were used as obstetrical guinea pigs? That doctors use drugs to confine deliveries to banker's hours? That some women have orgasms with vaginal births? The answers-the surprising, frustrating, tantalizing answers-helped me realize that my childbearing experience, like my family's chain of births, was merely a reflection of its time and place. My son's birth may have been just as painful as the drawn out, agonizing vaginal birth that my mother had for me. But it was certainly different. (For starters, I was conscious and accompanied.) And, of course, it could have been far, far worse. After all, my precious son is alive and well. It is astonishing to me that we can touch the moon and predict the weather, map the human genetic code and clone animals, digitize a photograph and send it from Tokyo to Tehran with the touch of a button, but we can't figure out how to give birth in a way that is-simultaneously-safe, minimally painful, joyful, and close to nature's design. As you will see, if history is our guide, we never will figure out the ultimate way to give birth. And we probably will never stop trying. For no matter that birth is the most natural of events, the arrival of a healthy baby is truly a miracle.

1 EVOLUTION AND THE FEMALE BODY I spotted Lucy, framed and hanging on the walls, in the bowels of the American Museum of Natural History. The three-million-year old fossilized australopithecine was a creature in mid-evolution between ape and Homo sapiens. She is one of the oldest human ancestors ever discovered. Having just seen the expansive pelvises of knuckle-scraping apes and chimps in other displays in the museum, I was shocked to see Lucy's pelvis, so tiny and elliptical from hip to hip that it could not have been easy for her to give birth, not even if the baby's head was the size of a lemon. Staring at Lucy's remains, I imagined the agony and ecstasy of birth since the beginning of time. And I thought about the connections between her bones and the advent of midwives, epidurals, surgical instruments, medical malpractice claims, a newborn with a cone head, and virtually every trendy technique that has come and gone throughout the centuries. It was clear that if we had ape-sized pelvises, we'd need no midwifery help, no sterilized stainless-steel paraphernalia, and no Demerol to give birth. But there would be other consequences. Lucy, unearthed in Ethiopia in 1974, was related to those apes and chimps; she had long arms, short legs, and a face with apelike features. But she was clearly different in one respect. She walked upright. And there was her compact pelvis to prove it. As an evolutionary entry point, Lucy can help explain not just the physical aspects of human birth, which have become remarkably more difficult since we began walking upright and producing smarter offspring with the requisite larger crania, but also how primitive behaviors that may have existed in her era are still affecting labor and delivery today. Since Lucy's lifetime, the female pelvis has remained narrow, so as to accommodate our walking upright, but it also has evolved in shape to accommodate the newborn head, which has grown in size over hundreds of thousands of years as the brain enlarged. Today, the upper opening of the pelvis is wide from side to side, as was Lucy's; the lower pelvis, however, the baby's exit, is widest from front to back. And therein lays the problem. The obstetrical consequence of such a design is that human birth is, quite literally, a twisted process. In order to pass through the birth canal, the baby's head-the largest part of its body-must rotate as it descends in a grinding pirouette. A baby monkey, on the other hand, does not need to turn: It emerges face up, having had plenty of room to simply drop down the chute. The contrast between human births and those of four-legged mammals is stunning. Women have a much more difficult time than, say, polar bears, or the free-ranging howler monkey, which can deliver in about two minutes, as each has plenty of space in her birth canal. In fact, we are the only mammal species that needs assistance to give birth.


Excerpted from Birth by Tina Cassidy Copyright © 2006 by Tina Cassidy. Excerpted by permission.
All rights reserved. No part of this excerpt may be reproduced or reprinted without permission in writing from the publisher.
Excerpts are provided by Dial-A-Book Inc. solely for the personal use of visitors to this web site.

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Birth: The Surprising History of How We Are Born 3.9 out of 5 based on 0 ratings. 8 reviews.
Anonymous More than 1 year ago
I was pregnant when I turned 12
bella74 More than 1 year ago
This book raised my consciousness about midwifery and how obstetrics/gynecology emerged making childbirth big business by frightening women into seeing it as a pathological experience instead as a normal part of the life cycle. It's not called labor for no reason. Embrace it instead of fighting it. Anxiety and fear intensify our pain perception.
Anonymous 4 months ago
How do you manage!!!!! Im a 12 yr old girl who needs a nook friend. Im very supportive! What does birth feel like? How are you? I love the sex stuff. Who is the father? How did it happen. I have soooo many questions!
Anonymous 10 months ago
Im pregnat at 10 ys old!
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