| Foreword | xi |
| Preface | xiii |
| Acknowledgments | xix |
Chapter 1 | Introduction | 1 |
Chapter 2 | The Knife Unsheathed: Cesarean Section in the United States | 7 |
| The State of the (Obstetric) Union | 7 |
| A Brief History of Cesarean Section | 10 |
| Factors in the Rising Cesarean Rate | 11 |
| Indications for Cesarean Section | 15 |
| Absolute Indications | 15 |
| "Gray Area" Indications | 16 |
| Relative Indications | 16 |
| The Cesarean Population | 24 |
| Risks of Cesarean Section to the Mother | 26 |
| Major Abdominal Childbirth | 26 |
| Maternal Death | 29 |
| Maternal Illness and Disability | 30 |
| Psychological Complications | 33 |
| Risks of Cesarean Section to the Infant | 34 |
| Risks of Cesarean Section to the Mother/Infant Relationship | 37 |
| Costs of Cesarean Section | 39 |
| Conclusions | 39 |
Chapter 3 | Voices of the Victims (Letters from Cesarean Mothers) | 41 |
Chapter 4 | Grieving ... and Healing | 59 |
| Grieving? For What? | 62 |
| Factors Affecting Grieving | 64 |
| Cesarean Sections: Decisions of Love | 65 |
| Grieving Responses | 66 |
| Fathers' Grief | 67 |
| Identifying the Symptoms ... | 68 |
| ... And Working Our Way Through ... | 69 |
| ... To Healing | 70 |
| Conclusion | 74 |
Chapter 5 | Of Sound Mind and Belly: Uterine Dependability | 75 |
| The Uterus and the Cervix | 78 |
| Uterine Incisions | 79 |
| Popularization of Repeat Cesarean Section | 80 |
| The Transverse-Incision Revolution | 81 |
| The Specter of Uterine "Rupture" | 83 |
| Iatrogenic Causes of Uterine Instability | 85 |
| Signs of "Rupture"? | 85 |
| When Instability Does Occur--Sterilization or Repair? | 86 |
| Scare Tactics | 89 |
| Growing Support for VBAC: The Studies | 92 |
| The 1940s | 92 |
| The 1950s | 92 |
| The 1960s | 93 |
| The 1970s | 94 |
| The 1980s | 95 |
| "The Experts" Speak Up ... Sort of | 96 |
| VBAC: Getting Down to Specifics | 97 |
| "What If My Pelvis Is Too Small?" | 97 |
| Failure To Progress | 99 |
| More than One Cesarean | 99 |
| VBAC after a Previous Uterine Infection | 100 |
| Breech VBAC | 101 |
| VBAC Twins | 101 |
| A Time Limit for VBAC Labor? | 101 |
| How Many VBACs? | 102 |
| How Long between Pregnancies? | 102 |
| Is It Ever Too Late To Decide on a VBAC? | 103 |
| If at First You Don't "Succeed" ... | 103 |
| Forceps | 103 |
| "Your Uterus Is Paper-Thin!" | 104 |
| What about Hysterography? | 104 |
| Fibroids | 105 |
| "Management" of VBAC Labors | 105 |
| Manual Exploration of the Uterus | 106 |
| VBAC with a Vertical Incision | 107 |
| Inverted-T Incision | 109 |
| Hysterotomy | 110 |
| Our Statistics | 110 |
| Out of 105 Women ... | 111 |
| ... And out of 105 Labors ... | 112 |
| ... Came More than 105 Babies! | 112 |
| Healed and Healthy | 113 |
Chapter 6 | The Fallacy of Natural Childbirth | 117 |
| How Natural Is Natural Childbirth? | 117 |
| Purebirth | 119 |
Chapter 7 | Increasing Your Potential for Normal Birth: Nutrition and Exercise | 123 |
| Father's Nutritive Role | 126 |
| A Few Nutritious Tips | 127 |
| Exercise during Pregnancy | 131 |
| Reaping the Rewards | 134 |
Chapter 8 | Diagnostic Time Bombs? | 135 |
| Pregnancy as Pathology | 135 |
| Informed Consent? | 135 |
| Women as Lab Rats | 138 |
| Tests during Pregnancy: Help or Hindrance? | 139 |
| Estriol Testing | 140 |
| Ultrasound | 140 |
| Amniocentesis | 144 |
| Oxytocin Challenge Test | 146 |
| Non-Stress Test | 147 |
| X-Rays | 147 |
| "Don't Worry Your Pretty Little Head!" | 150 |
| Ignorance Is Bliss? | 150 |
Chapter 9 | Birth Interventions and Their Consequences | 153 |
| When To Go to the Hospital | 154 |
| Upon Your Arrival ... | 155 |
| "Just a Little Ride" | 155 |
| Admissions Procedures | 155 |
| In the Labor Room | 156 |
| Maternal Position during Labor | 158 |
| The "Prep" | 160 |
| Enemas | 160 |
| I.V.s vs Food during Labor | 162 |
| Amniotomy and Infection | 168 |
| Vaginal Exams | 173 |
| A Breath of Fresh Alternatives | 175 |
| ... Back to the Labor Room | 176 |
| Induction of Labor | 176 |
| Electronic Monitoring Devices | 180 |
| Drugs | 183 |
| Second Stage | 187 |
| In the Delivery Room | 189 |
| Anesthesia | 189 |
| Forceps | 190 |
| Episiotomy | 192 |
| Stirrups | 196 |
| Birthing the Placenta | 196 |
| Cord Clamping | 196 |
| "Welcome to the World, Dear Child": Baby's Own Interventions | 198 |
| Silver Nitrate | 200 |
| Vitamin K, Circumcision, and Jaundice | 202 |
| Going Home ("Hate To Eat and Run ...") | 205 |
| A Note about Breastfeeding | 205 |
| Judicious Use of Medical Interventions | 206 |
| Why Reinvent the Wheel? | 207 |
Chapter 10 | Paternal Perspectives | 211 |
| Paul's Story | 211 |
| Martin's Story | 218 |
Chapter 11 | Labor Support | 223 |
| "The Climb" | 223 |
| The Climb--with Help | 225 |
| "No Drugs--Just Hugs!" | 226 |
| Why Not the Hospital Staff? | 228 |
| Mates as Labor Assistants? | 229 |
| Supporting the Laboring Woman | 233 |
| Choosing a Labor Assistant | 235 |
| Labor Support: "Where Can I Find It?!" | 235 |
| Additional Support | 236 |
| Labor Assistants Are Not Magicians! | 236 |
| Consumer Power | 238 |
| Siblings at the Birth | 239 |
| Preparing Children for the Birth of a New Sibling | 240 |
| Friend (or Foe?) | 242 |
| Beyond Labor Assistants | 243 |
Chapter 12 | Mindscapes | 249 |
| The Body and the Mind | 250 |
| The Power of Beliefs | 251 |
| Our Beliefs Influence Our Births | 256 |
| Identifying Beliefs | 259 |
| Feeling Safe | 260 |
| The Pressure To Perform | 266 |
| Birth, Death, and Pain | 267 |
| Birth as a Sexual Experience | 268 |
| Territorial Primacy | 272 |
| From Daughters to Mothers | 274 |
| Opening the Heart | 276 |
| Love: Birth's Most Precious Assistant | 276 |
| Creating a Cesarean | 282 |
| "Why Me?" | 284 |
| "But I'm Due on Tuesday!" | 285 |
Chapter 13 | Planning Your Birth | 287 |
| Childbirth Preparation | 288 |
| Traditional Course Content | 290 |
| Finding the Right Instructor | 295 |
| Choosing Your Birthplace | 299 |
| For Those Who Choose a Hospital Birth | 299 |
| What about Homebirth? | 307 |
| Roadblocked? | 309 |
| Breech Presentation | 309 |
| Herpes | 314 |
| When Purebirth "Fails" | 316 |
| Choosing a Physician | 317 |
| Interviewing an Obstetrician | 324 |
| Changing Physicians | 333 |
| Doctors Who Care | 333 |
| Medical Records | 334 |
| Reclaiming Responsibility | 336 |
Chapter 14 | In Case a Cesarean Is Necessary | 339 |
| Prenatal Planning | 340 |
| Delivery | 341 |
| Postpartum Planning | 343 |
| Your Newborn | 344 |
Chapter 15 | Voices of VBAC (Letters from VBAC Mothers) | 347 |
Chapter 16 | Cesarean Deliverance | 381 |
| Appendices | 383 |
A | Labor Chart | 384 |
B | Preventing Unnecessary Cesareans | 386 |
C | VBAC Classes: Questions for Private Discussion | 392 |
D | VBAC Classes: Questions for Open Discussion | 393 |
E | Resource Groups | 394 |
F | Sample Affirmations | 396 |
| References | 397 |
| About the Contributors | 427 |
| Index | 429 |