walkitout (walkitout) wrote,

_Birth_, Tina Cassidy

Subtitled: _The Surprising History of How We Are Born_

IIRC, I picked this up at a Barnes & Noble around here within the last year; I have the paperback copyright 2006 which is compatible with that recollection.

Cassidy's front matter summarizes her birth experiences and the birth experiences of the women in her family going back a couple generations. The conclusion rounds out the book nicely by describing the birth experiences of some of her friends, and that birth is and always has been defined by the culture of the time and place.

Between those reasonable bookends both personal and philosophical, Cassidy sketches the usual territory: bipedalism and big heads, midwives vs doctors/obstetricians, location of birth, pharmaceutical pain relief, c-sections, instrumental delivery, birth attendants other than the midwife and/or obstetrician and what rituals, support system and so forth occur post-partum. For a highly readable 300 page book, Cassidy covers the material extremely well. Of course I could wish that along with her description of incubators she had mentioned kangaroo care, just as I could wish she didn't take Odent's opposition to the presence of the father quite so seriously. And I have to say that my experience of midwives does not match her summary (aging hippies, as near as I can tell); she really missed an opportunity to get into the concessions made in exchange for licensing and the impact that has on what options are available to women.

I was extremely impressed by her description of Friedman and his curve, a story that I do not recall reading anywhere else in any detail.

I noted several passages as really standing out. First, the attitude of the Catholic Church towards craniotomy. Cassidy is particularly fascinated by this procedure, because she asked what would have been done in times past had c-section not been an option and this was described to her. On p. 105: "In 1733, doctors had asked theology specialists at the Sorbonne in Paris whether it was religiously acceptable to sacrifice the mother by performing a most likely lethal cesarean if the baby could not be vaginally delivered. The scholars said the conflict of having to choose which one should live -- woman or child -- favored the baby because it had to be baptized, or else its soul would be stuck in purgatory.

In his 1930 encyclical, Pope Pius XI declared that doctors could not take a baby's life to save the woman's. After the pope's directive, cesarean rates spiked, as indeed did maternal mortality".

I've known for more than a decade where the anti-choice crowd was headed: they may have started with particular forms of abortion or abortion under particular circumstances, but their goal was ultimately the complete destruction of women's health by banning contraception, and by always placing the soul of the unborn at the center of the debate. They're headed that way because that is, ultimately, where they came from.

On page 120, Cassidy comments in passing that, "cerebral palsy...stems from lack of oxygen either at birth or before labor", which as near as I can tell is no longer believed to be true. I _thought_ we'd understood that was no longer true quite a while ago, but surely the latest on magnesium sulfate should have made that abundantly clear (true, _that_ revelation occurred after the time of writing).

Finally, in several places in the text, including page 140, rickets is attributed to failure to consume milk. Which is really stupid. Rickets happens when people are covered up too much to manufacture vitamin D, or never go outdoors, or have really dark skin and live really far north and use sunblock a lot or whatever.

On the whole, a remarkable single-volume survey of the topic. I'm a little stunned. I didn't have very high expectations.

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