Choosing a Childbirth Education Program

by Ashley Collins

Choosing a childbirth education program has been a struggle for me, until I found BirthWorks International. Some programs place a heavy value on one "method" over another. Some will provide tools parents need to cope with a birth at a home or at a hospital but rarely will help women develop a universal "know-how" and help them trust in their gut instincts. I spent a great deal of time searching for a program that would prepare mothers for whatever path their birth journey took. I looked for a program that helped women create trust in their bodies, instill confidence in their partners to best support them and to remove the fear of birth that our culture has created today. I am happy to have found this training through BirthWorks International.

As a birth doula, I support women from all walks of life who have a wide-range but still deeply personal beliefs and goals for their births. It's never my job to judge or create bias for certain birth preferences over another. It's simply my duty, as their advocate, to provide couples with all the resources thy could need to make an educational, very informed decision that is best for their family. As a BWI Instructor, I would strive to help maintain this level of non-bias in my classes and hope to help women learn to trust their own instincts, especially during birth.

It is also an important role of mine, as a birth doula, to listen for any hidden fears from expecting parents and to help them process those worries prior to giving birth (if possible). Often times, empowering mothers and partners with information can help remove some of the fear, but sometimes just providing a safe space to talk through concerns is just as powerful. This is never-more true than with experienced parents who have experienced previous birth trauma. As a doula, I've seen over and over labors stalled or slow to start because the mother has a mental or emotional block. By gently offering a chance to talk through her fears or even just an opportunity to speak them aloud, her labor and birth will likely quickly pick up. Creating a safe space in my class for parents to work with me and/or each other, in community, to help bent their fear or work through past traumas will be a priority of mine.

My own daughter's birth was quite traumatic for my husband and I. Born at barely 29 weeks via emergency cesarean; we are a real-life lesson of "best laid plans gone off track"! I fully understand, through my own experiences, that a laboring mother's goals may change, and I want to have the opportunity to help her feel prepared for her birth no matter what path it takes!

I also hope to instill the importance of breastfeeding for both baby and mother to my students. My daughter, despite being born so small and so early, was able to breastfeed for 15 months, starting at just 30 weeks gestational age! She is a testament to the power of breast milk for infant development and nutrition!

Additionally, I can absolutely support VBAC mothers and partners in their trails of labor. As a cesarean mother and local ICAN member, I will make sure my students are aware of the abounding VBAC resources we have in our area by connecting them to supportive care providers, upcoming ICAN meetings and helping them build trust again in their own bodies!

Finally, I am very much looking forward to completing the training required to become a BirthWorks International instructor. I feel that the mothers and partners of Durham, NC and surrounding areas will truly benefit from having classes so close to home. I hope that by keeping my classes small, and held in my own home, I can help create a sense of community among expecting parents as they walk along a similar life path.

Becoming Home: A Memoir of Birth in Bali

by Melinda Chickering

When I tell friends from the USA, my home country, how we chose to give birth, they always say, “You’re so brave!” What would possess an educated, middle-class, thirty-something American woman to choose to give birth in a bathtub in Bali, rather than ensuring that she had the most advanced medical care in the world at her disposal, just in case?

Friends and family at home in the USA followed their cultural cues and ob/gyn’s advice. American culture prizes rationality, efficiency, risk mitigation, comfort and convenience. Most people take their doctors’ advice, have extensive pre-natal testing, give birth in a hospital, experience numerous interventions, and do not consider low-tech alternatives. Without the cultural tethers of ‘home’ and family, we faced a daunting freedom and sought our own way. I had always been one to do my research, and the pregnancy research revealed polarized opinions about how and where it’s best to give birth.

In over 30 years on Earth, I had never seen a birth - not of a farm animal, a pet or a person. My mom has four children, including two who appeared when I was an adolescent. Presence at their births could have been a marvelous bit of sex education! But in my home culture, birth is kept behind closed doors, a mysterious event fraught with pain, risk and fear. I hope that sharing my story will strip away some of the mystery and reveal some of the magic.

This is the story of how and why we decided to bring our baby into the world as we did, how it went, and how it changed my outlook on life. The answers we found in Bali and within ourselves paid off in a personally transformative experience. On the journey from head to heart, I found strength in loving support and empowerment in surrender. My experience of birth has become a touchstone of feeling more at home in the world, and in my own skin.

Becoming Home unfolds against the backdrop of contrasting cultures - eastern and western, traditional and modern. It braids together my experiences of Bali, of pregnancy and birth, and my own very personal shifts in the process.

My fears about giving birth arose from growing up in a culture focused on pain, inconvenience and risk mitigation on birthday. It was hard to trust that everything might be just fine. As a child, I had also felt vulnerable and unsafe, even in my own home. This was due to early experiences with divorce, drug and alcohol addiction and sexual abuse. From a child feeling unsafe, I grew up to be hyper-vigilant adult. These influences made it doubly difficult for me to surrender to the unknown and trust my body’s innate wisdom.

This also made it doubly worthwhile to do so. The fear that focuses on preventing worst-case scenarios often prompts interventions - even in healthy, normal pregnancies like ours - that also numb the potential of best-case scenarios. Our water birth at a small neighborhood clinic in Bali was a sacred experience that put me more in touch with myself and my sense of the divine as well as with my husband and our baby.

Becoming Home teases out the potential for birth to be more than birth - even a beautiful, gentle, empowering, loving and healthy one. It can be an opportunity to reach deep inside oneself and find the comfort of Home within. Our story also illustrates the contrasts not only between cultures of birth (modern and medicalized / gentle and natural) but also fundamental cultural contrasts between the cultures of Bali and the USA (east and west). There are some stark contrasts here that are no more vividly represented than in the context of such a precious and vulnerable experience as pregnancy and birth.

While modern medicine has a crucial role to play in emergencies, our pregnancy and birth were textbook normal, without pathology or complication. I believe that if we had chosen a hospital birth with many interventions, as is common in contemporary America, we would have forgone a huge opportunity. I hope our story inspires others to take their own leaps of faith – in birth or in life. Growing up in Iowa, I always dreamed of traveling the world, but I never imagined I would give birth in a bathtub in Bali.

Melinda Chickering is a writer and journalist who lives in Bali. Pre-order her book Becoming Home: A Memoir of Birth in Baliat https://publishizer.com/becoming-home/ .

My First BirthWorks Practicum Childbirth Class

by: Cathy Daub, CCE(BWI)

You’ve read the books.  You’ve conducted your hospital surveys.  You’ve written your topic papers and completed your medical study critiques along with other requirements. You’ve attended a BirthWorks Childbirth Education Workshop.  You’ve read the BirthWorks 500+ page comprehensive Educator Manual and completed your Comprehensive Essay Exam.  You’ve advertised for your first practicum class and there they are – birthing parents excited about what they are about to experience. You may ask yourself, “How will all my training come together for this class?”  “Am I ready?” “Will I be able to answer their questions?”  “Do I look nervous?” “How can I give them the very best class to help prepare them for having their babies?” “What will it be like working with parents in a group setting?”

I wanted to share the experience one of our trainees recently had teaching her first BirthWorks Practicum Childbirth Class:

The class went great! I was nervous of course and wasn't sure how it was going to fit together, but it went so well. I got great feedback, especially being told that the men were enjoying the course. All the couples said they felt so much closer, and the couple who had their baby half way through came back for the last class because they had enjoyed it so much!

I think the training really prepared me well for questions that came up, and for facilitating the discussions. I think the workshop really helped me understand how to lead the classes and gave me good ideas for visualizations and how to conduct the pelvic bodywork parts.

Everyone also got a lot out of the grief class.  They all didn't expect the class to be what it was, and they all kept coming back to that class as their favorite!

It was just so good. Now I just need to see how they all get on in their births.  I will see them all in August for a reunion!                                Lindsey Welch, MD

When I taught the first BirthWorks class in 1981, I had advertised in our local paper and received nine responses.  Five couples actually signed up for my class.  I was amazed. Then there I was in the room with them, my notes in my lap and when I looked up at them and saw them all looking at me, it suddenly became real.  I was a BirthWorks childbirth educator. These couples had come to me to learn what they needed to know about giving birth.

The class surpassed my expectations.  One woman said she didn’t know if she should come or not as this was her fourth baby and she’d already been to three different classes for her other three.  But a woman who had taken the class said, “Go.  This is different.”  And she came.  At the end, she said she learned so much more than she expected.  She learned what a woman really needs to know about giving birth. She felt more confident, more prepared emotionally, and had more insights about pelvic positioning in labor and birth.  She ended up helping me develop our BirthWorks training workshops and to this day remains one of my soul sisters.  In fact, I’ve met some of my best friends through BirthWorks.

The impact of BirthWorks childbirth classes is much greater than an instructor realizes while she is teaching the classes.  One man called me six months after he and his wife gave birth, to tell me how helpful the classes were in helping their marriage.  The classes were also instrumental in helping them to have a beautiful VBAC birth. 

The impact of the BirthWorks training is also profound.  One woman wrote me after 20 years to tell me how much the BirthWorks philosophy is helping her in her current management position and also through her life.

Birth is instinctive.  Birth is ancient.  Birth is about coming home to ourselves and feeling our own power, becoming empowered. Birth is about life.  All women are born with the knowledge about how to give birth.  When they learn to have more trust and faith in their bodies’ ability to give birth, their lives change.  There is transformation in becoming parents, but also in connecting with the wisdom within.  

Meet Our Experts

BirthWorks International is pleased to welcome a diverse group of birthing professionals to answer your questions about birth, health, pregnancy and nutrition! With years of experience working with pregnant women and their needs, we're confident that our panelists have just the expertise that you'll be looking for. As our Celebrating Birth 2014: Ask the Experts event approaches in just over a week, we are excited to share with you our team:

Sarah Appleby-Wineberg                                                              Lori Feldman-Winter
Jeffrey Pinto                                                                                     Heidi Ojha
Brittany Sharpe-McCollum                                                          Geoffrey Bowers
Christy Santoro                                                                              Ruth Wilf
Jill Wodnick
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Sarah Appleby-Wineberg, CNM, MSN, WHNP is a certified nurse -midwife in a full scope practice in Sewell, NJ.  Sarah is one of four Rowan University Midwives who provide 24/7 L&D coverage for their local community hospital, as well as complete gynecological care for women throughout their lifespan. Sarah was first drawn to midwifery while working as an exercise physiologist doing NIH funded research on Exercise and Pregnancy in the early 90s.  While collecting observational data during labors, she was often drawn into the role of support person for her subjects, and soon became hooked on the power of women and birth. 

A graduate of Oberlin College (B.A.), the University of Evansville School of Nursing (B.S.N), and the University of Pennsylvania Midwifery program (M.S.N), Sarah shares her busy life with her supportive professor/musician husband Bryan and her two beautiful inspiring teenage daughters, Hannah and Kate.
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Bio - Reach MD;
Photo - Cooper Health

Lori Feldman-Winter, MD, MPH, is an associate professor of pediatrics at the University of Medicine and Dentistry of New Jersey, and the division head of adolescent medicine at Cooper University Hospital in Camden, New Jersey. Dr. Feldman-Winter is also an executive committee member of the American Academy of Pediatrics section on breastfeeding.

Dr. Feldman-Winter's special interests include general adolescent medicine, nutrition, and breastfeeding medicine. Her research also centers around breastfeeding medicine, in addition to her focus on health systems and public health, nutrition and growth, and adolescent rights and consent.

Dr. Feldman-Winter received her medical degree from the Albert Einstein College of Medicine, and completed her internship and residency at the Children's Hospital of Philadelphia.
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Photo & Bio via Healthy Living Blog

Jeffrey Pinto, D.O., is an internal medicine physician dedicated to living a healthy lifestyle who believes that good health starts with making the correct dietary choices. He hopes to improve the diet and health of his patients, friends, and family by providing them with the template by which I live my own life via his Healthy Living Blog at drjeffreypinto.com.  Good health starts with making the correct dietary choices.  His interests lie in choosing, preparing, and eating food that is whole (unprocessed), plant-based and low in fat.
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Heidi Ojha, PT, DPT, OCS (Orthopaedic Clinical Specialist), FAAOMPT (Fellow, American Academy of Orthopaedic Manual Physical Therapists), currently is full time faculty at Temple University and instructs in their Doctor of Physical Therapy and Orthopaedic Residency programs.   She has published various articles in peer-reviewed journals on orthopedic physical therapy, has received grants from the American Physical Therapy Association (APTA) to fund this research, and regularly presents her research at national conferences.  She teaches in the area of women’s health and is knowledgeable about evidence informed interventions for pelvic floor conditions.  She has two daughters, both of them delivered at home with assistance from a Certified Professional Midwife.

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Brittany Sharpe McCollum, CCE(BWI), CD(DONA), is owner of Blossoming Bellies Wholistic Birth Services, providing Birth Works certified childbirth education and DONA certified birth doula support to the greater Philadelphia area.  Brittany has been supporting expectant and new families since 2007, when she began teaching out of her South Philly home. She still teachers her classes in South Philadelphia but also facilitates in Fairmount, Mt. Airy, and Collingswood New Jersey.  Providing families with resources, confidence, and research-based information are at the core of Brittany's goals as a birth professional. 

In helping parents to recognize their strength as humans, role models, and advocates for the needs and wishes of themselves and their children, Brittany assists families in creating birth and parenting experiences of which they feel positive, confident, and informed.  Her approach to birth and parenting focuses on building awareness of one's intuition and combining it with learned knowledge in a way that is respectful of the needs and abilities of each individual.

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Photo & Bio via
GardenStateOBGYN.com

Geoffrey Bowers, MD, completed his medical education at Jefferson Medical College and his residency training at Jefferson University Hospital, where he served as Chief Resident of the Department of Obstetrics and Gynecology. In addition to being admitted to Alpha Omega Alpha, the medical student honor society, he was the recipient of numerous academic honors including Most Outstanding Resident and the Senior Resident Gynecologic Surgeon Award of the Jefferson Department of Obstetrics and Gynecology.

After completing his medical training, Dr. Bowers worked as a staff physician at Abington Memorial Hospital in the Department of OB/GYN for two years and then moved to Jefferson University Hospital as an Assistant Professor in the Department of OB/GYN. He is the co-author of numerous articles in peer reviewed publications and has made presentations at many professional society meetings and seminars. He has completed Masters Level training on the DaVinci Robot and has performed over 200 robotic surgical cases. Dr. Bowers became Board certified in 2013.

Dr. Bowers resides in Philadelphia with his wife, Michele, and their daughter. In their spare time, they enjoy spending time at the Jersey Shore.

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Christy Santoro, CPM, LM, is the owner of Motherland Midwifery, a home birth midwifery practice based in Philadelphia, PA. She is also blessed to be mama to Itzela and Eliodoro. She works closely with a small number of families in the Greater Philadelphia Region and South Jersey who trust in birth as a natural process. Each expectant mother receives personalized care from a midwifery team that includes Christy and another midwife or trained birth assistant and an apprentice. We give information, resources, love and support for women and families to make informed decisions about their pregnancy, birth and parenting journey. We provide a full spectrum of family-centered prenatal, birth and postpartum care. 



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Photo & Bio via CIMS

Ruth Wilf, CNM, PhD, is a certified nurse-midwife at The Birth Center, in Bryn Mawr, PA. Originally trained as a biologist, through having children in the 1950’s and ‘60’s Ruth and her husband became increasingly dissatisfied with what was being offered to people having babies, so in the 1960’s Ruth became involved (at first as a parent) with the early childbirth education and breastfeeding movement in this country and since then she has never looked back.

Among other things Ruth organized early childbirth conferences for ICEA and was on the ICEA Board, as far as she knows started the first childbirth classes for clinic patients in this country (1968).  She was one of the founders of the pioneering Booth Maternity Center in Philadelphia (1971), where nurse-midwives were the primary caregivers  (with obstetrical back-up) offering “family-centered maternity care” and parent choice for women from all walks of life who were all treated equally, another first on several counts. She lectured widely about Booth and was fortunate to inspire the start of a number of other midwifery practices, both in and out of hospital. Ruth became a nurse-midwife in 1974 and has practiced continuously since then, always teaching and precepting nurse-midwifery students, especially through the Frontier Nursing Service (now Frontier Nursing University) and the University of Pennsylvania.

In 1981 she founded the first midwifery service in southern New Jersey. From 1988 to 2008, she was a nurse-midwife at Pennsylvania Hospital in Philadelphia, and she has been at The Birth Center in Bryn Mawr since then.  Volunteer activities include: Editorial board of the journal Birth, Issues in Perinatal Care, since its inception in 1974, a member of the Leadership Team of CIMS (organized/chaired 5 conferences), a CIMS representative to the U.S. Breastfeeding Committee (USBC), and numerous others. Her passion for improving maternity care remains undiminished, and she has never lost her primary orientation as a parent/consumer deserving respect for the natural process and for choices in maternity care.

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Jill Wodnick, LCCE, CLC, is a national doula trainer and Lamaze educator with experience leading a community doula program to reduce perinatal disparities.  She is affiliated faculty at  Montclair State University’s Center for Autism & Early Childhood Mental Health running the 'Giving Birth and Being Born' initiative. Frequently speaking about birth, she presents webinars and keynote addresses for groups like the NJ Hospital Association, NJ BirthNetwork, presented at Health Connect One's national community doula symposium and other local venues. Jill serves on a national task force to advocate for Medicaid coverage of doulas and leads local programs to improve perinatal outcomes by focusing on health literacy, reducing disparities and breastfeeding initiation and retention. Jill is a certified Lamaze educator and certified lactation counselor

Jill has taught nurses, physicians, community health workers and hundreds of expectant parents. From 2005-2009, she was the Expert Doula for Pregnancy Magazine, Destination Maternity’s website and the PBS program “Parental Wisdom” and has published numerous articles for International Doula Magazine. Jill was invited to be part of the March 2013 United Nations Commission on the Status of Women symposium panel representing prenatal and perinatal educators about preventing all forms of violence through the World Organization of Prenatal Educators Association. Jill infuses songs and spirit into her work and is proud to be part the "One Million Women Drumming" initiative.

From 2010 through December 2012, she has organized the Community Doula Fellowship as a consultant to the Partnership for Maternal and Child Health of Northern NJ funded by the Merck Foundation’s NJ Neighbor of Choice award. Jill has taught persuasion, public speaking, communication, and creative drama for Montclair State University, Seton Hall Prep, Seton Hall University, the PA State System of Higher Education's Undergraduate Women's Leadership Institute, Kent Place's Girls Leadership Institute, and the NJ Governor's School of Public Issues.

Jill can be found singing, baking bread and playing Yahtzee with her husband and three boys, Nathaniel, Sebastian and Emerson and volunteering as a parent for Hillside School's Drums of Thunder program.

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We'll see you there !

Meet us in the Conference Center at the Cherry Hill Library on May 22 at 7pm to meet the panelists, win prizes, gain invaluable information and even meet local vendors. We'll bring the refreshments and the fun, you bring your questions!

The Cherry Hill Library is located at 1100 Kings Highway North, Cherry Hill, NJ 08034. If you have any questions, call (609) 953-9380 or email the Program Coordinator Trish Tate at trisht@birthworks.org.

Birthing Gowns for Labor

by Cindy Lintel, creator of BG Birthing Gown

“Do I have to wear THAT?”  Is the question that changed my life.  My name is Cindy Lintel.  Lucky for me I have been a Labor and Delivery Nurse for over 30 years.

In 2009 a gal came in to my Birthing Center and asked if she really had to wear ‘that hospital gown’.  It was this question and Kristin’s birth that changed forever the way I see women birthing their babies.

Wearing her favorite maternity dress, Kristin seemed to sashay through her labor.  She was having her first baby and yet, there was an energy…a confidence … an ATTITUDE that I rarely saw and I wondered what Kristin’s secret was?

Unlike generations of women before her, Kristin had not been stripped of her personal belongings and made to wear a worn out ill fitting “gown” that some stranger had worn the day before. Instead of being dressed like a sick patient, Kristin kept her clothes on!  She wore a dress that FIT her, made of a soft COMFORTABLE fabric, a dress that COVERED her!   My Ah-ha moment came when I realized Kristin was dressed for her baby’s birth!

After much research, I realized there were very few birth wear options, so I went about to create the BG Birthing Gown.  I knew the dress had to be medically appropriate. I didn’t want women to be told they could not wear it.  For the medical staff, I put Velcro at the shoulders for easy access for IV’s, vital sign monitoring and EKG accessibility…More importantly, I put Velcro at the shoulders to create the easiest access for breast feeding babies! In the BG,  moms only expose one breast at a time, as compared to the hospital gown, where women wind up bearing all while breast feeding in a hospital gown.

The BG was designed as a wrap style dress, as a one size fits most design, in a soft and stretchy Rayon/Lycra blend.  Women are CONFIDENT and COMFORTABLE knowing they are COVERED and wearing a dress that FITS! If mom wants a back massage, or if needs anesthesia in the BG, she unties and the back opens from side to side for best in back exposure.  The BG has belt loops in the front, so when she is untied, her ties always stay in the front! 

It is a joy to know I have helped thousands of women to Celebrate their Births Beautifully well beyond the walls of my Birthing Center.  Knowing women like Kristin are empowered instead of feeling vulnerable, more inclined to participate in their birth process, walking the halls, moving, swaying and sashaying through their labor with a new energy…confidence…a great attitude, being mindful of their births, not worried about being over exposed in the hospital gown.

To Dress for Your Baby’s Birth, please visit WWW.BIRTHINGOWN.COM or WWW.BIRTHWORKS.ORG. Best of luck at your Birth!

Birth: The Mystery

by Mali Schwartz

A physician who specializes in infertility problems told his colleague the following: "One day I was peering through a microscope at a fertilized ovum, and I realized that all that this cell will have is carbon, oxygen, hydrogen, nitrogen and a few trace metals; and from this single cell will develop a whole human being, with a brain comprised of two hundred billion specialized cells." I knew at that moment that there must be a G-d.

Marianne Littlejohn, a professional nurse and midwife in South Africa, feels that “Giving birth and raising children is the most life-changing event a woman ever experiences. It is both a peak experience and deeply spiritual at the same time. ”  Marianne has three adult sons, all born at home, which fueled her interest in birth and child development and she facilitates peaceful parenting practices.

She has attended home births, water births and hospital births and facilitates calm birth, gentle birth, undisturbed birth and ecstatic birth, as well as assisting women who require a caesarian-section to stay connected with their baby skin-to-skin after the operation.

A husband of one of Marianne’s clients expressed the wonder he felt as a witness to his wife’s water birth:  How could I possibly explain, as a father, what it feels like to have the silky soft hair of my baby’s head stray gently through my fingers during the very earliest stage of a water birth?  Is it not something surreal to stroke your wife’s back with one hand, comfort her with kisses and gently hold our baby’s head in the palm of the other while awaiting the next contraction?  When the shoulders popped out our appointment with relief seemed ever more tangible yet those vivid moments have been indelibly engraved upon my being: such awareness, such an awakening. One almost feels guilty sharing it. The first contractions bring small pieces of hope and excitement but the very last one sweeps you away like a car in a tornado – a baby, head to toes came into (our) being.

What a beautiful homage paid to the process of birth!


From a physician who understands the difficulties that have to be surmounted when couples deal with infertility, to a husband who expresses his wonder at the mystery of birth, these two individuals beautifully express a sense of awe that surrounds the miracle of birth.

Review of the Essential Homebirth Guide

by Jane Beal, PhD, CD (DONA), CCE (BWI), CLS

The Essential Homebirth Guide is my new favorite book. It is wondrous, wise, and woman-centered. It is really the only book like it on the market for families planning or considering birthing at home. It’s also a great resource for homebirth midwives and childbirth educators looking to provide a valuable educational resource to expectant parents.

The information in the book is well-structured. After a foreword by Dr. Christiane Northrup, a welcome note, and a note from the authors, the book features twelve chapters, five appendices (on questions to ask during an interview, further reading for the homebirth family, resources for childbirth education and support, resources for higher risk mamas with homebirth hearts, and the photo credits), acknowledgements, notes, and an index. Each chapter begins with a brief overview of the contents (bullet-pointed) followed by a quotation from a mom that conveys her perspective. Every chapter is full of questions that families might ask (or might need to ask but not know that they should), followed by answers and explanations. Interspersed throughout each chapter are stories from mothers, black and white photographs, and occasionally an offset box that begins “the midwife says … “ or contains some useful, related information. The question-and-answer format really makes the chapters easy to understand. The cheerful, down-to-earth tone makes it easy to enjoy.

Chapter 1 tells the story of homebirth, giving a brief history that mentions early American midwives like Bridget Lee Fuller who caught babies on the Mayflower and Martha Ballard who practiced during the Revolutionary War era. It discusses the rebirth of natural childbirth and homebirth midwifery in the 1970s, referring to Ina May Gaskin, as well as some of the reasons that motivate families to seek homebirth today: many women are seeking it because they feel that birth is not a medical event nor should it be treated as one (p. 8); for others, it is more affordable care (p. 9); and some choose it because of deep religious convictions (p. 10). A growing number of women who have experienced birth trauma in the hospital are seeking a different kind of birth experience at home.

Chapter 2 focuses on early pregnancy, finding a care provider, and the importance of prenatal nutrition. The authors outline the distinctions amongst midwives: direct-entry midwife, certified professional midwife, licensed midwife, certified nurse-midwife, and physicians, including reference to the MDs, DOs and obstetricians who attend homebirths in some communities. 

Chapter 3 focuses on what prenatal care with a homebirth midwife is like. Since midwives focus on holistic care, prenatal visits are 30-60 minutes long (compared to the average obstetrician visit, which is only 7-15 minutes long), giving the opportunity for conversations that build trust and develop relationship. Visits naturally include good, standard care: checking maternal blood pressure, pulse, weight, and urine as well as fetal heart tones and position. But mothers are involved in this process, reporting their own weight and learning how to read their own urine analysis strips. This is all part of encouraging home birthing families to take responsibility for their own self-care.

Chapter 4 discusses relationships in the mother’s life to her partner, her parents, coworkers and even strangers, and how these relationships might be affected by her desire or decision to birth at home. It gives wise advice for coping with diverse reactions to this choice. Chapter 5 is likewise about communication, specifically the importance of informed consent, crafting a birth plan for homebirth and the possibility of hospital transport, and involving family members in the plan with the understanding that it’s important not only to be informed, but flexible (since things really go exactly as we plan them!). 

The authors give BRAINS as a great acronym for:

• benefits
• risks
• alternatives
• instincts/intuition
• now/never/nothing and
• safety/satisfaction (p. 76-77)

These six evaluative measures can be helpful when applied to any decision being made during the childbearing year.

Chapter 6 focuses on the birth team and different types of childbirth education. The authors note the great benefits of having a birth doula for physical and emotional support. They mention four doula training organizations: ALACE, Birth Arts International, CAPPA, and DONA. In the next edition of the book, I hope they will also mention TOLABOR: The Organization of Labor and Birth Options and Resources (http://www.tolabor.com) and BirthWorks doulas. With childbirth education, they give a brief survey of Lamaze, the Bradley Method, HypnoBabies and HypnoBirthing, Birthing from Within, and The Pink Kit. Again, I hope they’ll also mention BirthWorks childbirth education classes in the next edition, as these classes are excellent preparation for VBAC, HBAC, and homebirth in general.

This chapter also mentions a variety of other professionals and services that pregnant and birthing moms can benefit from, including postpartum doulas, massage therapists, and chiropractors as well as Mayan abdominal massage, yoga, and acupuncture.

Chapter 7 is all about special circumstances that might impact a family’s decision to have a homebirth. The authors begin by addressing risk and fear. They go on to discuss twins and breech babies. They acknowledge that some, but not all, homebirth midwives attend twin or breech births. They explain state regulations that may restrict a midwife’s ability to attend as well as the risks that make hospital-based resources useful in some of these cases. 

They also take time to acknowledge the emotional impact a personal history of abuse can have on a childbearing woman. I hope the authors will expand this section in the next edition because this is such a critical issue facing a third of childbearing women today. On a related note, they discuss the pressures facing teen moms and what a great option homebirth can be for them. The story they include from the perspective of Nikki, a teen mom, is one of the most encouraging, inspiring, and witty in the whole book. 

Chapter 8 focuses on HBAC: homebirth after cesarean. It’s a splendid chapter exactly in line with the BirthWorks philosophy and the principles of ICAN: International Cesarean Awareness Network (http://www.ican-online.org). It reassures mothers that home birth is certainly possible after cesarean and informs them of their options and resources.

Chapter 9 considers the “big ten” pregnancy-related issues: the emotional experience, anemia, vitamin D deficiency, Rh-negative blood, GBS, gestational diabetes, thyroid problems, common cold, hypertensive disorders, and miscarriage. The information provided is concise and comprehensible with an emphasis on prevention. As the authors say, “What is the take-home message? … 1) Make sure that the calories you ingest are nutrient dense and 2) exercise regularly” (p. 209). This is an excellent message! Good nutrition does prevent many (though, of course, not all) pregnancy-related complications. 

Chapter 10 focuses on labor and birth at home. The authors discuss the importance of cleaning the house before the birth, in some detail, and what to do with pets and siblings as well as the necessity for a homebirth kit. In this chapter, they also discuss what to pack in a bag in case of hospital transport and options for what to do when a pregnancy is postdates, including out-of-hospital methods of induction. They discuss the experience of early labor, some pain relief measures for active labor (with an emphasis on water birth), and pushing out and catching the baby. 

They mention some of the top reasons for transport to the hospital: fatigue, pain management, maternal fever or high blood pressure, significant blood loss prior to the birth, baby’s heart rate too low or too high, meconium in the amniotic fluid, uncontrolled postpartum hemorrhage, retained placenta, newborns who cannot maintain their temperature, and other newborn anomalies that require pediatric care (p. 266). This provides a good overview for parents and helps to foster realistic expectations. 

Chapter 11 focuses on the postpartum period, including immediate postpartum care, skin-to-skin mother-baby contact, breast-feeding, and newborn medications (eye ointment and Vitamin K) and screenings (initial heel-stick and others). The authors discuss postpartum depression and how to get help for it. Happily, they note the postpartum depression is rare in homebirthing mothers, but it does occur, so it’s important to be on the look out for it. They are careful to distinguish between normal “baby blues” and PPD. In this chapter, they mention placental medicine, including encapsulation, as one option that families may use to combat PPD.

The final chapter includes, in the tradition of Ina May Gaskin’s Spiritual Midwifery and Guide to Childbirth, eight birth stories from mothers with different homebirth experiences. There is a note of realism and a diversity of experience represented in the stories. The mothers express themselves honestly, often with a great sense of joy and triumph, but they don’t over-idealize their experience. Only one says she had a pain-free birth, and none mention an experience of orgasmic birth. Perhaps these are the sorts of stories that connect to most American women’s experiences of childbirth, even at home, today. 

I recommend this book wholeheartedly to expectant parents, childbirth educators, and midwives. Doulas looking to add to their resources for families should pick this book up immediately. In my opinion, it is the best book for American families on midwifery care and preparing to birth at home available today.

Jane E. Drichta, CPM and Jodilyn Owen, CPM, The Essential Homebirth Guide (New York: Gallery Books, 2013). 379 pp. $12.68 Amazon Paperback / $10.38 Kindle.