Author Dr. Anne Lyerly Writes About What ‘A Good Birth’ Is In Her New Book
Whenever two moms become friends, they inevitable share their birth stories. It’s just such a huge and ingrained moment in a woman’s life. Now health expert, Anne Drapkin Lyerly, M.D., has asked real mothers about our experiences and written a book about it. Currently expecting her fifth child, she knows what she’s talking about. In A Good Birth: Finding the Positive and Profound in Your Birth Experience, Dr. Lyerly discusses all the stuff we worry so much about. See what her angle is in our exclusive Q&A below.
KK: What is “A Good Birth”?
ADL: Indeed, that’s the question at the heart of my book. Broadly speaking, a good birth is a birth that a mom can look back at and feel good about – embrace, relish, value for what it was and what it meant – and means to her, on terms that make sense to her.
A Good Birth is also the title of my first book – definitely a labor of love, written in the first intense year of my fourth baby’s life, but conceived long before he was. For years I’d been frustrated by the contentious debates between midwifery and obstetrics, and by literature that was overly simplistic and dominated by the voices of practitioners and advocates rather than childbearing women themselves. It struck me that for decades society has taken seriously the notion of a “good death” but too many books on birth these days focus on birth plans or medical considerations, narrowly construed, without attending to the ways that birth is a serious life event, a bookend of life that deserves our attention and due regard. So I conducted a large study called The Good Birth Project, in which I asked a wide variety of women to talk about their births, what made them good, what made them bad. Their stories are the basis for A Good Birth – are gorgeous and full of wisdom and insight, and together point toward a better way of thinking and talking about birth than what we have now.
KK: Why is there so much controversy today about birth alternatives (midwives, home births, etc)?
ADL: Part of it is that birth matters to us – it always has. Not just that it happens, but how. Memories of birth endure, stories of birth get told and retold. Birth is a major life event, we care how it happens, we care about that moment that we “meet” our child. And the stakes are high – birth involves bodily integrity, intimacy, private decisions, children. In those ways controversy it to be expected, perhaps welcomed.
But part of the controversy comes from the way we talk about birth these days – and here we have gotten it wrong, much to the detriment of mothers and mothers-to-be. After years of attending births, giving birth, thinking and writing about birth, I’ve concluded that what stokes the fires of controversy is a deep confusion about the goals of birth – about what it is that makes birth “good.” One view is that birth is normal and natural: a good birth is one that uses as little technology as possible. The other view is that birth is complicated and potentially risky: A good birth depends on a good outcome, and that’s it. Anything else is icing on the cake. Of course neither view is quite right. Both reflect professional agendas, and together leave moms with feelings of guilt and uncertainty when they look back on their birth experiences. As I listened to women – especially those who’d had a chance to reflect – I became convinced there was a different, more productive and authentic way of looking at and talking about what makes for a good birth – that is what The Good Birth Project was all about.
KK: What are the 5 keys to having a positive birth experience?
ADL: As I say in my book, what struck me time and again as I listened to women was not what distinguished one birth from another but what they had in common, which boiled down to five key elements.
1. Agency: a good birth is one in which we have a hand in shaping, that is informed by the things we value – a birth in which we feel involved and present.
2. Personal security: a good birth is one in which we feel safe and secure, in trustworthy hands.
3. Connectedness: the degree to which we feel meaningfully connected to our loved ones, our care providers, and of course our baby.
4. Respect: a good birth is one in which we feel others respect us, our newborn, and more broadly birth as a meaningful event in our lives.
5. Knowledge: a good birth is one in which we have enough information before and during the event that we have a sense of what is happening and why; but it also depends on the wisdom we garner by virtue of going through it. As you can imagine, these things can all be cultivated no matter where you give birth (home, birth center, or hospital) and no matter how (vaginally or by cesarean). I explain the myriad ways that women have found these things in births they’ve experienced, and can clear the way for them as they look toward giving birth in the future.
KK: After giving birth to 4 boys, you are about to have a daughter. Congratulations! How are you preparing for this birth compared to your 4 previous birth experiences?
ADL: I am really excited about our news – thank you! When people talk about “preparing” they often mean one of two things: either getting stuff together (we need pink, that will be a fun task!) or making a “birth plan” (which I tend to discourage, if it means a long list of things you want to have happen; as many of the wise women I interviewed learned, birth often eludes the best laid plans – and that’s okay!). There is, though, a kind of preparation I think is really important – and is has to do with preparing oneself.
This birth feels different to me, and not just because I’m expecting a girl, but because of what I’ve learned through researching and writing A Good Birth. I’ve heard lots of writers say something like, “I write so that I know what I think” and there is a sense for me in which writing A Good Birth was the best thing I could have done to prepare myself for giving birth to my daughter – even though that wasn’t the point of it. I’ve learned so much in listening to women, thinking about what mattered to them in birth, and writing about what mattered to me. My goal in writing the book was to give women a way of thinking about birth that doesn’t turn on whether it was “natural” or not or whether it met some imagined ideal, to help them stay open and attuned to the deep things that they are likely to see as valuable, eventually. My hope is that what I learned in writing will carry through for readers looking ahead toward birth or looking back on it. Also, writing can be a great way for anyone to “know what they think” and I encourage women to find ways to get their own words out. In fact, starting this month, there is a community Your Story on my website to share reflections on A Good Birth as well as ideas about what it is that makes for a good birth. I’m looking forward to a rich and lively conversation. Most of all I want to hear your stories. Find it at www.annelyerly.com/yourstory.
About the Author
Anne Drapkin Lyerly, M.D., M.A., is Associate Director of the Center for Bioethics and an Associate Professor at the University of North Carolina, Chapel Hill, in the departments of Social Medicine and Obstetrics and Gynecology. As an obstetrician, she has attended women’s deliveries for over a decade. Widely featured in the media as a women’s health expert, she lives in Chapel Hill with her husband and their four sons.
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