Why This Book Was Written
It is with great joy and excitement that I write this second edition of The Well Pregnancy Book. I would like to thank the hundreds of thousands of readers who made the first edition successful and would like to welcome new mothers and fathers to what I believe is a wonderful time. Pregnancy, childbirth, and new parenthood constitute a special time in our lives. Pregnancy and birth are one of the great mysteries, and to live and share that mystery ties us all together and unites us to everything around us. How many times in our lives do we exist in a space of creation? How often does the everyday world show us its majesty and power?
To come down to earth, I write this new edition with the knowledge that prenatal education is even more valuable in helping pregnant women than Nancy and I had thought. New studies have shown that learning about pregnancy and childbirth increases satisfaction and participation for the pregnant woman and decreases her need for pain medication during labor. Learning about what is normal in her body relieves her worry and raises her expectations of a positive experience. New studies have shown that a mother's expectations tend to be fulfilled during labor. If she believes she will do well, she is more likely to have a positive birth experience. I hope that this book will give mothers a positive picture of pregnancy and childbirth, relieve worry, and help the mother and father fully experience the joys of this mysterious time.
Since Nancy and I wrote the first edition of The Well Pregnancy Book, many things have changed in obstetrics. Prenatal tests have increased in sophistication, new studies have further elucidated which interventions are most helpful in prenatal care and in labor and delivery, and new treatments have emerged for both mother and baby. Perhaps the largest changes have taken place in the attitudes and preferences of the mother. Pregnant mothers are now more likely to give birth in a hospital with an obstetrician in attendance and more likely to use epidural anesthesia. In general, mothers are more interested in what can be done to reduce risks than to reduce technical interference. Mothers of today are less likely to be distrustful of medical authority than mothers at the height of the maternity parents' movement of the late 1970s, and they may be more interested in comfort than in control. The contemporary mother is more likely to be working away from the home. She has a healthy interest in her baby and her long-range future and perhaps less interest than her predecesor in the perfect delivery.
I hope these changes help make the experience of pregnancy and childbirth better for the new parents. Many of the things we helped ask for, such as support for the mother during labor, and newborn bonding, have now become routine, so that the mother need not fight for control as she used to do. But I also hope that the focus of technology does not take away from the comfort and satisfaction of the mother by creating a delivery experience designed for the caregiver and not the mother. After all, the goal for both the mother and the caregiver is a healthy baby and a joyful delivery. We believe that childbirth should be mother-and baby-centered to best achieve this goal.
I believe that pregnancy is extraordinarily beautiful, if not holy. A pregnant woman is a metaphor for the earth. She is all creation, she is growth, she is manifestation, and the experience is not under her control or the father's control. Pregnancy is the earth speaking. She -- the earth -- is pregnant through the new mother and father. This makes the pregnant woman beautiful and holy.
A woman is never more beautiful than when she is pregnant. She is like a fairy woman, like a spirit lover, like a goddess. It is as if she has come into her own, flowered, bloomed. It is as if through her the earth and the sky have spoken. In becoming pregnant, a woman is like the greatest manifestation of the feminine, she is Her in her most beautiful and fullest form. She grows like the universe, expands like space. I think both the mother-to-be and the father-to-be know this deep inside of them. Even if a woman feels clumsy and large and looks different, she knows that she is very special in a soft, intense way while she is pregnant. The parents-to-be also know that their baby is unique and precious, that he or she is like a baby of God, is blessed, new, and is from above them. The mother-to-be and father-to-be are not unlike the manifestation of a living myth, the myth of God and a Goddess giving birth to a holy child. I think this is why some parents love each other so deeply during pregnancy, childbirth, and the newborn period. They know that their baby-to-come is the purest manifestation of their love on earth, and this heals them and everyone around them as the baby is born.
This is the first book in a series. The second and third books have already been written. In 1976 we wrote a self-help medical book called The Well Baby Book, which we began just before the birth of our second child. The book was specifically written for new parents, and its goal was to help create happy, healthy babies. We did not give parents any dogmatic solutions or advice but tried to provide them with a broad understanding of growth and development, of health and disease, so that they could make their own choices about patterns that would contribute to their baby's lifelong health. Our next book, The Well Child Book, was written as our children started to grow up. It also pursued the objectives of wellness and preventive medicine, but for the age group of four to twelve.
We began the present book because we realized that the same concerns needed to be addressed in terms of pregnancy. There was a lot of information that still was not readily available to the layperson, and much that needed to be demystified. We wanted to give expectant mothers and fathers information on the normal processes of pregnancy and childbirth, so that they would develop confidence in the mother's body and a profound respect for the natural changes her body would undergo during gestation. We believed such information helps because it replaces fear of the unknown with understanding, enables parents to avoid those things that might have negative effects on the baby, and gives parents a realistic basis for positive images of labor and delivery. Our goal in The New Well Pregnancy Book was to help foster happy, healthy pregnancies with good deliveries and healthy babies. In this book we tried not to give rigid answers or advice but to make parents aware of the way pregnancy is currently managed so they will be able to make their own choices and feel comfortable and satisfied with the outcome.
Birth is a natural process, which women and babies have evolved over millions of years. Both mother and baby are eminently suited to play out their parts in the processes of fertilization, conception, gestation, labor, and delivery. If a mother were asked to "design" a baby, "grow" it, and bring it forth from her body, she could not do it. Yet her body has the wisdom to do just that in a manner that never ceases to be miraculous. So an expectant mother's learning doesn't have to do with how to grow a baby but with helping her body do what it instinctively knows how to do without getting in its way.
Basically there are two major ways in which expectant mothers hinder their own bodies: one physical, the other mental. In terms of the mother's physical environment, her diet, exercise, exposure to chemicals, and general health are all important variables. Doctors are beginning to learn that certain things in these categories will help the mother's body work at its best, while others may impede it. For example, a baby is much more likely to be healthy if its mother has an optimal diet than if her diet is deficient in calories or protein. In terms of the mother's mental environment, her experiences and her perceptions of them are the important variables. The less fear, stress, and anxiety the mother experiences, the less complicated her pregnancy and delivery are likely to be. Blood flow to the uterus, which controls the delivery of food and oxygen and the removal of waste products, is governed by the autonomic nervous system, the unconscious branch of the nervous system. When a mother can relax and visualize positive images, blood flow to the uterus is maximized; her body tends to nurture the baby in an optimum way during pregnancy and to promote the most effective contractions during labor and delivery. A relaxed, reassured mother who is knowledgeable and feels loved and supported is able to keep out of her body's way by releasing tension and fear and by allowing her body to take over with the inborn skills it has evolved over the centuries. In The Well Body Book, Michael referred to this kind of inborn body wisdom as the three-million-year-old healer. In this book, in a similar way, we visualize that each pregnant woman has inside her a three-million-year-old mother. When a woman lets go of fear and tension, her three-million-year-old mother is free to work at her best.
Having a Baby Today
Having a baby at this time in our culture not only requires a mother to let her three-million-year-old mother work at its best but requires her to be able to understand and deal with technical medical knowledge when necessary. Modern medicine has tools that have helped optimize the chances of a healthy pregnancy and delivery in certain situations, but these tools and techniques are too new to have become part of any mother's age-old bioprograms or cultural patterns. Mothers may find certain medical techniques to be anxiety producing and in conflict with their instinctual feelings. Thus, some midwives, childbirth educators, and doctors believe that medical intervention can be counterproductive in some instances, working against the natural processes involved in pregnancy and birth. This is the dilemma of modern obstetrics, and it has led to a split between those who feel they want as natural a pregnancy and delivery as possible and those who feel that medical intervention during pregnancy and delivery maximizes the health of the mother and, particularly, the health of the baby.
Most women having a baby in the United States today -- and an increasing number of expectant mothers throughout the world -- will experience some degree of medical intervention during pregnancy or delivery. We therefore feel that it is important to include information on the most commonly used procedures and laboratory tests as well as on cesarean birth. We believe that the more a mother understands about such medical practices, their rationale, and the choices open to her, the less frightened or upset she will be in dealing with them.
Every mother and father hope for a magical delivery, and this is true of many births, but it is unfortunately not the reality of every one. We hope to help all mothers achieve as positive a childbirth experience as possible among a realistic range of possibilities. We acknowledge that not every woman will have an uneventful, joyful birth, although our wish is to facilitate just that outcome. For this reason we have chosen not to deal exclusively with home deliveries, technical deliveries, or prepared childbirth. We have attempted to make the book useful for as diverse a group of mothers and fathers as possible. This was a complex task because of the great divergence that presently exists between natural and technical obstetrics, and because of the wide scope in the guidelines for managing certain obstetrical situations. We've tried to make the material in the book as applicable for a mother having a home delivery as for a high-risk mother having a cesarean birth, by concentrating on the fundamental events and feelings as well as on the various ways of handling different situations. We have focused on anatomy and physiology to see how the three-million-year-old mother normally works. And we have shown through numerous studies how different factors affect fetal development and birth. We have emphasized how relaxation and support help any mother have a more positive pregnancy and birth experience. All this information enables parents to make educated choices and to take more responsibility throughout gestation and delivery. Studies have shown that the single most important factor in helping to ensure a mother's satisfaction with her delivery is her feeling that she was an active participant and had a measure of control over the situation. To make choices and have control, a mother needs to understand the alternatives and the reasons for them.
We see The New Well Pregnancy Book as an adjunct to childbirth preparation classes, not a substitute for them. Not only can the birth educator answer parents' individual questions and respond to their specific needs, but the class members generally become a support group for each other. Also we do not focus on one method of childbirth preparation or one labor-management technique, because they vary widely from doctor to doctor and from one geographical area or hospital to another. Each doctor or midwife tends to handle particular medical situations in one of several prescribed ways, depending on his or her obstetrical philosophy and the specifics of the situation; thus, only those professionals, not a book, can say how they will deal with a particular situation. We have tried to give mothers enough information to enable them to question and confer knowledgeably with their doctors. It is our desire that this book help mothers and fathers to increase the health, and enjoyment of the birth of, their baby. We hope that whatever type of birth experience parents have, they will emerge from it with a sense of satisfaction and completion that will send them into the coming years of parenting with boundless love and energy.
Copyright © 1986, 1996 by Mike Samuels, M.D. and Nancy Samuels