A Good Birth - Anne Drapkin Lyerly Review

A Good Birth – Processing Childbirth

In Pregnancy by Happy Mom Guide Staff

A few months ago, I visited Daedalus Books (a giant book warehouse, and maybe one of the coolest places in Maryland, that sadly, closed down recently), and came upon a book called “A Good Birth” by Dr. Anne Drapkin Lyerly. It was convenient that I came across this book, because as we were getting ready to welcome our second child, one of the things I wanted to do to prepare for the experience of giving birth a second time was to reflect on and process, my experience of childbirth the last time around. (And this book was instrumental to that processing).

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In a lot of ways, my experience of giving birth to my older son was a really positive one: A lot of things went right: We had a multi-day stay in a clean, first world hospital. Both I and my child were afforded access to Western medicine. I had only moderate (and common) physical trauma resulting from giving birth. And, at the end of the whole experience, we got to come home with our beautiful and healthy baby boy. Overall, our family left the hospital healthy, grateful, alive, fortunate, and together.

And yet. Those outcomes (healthy baby, overall healthy mom) — thankful for them though we may be — are not the only ones that matter. Even with those outcomes, a birth experience can still include (besides the physical pain): guilt, sadness over things not going as planned, worry over things that went wrong, even trauma (consider the moms with PTSD after birth).

And even when moms have birth experiences they describe as overall positive, they may also have had experiences that were deeply upsetting, or even terrifying. Yet for these moms — the healthy moms with healthy babies and overall positive outcomes — it can even feel like there’s no room for complicated feelings about the experience. As birth doula and yoga teacher Sarah Longacre writes,

“In our culture, we don’t know how to talk about birth experiences in a way that feels good or promotes healing. The canned response we give after hearing a birth story, particularly one that didn’t go as planned, is, ‘Well, at least you and the baby are healthy!’
Yes, it’s true: it’s great that mama and baby are healthy, but this response negates and ignores any trauma or emotional pain that the birther may have suffered.”

Birth doula Sarah Longacre (Read more here)

I’d add that if moms have lingering negative feelings — despite a “healthy” medical outcome — they absolutely shouldn’t feel any guilt about it. Giving birth is the hardest, most physically demanding thing a human being can do, and you are so deeply vulnerable when you’re doing it. Anything upsetting or terrifying moments can leave a big impression on you and your memories of the experience, and it’s normal to have mixed feelings when looking back on the overall experience. And therefore, it’s normal to have to work through those feelings.

In my own labor and delivery / childbirth experience with my first, a handful of things that happened — between the onset of labor and being discharged from the hospital — that were negative and scary. I’m so grateful everything “turned out fine” in the end, but in the two years that have followed, some of those negative elements of the experience have lingered in both mine and my husband’s minds, and therefore, influenced our thoughts about labor, birth, and perhaps even hospitals in general. And as a result, there’s been a sense that this is something I should probably process before we do it all over again.

So when we found out I was pregnant again (here’s an informative but TMI post about getting pregnant after stopping breastfeeding), it felt important to me that we work through some of those memories, process them, and get prepared for this next birth experience in as positive a way as possible. And processing a childbirth experience — even one with positive measurable medical outcomes — can be incredibly necessary. As Sarah Longacre says,

“Literally every person who has given birth needs to set aside some time to process the experience. Even if a birth seems to have gone smoothly to others in the room, the birther may still have experienced disappointment, guilt, shame, or trauma at some point during her pregnancy, birth, or postpartum experience.
While these feelings may be more prevalent following births with unexpected outcomes, even an insensitive comment from a care provider can harm someone during their birth.”

Sarah Longacre (Read more here)

With that in mind, it felt important for me to take the time to think through my previous experience, in an effort to head into my next childbirth experience feeling empowered and positive. That’s where Dr. Lyerly’s book was so helpful.

A Good Birth

Dr. Lyerly’s “A Good Birth” is based on a giant research study called the “Good Birth Project.” It delves into the childbirth experiences of over a hundred mothers in order to try and answer what it is — if it’s not just health outcomes for baby and mom — that contribute to a positive birth experience. Dr. Lyerly’s book doesn’t discuss the “goodness” of birth based on medical outcomes alone, but instead, focuses on the actual experience of childbirth as important for its own sake.

The book examines what makes for “a good birth,” from the perspective of actual mothers (and also, occasionally, Dr. Lyerly’s personal experiences; she’s a mom of five kids). This takes the form of anecdotes and little vignettes describing different moms’ good and bad experiences, and factors that made those experiences feel good or bad to those moms. And reading through these snippets of other moms’ positive and negative experiences has been so, so validating and comforting… I’d recommend this book to all moms looking to process their childbirth experience and/or prepare for another one for the value of those examples alone.

And the book is also beautifully organized such that the aforementioned experiences are examined in terms of themes. Dr. Lyerly’s research identifies 5 major themes that factor into, or influence a woman’s experience of her birth experience and its “goodness”: agency, personal security, connectedness, respect, and most importantly (to me), knowledge.

For me, at least some of the negative things I experienced in my first childbirth experience were tied to confusion, which stemmed from a lack of knowledge. 

In my first childbirth experience, I struggled with not knowing enough. I didn’t know when (or whether) to advocate for myself vs. when to truly trust my medical team when we weren’t on the same page. I didn’t know what was right. I didn’t know what to insist on, and what to leave up to their discretion. Because I didn’t have sufficient knowledge, I experienced confusion and stress during labor, before being admitted, throughout labor, and even after our son was born.

But I’ve been able to work through some of that, at least in part, thanks to this book. Because Dr. Lyerly is an OB/GYN and research scholar, she uses some parts of her book to explain the reasoning behind some of the decisions OBs may make (as well as to shine a light on what constitutes a “good birth” medically speaking). Being armed with this knowledge, plus the knowledge I’ve gained from my own personal experience with having had a baby before, makes me feel more empowered this time around. This is true even while I know that there is plenty that is not controllable about birth. In fact, thinking through the controllable, and the uncontrollable, is another thing that this book has helped me with. This has been helpful in processing what was and wasn’t in my control (or my doctor’s control) during my first childbirth experience, and also in preparing for the reality that only some things will be controllable this time around as well. Knowing that, and thinking about that, has also helped me feel more empowered and positive.

For me, it’s been really important to process some of the things that happened in my previous birth experience as I head into this next one, specifically because I want to feel empowered and hopeful and happy (and not scared and nervous and worried). Obviously people process things differently, and come to feel empowered through different things, but for me personally, the thing that has been helpful in processing my childbirth experience was this book.

Side note about how this book pertains to my book

This book also ended up being really interesting to me in context of my work. It was serendipitous that this book ended up in my hands, also, because it’s the kind of book I’m writing, and was therefore helpful for me in thinking about how to speak to my audience(s). When I say it’s similar to the kind of book I’m writing (even though mine isn’t about childbirth), I mean that it’s written for a hybrid audience of specialists/practitioners AND “regular” people, who happen to be the biggest stakeholders.

In Dr. Lyerly’s book, those specialists and practitioners are OB/GYNs and midwives; in my book, it’s teachers and other education leaders.

And both books are also directed at “regular people” — aka the biggest stakeholders.

In Dr. Lyerly’s book, those “regular people” (aka the biggest stakeholders) are the birth-giving mothers; in my book, it’s South Asian American people.

In both cases, it’s these “regular people” whose experience is being examined, and whose experience is the whole point.

From the perspective of researcher and writer, another thing that I love (and can identify with), is that Dr. Lyerly’s book “A Good Birth” doesn’t just focus on the measurable outcomes for the primary stakeholders (health of mother and child), but instead, focuses on their experiences and feelings, recognizing that those experiences are, themselves, significant and worth examining.

Similarly, my work also doesn’t focus on the post K-12 outcomes for the primary stakeholders, but instead, focuses on their experiences and feelings, recognizing that those experiences are, themselves, worth examining.

All of this is to say, both “A Good Birth” and my own book function in a similar way, positing that the experience (childbirth, in her case; the experience of being a student, in my book’s case) is, itself, worth examining, understanding, and even improving.

If you’ve given birth before, I hope you’ll take the time to process your childbirth experience, especially if there are any lingering negative memories. I especially recommend it if you’re heading into another birth experience. Below, I’m sharing some ideas for how you can process your childbirth experience, and/or have “a good birth” the next time around.

Ideas for processing childbirth experience

  • Do something to process your experience (peer support, in person, online, etc.)
  • Talk to someone who you think might be a great sounding board as you think through your thoughts. For me, chatting with my OB/GYN (who was not the person who helped me deliver my first baby, because she was not on call at the hospital when I was admitted) proved incredibly validating and reassuring.
  • Actually write out your birth story* (you don’t have to show it to anyone!) to help you process the experience.
  • I recommend looking over the document “Making Peace with your Birth Experience” (free, downloadable PDF) by Dr. Kathleen Kendall-Tackett, which offers tangible tips for processing your childbirth experience
  • Read books to help you better understand childbirth better, and to help you contextualize your experience. Obviously, I highly recommend Dr. Lyerly’s book, but there are countless other books about childbirth and processing childbirth out there. (Dr. Kendall-Tackett recommends reading books about childbirth as well, saying it will help you “put your birth experience in a broader perspective.”)
  • Learn as much as you can about your experience. Dr. Kendall-Tackett recommends obtaining copies of medical records to help you better understand what actually happened (but recognize that while it might help you better understand the experience, it might actually make you angry — that’s actually what happened with me when I reviewed the records after delivery!)
  • If this is an option: Go through your healthcare provider and/or insurance to determine if you can have short-term therapy to work through the experience
  • Try to put into words what constitutes “a good birth” experience for you. Though some things are out of your control, identifying the few things that might make you feel empowered might be helpful.

As I previously mentioned, I definitely recommend “A Good Birth.” Reading her book helped reassure me that it was entirely possible for this next experience to be completely different, and positive. (And honest conversations with my OB/GYN also helped immensely in this regard).

For the moms who have given birth:

What was your childbirth experience like? What would have made it better?

What might make you feel empowered heading into another childbirth experience?

PS – If you’re interested, here’s a post all about the “pregnancy essentials” that have gotten me through this pregnancy this time around. Also, did you know that La Leche League has community meetups all over the world and offers a ton of free resources online related to breastfeeding and motherhood?

PPS – The post I linked to about writing your birth story features artwork by Katie M. Berggren, who sells her beautiful artwork here. One of her pieces of art was also featured in this post by Dr. Natalie Duvall (about being a teacher and a mom), here at my blog, with Katie’s permission. Please support Katie M. Berggren’s art at her Etsy shop here.

About the Author
Happy Mom Guide Staff

Happy Mom Guide Staff

Happy Mom Guide is a site about being a happier mom.

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