In today's society where the Cesarean rate is 30% and climbing, it is refreshing to read a book supporting the power of a woman to give birth, not only in a natural way, but a home birth outside the medical arena. Written by a practicing obstetrician, whose training she describes as emphasizing the pathology of childbirth, Dr. Amali Lokugamagae introduces the reader to the hazards of our "risk-averse" society that has medicalized childbirth, converting a normal process into abnormality, and often creating illness where none had previously existed. Dr. Lokugamagae's transformation of pregnancy care came as she worked with traditional Chinese medicine to conceive her own child and then moved through her pregnancy as she experienced her baby taking over all her systems. Dr. Lokugamagae goes into detail of the alternative methods of care for herself and her baby she sought out, such as Gowri Motha's "The Gentle Birth Method of Yoga," "The Active Birth Centre" founded by Janet Balaskas, and the work of Michel Odent and Ina Mae Gaskin. She chose to prepare for a home birth assisted by a midwife. This very personal firsthand experience of childbearing led her to the transformation and destruction of previously learned ideas of assisting birth as she crossed into a new birthing world for which medical training did not prepare her. As readers, we benefit greatly by the expertise, insights, research, and lived experiences Dr. Lokugamagae shares as she compares and contrasts two often vastly different modes of care for pregnancy and childbirth.
In second section of The Heart of the Womb, Dr. Lokugamagae refers to the "The Theater of Birth," and leads the reader to the Western medicine view of Eve's suffering during childbirth to the guardians of childbirth as a rite of passage for a woman to journey into greater feminine wisdom and maturity. She provides the reader with an excellent description of the role of midwives and doulas, as she describes the separate perspectives of the midwifery and medical model of pregnancy and birth. She does this exceptionally well by describing her training as a young doctor where the focus was grounded in a culture of risk, and how doctors help and hinder the natural birth process. This powerful section of her book explains why it is so important for mothers and their partners to be aware of and understand the different perspectives being presented to them by their caregivers in order to advocate for what they need for themselves and their unborn child. Dr. Lokugamagae cites excellent sources of up to date research regarding the adverse effects of the variety of medical interventions that are typically performed at a birth and that are unfortunately either not known by those working with childbearing families or are not addressed or not duly considered.
Dr. Lokugamagae also provides information on alternative therapies such as yoga, meditation, and women gatherings during pregnancy. She points outs that these areas of care are not well funded by research because much of prenatal care is governed by the need to minimize litigations. Dr. Lokugamagae looks toward the future and advocates that research currently not fashionable in the scientific community needs to be done in these alternative caregiving modalities. She includes more of the natural birth gurus; Francosise Barbira Freedman, Yehudi Gordon, Frederick Leboyer, and Joseph Chilton Pearce.
In the final part of Lokugamagae's book, she includes a section she entitles "Empowerment of the Individual and the Collective." Here she summarizes as she invites the reader to explore the notion of the inner wisdom of the woman's body to birth and the inner connection between the unborn child and the mother's emotions. She provides support for what she advocates with good and current research citations. The core strength of this book is reading her transformation from the medical model of care to one of appreciating the power of the woman to give birth and communicate during pregnancy with her unborn child, information all pregnant women, their partners, and all those provide prenatal and perinatal care should know. Readers will appreciate the comprehensive work this author has done in providing the research to support her position to challenge the current system of care and to help change pregnancy and birth from a medical experience to its place as a natural experience for the mother and the child and families.