A nurse practitioner's eloquent discussion of the psychological and physical effects of medical interventions on pregnant and laboring women. Experience with the relatively easy home births of Amish women led Armstrong (A Midwife's Story, 1986, also coauthored with Feldman) to question the use during childbirth of drugs and surgical procedures in an impersonal hospital setting, She spoke with hundreds of women in diverse cultural, economic, and ethnic groups; travelled widely abroad to observe and study with pioneering, unorthodox visionaries; and talked with many conservative obstetricians and nurses. Her description of a baby born smiling instead of screaming is the most moving and persuasive of her observations. But there are others: e.g., her stories of women who have been shaved, gowned, confined to a hospital bed, separated from family, friends, and familiar environments, hooked up to a fetal monitor, and thoroughly frightened, compared to Amish women (and others) who are, by choice, confined at home and surrounded by a community of friends, husbands, and, sometimes, midwives. Armstrong reports on a clinic where women are encouraged to walk about, bathe, sing, dance, or do whatever their bodies and their psyches tell them--in the company of others. She also discusses the fact that most obstetricians are men, to whom labor and childbirth are inaccessible and largely inconceivable experiences, and talks of the training that directs them to replace caring support with technology. On the other hand, Armstrong speaks neither with disregard for medical advances nor with exaggerated claims for painlessness in natural childbirth. Indeed, she offers many criticisms of those claims. Her case for the midwife--which is basically what this book is about--is based on a philosophy that ""relies on the primacy of a woman's experience"" and that ""puts energy into patient education. . .and empowerment. . . For the high-tech practitioner, these tend to be no-account factors."" An inspiring and freshly stated vision of a central experience in women's lives.