I’d like to explain what led me to write the first, second, third, and now fourth editions of this book. The

first edition was published in 1989, after I learned some truths about what birth means to women and

about what it means to be a birth partner who deeply loves the woman giving birth. One of these truths is

this: How a woman gives birth matters—to her baby’s long-term health, to her family (including her

relationship with her partner), and to her mental and physical health and her self-confidence and selfesteem

as a woman and a mother. This is as true today, with this fourth edition, as it was in 1989, and for

generations (even millennia) before.

Another very important truth: How a woman is cared for and supported during birth is a major

influence, not only in how she gives birth but also in how she feels about it. Yet, medical care before and

during childbirth focuses almost exclusively on the physical safety of baby and mother. This medical care

places little emphasis on the mother’s emotional well-being, her relationship with her partner, and her

readiness to parent. Such matters are given low priority in our very expensive health-care system, which

is beset by nursing shortages, pressure to increase the use of medical and surgical interventions while

increasing efficiency, reduction of psychosocial support services, threats of malpractice lawsuits, and

other factors that work against personalized, flexible, woman-centered care.

I learned the importance of emotional care during labor when, in the late 1980s, I conducted a study of

women’s long-term memories of their birth experiences. The women were from childbirth classes that I

taught between 1968 and 1974. They had sent me their birth stories shortly after they gave birth. For my

study, I contacted the women 15 to 20 years later and asked them (1) to write their birth stories again as

they remembered them and (2) to rate their satisfaction as they looked back on their childbirth

experiences.