Summary:

The author looks at issues surrounding pregnancy, birth and motherhood, combining personal experience (both her own and those of friends and interviewees) with some statistical information.  The book is divided into three parts: "Pregnancy," with a chapter for each month; "Birth"; and "New Life," which looks at post-birth issues and experiences of being a mother, including bonding with baby, relationships with friends and partners, job/career decisions, and childcare.

Pros:

This book brings up important issues in modern American society regarding pregnancy, birth and motherhood/parenting.  In describing her own unhappy first birth experience, the author discusses some of the consequences of an all-too-frequent reliance on unnecessary interventions, in hospitals driven too much by financial considerations, where births are usually attended by surgical specialists (i.e. obstetricians), albeit mostly well-intentioned ones.

In describing the difficult to horrendous experiences of other women in conceiving and bearing children, the author discusses the many dangerous and sorrowful aspects of the commercialization and industrialization of fertility and childbirth.  She also shares with the reader the effect that experiencing pregnancy had on her own perspective on issues such as abortion, mandatory drug treatment for pregnant women, and the "ownership" of embryos, fetuses, and babies.

In describing societal attitudes about pregnancy and motherhood (many of which she apparently became truly aware of only in the course of her own first pregnancy), she discusses the very real problem we have as a culture with acknowledging both the positive and the negative aspects of these issues (a societal problem which I would argue is not limited to these issues, but that's another topic for another time...).

The author deals with all these issues and others with obvious sincerity and intelligence, and she equally obviously feels strongly about the need to improve the situation.

Cons:

First of all, this is not a book for those looking for guidance in having a more positive pregnancy and birth experience.  Although she does present some statistical information, the book is far more geared to reciting the personal experiences of the author and the other women she spoke with.  The book has nothing to offer in the way of concrete advise — the author describes the many problems, but jumps from there directly to calling for a revolution which will fix everything, from expectations placed on pregnant women to the way births are handled to how men and women negotiate (or currently mostly fail to truly negotiate, in her experience) the new reality of their lives as parents.

Secondly, the author has no problem with indulging in non-constructive criticism which ranges from the overly personalized to outright name-calling.  She doesn't like What to Expect When You're Expecting, which she calls, "a book that is the intellectual equivalent, in my opinion, of an epidural" [page 4].  She refers to La Leche League as "neonatal activists that my friends and I came to call 'the Lactation Fascists'" [page 268].  While such writing is perhaps quite witty, I find it unhelpful in the context of exploring the issues surrounding these topics, given that both of the above examples are as sincere as she in wanting what's best for mother and child.

(For the record, I rather disliked What to Expect... myself, but feel quite positive towards La Leche League as an organization, although like any organization they have their faults.)

Another thing which I found distracting from the overall effect of the book was that the author doesn't really tell you when the events she describes took place.  From context it would seem that her first child was born in the mid-1990s, but she never really says — she speaks of the "Baby M" case, which was in the news in 1987-88, as being "the hot topic of the moment" "a couple years before" [page 54] and indicates that she had a second child five years later [page 275], which indicates to me that her first child must have been born in the early or mid-1990s.  Although I can think of valid reasons why she may have chosen this route (e.g., an attempt to keep the book from sounding dated too quickly or protection of her personal privacy), it does make it more difficult to contextualize her experiences and determine how much time for improvement there has been.

Finally, on a purely technical note, I found the arrangement of the end notes mostly unhelpful.  The notes are arranged with the page number at left (which is fine) and the text to which the note refers to the right of that in quotation marks — making it difficult at times to determine exactly what the note attaches to.  However, I suspect this is a problem of the marketing of the book as a popular work, and not the author's doing.  I am more likely to fault her for the fact that, more often than not, the information I would have liked further references for had no end notes at all.

Conclusions:

I feel I should point out (for the record) that my reactions to this book are as much informed by my own experiences as the author's observations are by her experiences.  She describes herself as an independent, feminist woman and obviously had simply assumed that whatever problems existed in this area would be resolved by the time they were directly relevant to her.

I grew up in a small town in the Midwest, the eldest child and only daughter of a woman who chose to stay home and raise her children herself.  I know now that my mother's choice to stay at home was in part made possible by our relative financial security, but I also know it was made possible by the many things my parents chose to see as unnecessary, despite our culture's assurances otherwise: two cars, annual family vacations to Disney World, the latest fashions, and the like.

My mother's choice was one she made and accepted, but I was in college before I "forgave" the feminist movement for what I saw as their abandonment of her for that choice.  In many ways it still seems that choosing to stay home is an unacceptable non-choice to many feminists, perhaps because we haven't completely fixed a society which places little to no value on the work of caring for children and raising a family.  Yet these men and women merely perpetuate that attitude by not giving due respect to the women (and increasingly, men) who are working at home, raising children, and caring for the most basic needs of the family.

My mother was a La Leche League leader most of my childhood, so I grew up around women and their babies.  I was raised in a family which talks about everything, including the ups and the downs of pregnancy and parenting.  One of my aunts, who is just eight years my senior, has always made it her business to keep me informed about what was just over the horizon for me, and I know from watching her just how hard it can be to be a mother and work outside the home (three kids and she's an elementary school teacher).  I've known since I was in my late teens that being a parent meant changes to one's sense of self as well as to one's material and physical well-being.

That being said, I sometimes had a hard time accepting the author's shock and incredulity at her own experiences in becoming a mother: Most doctors prefer quiet patients who don't ask questions and simply accept the doctor's pronouncements as Gospel?  Hospitals make decisions based on what's most expeditious, most likely to save/earn money and least likely to generate lawsuits, not purely on what's healthiest?  The world places little to no value on the work of child-raising?  You're kidding!  (Okay, I'll drop the sarcasm...)

It's not that I thought her reported reactions were insincere, but rather that they were annoyingly naïve in such an obviously intelligent woman.

As a whole, the book seemed content to recite the awful experiences of a handful of women (and they were awful, I don't argue that) and then call for systematic change without offering much guidance at all in the realm of the practical.  The author does describe what she sees as the solution to the situation she found — a system where midwives provide the majority of the care, with obstetricians acting as the specialists they are and providing the specialized care truly needed only in difficult pregnancies and births. But she provides no guidance in what one could do to move closer to this reality.

In conclusion, when I went looking for it, I found this book in the "Women's Studies" section rather than the "Childbirth" section, and having read it, I feel it was properly shelved.  The issues it raises are important, and as a thought-provoking read on the topic of motherhood (from early pregnancy through the first few months) I would recommend it, with the caution that the reader be prepared for a very specific and one-sided point of view.  But if you're looking for a book that will help you have the birth you want, try something else (I'd suggest Henci Goer's The Thinking Woman's Guide to a Better Birth or A Good Birth, a Safe Birth).