Ina May Gaskin: "Birth Matters: A Midwife's Manifesta"
http://thedianerehmshow.org/shows/2011-07-25/ina-may-gaskin-birth-matters-midwifes-manifesta
Fetal monitors, forceps and medication have become commonplace in American delivery rooms. Now a third of American babies arrive by C-section. A new book examines the industry of delivering babies. The author - veteran midwife Ina May Gaskin - says a climate of fear has led some women to give up control of the birth process to the medical establishment. She advocates greater respect for women's bodies, wider acceptance of natural deliveries - and new efforts to reconcile modern life with a process as old as humanity itself. Ina May Gaskin talks about her "midwife's manifesta."
Guests
Ina May Gaskin
founder and director of the Farm Midwifery Center in Tennessee; author of "Spiritual Midwifery" and "Ina May's Guide to Childbirth."
Comments
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My son was born at home 32 years ago. I was attended by a doctor for the last 7 hours of labor because the midwife was busy that day. Otherwise, she would have been with me through most of the labor, and would have called the doctor when she felt that the birth was about to happen.
I sought a home birth after being given the alarming news by my OBGYN (the day she confirmed my pregnancy) that I had a 25% chance of a Caesarian Section. Many questions later, I determined that my high chance of a Caesarian was because my doctor practiced at a major teaching hospital which had a very high Caesarian rate compared to ordinary hospitals. I searched high and low for a hospital that would guarantee me a less invasive, less dangerous, non-humiliating birth experience. But alas, even when I found doctors who gave lip service to "natural" childbirth, none of them would guarantee that the hospital wouldn't restrain me, perform a routine episiotomy, and insert an IV line before the doctor even arrived.
Home birth was the answer for me. A half hour after my son's birth, my husband and I sat in bed with our baby, sharing a meal with the doctor and our family. The next day I was up and completely able to take care of my baby and attend to all that I wanted to do around the house.
I am astonished that many young women today actually seek costly, dangerous Caesarian births. And many of those who attempt vaginal deliveries demand drugs to prevent pain that might not happen if it weren't for the contraction-enhancing drugs that they are given. Women and doctors seem to have less knowledge about normal childbirth today than they had 30 some years ago!
Why do we allow normal pregnancies to end up in hospital with drugs, expensive nursing care, and needless obstetrical technology? These costly, invasive measures should be held back for certain high risk pregnancies, or unusually complicated deliveries, but not for normal, healthy childbirth.
Mary Jo
Ina May Gaskin has done more single handedly for longer than almost anyone I can think of. Her reach has been extensive and doctors actually listen to her. At least some of them have and I hope more and more will.
She understands and trusts birth. And she understands and trusts women to know how to do it if supported by caregivers who are not fearful or intrusive. I have the greatest respect for this extraordinary woman. If you possibly can listen in, do so.
And buy her book. In fact it would be a good idea to buy several copies and give some to others. So many women in the 21st century are fearful and uneducated about birth.
Ina May can help women understand that birth matters, not just to each individual but to the whole world and the future of it's inhabitants.
Question for Ina May:
After reading Ina May's Guide to Childbirth and attending natural childbirth classes, I felt informed and empowered about labor, and found an obstetrician known for being supportive of natural birth. When the day came, however, my water broke, and I spent thirty-seven being pushed into interventions I swore I would never have — pitocin, constant fetal monitoring, and, after stalling at nine centimetres, an epidural that left me numb and powerless for two hours of pushing. My son was born via c-section.
I feel strongly that, had I simply been left alone, I could have delivered my son myself. I wish every day that I had fought for a better, more joyful birth for the both of us, that I had been brave enough to say no to my doctor.
There is so much material over how to avoid unnecessary interventions and c-sections, but I haven't found much help for those of us who ended up with them anyway. Do you have any advice for how to cope with the regret from a defeating birth, and how to have the courage to try again?
Thank you,
Mercy
Tulsa, OK
Mercy,
I'm sorry to hear you feel birth defeated you. I hope that through support, information and time, you will be able to look at your birthing experience in a different light. I experienced the same feeling of defeated birth with my first daughter, and it was hard for me to overcome the regret and guilt I felt (not saying that you do!)
With the birth of my second daughter, I was able to heal from the bad association I held fwith my first birth experience. With this, I knew I had to empower women and families, and do everything in my power to keep others from feeling the helplessness I felt, and so I became a doula.
I have been a doula for 2 years, and at every birth I have attended, I have helped families keep focus and strength. I would strongly urge you to look into how supportive a doula can be during this transformative process. They have the experience, knowledge, love, and compassion that is really invaluable.
Best,
Maureen
Tallahassee, Fla
Foundations of Birth
I had my son at home 28 years ago, a vaginal birth after a c-section. Thank God for Nancy Weiner Cohen's book SILENT KNIFE. It gave me the education that most in the medical field seemed to lack. I am also so grateful to Ina May Gaskin for SPIRITUAL MIDWIFERY and her newer books which my daughter is now reading as she prepares for the birth of her daughter.
Thank you, Ina May for all you have contributed to the most important event in many women's lives. We truly love you for all you have given us.
Mercy, I, too, am sorry to hear of of your experience. In fact, I just heard from two other ladies in the last two weeks the exact same story, and they even went with homebirth midwives. Finding the right provider is apparently harder, more complicated and more of an important step than it seems.
You asked for help to grieve and move forward. I know that some women have found tremendous healing and support in their local ICAN chapters (International Cesarean Awareness Network). http://www.ican-online.org/ If you live near Tulsa, this would be your chapter:
ICAN of Tulsa
Contact: Stephanie Shumaker
eMail Address: icanoftulsa@yahoo.com
Telephone: 918-348-1711
Or Contact:
Telephone: 918-845-0548
It is surely a challenging process, but it is important to distinguish this experience from what you and your body are capable of. Your body does work and can be trusted. You are powerful and can have an empowered birth. More than that, you deserve one. We now live in a world with an internet ability that allows us to connect with like-minded people from all over. There are wonderful and inspiring resources and people waiting to give you what you need to heal and find your strength. When/if you are ready to have another child, surround yourself with positive and supportive people and stories. You *can* do this!
Sheila
I'm really looking forward to hearing this show today on Maine Public Broadcasting. Ina May has been a huge source of information, education and inspiration for me--from Spiritual Midwifery to Birth Matters--and about everything she's done in between.
I had my son at home in Montville, Maine in 2004. My homebirth experience was so transformative, so empowering that I now make documentary films about homebirth and midwifery care. My current project is "At Home in Maine" and features 11 authentic, artistic portraits of the homebirth experience. To view the films go to: www.mainehomebirth.wordpress.com
Not just for Mainers--but for anyone who would like a picture of normal, natural, woman-centered birth.
My favorite quote from Birth Matters: "The right to a positive and safe birth is just as important as the right to choose whether or not to have a child." For many women, a homebirth with midwives is where they feel the most safe and supported.
Thank you Ina May for all that you do for women and babies--and to Diane Rehm for doing a show on this remarkable woman!
Nicolle Littrell
Dear Ina Mae,My husband and I are having our second child somewhere around September 1, 2011 (my EDD). We chose to do a home birth this time around because with our first child we had a lot of unecessary intervention and were pushed to have a Csection after only 10 hours of labor. Luckily, we both stood firm and our son was born vaginally. The experience left us distressed with the medicalization of birth and this time around we wanted to look for alternatives.We have a wonderful Certified Nurse Midwife and a birth assistant for our home birth and we have chosen who will be surrounding us for this monumental occassion.As the day draws closer when we will welcome our second child into the world and we prepare to birth at home, I find myself increasingly anxious. Due to the medical interventions last time, I have no real frame of reference for what to expect and no matter how many videos I watch or birth stories I read I am nervous that I can't trust my own body or it's reactions. Will I know if something is wrong? Do you have any advice for women who have had intervention filled births and are looking forward (though with some nervousness) to their first natural child birth experience?Many thanks,
Ingrid
I read Ina May's Guide to Childbirth during both my pregnancies. I also attended a birth class that stressed the role of the parents in the childbirth process, even if the birth took place in a hospital.
My second delivery was a wonderful experience. I was confident enough to labor at home, although I knew I would go to a hospital because we live in a rural area with no midwives, and relatively far from a hospital. Our son was born happy and healthy in the front seat of our van on the way to the hospital. My husband and I delivered him ourselves.
However, when we arrived at the hospital, the birth was treated as an emergency, with the nurses taking the baby from me and running into the building. Luckily, the hospital heard our complaints and instituted additional training for OB nurses.
I'd like to express my appreciation for Ina May, and am wondering how the laws regarding midwifery differ among states. I would have chosen a midwife for my second birth, but there were none in rural southwest Virginia.
I wanted, more than anything, to give birth naturally. After 7 days of labor, it becamse clear that I was not going to be able to do so. My cervix never dialated beyong 3c.m. I finally consented to a C-Section. I am glad I tried for so long. However, I still feel a loss 9 years later that I was not able to give birth, but instead had the baby surgically removed. It is a loss in my life.
My oldest nephew was born on The Farm under Ina May's care in 1985. ^-weeks later, I was in labor at home with our first son with two local midwives, one of whom had apprenticed with Ina on The Farm. During labor our baby flipped and our midwives had never delivered a frank breech before, so we decided to transport to the hospital, where our son was born, without drugs, less than a half-hour later. The next day I left the hospital with my husband and our son, against doctor's orders and we went home to become a family. Our next two births were amazing, successful home births. One of our midwives has been at each of the births and we have a bond with her that ties our hearts and souls together forever.
I just want to thank Ina May for everything she has done for women and babies. Love, love, love to her!
Ina May,
I just ordered your latest book and will buy more copies for each of my three daughters. I had all four of my children at home, the last at the age of 45. Every birth was wonderful, uncomplicated, and a completely empowering experience. I read Spiritual Midwifery many times over the years and my two oldest daughters have read it as well. Thank you so much for working for midwifery and home birth. You are absolutely my hero.
Jean
My son was born this winter in a hospital with a natural birth friendly OB. I wanted a natural birth. He was late and I was induced when he was 12 days late. I tried everything to induce labor naturally including drinking castor oil. MD's no matter how natural birth friendly they are, do not typically let mothers go past 2 weeks their due date. What would a midwife in a home birth setting have done in my situation? How long could I have gone past my due date? How long is safe? I labored on the induction drug for about 16 hours until I got an epidural. My concern is my next children will also be late and I will be induced again.
A question for Ina May Gaskin:
What questions can people ask a midwife practice to tell if the practice really supports natural birth? I ask because my wife and I experienced a hospital-based midwife practice that claimed to support natural birth, but then pressured us toward hospital practices like induction with pitocin. Are hospitals taking over the meaning of "midwife" and "natural birth" in the same way that you can find "natural" Ruffles potato chips in brown paper wrapping in the "natural" section of the grocery store? How do you tell, before it's too late, that a birth is really natural and not just being marketed as natural? Is this a good reason to have birth at home, rather than a hospital "natural birth" that might not be natural at all?
By the way, my wife did successfully use hypnobirthing to have an induced birth without epidural in the hospital (at 42 weeks and three days), but it was a fight to do so.
Sincerely,
Chris
What does your guest feel about women who want and choose intentionally hospital births? At times it seems both sides of this issue disdain others who choose the other route. In my experience the dis-empowerment and disappointment result primarily from the birth experience not living up to a woman's expectations. Having made this observation before my first delivery, I strove to enter the experience with few expectations. I knew I wanted a hospital birth if possible, so I planned for that, but beyond that--what or how many interventions, I figured I would take each as they came, seeing what my body could endure or what seemed appropriate at each turn. In the end, I really only wanted a healthy baby. I ended up being hospitalized a month before my due date with pre-eclampsia. I had a trying experience, but the staff was soo supportive and kind and in the end I had a healthy baby boy. So, despite the many interventions I endured, I feel empowered and successful. I feel we should acknowledge that it is possible to feel so on both sides of the coin. A hospital birth is not equivalent to disempowerment, nor does a home birth define the opposite--the difference is really in the expectations.
Jennifer
Houston, TX
I am a retired nurse-midwife from Salt Lake City Utah and was fortunate enough to tour Ina May's birth center in Tennessee many years ago. It's very frustrating for those of us who believe in natural birth to realize the lack of progress in this area over the past 20 years or so. In fact, I would go so far as to say the medical practices and OB-spin ie. injectiing the 'fear factor' during prenatal visits, have gone backwards, doing a great many women a huge disservice. Congrats to Ina May on her book...I'll be picking it up today and recommending it to my two nieces, both due in the next few months and whose births I will be attending.
I watched the documentary called "The Business of Being Born," which I highly recommend to new mothers. Can you please comment on the claim that the documentary makes that it is the invention of the epidural which causes many of our problems today that lead us to have a C-section?
I watched the documentary called "The Business of Being Born," which I highly recommend to new mothers. Can you please comment on the claim that the documentary makes that it is the invention of the epidural which causes many of our problems today that lead us to have a C-section?
I mis-spoke. My nephew and first son were born in 1981! Our second son was actually born in 1985, and our third in 1989. Sorry for that mistake.
Question/comment for Ina May:
I had two natural births in a birth center and they were wonderful experiences. However, when I tell people about them, I often find that people tune out the minute that I say the word "midwife," because the word has been so vilified throughout the 20th century.
I wonder if changing our vocabulary would help the natural birth movement. Although midwifery has such a rich history that it is an insult to change the name, would people be more receptive to a natural approach if they were attended by a "licensed birth practitioner" or similar? On the one hand, it plays in to the medicalized vision of birth. On the other hand, do we need to just cast down our bucket where we are, and accept the fact that America has negative association with the word "midwife", but might be more open to the same practices under a different name?
Thanks,
Michelle
Hi
I gave birth in europe two times. To two big babys, in hospitals
I had two midwifes plus my doctor at each birth, thank god
Midwifes were wonderfol and my doctoe let them do their work and helped when nececery
Thank you, wonderfull show
Sarah
Our daughter was in a breech position, back in 2005. Our local doc wanted to do C-section and didn't want to even wait for labor. So we went down to see Ina May. Spent two days with her. It was a memorable experience, and Ina May's wisdom is beyond anything we've encountered with medical docs. Unfortunately, the baby didn't come out, and we ended up going to the regional hospital for an emergency C-section. My point is, medical intervention does have its place, but we need to give the natural process as much time as necessary before intervening.
I gave birth to my son in 1990 in the hospital, due to pregnancy complications, with a midwife assisting the OB. In 1991 my daughter was born at home with the assistance of two midwives. The contrast was huge. My home birth was gentle, peaceful, joyful and without any negative energy. We were able to enjoy the hours after the birth without the constant interruptions and nagging of a nursing staff with their own agendas. I see differences today in my two children and attribute at least some of that to their birth experiences. I support midwives and the option for home births wholeheartedly!
Elizabeth, Boca Raton, FL
I went to a Maternity Center when my daughter was born 13 years ago. Although I support midwifery I had a very bad experience. My midwife had been up for 36 hours and had no patience whatsoever. Although it was my third child and I expected an easy delivery like the first two it was long and painful and when I requested the pain relief that was mentioned in the orientation I was refused. I was scolded for screaming. I was positive for beta strep and my HMO required a 12 hour stay after delivery. My midwife tried to convince me to ignore the requirement and get out. She told me I was taking up bedspace and causing an inconvenience. My daughter was born and is fine and healthy but I have a lot of lingering resentment about how I was treated. My experience leads me to comment that there is a faction in the midwife community that is as hostile to conventional childbirth methods as their extreme counterparts in the medical community are to midwives. I was treated like childbirth was some test of character that I had clearly failed. My experience in hospital with my first two children was wonderful. One was without any anesthesia. The maternity center in Bethesda MD where my daughter was born has gone under and it is no surprise to me.
I have two healthy children that were both born via cesarean. I would have preferred vaginal births and worked with midwives and a doula but alas, this did not happen.
The first time I gave birth I was in labor for four days and never progressed more than 3 centimeters. Following this very tiring birth, I was able to rest and gain back my mental and physical strength. The second time, a couple of years later, I was in labor for three days and when finally reaching 10 centimeters and seeing/touching my child's head, was told that my child was unable to push past two bones inside my vaginal canal and would need to be delivered via c-section. My second birth was very painful, with a lot of back labor and by the time I gave birth, I was incredibly exhausted. This exhaustion followed me for months following my second child's birth.
Prior to my births (esp the second one), I felt I was able to accomplish anything. Since then, I have had a difficult time reconciling my birthing experiences. I wish they had been more empowering!
I am someone who is very healthy and active, eats healthily, believes in slings and many of the other thoughts people associate with attachment parenting, yet when I read books or hear interviews on natural birthing I feel that there is little place for someone in my circumstance.
Ms. Gaskin, I would appreciate your comments.
I'm happy for those of you who choose natural or home births, but for my 4 children I wanted the safety and security of a hospital, with the technology and knowledge that goes with it. I am no less a mother because my first child was born by c-section, or my second, third and fourth were delivered vaginally. Nor am I less a mother because I wanted all the pain medication I could get to make the process easier on me, since after the first child I knew I needed to get home as quickly as possible to the rest of the crowd.
I always get the feeling from midwives and the natural birth crowd that they think I would have had a better experience had I done it their way, but please believe me when I say that the only improvement in the birth experience would be to be put to sleep at the first contraction and wake up when it's all over. I do not consider it to be a beautiful or uplifting experience. I adore my children, but the birth process is painful, messy, and often prolonged, and I had no desire to share it with ANYONE (not even my husband).
Its a good thing I planned a homebirth with my fourth child. I would not have made it to the hospital. My midwife made it just in time. I did need her, as I had dystocia.
@ Victoria:
I would love to hear a midwife's answer to your question, but I can tell you from my personal experience with my son's planned home birth in 1979, that despite my being a full two weeks "overdue" the last time I visited the doctor's office for a pre-natal exam, he sent me on home with his best guess that I would probably go into labor within the next week. As it happened, my water broke in the middle of the following night, and I was having mild contractions by dawn the next day. The doctor arrived at my house around 1:00 p.m. that afternoon, and my son showed up at 8:30 in the evening. No one ever discussed inducing labor. There was no "prep", no drugs, and no episiotomy. I had the distinct impression that as long as all else appears normal, due dates are considered a moving target. In fact, I was always advised to think in terms of a "due month", not date. The doctor monitored my labor throughout the afternoon and evening (between reading the books on my bookshelf and snacking in the kitchen), and never gave me the impression for a moment that I wasn't producing fast enough. Later, he told me that if I had been in hospital "pushing" for 3 and a half hours, as I was, they would have done a forceps delivery since the baby was in the transverse position (and it took him all that time to turn around in the birth canal to be born facing the normal way).
My first 4 children were born in a low-intervention hospital w/ the corresponding lowest c-section rate in the state of CT. .Simply there was no reason for me to be in a hospital at all...I never had any medication, never had an IV for childbirth, and I would pop the baby out shortly after arriving there, except my first husband insisted that I go there....When I was expecting my 5th child, by now divorced ....I planned a home birth w/ midwives....I was 38 yrs old and my family thought I was insane. This was 1990 and there hadn't been a home birth in my family since 1929...but w/o family support and a father who also had his doubts (but he wasn't my legal husband so he really had no say in the matter!!!) I went ahead and planned for my child to be born at home with very supportive and skilled midwives. My son was born on my living room floor after my longest and hardest labor, he was also my biggest baby ...there were no strangers in the room--only friends and family (my two youngest daughters, ages 4 & 9 were present & they were well prepared for what was going to happen via videos), the cord was not cut until long after it stopped pulsating & long after the placenta was born, cut by my 4-yr old daughter with my help....an amazing, beautiful & empowering experience ..It was the safest &most peaceful birth I could have given my son....My hospital births were not horrible, but there is nothing that can compare with giving birth in the comfort and safety of one's own home...and shortly after my son was born, we looked out the front window and my lawn was covered with dozens of wild rabbits who had come out of the woods to greet the new life .... Even though I am a retired grandmother now I am still an activist for home birth & always will be...I hope there will be more midwives in CT in the near future and home birth will be come the norm here rather than the rare exception.
Mercy - I recommend checking out Birthing From Within for help understanding and processing any lingering unhappiness about your ceasarean. It's helpful for preparing for birth and for dealing with overwhelming, traumatic, or disappointing birth experiences of any kind. I found it uniquely helpful after my difficult ceasarean birth.