Birth Matters: A Midwife's Manifesta Paperback – Mar 22 2011
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"A stand-out by Ina May Gaskin...elegantly covers the normalcy and power of birth, includes birth stories, and makes sound arguments for more support and less intervention. An essential acquisition."—Library Journal (Starred Review)
"Ina May Gaskin is such an important figure in the effort to bring a more kind birthing process back into the mainstream, so check out her book if you'd like to learn more about having a blissful, powerful birthing experience." —Alicia Silverstone, The Kind Life
About the Author
Called "the mother of authentic midwifery," INA MAY GASKIN has practiced for nearly forty years at The Farm Midwifery Center, which is noted for its low rates of intervention, morbidity and mortality. She is the only midwife for whom an obstetric maneuver has been named (the Gaskin maneuver). She lives in Tennessee.
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Top Customer Reviews
i think this one really puts together many of the
concepts presented her other books in a interesting
and relevant way, both personally and politically..
ina may has a great perspective, and writes with
humour, encouragement, and a pleasing flow.
Most Helpful Customer Reviews on Amazon.com (beta)
My husband, our daughter and I went to Ina May's book signing in Brooklyn on Sunday. It was wonderful. Since we came home, I have not been able to put the book down and it opened my eyes to the beautiful reality that I was privileged enough to live and conversely to the horror that I managed to escape....
When I decided to give birth at The Farm I did not have any knowledge about birth. The pregnancy had not been planned and I always thought that I would have children much later. I knew nothing of the typical birth experience of todays moms in America. What I did know was that I was not very comfortable with my OBGYN nor with the hospital where most of my prenatal care took place.
My OBGYN seemed to me at the time like she was bored by "normality" and was only excited when abnormalities came up. When a blood test came back positive for toxoplasmosis I saw a flash of excitement in her eyes where I would have wanted to see compassion. This did not sit well with me. Topped with a lot of pressure to have sonograms and tests of all sorts (I reluctantly had the nuchal translucency but stubbornly refused the Quad test which infuriated the doctor). At the end of the day I was also confronted with huge medical bills which I was paying out of pocket because no insurance would cover me for cause of "preexisting condition". I was utterly shocked. Was pregnancy an illness?
I quit the OBGYN and had the rest of my prenatal care at the hospital for $15 a visit (this fee was based on my income). I really disliked everything at the hospital but at least I could afford it. However, I knew that I would never be able to give birth there and that if forced to, I would probably be bitter about it for the rest of my life.
I have always been wary of hospitals for a number of reasons but the most important one is that hospital staff never look healthy. Also, I always associated hospitals with illness.
I thought that these circumstances were unique to me. I thought that my OBGYN was sadistic but that this surely must be an exception to the rule and that the majority of doctors were compassionate and grateful to have the wonderful job of bringing babies into the world. I thought that the hospital was scary but that no doubt all other hospitals would be much more appealing. I thought that not being insured was the cause of my not having the choice of care I wanted.
Now that I am reading "Birth Matters" I finally understand that being insured or not has nothing to do with the type of care you get. I understood that most OBGYN are just like the one I went to, and that most hospitals are indeed scary. I understood that not even money or insurance protects you from being a guinea pig.
I was unaware of all of this when I came to visit Carol Nelson at the Farm. All I knew was that I liked her immediately, I liked the Farm and the idea of being surrounded by nature (as opposed to being in NYC) and even better: I could afford it. It seemed like the perfect, logical thing to do. I had no idea how incredibly lucky I was.
The birth of my daughter was everything I had hoped for, but I took it for granted. A female giving birth goes without saying. What could be more normal? It hit me as I was reading other women's birth stories in "Birth Matters" that some women chose a natural birth because of a previous bad experience or after conducting extensive research on the matter. They were thorough and critical and made a deliberate choice. I in comparison feel like I got lucky and followed my gut. I expected a wonderful birth. I did not realize that it was an exception in this country.
Today, after reading "Birth Matters", I am absolutely overwhelmed with gratitude. Today I know I had more than a wonderful birth, I had a perfect birth. I thought Carol was a great midwife doing a great job, but today I know she is an angel operating against extraordinary odds.
I would like to say thank you to Carol, Ina May and all of the Midwives of the Farm doing what you are doing. May you be blessed with a long and healthy lives. I know that the babies whose first vision are your face and whose first touch are your touch are blessed.
Another reason this book would be of interest to a general adult audience is that Gaskin examines the politics of childbirth. Even though I grew up during the women's movement of the 70s, I was not aware of how negatively pregnancy and birth were viewed by many of the movement's early leaders nor how this negativity may have influenced a generation of young women. As a business person in the 80s and 90s, I did watch childbirth become an important loss-leader and/or profit center for many hospitals and saw the rise and fall of all the birth centers in my community, as well as the opening and closing of the nurse midwife program at the state university. I understood the profit/loss and cost containment principles at work, but not the larger societal impacts these changes would cause. Gaskin makes a strong case for continued consumer support for midwives and birth centers, for the good of women and society, for better health and stronger communities. Perhaps healthcare reform will provide some momentum for this trend.
The women's stories included in the book are inspirational. I only wish there were more, or an entire volume of just the birth stories. The personal accounts of joyful, painless or almost painless births were truly eye opening and made the strongest case for natural childbirth. So many women I teach are really terrified of giving birth, even or especially those with prior experience; I wish they all would read some of Gaskin's mothers' stories to learn how empowering and wonderful childbirth can be. I wish I had read them before having children. In fact, Gaskin makes the whole childbirth experience sound so wonderful, it almost makes me want to run out and have a few more babies.
I would highly recommend this book as good reading for anyone, an inspiration for anyone who's pregnant, and a requirement for anyone working in obstetrics, labor and delivery. It only presents one point of view, so it's not the only reading I would recommend, but it should be on every reading list.
There were 50 cesareans out of 2,844 births.
Their practice included women who had breech babies, twins, and VBACs (vaginal birth after cesarean, which incidentally had a 96.8% success rate). In general maternity care in the US, these factors classify many women as high risk and often result in automatic c-sections performed by doctors who are unwilling or unable (due to training issues) to attend a vaginal birth attempt. These and other issues have caused the cesarean rate to climb each of the last 13 years to its current 33%.
Many would argue that the numbers from The Farm Midwifery Center cannot be compared to the general U.S. rates. I do understand that the women represented by these numbers opted into this practice. They weren't just `any women'. They embraced the midwifery model of care and were highly motivated to participate in this preventative, wellness model of care. A random pregnant woman off the street may not be in a place emotionally to have this type of birth experience. She may not even desire it. But does she even realize that she has a choice? Does she even realize how possible and safe and rewarding natural birth could be with a different approach to maternity care? If she is giving birth with a typical Obstetric practice, she certainly would not have the type of education and support offered to the women at the Farm.
Of the nearly 3000 women, 98+% gave birth vaginally. Certainly we can't expect every maternity caregiver to start producing these types of results, but doesn't it plant the seed that we could do better? Ina May Gaskin's pioneering efforts show us that it is possible for women to have healthy and empowered births. Her book combines her thoughts on how they were able to achieve these outcomes with inspiring birth stories to provide a hopeful glimpse of what is possible.
I applaud the title of this book, Birth Matters; It seems so clear and simple. It sums up perfectly the message that Ina May and many other influential voices have dedicated their lives to bringing to the world. In this manifesta, it will be made clear to you that Ina May does not do this work for money or fame, but because she cares about women and babies, who's lives are on the line.
Ina May has a vision. That vision is that outcomes for women and babies would be put first and foremost in America and that US maternal outcomes would be reported accurately. It doesn't seem like too much to ask, does it? Ina May tells us why this isn't happening, and more importantly what needs to be done to fix it.
Birth Matters tells the story of how we view birth. At the core of who we are as a society is the way in which babies are being born and how women feel about the process.
Ina May stresses the importance of passing on birth stories, and how this simple act can help shape a healthy birth culture. She includes birth stories in this book as well; What Ina May book would be complete without them?
She gets straight to the heart of the problems in our birth culture, e.g., our shame at the intimacy of birth, our ignorance and willingness to ignore the simple physiology of natural birth and it's connection with other innate bodily functions, and our denial of midwifery's impact on healthy birth outcomes and family relationships.
Dedication and research shine through in her attention to detail. She offers insights into the history of midwifery in the United States and those she refers to as "medical men"; How this history has shaped our current views and practices in maternal care. References are cited well, but it's Ina May's thoughts and opinions, not facts and figures, that make this book worthwhile.
While reading, one question remained. What did Ina May propose that we do about all of this? She presented a lot of problems, but did she have a solution? I am happy to report that Ina May does propose real solutions so that you and I can take action immediately. Read this book only if you want to shed light on the problems with our current birth culture and want to see real, lasting change.
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