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A woman who gives birth in the US today is more likely to die in childbirth than her mother was. With one in three babies born via cesarean, the US ranks behind thirty other nations in neonatal mortality rates, and forty other nations in maternal mortality rates. Confidence in women’s bodies and women’s choices has been lost.
In Birth Matters, Ina May Gaskin, author of Spiritual Midwifery and Ina May’s Guide to Childbirth, reminds us that the ways in which women experience birth have implications for us all. Renewing confidence in a woman’s natural ability to birth provides transformative possibilities for individual families, and for society at large.
Known around the world for her birthing practice’s exemplary low rates of intervention, morbidity and mortality, Ina May Gaskin has gained an international reputation in obstetrics for demonstrating the magic key to safe birth: respect for the natural process. Birth Matters is a spirited manifesta showing us how to trust women, value birth, nurture families, and reconcile modern life with a process as old as our species.
Posted by Karen Hall on 6th Apr 2012
Ina May’s new book is a manifesta setting out the philosophy of natural birth, and therefore nothing that has not been said by wise women (and men) countless times before. The value of this work is its comprehensive, detailed, and clear presentation of the information, such that surely no rational human could disagree. It is a scientific celebration of what nature has achieved and what women are capable of. The first chapters set the subject in its global context, and birth stories are scattered through the text to remind the reader that while these are global, political issues, they have personal, individual impacts. I have learned about the cultural loss of breastfeeding knowledge, and it makes a sad kind of sense to me to be reading the same description of society’s attitude to birth: the loss of skills among health professionals and the consequent loss of positive birth stories. This cycle will be perpetuated and added to, and will spread beyond the US increasingly rapidly, as we lose touch with and confidence in our own bodies. Ina May Gaskin discusses the role of feminism in driving an ‘escape’ from pregnancy and motherhood, a push towards equality between men and women instead of a celebration of the important differences between us. Why should power be measured only in masculine terms and defined by the choice NOT to do something? Ina May’s positive, empowering feminism offers a far wider range of choices. ‘ It seemed crazy to me to take on the belief that the human female is the only mammal on earth that is a mistake of nature… it’s our minds that sometimes complicate matters for us. (p.23)’ She quotes Simone de Beauvoir describing the pregnant women as inciting fear in children and contempt in young people, ensnared: “life’s passive instrument.” De Beauvoir, the great feminist intellectual, writes as though she believes what men have said for centuries about women’s bodies: that we are disgusting, inefficient, and inferior to men (who cannot, normally, grow or feed babies); and seems unaware that historically speaking, medical men who profit from managing birth have had personal and financial interests in telling women that it is a dangerous and painful process, that requires the presence of a qualified doctor. Again the parallels with the unethical practices of formula manufacturers undermining women’s knowledge of and confidence in breastfeeding are clear. Some of the practices resulting from this basic assumption of women’s inferiority and ignorance are barbaric, and many persist in 21st Century western healthcare. The book describes a bleak outlook for maternity care and motherhood in a world where politics and economics are everything. Yet the short-termism of the idea that labouring women must be cured or rescued from themselves costs far more in terms of money, life, and quality of life. How can this be an acceptable situation? I was struck by the anecdote in which a couple kissed to raise oxytocin levels and aid relaxation and the progress of labour. It helped me to think about the way I talk to antenatal groups about the role of oxytocin in breastfeeding. And also of the way the idea of sex to bring on labour has been reduced to the role of prostaglandin, when everything about it promotes skin contact, eye contact, and a feeling of well-being. In this, I find yet another example of the big picture being reduced to one male-orientated detail. I was aware that birth in the US was highly medicalised, but the details and the implications of that, as clearly laid out by Ina May Gaskin, are horrifying and depressing. At the same time, the positive birth stories are affirming, empowering tales, a contrasting picture of the good that is possible when women are informed and respected.
Posted by Rachel Evans-White on 6th Apr 2012
I am a first year student midwife, and having read two of Ina May Gaskin's previous books, I was eagerly awaiting my copy of Birth Matters. I was not disappointed! The book is very informative and evidence-based yet easy to read. Midwives, parents-to-be, or anyone with an interest in childbirth will find this book fascinating. The author writes mainly from an american perspective, yet all nationalities and cultures would benefit from her wisdom, experience and insight. The book covers the history of childbirth and midwifery, feminism, the use of technology in childbirth, caesarean sections, and ends with the author's vision for the future. There is a chapter aimed at fathers-to-be and the book is interspersed with birth stories. Highly recommended!