“Birth Matters: A Midwife’s Manifesta” by Ina May Gaskin, 2011
Reviewed by Cristin Tighe
No doubt again that Ina May’s honest, straightforward, academic and spiritually-rooted experience and knowledge has an impact on my role as a doula. As before, her highlight of the importance of birth stories is key, as they teach and educate us about the true experience of women and families (before and after birth). Especially in the case of this book, the stories share about women tuned-in to their inner calm and power to birth naturally more of the time, with better outcomes and easier postpartum time.
Her historical sharing about feminism (and the duality of blending in to patriarchal structures or standing as a force separate), the state of midwives/maternal care (in the US in particular), the realities of technological advances, and her vision and the defenders needed to fulfill it, all empower and inspire (even given it being published 7 years ago).
Without a doubt reading this book, we can understand the sacred power women hold through the domain of birth, and feel the deep incongruence when women have little-to-no, decision-making power about their treatment during pregnancy and birth (p.2-3). This points to the even deeper need for empowerment of women to make choices that are real choices (not sacrificing themselves), and for their involvement in leading future maternal care policies that naturalize and humanize birth (p.8-9).
The idea of reframing women’s “pain” into power (that the medical establishment might be “ejecting them from their seat of power” versus “saving them from the specter of pain and danger” (p. xi) is so significant. Recognizing that the surgical perspective that floods birth with imposed rules (p.22), and acknowledgment and healing of past losses related to this (from death to birth trauma and in between) are needed to allow knowledge and empowerment to rise over a fear-based future.
Immense amounts of questions arise about why we allow technology to change the process — we need to consider each technological advance more and more and ask why we trust them (scans, monitoring, inductions, epidurals and cesareans) more than we trust these mothers who grow miraculous babies without much intervention. Trusting women’s bodies (i.e., allowing time to labor, letting hormones do their job without intervention, intentionally creating the environment for them to get into a relaxed altered state to birth, having space for sexuality in birth (p. 51-62), “sphincter law”, the exceptionally significant value of vaginal birth, skin-to-skin and breastfeeding are key.
We have a strong foundation as seeds in the mid-wifery model (based on observable living women and the ways the pelvis moves and labor progresses (p. 63-64) which trusts that “spontaneous labor in pregnant women can not be improved upon, and that the process of such labor is so delicate that interference in the process may actually deflect it from its optimum course.” (p.71). This also shows that homebirth is a viable acceptable alternative to hospital birth for most women with low-risk situations and midwives to assist them (p. 98).
It is so important our women-centered ideology values the human rights of mother to live (and much more) and of the baby (p. 41). It needs to value maternal life (as despite more spending and infrastructure than most countries, our outcomes are worse) and we need good data and organized women to step up, question and demand change, not in a polarized way, but one that speaks to our collective power from within and all together.
More than that, it should include a deep respect for epi-genetics, prioritize the health of each newborn early on and through its life, and understands how even one baby girl’s health (through the microbiome) impacts future generations. As always, it’s amazing how much Ina May can say in one book, and how deep impact the impact is one me — as a woman, mother, childbirth educator, pregnancy yoga teacher, and birth and postpartum doula. With gratitude.