By Jennifer Block
Ina May Gaskin started delivering babies in 1970 while on a hippie cross-country trip known as the caravan. She had no medical training, just a master's degree in English and a gut feeling that women deserved kinder, gentler births. When the hundreds of caravaners settled in Tennessee on what they called the Farm, Gaskin and several other women began delivering the community's babies at home and also opened one of the first, nonhospital birthing centers in the country. Word got around when Gaskin wrote about her successes in Spiritual Midwifery, and a movement was born.
Today, women still travel far and wide to give birth on the Farm, and Gaskin's methods have the respect of clinicians around the world (there is even an obstetric maneuver named after her). Now 71, she is credited with reviving what was essentially a dead profession in the U.S., inspiring scores of women to enter the field and helping found the Midwives Alliance of North America. But even while midwives attend more births in the U.S. — about 7.5% in 2008 — they're finding it increasingly hard to get practice agreements with doctors and hospitals. In her latest book, Birth Matters: A Midwife's Manifesta (Seven Stories, April 2011), Gaskin argues that America needs midwives more than ever. (Read "American Women: Birthing Babies at Home.")
You started attending births with no formal medical training. How did you know you could do it?
I knew how to deal with potential complications because kind doctors helped me. But basically I was behaving the way my aunt, who had a farm, would around any laboring mammal. You don't disturb her, you don't upset her. She deserves peace and quiet and respect. Doing that meant that no C-sections were necessary for the first 200 births on the Farm.
The C-section rate on the Farm is very low, under 2% for about 3,000 births, while the average in the U.S. for low-risk women is 20%. Can you explain?
It's very rare to see an undisturbed birth in a modern U.S. teaching hospital, but when you see a woman who isn't frightened, who's giving birth without interference, you stand back in awe and realize how little needed you are except in the rare circumstance. That doesn't mean that you shouldn't be around in case there is a problem. It just means that you should be able to tell when there's a problem, and you should be able to tell how not to create problems. (See the risks of early C-sections.)
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