Ina May Gaskin

Ina May Gaskin at Nambassa 3 day Music & Alternatives festival, New Zealand 1981.

Ina May Gaskin, CPM, has been described as "the mother of authentic midwifery."

Family

Gaskin was born to an Iowa Protestant family (Methodist on one side, Presbyterian on the other). Her father, Talford Middleton, was raised on a large Iowa farm, which was lost to a bank not long after his father’s accidental death in 1926. Her mother, Ruth Stinson Middleton, was a home economics teacher, who taught in various small towns within a forty-mile radius of Marshalltown, Iowa. Both parents were college graduates, who placed a great importance on higher education.

Her maternal grandparents ran a Presbyterian orphanage in Farmington, Missouri, a small town in the Ozarks. Her grandmother, Ina May Beard Stinson, directed the orphanage for many years after her pastor husband’s death. She was an avid member of the Woman's Christian Temperance Union and a great admirer of Elizabeth Cady Stanton, Susan B. Anthony, and Jane Addams. Gaskin’s paternal grandparents were all farmers. Adam Leslie Middleton, her grandfather, traveled and worked with farmers from Iowa, Illinois, Minnesota, South Dakota, Nebraska, and Kansas in cooperative grain marketing, organizing communities, as well as larger outlets in Chicago and other large cities, to establish local cooperative grain elevators. His work as an organizer took him to Canada to work with wheat growers, and to Washington, D. C., on the invitation of the Secretary of Agriculture under President Warren G. Harding, Henry C. Wallace, father of Henry A. Wallace, President Franklin Delano Roosevelt’s Secretary of Agriculture.

The Farm Midwifery Center

In 1971 Gaskin, with her husband Stephen, founded a commune called The Farm in Summertown Tennessee. There, she and the midwives of the Farm created The Farm Midwifery Center, one of the first out-of-hospital birth centers in the United States. Standards of birthing at the Farm are modeled to the recommendations of the American College of Obstetricians and Gynecologists. Family members and friends are commonly in attendance and are encouraged to take an active role in the birth. The Farm Midwifery Center has been able to maintain extremely low rates of medical intervention with consistently good birth outcomes for nearly four decades

Significance of her work

According to Carol Lorente (1995), the work of Gaskin and the midwives might not have had the impact it did, if it hadn't been for the publication of her book Spiritual Midwifery (1977):

"Considered a seminal work, it presented pregnancy, childbirth and breastfeeding from a fresh, natural and spiritual perspective, rather than the standard clinical viewpoint. In homebirth and midwifery circles, it made her a household name, and a widely respected teacher and writer."

Gaskin has been credited with the emergence and popularization of direct-entry midwifery (i.e. not training as a nurse first) in the United States since the early 1970s. Between 1977 and 2000, she published the quarterly magazine Birth Gazette. Ina May’s Guide to Childbirth, her second book about birth and midwifery, was published by Bantam/Dell in 2003. Her books have been published in several languages, including German, Italian, Hungarian, Slovenian, Spanish, and Japanese.

Since the early 1980s, she has been an internationally-known speaker on maternity care independently and for the Midwives Alliance of North America (MANA), lecturing throughout the world to midwives, physicians, doulas, expectant parents and health policy-makers. She has spoken at medical and midwifery schools in several countries and at both the Starwood Festival and the WinterStar Symposium, discussing the history and importance of midwifery.

She is the founder of the Safe Motherhood Quilt Project, a national effort developed to draw public attention to the current maternal death rates, and to honor those women who have died of pregnancy-related causes during the past twenty years.

She has appeared in such prominent films as Ricki Lake's movies Orgasmic Birth (2009) (directed by Debra Pascali-Bonaro) and The Business of Being Born (2008) (directed by Abby Epstein). She also appears in With Women: A Documentary About Women, Midwives and Birth (2006).

Outcomes

A study of home births assisted by the midwives of The Farm, (Durand, (1992)) looked at the outcomes of 1707 women who received care in rural Tennessee between 1971 and 1989. These births were compared to outcomes of over 14,000 physician-attended hospital births in 1980. Comparing perinatal deaths, labor complications, and use of assisted delivery, the study found that "under certain circumstances, home births attended by lay midwives can be accomplished as safely as, and with less intervention than, physician-attended hospital deliveries."

The Gaskin Maneuver

The Gaskin Maneuver, also called all fours, is a technique to reduce shoulder dystocia. Gaskin claims to have introduced it in 1976 after learning it from a Belizean woman who had, in turn, learned the maneuver in Guatemala, where it originated. In this maneuver, the mother supports herself on her hands and knees to resolve shoulder dystocia. Switching to a hands and knees position causes the shape of the pelvis to change, thereby allowing the trapped shoulder to free itself and the baby to be born. Since this maneuver requires a significant movement from the standard lithotomy position, it can be substantially more difficult to perform while under epidural anesthesia, but still possible, and can be performed by an experienced delivery room-team.

Recognition

Ina May Gaskin has lectured and continues to lecture at midwifery conferences and medical schools all over the world. On June 14th, 2008, she led a workshop called 'A Guide to Natural Childbirth' at the New York Open Center in Manhattan. She served as President of Midwives' Alliance of North America from 1996 to 2002. She received the ASPO/Lamaze Irwin Chabon Award (1997), and the Tennessee Perinatal Association Recognition Award. She was featured in Salon magazine’s “Brilliant Careers” in 1999. In 2003, she was made a Visiting Fellow of Morse College, Yale University. Ina May was awarded the title "Honorary Doctor" in recognition of her work demonstrating the effectiveness and safety of midwifery by the Thames Valley University, London, England, on November 24, 2009. On September 29, 2011, Ina May Gaskin was announced as a co-winner of the 2011 Right Livelihood Award, sometimes also called "the Alternative Nobel Prize".

Bibliography

Books

• 1987 - Babies, Breastfeeding & Bonding (Bergin & Garvey Publishers) ISBN 0-89789-134-1
• 2002 - Spiritual Midwifery (The Book Publishing Company) ISBN 1-57067-104-4 (1st edition 1977)
• 2003 - Ina May's Guide to Childbirth (Bantam) ISBN 0-553-38115-6
• 2009 - Ina May's Guide to Breastfeeding (Bantam, US) ISBN 9780553384291 (Pinter & Martin, UK) ISBN 9781905177332
• 2010 - Birth Matters: A Midwife's Manifesta (Seven Stories Press, US) ISBN 9781583229279 (Pinter & Martin, UK) ISBN 9781905177585

Articles

• All-Fours Maneuver for Reducing Shoulder Dystocia During Labor, The Journal of Reproductive Medicine, May, 1998.
• Induced and Seduced: The Dangers of Cytotec. in Mothering, July-August, 2001. Retrieved: 2006-08-26.
• The Undervalued Art of Vaginal Breech Birth: a Skill Every Birth Attendant Should Learn in Mothering, July-August, 2004. Retrieved: 2006-08-26. {Broken Link}
• A Summary of Articles Published in English about Misoprostol (Cytotec) for Cervical Ripening or Induction of Labor, 2005-09-05 Retrieved: 2010-01-22.

Filmography

• With Women: A Documentary About Women, Midwives and Birth (2006)
• The Business of Being Born (2008)
• Orgasmic Birth: The Best-Kept Secret (2009)

External links

• Ina May Gaskin Official website
• Safe Motherhood Quilt Project
• Farm Midwifery Workshops
• The Farm Midwives Website
• Ina May Gaskin IMDB
• Profile by Viv Groskop, The Guardian, September 2009