An Interview With Ina May Gaskin

By Stacy Fine
Web Interview - June 29, 2007

In August of 2003, the VBAC birth of my second child began at the Farm Midwifery clinic in Summertown, TN, attended by Pamela Hunt and Ina May Gaskin. I'll never forget the gold full moon of that soft humid night, and the natural sounds churning in the surrounding forest. My experience was deep and sexy. I was encouraged by the midwives to embrace labor's contractions as rushes. Indeed, this suggestion was transformative—pain turned to pleasure! While this labor progressed nicely, after 14 hours Ina May and Pamela said my cervical lip was not retracting. I decided to go to the hospital. Everyone present agreed with my choice. My husband and I followed Ina May's car out to Maury General Hospital in nearby Columbia, TN. A few hours later my beautiful 9 lb 5 oz baby boy was born. Becoming a mother and having an empowered second birth were radicalizing, pivotal experiences, reflected in the new direction of my writing—which has been mainly about music and fashion until now. The following interview with Ina May Gaskin originally appeared at www.feminist.com.

SF: How do you define "midwife"?

IMG: A midwife provides prenatal care and education, attends women as they give birth, and cares for them and their babies during the postpartum period. In hospitals, sometimes some of these jobs are performed by nurses or pediatricians.

SF: How did you become a midwife?

IMG: My first birth took place in 1966, and I was very surprised to find out that as a first-time mother, my obstetrician was unwilling to allow my baby to be born without medication. This was because he intended to use forceps (whether they were truly necessary or not), because most US obstetricians then believed that this was safer for mother and baby than allowing the normal birth process to take place. This idea was obviously revised a few years later, but I had no choice in the matter for this particular birth. Because I was a graduate student in English literature, I was aware that many women and babies had been injured during forceps deliveries. Besides, I was sure that women's bodies could function better than my obstetrician had been taught they could. That whole experience really opened my eyes to how little scientific evidence underlay the obstetrical beliefs and procedures that were commonly used. Around that time, I heard a few women tell their home birth stories. Invariably, these were empowering stories. I was awed by these women who found ways to give birth at home—most of them pressured a friend, who happened to be a labor and delivery nurse, to sit with them during labor. After hearing a couple of women's stories, I knew that I wanted a home birth myself and that if there were any way for me to become a midwife, I would like to be one. It wasn't long before I had a chance to observe my first birth. The woman refused to go to a hospital and wanted me to stay with her. Her husband was prepared to catch the baby. I was lucky enough to see what seemed to me to be a short, relatively easy labor that ended with a perfectly healthy baby. There was no time to be worried during labor because it went so quickly. There were several other women who were aware of this birth, and when it was finished, it seemed that they were ready to regard me as a midwife. So, one by one, these women gave birth, and after the birth of the third baby, I was offered a seminar in emergency childbirth by a generous obstetrician. That seminar prepared me for the birth of the fourth baby, who needed resuscitation at birth and his mother, whose bleeding had to be stopped just after birth.

SF: How did the Gaskin Maneuver come to be?

IMG: About six years after I began assisting at home birth, I had a chance to go to Guatemala to do some development work following a tremendous earthquake. While there, I met a midwife, who happened to be the district supervisor of indigenous midwives. These indigenous midwives were too poor to have been able to go to school, so they were illiterate. However, the district midwife, whose midwifery education had taken place in Belize, along the lines of the British model, told me that the indigenous midwives had a better technique than what she had been taught to deal with the much-feared complication when the baby's shoulders get stuck after the birth of the head. She told me that instead of twisting and trying to rotate the baby, they merely got the mother to turn over from her back to a hands and knees position with her back arched. This change of position usually solves the problem of stuck shoulders and the mother is able to push her baby out without further ado. Occasionally, additional maneuvers are necessary, such as delivering one of the arms. I have had several obstetricians tell me that the positional change was the only technique that freed a badly stuck baby.