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Birth Matters: A Midwife’s Manifesta, by Ina May Gaskin — A Book Review

By Hope Lien CD(DONA)

In her influential new book, Ina May Gaskin, the godmother of natural childbirth and world renowned midwife, writes of the harsh realities of the maternity care system in the United States– with some of the highest maternal morbidity in the developed world. She compels readers to consider that every woman should have the right to positive and safe birth. Gaskin’s evidence -ased work, rigorous examination of past, present, and future maternity practices, and intimate writing style all made this a delightful read.

There were many parts of this book that resonated with me, both as an advocate for women to receive better care, and personally as a female consumer. In the beginning of the book, Ina May reflects on the way she reminds women to trust their bodies to birth. “Let your monkey do it,” is a phrase Gaskin refers to in the book, and often encourages women to remain in a sort of primal state that their body will best progress in during labor.  By staying in tune with their natural birthing state, and when placed in a comfortable environment, such as their home, women are able to avoid many interventions imposed on them by the obstetrical system today.

Birth Matters is peppered with birth stories from the Farm Midwifery Center where Ina May lives and works as a midwife. These tales of the great strength of women who have birthed their babies without the use of pain medication or surgical measures give power to the opinions expressed throughout her book. Gaskin devotes an entire chapter to discussing technological advances in the obstetrical realm and the ways in which women may have been better off without. She educates readers about the effective and safe options that were previously available before the invention of ultrasound to predict a baby’s weight, widespread c-section for breech babies, and electronic fetal monitoring, to name a few.

One of my favorite sectionsof the book speaks directly to fathers-to-be. In this section, Gaskin gently encourages partners to be familiar with the sphincter law, the idea that the cervix opens best in privacy and to follow a mother’s cues to show you how to move through the labor process. She also suggests how to help the laboring woman tune into her “monkey” or most primal state, and keep her adrenaline or fight or flight response low, while boosting her oxytocin and beta endorphins which keep labor moving and reduce pain levels. Gaskin does an excellent job of encouraging fathers and reminding them that birth is a normal process, although the media may tell you otherwise.

At the end of the book, Ina May shares her vision for subsequent births here and around the world. She maintains a hope that one day medical personnel will be more properly educated to assist birthing women, and that maternity care standards would be revised. Most importantly, Gaskin is optimistic that we can develop a better way to keep track of all maternal deaths taking place in the US, and that we could develop better practices based on the outcomes.

Birth Matters is a persuasive and enticing look at birthing standards in the US, with many traditional and non-invasive ways to improve upon them. It is certainly one of Ina May’s most far-reaching call to women and maternity care specialists everywhere to improve the care we offer to expectant mothers, both here and around the world.

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Filed under Midwifery, Pregnancy