Birth Matters: A Midwife's Manifesta

This book is very interesting reading, even if you're not expecting a baby. Gaskin gives a little of her own history as a midwife and goes into some detail about the history of midwifery, especially in the United States. As an RN, mother, and childbirth educator, I thought I knew more about midwifery and obstetrics than I did. Gaskin's book gave me a whole new perspective. Mainly, physicians/obstetricians are trained as surgeons to deal with birth problems. Most of them never have a chance during training to observe a natural, un-medicated childbirth, so they go out into practice expecting the worst, that most deliveries will require medical intervention. Common sense would tell us this couldn't be the case or the human race would have died out long before the development of modern science, but I and many of my peers have bought into the belief that hospital births are the "safest." Gaskin makes a good case that for healthy mothers and babies this may not be true. Although her opinion is admittedly biased, she presents plenty of facts and published evidence to support her position and is pretty convincing. Another reason this book would be of interest to a general adult audience is that Gaskin examines the politics of childbirth. Even though I grew up during the women's movement of the 70s, I was not aware of how negatively pregnancy and birth were viewed by many of the movement's early leaders nor how this negativity may have influenced a generation of young women. As a business person in the 80s and 90s, I did watch childbirth become an important loss-leader and/or profit center for many hospitals and saw the rise and fall of all the birth centers in my community, as well as the opening and closing of the nurse midwife program at the state university. I understood the profit/loss and cost containment principles at work, but not the larger societal impacts these changes would cause. Gaskin makes a strong case for continued consumer support for midwives and birth centers, for the good of women and society, for better health and stronger communities. Perhaps healthcare reform will provide some momentum for this trend. The women's stories included in the book are inspirational. I only wish there were more, or an entire volume of just the birth stories. The personal accounts of joyful, painless or almost painless births were truly eye opening and made the strongest case for natural childbirth. So many women I teach are really terrified of giving birth, even or especially those with prior experience; I wish they all would read some of Gaskin's mothers' stories to learn how empowering and wonderful childbirth can be. I wish I had read them before having children. In fact, Gaskin makes the whole childbirth experience sound so wonderful, it almost makes me want to run out and have a few more babies. I would highly recommend this book as good reading for anyone, an inspiration for anyone who's pregnant, and a requirement for anyone working in obstetrics, labor and delivery. It only presents one point of view, so it's not the only reading I would recommend, but it should be on every reading list.

Ina May is truly an inspiration, ahead of her time and a wonderful storyteller. In this book, she explains in detail the history of midwifery and obstetrics and when one understands the history of it, one understands why things are as they are now. I especially love the part where she explained about physicians are trained through the 'illness model' whereas midwives uses the wellness model, which makes so much sense that they have a better understanding and respect for natural physiological birth. And this respect and understanding is why in countries that practices midwife-led maternity care, e.g. the Netherlands, the maternal mortality is extremely low. It's just good sense. It definitely gave me a profound respect for midwifery. As opposed to countries with physician-led maternity care, (and this is not to condemn the physicians, as I understand now it was because of how they were trained), the maternal mortality is much higher, mostly due to unnecessary medical interventions. They would fare much better if they joined forces with midwives. One other key point she adressed was about manipulated studies eg the Pang and Wax study; manipulated to influence the masses and the professional community. In effect, convincing women and physicians alike that birth is inherently dangerous and in need of interventions. It made me realize that the people behind the ethical boards are human after all and can still have evil n greedy intentions. It truly is an appaling study and the same goes to the many routine practices in obstetrics that is not evidence based. In addition, I am also horrified to learn the products aimed at women and the effects which had been detrimental to their health. These products include silicone implants, hormonal contraception amongst many others. Lastly, I am love with the concept of Ina May's The farm. It is an awe-inspiring community and amazed with the birth stories which is so full of oxytocin that is shared by the author. It gives the reader a glimpse of how varied but still natural birth can be. The rate of intervention at the farm is nothing short of remarkable and should be emulated by hospitals everywhere. Personally, it makes me want to be a midwife because of their awesomeness. In conclusion, this book lives up to its title and it empowers women to do their own research and take their birth back; to trust their own bodies and their ability to birth and how much it really matters for the child and to the mother as well, as a good birth experience is invaluable to the mother's wellbeing and affects her journey of motherhood greatly. A good birth equals to happy mom and baby and this equals to a happy family unit and subsequently a happy community. As Ibu Robin Lim says "Peace on earth begins with birth".

I was so impressed with the birth statistics from Appendix D for The Farm Midwifery Center from 1970-2010. There were 50 cesareans out of 2,844 births. That's 1.7%. Their practice included women who had breech babies, twins, and VBACs (vaginal birth after cesarean, which incidentally had a 96.8% success rate). In general maternity care in the US, these factors classify many women as high risk and often result in automatic c-sections performed by doctors who are unwilling or unable (due to training issues) to attend a vaginal birth attempt. These and other issues have caused the cesarean rate to climb each of the last 13 years to its current 33%. Many would argue that the numbers from The Farm Midwifery Center cannot be compared to the general U.S. rates. I do understand that the women represented by these numbers opted into this practice. They weren't just `any women'. They embraced the midwifery model of care and were highly motivated to participate in this preventative, wellness model of care. A random pregnant woman off the street may not be in a place emotionally to have this type of birth experience. She may not even desire it. But does she even realize that she has a choice? Does she even realize how possible and safe and rewarding natural birth could be with a different approach to maternity care? If she is giving birth with a typical Obstetric practice, she certainly would not have the type of education and support offered to the women at the Farm. Of the nearly 3000 women, 98+% gave birth vaginally. Certainly we can't expect every maternity caregiver to start producing these types of results, but doesn't it plant the seed that we could do better? Ina May Gaskin's pioneering efforts show us that it is possible for women to have healthy and empowered births. Her book combines her thoughts on how they were able to achieve these outcomes with inspiring birth stories to provide a hopeful glimpse of what is possible. [...]

I have already read Ina May's previous book, Ina May's Guide to Childbirth , and found this an excellent companion to it. There are a phenomenal number of statistics and other information cited, many from studies and surveys completed within the last decade. Fewer anecdotes were included in this book than the previous, and they are spread throughout the book as opposed to all being in the first section. However, they were very enjoyable and, being more recent, had much less of a "hippy" vibe than those in the first book. Overall I'd recommend this book to anyone who foresees themselves facing a pregnancy in their own life or in that of a loved one's. I feel Ina May does an excellent job of presenting her own opinions on the subject while not criticizing mothers who have made choices contrary to her recommendations and I found this to be a very refreshing break from some of the more intense, more one-sided arguments currently in print. There is no doubt as to what points she is trying to make, but it is equally obvious that she values the emotional and physical health of women and their babies above all else. I found this open-minded and highly rational viewpoint to make for an excellent and informative read and I would highly recommend it.

I have enjoyed reading all of Ina May's books over the last few years, but this one is by far her best. It is an excellent and up to date (2010) discussion of the current issues related to women's health and birthing. I appreciate her succinct and scientific discourse on the topic and it is quite evident through her writing that she is an expert in her field. Having read the majority of her works in the past, there was some repeat information. This, however, is necessary for those that have never read her material in the past and is presented with some new insights. My first reaction was that this book should be used as a text in Women's Studies courses. I highly recommend this book for every man, woman, and experts in the field of obstetrics/midwifery. A very empowering book.

Ina May, 2011 recipient of Sweden's Right Livelihood Award, has outdone herself again. As a doula and natural childbirth advocate, I so appreciated this detailed account of the history of childbirth in our country and around the world. I poured through this book in two days. She speaks frankly about her opinions after attending nearly 3,000 births (with less than 2% c-section rate) and clearly sites various sources supporting her beliefs that women and newborns would be better served by returning to ancient wisdom that is quickly being forgotten by the obstetric community in America. She is brave in her calls to action, asking ACOG to follow the good examples of their peers in the UK by accurately reporting maternal deaths. This book deserves the attention of the entire childbirth community and should be required reading for all students and practitioners, mothers and fathers-to-be, and anyone who cares about the safety of women and their unborn children. By bringing our history of childbirth into the light, this book has the potential to create good and necessary change by reminding readers just how natural and important it is to empower a woman to deliver her baby on her terms.

I love Ina May, and I love this book. It has a wealth of material and information--all essential to an informed pregnancy, labor, and delivery. One star off because some of the birth stories are repeated in other Ina May books. If you're undecided between this book and Ina May's Guide to Childbirth, and only want to purchase one, go with the Guide. I have both and am glad I do.

When having my daughter, I researched pregnancy and labor quite a bit. I _loved_ Gaskin's books, and _Birth Matters_ was no exception. I think as Gaskin discusses, there is a huge disconnect between medicine and midwifery in this country--and it doesn't need to be that way. I live in an area with limited options for birthing. I used an OBGyn. I had an amazing birth experience with my OBGyn and at a hospital. My OB was a wonderful combination of midwifery and medicine: I absolutely adore her. The hospital staff was also amazing: I held my daughter _immediately_ after birth for skin-to-skin contact and nursing. So, although I know there is a huge disconnect with medicine and midwifery, I do not think the majority of doctors or OBGyns are greedy, c-section monsters, as some other reviewers stated. I think pitting medicine against midwifery is damaging to all--which Gaskin addresses in _Birth Matters_ and her other works. All this to say, as a doula, I also see how much medical intervention is unnecessary; that the labor process isn't necessarily trusted and often seen as scary. I personally was able to have such a positive birth experience because my OB listened; I also arrived at the hospital in transition. Gaskin does such important work for women and babies. Our system in the US needs to change.

if you want to read just one book by ina may, i think this one really puts together many of the concepts presented her other books in a interesting and relevant way, both personally and politically.. ina may has a great perspective, and writes with humour, encouragement, and a pleasing flow.

Good information here about why it's important to give birth naturally.

Ina May's new book is a manifesta setting out the philosophy of natural birth, and therefore nothing that has not been said by wise women (and men) countless times before. The value of this work is its comprehensive, detailed, and clear presentation of the information, such that surely no rational human could disagree. It is a scientific celebration of what nature has achieved and what women are capable of. The first chapters set the subject in its global context, and birth stories are scattered through the text to remind the reader that while these are global, political issues, they have personal, individual impacts. I have learned about the cultural loss of breastfeeding knowledge, and it makes a sad kind of sense to me to be reading the same description of society's attitude to birth: the loss of skills among health professionals and the consequent loss of positive birth stories. This cycle will be perpetuated and added to, and will spread beyond the US increasingly rapidly, as we lose touch with and confidence in our own bodies. Ina May Gaskin discusses the role of feminism in driving an `escape' from pregnancy and motherhood, a push towards equality between men and women instead of a celebration of the important differences between us. Why should power be measured only in masculine terms and defined by the choice NOT to do something? Ina May's positive, empowering feminism offers a far wider range of choices. ` It seemed crazy to me to take on the belief that the human female is the only mammal on earth that is a mistake of nature... it's our minds that sometimes complicate matters for us. (p.23)' She quotes Simone de Beauvoir describing the pregnant women as inciting fear in children and contempt in young people, ensnared: "life's passive instrument." De Beauvoir, the great feminist intellectual, writes as though she believes what men have said for centuries about women's bodies: that we are disgusting, inefficient, and inferior to men (who cannot, normally, grow or feed babies); and seems unaware that historically speaking, medical men who profit from managing birth have had personal and financial interests in telling women that it is a dangerous and painful process, that requires the presence of a qualified doctor. Again the parallels with the unethical practices of formula manufacturers undermining women's knowledge of and confidence in breastfeeding are clear. Some of the practices resulting from this basic assumption of women's inferiority and ignorance are barbaric, and many persist in 21st Century western healthcare. The book describes a bleak outlook for maternity care and motherhood in a world where politics and economics are everything. Yet the short-termism of the idea that labouring women must be cured or rescued from themselves costs far more in terms of money, life, and quality of life. How can this be an acceptable situation? I was struck by the anecdote in which a couple kissed to raise oxytocin levels and aid relaxation and the progress of labour. It helped me to think about the way I talk to antenatal groups about the role of oxytocin in breastfeeding. And also of the way the idea of sex to bring on labour has been reduced to the role of prostaglandin, when everything about it promotes skin contact, eye contact, and a feeling of well-being. In this, I find yet another example of the big picture being reduced to one male-orientated detail. I was aware that birth in the US was highly medicalised, but the details and the implications of that, as clearly laid out by Ina May Gaskin, are horrifying and depressing. At the same time, the positive birth stories are affirming, empowering tales, a contrasting picture of the good that is possible when women are informed and respected.

Good book!

I learnt a lot about the US way of giving birth and what changes need to take place. Ina may has a great plan and structure and it's on us women to carry this light, starting with education our womenfolk. Family members friends work colleagues etc