A midwife's manifesta on how to have a fearless birth

Birth Matters by Ina May Gaskin
Birth Matters by Ina May Gaskin
Birth Matters, a new book by pioneering midwife Ina May Gaskin aims to empower women to gain control over their bodies in order to have the kind of birth they want

So, you've read the Ecologist'sBirth Uncut' Maternity Special and it's sparked off an interest in the idea of a more natural, less medicalised birth. This book by renowned American midwife Ina May Gaskin will renew your confidence in women's natural, innate ability to give birth.

Before I read Birth Matters, I had barely heard a single positive birth story. Most were horror filled accounts of women stuck in labour for over 24 hours, screaming for epidurals, enduring a series of complications, interventions and agonising after-effects. As a result, the prospect of birth filled me with fear and dread.

Birth Matters is therefore an empowering read. It's about women gaining control over one of the most fundamental processes of life by learning to trust their body and tune into a kind of primal, ‘inner ape' instinct.

Gaskin has four decades of experience as a midwife at The Farm Midwifery Centre, based on an eco-commune in Tennessee. The Farm has handled over 2,800 births with an astonishingly low C-section rate of just 1.7 per cent. (In the US, the C-section rate is 34 per cent and in the UK 28 per cent.) Her knowledge on birth is grounded witnessing hundreds of natural, unmedicated births and observing what both helps and hinders the process. Fear, for instance, can slow down labour: ‘sudden fear or even the wrong person entering the room can cause the cervix to close in many women,' she writes.

The first section of the book reveals Gaskin's keys to a safe, natural birth. These include the ability to move around and change position, emotional and loving support and a stress free, undisturbed environment. She explains the role of natural hormones in labour - for instance, when women are spoken to with words of love they secrete a natural form of oxytocin which causes uterine contractions and keeps labour moving. She says women giving birth need to access the ‘wild women' or ‘inner ape' within, rather than a logical, thinking state. The overall ethos seems to be: trust the natural process. To inspire, there are first hand birth stories interspersed throughout the book of women who either gave birth at The Farm or at home.

Much of the second half of the book is focused on the birth model in the America, where the situation for women seeking a midwife-led, natural, drug-free birth is more tricky. With one in three babies born via cesarean, the US also has a maternal death rate higher than in any other developed country. Gaskin says the nation's rising maternal death rate is down to the increase in C-sections and the drugs sometimes used to induce labour.

She makes a compelling case for the need for more American midwifes - currently there is a ‘national lack' after the profession was essentially eliminated for several decades in the mid-twentieth century. Armed with research, she shows how midwife skills were replaced by a medical model that embraced new technologies and drugs in the first half of the 20th century. She examines the ‘vast gulf' between the basic knowledge base of midwives and that of most obstetricians, distinguishing the midwives' 'wellbeing' model of care from the medical 'illness' model of care. For example, ‘whereas medical men's solutions to birth complications have tended to focus on the creation and use of tools to solve the problems, a midwife might ask a woman to move her body in such a way as to change the baby's position.' The book concludes with Gaskin's vision for the future of ‘women centred maternity care' in America.

It's a fascinating read and one I'd recommend to any woman who is pregnant or fearful of birth.

Birth Matters by Ina May Gaskin (Pinter & Martin, £9.99)

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