The Feministing Five: Ina May Gaskin

Ina May GaskinAs promised, this week’s Feministing Five is with the legendary Ina May Gaskin. Ina May is the famed “midwife of modern midwifery” and has revolutionized the way the world views this ancient practice since the emergence of her seminal book “Spiritual Midwifery.” This past month, Ina May was awarded the Alternative Nobel Peace Prize in Sweden called The Right Livelihood Award, which “honours and supports those offering practical and exemplary answers to the most urgent challenges facing us today.” And indeed, Ina May does. A pioneer in the natural birth movement, Ina May firmly places control back into women’s hands from what she calls “male-centered, misogynistic birthing processes” which views women’s bodies as defective designs and allows for profit to be made from women’s fears of their own bodies.

Born in 1940, Ina May was an English major who accidentally fell into midwifery. Her and her husband Stephen Gaskin (also winner of The Right Livelihood Award in 1980 and infamous teacher of the Monday Night Class in the 1960s) went on to establish The Farm, a 1,750-acre commune in Tennessee, with a population once at its highest of 1500 residents, where Ina May runs The Farm Midwifery Center. The cesarean rate at The Farm’s clinic is less than 2% and people from all over the world come to receive their home birth services.

Ina May has written several books, her most recent being “Birth Matters: A Midwife’s Manifesta.” She is the only midwife to have an obstetric maneuver named after her, called the Gaskin maneuver, which resolves shoulder dystocia during childbirth.

It was such an inspiration to interview Ina May. The passion that she has for her work is infectious. A staunch advocate for woman-centered childbirth processes, she is a firm believer in taking back the power to give birth when and how we choose. How much more feminist could that be?

And now, without further ado, the Feministing Five, with Ina May Gaskin. (And don’t forget to stay tuned next week for a special Part II of this interview!)

Anna Sterling: How has feminism impacted your midwifery work?

Ina May Gaskin: Feminism was very powerful to me when I got the phrase from Robin Morgan, “Sisterhood is powerful.” I was experiencing those three words as a new mother because I was realizing that isolated, I had no power. During my first birth, I was subjected to insane treatment– mandatory forceps delivery. I came into contact with women a year and a half later who were saying,”This is not going to happen to us again,” and stayed at home to give birth the next time. They persuaded a friend who was a labor and delivery nurse to act as a midwife. These women came out of this experience so powerful, happy with the birth and baby obviously healthy and doing well. Instead of being scared afterwords in her new role as a mother, she was powerful and you could feel it. That excited me.

Another three or four years later, I was lecturing at Yale and I thought people would be excited about the midwifery portion because the women in my village found it so empowering that we didn’t have misogynistic obstetricians that were so prevalent back then jamming forceps into us and pulling our babies out. Instead, we could give birth ourselves. I was booed off the stage and I thought what are these young women reading? This doesn’t feel like feminism to me. What could be more feminist than taking back the power to give birth on your own terms and saying, “No, I don’t want a male obstetrician who is really misguided into thinking my body is some sort of defective design brewing around my legs and yanking my baby out with instruments before I give him a chance to show him what I can do?” There was no choice then. I guess we started a revolution in birth because I wrote a book with the help of a lot of community members and it became the first big selling midwifery book in the country and has been credited with helping nurse midwifery get off the ground.

AS: Who is your favorite fictional heroine, and who are your heroines in real life?

IMG: Katarina Schrader was a Dutch 17th century midwife who attended more than 3000 births before C-sections were done and had a lower maternal death rate than the U.S. did in 1936. This is amazing. There’s a complication and it’s pretty prevalent in the U.S. because it’s related to how high the C-section rate is. At that time, it was rare because there were no C-sections. It’s when the placenta plants itself over the cervix so when the baby is being born, the mother has a profuse hemorrhage and can lose her life quickly. The first time this midwife encountered this rare complication (now, not so rare) the mother and baby died. The second time, she thought it through and she was ready for it. She scooped the placenta out, she put her hand into the woman’s vagina, pushed up on the baby’s head, pushed her hand further up until she could reach the baby’s feet and gently pulled the baby up by its feet. She saved mother and baby seven times she encountered that. Today, women are still losing their lives due to this complication. That incident has gone up as a result of the high rates of C-sections.

Also, Ignaz Philipp Semmelweis. He was a young doctor, Hungarian by birth, in Vienna, Austria working in a time where you had two clinics. Poor women went to the doctor’s clinics and the women with more money went to the midwives clinic. The death rate at the midwives clinic was almost zero (speaking of mothers) and in some seasons, it was 50% at the doctor’s clinic. The reason these women were dying was because the doctors wouldn’t wash their hands. They were doing autopsies where they were learning anatomy on the bodies of dead women and then do a vaginal exam and a healthy young woman would die 3-5 days after giving birth. Semmelweis had the courage to open his mind and learn what might be causing this and he could prove that washing hands would save the lives of women, but he couldn’t convince the other doctors to do it. He died in an insane asylum. We’re kinda back there. That man was so heroic that he deeply inspired me. I also had to learn from him how not to go crazy knowing how to save lives without pissing people off or making them feel guilty that they can’t learn from you.I’m reading a book right now in German. I think that our distorted views of birth that we have here in North America stem from the European witch craze that took place between the mid 15th century and 18th century when midwives were the principal victims who were executed in a lot of different European countries—Germany, Italy, France, U.K. This story is about a young woman who was accused of being a witch. We’re now in a simmering witch hunt. I read the reviews that some had to say and they found it hard to believe that it would ever be that bad, but it was. It’s history. It’s fictionalized history, but it’s history.

AS: What recent news story made you want to scream?

IMG: That home birth isn’t safe. To suggest automatically that planned home birth isn’t safe is to accept a propaganda that’s being put out for more than a century in this country that is now sweeping the world because it’s a way of scaring people and a lot of money can be made from that. If you don’t have home birth as one of the choices women have then we can be exploited and birth can become a commodity the same way water is being grabbed and sold to people and the way food is being controlled by multinational corporations. For women to get it that we’re not inferior to squirrels, cows, rabbits and elephants, is a very radical thought that’s actually true. When you have about 5000 species of mammal and we’re encouraged to believe that we’re the only one that can’t give birth, that’s mis-designed? That takes quite a stretch but that’s the overall belief system our culture has taught us to adopt, and it’s not true. For someone like me and most of my partners who have not had formal medical education, how could we produce such good results? We had 186 babies from the beginning before we had a need for a C-section. Now 1 in 3 and in some places half the women are having C-sections? Who is benefiting from that?

AS: What, in your opinion, is the greatest challenge facing feminism today?

IMG: You have to put mothers into feminism. I think second wave feminism found the motherhood question so difficult that it shied away from it and so the only part of reproductive rights had to do with abortion rights. Yes, we have to have that but we also have to have choice in how we give birth, with whom, where and how. We shouldn’t have corporate entities like multinational insurance companies dictating how we give birth. Insurance dictates to hospitals and to doctors and doctors dictate to midwives and all of this dictates to women, “This is how you’re going to give birth. In essence, we own you. You don’t.”

AS: You’re going to a desert island, and you’re allowed to take one food, one drink and one feminist. What do you pick?

IMG: Water. I’d probably have something Japanese—sushi with miso. Elizabeth Cady Stanton rocked. She found it possible to imagine that you could be a powerful mom. She had help from Susan B. Anthony who would take care of her 7 kids while Elizabeth went into the attic and wrote powerful speeches. I love that kind of feminism where you had someone who didn’t have kids and someone who did team up and put their energies together. I think what those two women had was amazing and I think we need that kind of cooperation amongst feminists today.

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65 Comments

  1. Posted December 30, 2011 at 1:58 pm | Permalink

    I hope in the follow up interview there is information included about her work against maternal mortality in the United States. She has done great work including her quilt project against maternal mortality. People who don’t know her name to know about her work against the high rate of death in the United States for a developed country. Thank you again for this great interview.

  2. Posted December 30, 2011 at 3:32 pm | Permalink

    Thank you for interviewing Ms. Gaskins! :) It’s fascinating to read this interview! I always felt like she must be a feminist.

    Her book was a feminist revelation to me when I was around 12/13, raised in a conservative Christian/Quiverfull family. Most of the women I knew (my mom’s freinds) really admired and respected Gaskins and hers was one of the only non-Christian books in the homes of most of the families I knew including my own. They didn’t use the word “feminist” in the book but even with my limited exposure to “feminism” (it was considered very bad), I felt like what “Spiritual Midwifery” represented was and still feel like it is. Another one I read was “Immaculate Deception” by Suzanne Arms and I thought it also had a feminist feel. Anyway I feel like Ms. Arms and Gaskins nurured feminist, sisterly values in alot of women, even if they didn’t use the word “feminist”. :)
    I ‘m looking forward to reading part 2 of this interview :)
    Thanks again :D

  3. Posted December 30, 2011 at 7:29 pm | Permalink

    Unfortunately, this interview fails to include some very important information about homebirth and about Ina May Gaskin.

    1. Homebirth isn’t safe. All the existing scientific evidence, as well as state, national and international data show that homebirth has an increased risk of newborn death. The most recent CDC data shows that planned homebirth with a non-nurse midwife has a death rate that is more than SEVEN TIMES HIGHER than comparable risk hospital birth. (2.62 deaths per thousand compared to 0.34 per thousand in the hospital).

    2. The only scientific study of The Farm (Durand, 1992, reprinted in full on Gaskin’s website) claims to show that homebirth at The Farm is as safe as hospital birth. If you read the paper carefully, you will see that Durand did not compare homebirth to comparable risk hospital birth; he compared homebirth to a study of HIGH risk births. That was the only way to make the appalling death rate at The Farm look acceptable. Since then, there has been no data from The Farm published in a peer review scientific journal.

    3. Ms. Gaskin is a feminist anti-rationalist. Feminist anti-rationalists dismiss science as a male form of “authoritative knowledge” on the understanding that there are “other ways of knowing” like “intuition.” Many are post modernists who believe that reality is radically subjective, that rationality is unnecessary and that “including the non-rational is sensible midwifery.”

    4. Ms. Gaskin appears to be mired in the past. She like to claim that modern obstetrics is misogynistic and patriarchal, but seems to have missed the fact that most obstetricians are now women. Women obstetricians do not consider science to be the exclusive province of men, and do not consider “intuition” to be a substitute for the education and training is science, statistics and obstetrics.

    5. Ms. Gaskin claims that Semmelweis is her hero because he discovered the cause of puerperal sepsis, ” but he couldn’t convince the other doctors to do it. He died in an insane asylum.” That is not what happened at all.

    According to medical historian Irvine Loudon:

    “…But most of the claims made about him in the twentieth century – that he was the first to discover that puerperal fever was contagious, that he abolished puerperal fever (or that if he did not, it was because of the stupidity of his contemporaries), and that his treatise is one of the greatest works in nineteenth-century medicine – are sheer nonsense…”

    6. Homebirth is not a feminist statement. Feminism is about choice; women can make whatever choices they deem best for themselves, regardless of society’s view of what is “proper” for women. But that doesn’t mean that every choice made by a woman is a feminist choice. It is not a feminist choice to wear a burqa; it is not a feminist choice to remove your daughter’s clitoris with a dirty razor blade; and it is not a feminist choice to declare that you are subservient to your husband.

    Similarly, it is not a feminist choice to ignore scientific evidence.

    • Posted December 31, 2011 at 3:51 pm | Permalink

      Amy, I am not able to check your claims on the CDC stats at this time, but your other comments are grossly exaggerated and wrong. First, neither feminism. Or Ina May Gaskin dismiss science. They dismiss the institutionalized male bias that nearly always exist in accordance with medical studies. Take the number of years it took to determine that women have vastly different symptoms than men during and immediately preceding an MI. It took “science” far too long to figure that out because it was me focused, as is medical education and as are most OB residencies. Despite women making up a majority of obstetricians, a fact I will stipulate though I am not certain it is accurate, they were educated and trained based on the still prevalent male bias.

      Furthermore, I would invite you to look at the Farm statistics again. The death rate there is phenomenal. Again, I am unable to verify at this time, but as I recall, there have been only three neonatal deaths, none due to the midwifery care. It is one thing to disagree with her philosophy or her methods, but to malign her with falsehoods is something else entirely. And you wonder why so many women, and men for that matter, distrust physicians.

      Nobody in the interview or elsewhere suggested intuition as a substitute for scientific knowledge. Intuition has been responsible for the discovery of a great many scientific discoveries. It is an invaluable adjunct to book knowledge and practice that treats all women as carbon copies. I would suggest to you that Dr. Semmelweis would agree. Incidentally, Ina May did not say he discovered hold bed fever. His intuition and subsequent practice of handwashing as a method of prevention is well document, as is the resistance of his contemporaries.

      You could do worse than to take a lesson from Ina May Gaskin. She is very well educated, which is how she managed to self-educate as a midwife. The educational and practice standards she helped develop for Certified Professional Midwives put the standards for CNMs to shame. She learned many lessons from a physician who was not threatened by her practice and taught her the dying art of delivery breech babies safely. I dare say it is a skill you and probably 100% of your peers at the hospital lack. Rather than eschew his expertise, she embraced it. That is about as feminist as you can get.

      Lastly, before you claim that homebirth is unsafe, check the statistics from other western countries where they are common and have statistics that are equal to or better than those in the hospitals for like populations. Homebirth is safe, and safer when supported by the medical community rather than a medical community tha attempts to shame and intimidate women into believing it is inherently harmful.

      Your comments really underscore the need for women like Ina May to provide unbiased information. She is certainly not alone in this and despite what you might do in your practice, there are many physicians who agree with her.

    • Posted January 1, 2012 at 8:53 am | Permalink

      Original commenter is widely known as an anti-homebirth extremist who comments onseemingly every discussion of it on the net.

      As a homebirth mother, I did a huge amount of research on my options and determined that homebirth was in fact safer for me than hospital birth, at least here in the USA — I did choose hospital birth when I had my first kid in Europe, where midwifery care, with backup surgical care only when needed, is the norm in hospitals. As an attorney and a professional writer in a free country/democracy, the idea that people like the original commenter are trying to take away my reproductive rights (to choose where and how to give birth) because they disagree with my assessment of the data makes me ill. Especially since so many of the naysayers have a financial interest in taking our right to choose homebirth away.

      Ina May is a wonerful woman who has recreated a huge amount of knowledge about birth that was unfortunately lost in the sometimes misguided medical takeover of the process. Every other developed country in the world shows us midwifery care(in or out of hospital) and backup surgical care can be integrated seamlessly. All the countries that have lower mortality rate have that model. We don’t ave it here because of the way healthcare is financed. We spend more and get far less than our peer nations.

      • Posted January 1, 2012 at 10:37 pm | Permalink

        Dr. Tuteur is hardly an extremist. She is an advocate for informed choice in childbirth and for regulations on who can practice medicine in this country– specifically, she argues that the average home midwife is grossly undereducated and untrained for the task they perform, thus paid birth professionals should be limited only to those who have actually studied medicine, and she argues that the lies about homebirth (specifically that it is as safe as or worse, safer than giving birth in a hospital) need to be ended.

        She is only considered an extremist by women who have been persuaded to accept Grantly Dick-Read’s racist and sexist image of what childbirth should be like.

      • Posted January 2, 2012 at 11:32 am | Permalink

        Stella, how can you say homebirth is safe? We have very little data on death rates at home birth in the US, but what we have is AWFUL: in Missouri your baby is 20 times more likely to die in a homebirth than in a hospital unit, and in Colorado the increase in death in 2009 was 7 times and the 2010 numbers were so bad the midwives actually refused to release them, in clear violation of Colorado law. And you too can look through the CDC data base (I’ve done it; it’s not hard and see what the rate of death is at home birth across the country—more than 7 times the hospital rate.)

      • Posted January 3, 2012 at 9:25 am | Permalink

        There is little interest in taking away your “right” to homebirth. There is a lot of interest in eliminating unqualified pseudoprofessionals who prey on ignorance, refuse to practice within a safe scope of care, and promote dangerous practices and snake oil de rigueur.

  4. Posted December 30, 2011 at 7:57 pm | Permalink

    Thank you! This is something I’ve been waiting for from Feministing.

    I had my daughter at home and being a feminist definitely shaped my decision to have her at home.

    Ina May is right “You have to put mothers into feminism”

  5. Posted December 30, 2011 at 9:14 pm | Permalink

    Sorry. The small but sometimes unpredictable risk of placental abruption is enough for me to stay away from planning a homebirth. And that’s just one of the reasons I would stay away….I haven’t even gotten into the scientific data showing the dangers of homebirth in this country, especially with non-nurse midwives, or the other various things that can happen to women and babies during pregnancy and birth.

    (not my story, but highlights what needs to happen during an abruption for a happy ending)
    http://www.younghouselove.com/2011/04/claras-birth-story/

    I think we can all agree that hospitals and the medical world in general can stand to improve their relationships and communication with patients and make L&D wards more hospitable for women in general without compromising safety. Medicine can and does need to continually improve their care. Many hospitals are doing this, but the majority of physicians I think will agree we can even do more.

    But I think we can all also agree that Nature isn’t by any means perfect and just because someone gives birth in a hospital or via C-section or with the aid of an epidural, they are not somehow “inferior” to elephants (who seem to be great at giving birth without vets standing by). Ina May seems to suggest otherwise. Doesn’t sound feminist to me….

    And by the way, Ms. Gaskin, there are HUGE differences between the pelvis and pregnancy of an elephant (or chimpanzee, or cow, or rabbit) and that of a biped human woman which make our experiences as human rather unique with its own set of risks and benefits.

    • Posted January 1, 2012 at 8:57 am | Permalink

      Aren’t you glad you had the right to look at the risks and benefits and make a choice where to give birth? Reasonable people can differ on this issue, and anyone who has been pregnant more than once knows that every pregnancy is different. and women, not the government or financially interested doctors, should make the decision on where to give birth.

      • Posted January 1, 2012 at 10:45 pm | Permalink

        Reasonable people can disagree. Educated people cannot. Please, read information on homebirth written by actual doctors and those who have firsthand experience. Look at statistics. If you can do that and accept that it’s okay if your baby dies, which it is three times more likely to do at home than in a hospital if you are 100% healthy and low risk going into delivery, then by all means birth at home– it should not be illegal. But we should not allow charlatans like Gaskin here to charge MONEY to kill and maim their clients’ children without actually telling them the real-life risks and consequences. How many midwives actually will sit down and say to their clients “Your child is three times more likely to die if you go through with this. Even if I was a trained surgeon, which I am not, I could not actually help you in a serious situation as I do not have the technology or assistance required to save your child’s life. I cannot get you to the hospital in time all the time, it will be dumb luck and the help of skilled paramedics if I can in a true emergency. Yes, you and the baby are likely to survive, but you will have to trust that an imperfect process of natural selection that is designed to have a high death rate in childbirth will save you, because I am not going to be a significant factor in all this.”

      • Posted January 2, 2012 at 9:26 pm | Permalink

        For the love of god. No one is saying the government or doctors need to make decisions for women on where to birth.

        No one – not even Amy Tuteur, MD – advises making homebirth illegal or removing the freedom to choose where to birth from women.

        What we advocate – as feminists – are informed choices and informed choices cannot be made without a frank discussion of the scientifically deduced risks and benefits of all options.

        Credible literature suggests that worldwide, homebirth increases the risk of fetal compromise and and death compared to hospital birth, EVEN if you are “low-risk,” EVEN if you use a CNM, and even more so if you use a poorly trained midwife (the so-called CPM/DEM). Hospital birth may increase the rate of interventions – but it also increases the likelihood that you and your child will walk out of there living, breathing, neurologically intact compared to homebirth. The data also shows that hospital birth with either a CNM or an OB has a good safety record as well.

        If the data showed otherwise, Dr. Tuteur along with the professional medical establishment would certainly be singing a different song. But however the Ina May Gaskin’s of the world wish for it to be true, proof supporting their ideology is not borne out in the data. And in the recent literature that does exist, I challenge any of you to find the “male bias” in studies full of female patients.

        Women who are deciding where to birth need to know this. Yes, the chances of things going wrong anywhere are generally small, but that will usually come as no consolation to a woman who lost her child at birth. If you choose to homebirth, you need to acknowledge and accept that the risk of death or disability is greater to your child than if you hospital birth, and that the person who will likely be attending your delivery may not be as well trained or NEARLY as experienced in all kinds of birth as those who do so in a hospital setting.

        Dismissal of these latter points are either women ignoring the science, or women being misled by those who use women in vulnerable positions to validate their own ideologies. But if any woman can acknowledge the increased risk of homebirth and is well aware of how her attendant’s training stacks up to OB’s and CNM’s who work in the hospital, and they choose to do it anyway, then I would call that an informed choice.

        To summarize: Providing women with what we know to be scientifically true helps them to make truly informed choices, and women making informed choices is very consistent with feminism. This is our goal here.

  6. Posted December 30, 2011 at 11:44 pm | Permalink

    Leaving aside the issue of just how safe home births are (suffice to say that I don’t entirely agree with Ms. Gaskin), I do have a problem with some of the home-birth movement’s sense of ideological purity, which sometimes goes so far as to shame women who choose to give birth in hospitals and who choose to have modern pain mitigation. While it’s not obvious in this interview, some of that can be laid at Ms. Gaskin’s doorstep.

    • Posted January 1, 2012 at 9:03 am | Permalink

      So not true! Myself and most of my friends who are homebirth moms are all about CHOICE for birthing women. Sometimes I feel women who choose hospital in the US do it by default, and do not look at all the available information out there — nothing against them, that is what the system is designed to produce, but I at least want to stand as a voice reminding woment hey should question the system and make a decision that is right for them. I say this since I have lived and given birth in a country where HB is an accepted, government financed option and I saw most women actually looking at both options and making a choice between them, whereas here in the US, many women are unaware of the HB option. Maybe this is what you are interpreting as judgment.
      The US medical profession stands basically alone amongst its peers in advanced coutries in being a anti-HB lobbying machine, and as a result there is a lack of information and misinformaiton out there IF you use your OB as a gatekeeper in giving you info about your pregnancy and birth options. I think we just want women to understand the risks and benefits of both options, not choose one because they are pushed into it.

      • Posted January 2, 2012 at 1:37 am | Permalink

        Unfortunately, it *is* true. More than one of the women who have been hauled into the hospital where I work by EMS when their home birth has gone wrong (sometimes horrifically) express feelings of *guilt* that they were ‘incapable’ or ‘too weak’ or somehow ‘failed women/mothers’ because their perfect homebirth didn’t happen the way that it was supposed to.
        Here’s another view:
        http://www.salon.com/2011/12/20/what_do_you_mean_im_giving_birth_the_wrong_way/singleton/

        • Posted January 3, 2012 at 5:59 pm | Permalink

          I think the real issue is that women often feel guilt and shame if their actual birth does not measure up to the “perfect” birth they had planned. This is regardless of where (home, birth center, hospital, car, etc) they’ve given birth.
          Providers (midwives, OBs, nurses, pediatricians, counselors) that are aware of this potential for guilt (and post-partum depression) can help afterwards AND more importantly BEFORE the birth. Discussion about being flexible within your birth plan is important, and having a provider that has gotten to know you and is supportive is priceless. Many midwifes stay with their clients throughout the laboring process even if there is a hospital transfer. Helping women have individualized, thoughtful and empowering health care is a feminist issue.

          The labor and delivery department at the hospital system I work at reports that they see very few hospital transfers from homebirths and they are typically slow transfers that tend to go pretty smoothly. Certainly the ER nurse that delivered two months before me with the same team of homebirth midwives was pretty confident in her decision even after working several years at our level 1 trauma center that covers a very large region.

  7. Posted December 31, 2011 at 1:31 pm | Permalink

    Can we please not confound feminism with the naturalistic fallacy? Just because birth is “natural” doesn’t mean it’s safe or de facto good. Kidney stones are natural, I don’t see people feeling they are somehow morally superior for passing those at home without medication or medical supervision. Birth has been, and will continue to be, one of the greatest dangers to the health of women. That is just an empirical fact, not a paternalistic conspiracy. It’s not feminist to ignore scientific evidence because it doesn’t support your belief–no matter what that belief is.

    • Posted January 1, 2012 at 9:13 am | Permalink

      Most of us in the HB community are not ignoring scientific evidence! In fact we are advocating for evidence-based care. The US maternity care system is not evidence-based, meaning a lot of routine interventions in labor and delivery have not been shown to be beneficial or have in fact been shown to be non-beneficial. To learn this for yourself, pick up one of Ina May’s books read “Pushed” by Jennifer Block, or have a look at the Millbank report, available here:
      http://www.childbirthconnection.org/pdfs/evidence-based-maternity-care.pdf

      And every serious HB mom and/or advocate I have ever talked to believes strongly in the fact that reliable hospital backup is a necessity of any safe HB. I would never have gone into my labor, even though it was very low risks, without insuring a surgeon was in the 30 minute radius to help if something went wrong. In fact, studies have shown a well-planned HB with good backup can result in a shorter decision-to-incision time (from knowing something is wrong that requires a c-section to being on the table) than laboring in a US hospital. This is because often when a woman is laboring in a US hospital, a doc is not immediately available to do a c-section. Dr. Marsden Wagner, formerlyogf the WHO, has written alot about this.

  8. Posted December 31, 2011 at 1:59 pm | Permalink

    she is a firm believer in taking back the power to give birth when and how we choose.

    Unless you choose to give birth in a hospital, have a c-section, or use medicine during the birthing process. Or happen to not be a woman and give birth. That’s what I got out of this interview, anyway.

  9. Posted December 31, 2011 at 9:00 pm | Permalink

    Ina May Gaskin is not a feminist. She is a biological essentialist who has hijacked the feminist language of choice in order to increase her own influence and the success of the certification she has invented. She is not interested in supporting women’s choices but only it enforcing her ideologically-based demands that women conform to a specific set of actions for life choice as reproducers and “natural” delivery.

  10. Posted January 2, 2012 at 12:19 am | Permalink

    For a nice counterpoint to both the Gaskins and the Tuteur ends of the spectrum one could do worse than checking out Penny Simkin’s work. She’s been doing home- and hospital birth assisting since 1968, and has written a number of books and courses for prospective mothers, midwives, doulas, and other birthing companions.

    One idea that I think really separates Simkin from more ideological (medical and essentialist) schools of childbirth is her medications-preference scale, which definitely has room for… pretty much everyone regardless of ideology. Another is her her work on PTSD before, during, and after childbirth (a problem that can crop up in both the Gaskins and Tuteur’s camps as well as elsewhere.) Same with her pain-coping and pain-intensity scales. (Note: I had bone surgery about ten years ago and was surprised to note that both the surgical and nursing staff used Simpkin’s intensity scale when asking me about my pain!)

    Not to sound grumpy but the “Gaskins Maneuver” probably ought to be named after lay midwives in Guatemala who developed it and showed it to Gaskins.

    figleaf

  11. Posted January 2, 2012 at 1:51 am | Permalink

    Here’s a blog for a jaundiced look at the pro-hospital side:
    http://skepticalob.blogspot.com/
    The author is, frankly, rather mean, and pays too little attention to the feelings of birthing women; however, it’s a source for statistically sound studies and the polar opposite of Ms. Gaskin’s pov.

  12. Posted January 3, 2012 at 2:15 pm | Permalink

    Of course this article attracted the infamous, vile “Dr.” Amy (who isn’t even a practicing physician and NOT a member of the ACOG anymore.) She and her unstable little cronies attacked, tortured, and cyberbullied me throughout my entire 9 month pregnancy – WHY? Because I chose to have a homebirth after two intensely traumatic hospital births. Anyone who’s reading her site and listening to it needs to check their head. That lady PUBLICLY wished that my baby would die. IN PUBLIC. ON HER NUTTY BLOG.

    As for whether birth and our reproductive autonomy is a feminist issue, HELL YES it is. The maternal mortality rate in this country is the WORST of any industrialized nation. Is that because a few women are birthing at home? NOPE! It’s because our cesarean rate is 32%, and our rates of intervention are nearly 100% in some hospitals. That’s not because those interventions are necessary, unless you believe that women are born fundamentally broken. We are NOT broken. As Ina May says, “Your body is not a lemon.” We’ve internalized this misogyny for too long. Yes, some women need modern science for birth. MOST women do not. I’ve had the cesarean that nearly killed my spirit. I had the vaginal birth in the hospital that I practically needed lawyers at my bedside for. And I had the beautiful, swift, safe, practically PAINLESS homebirth that made me feel more connected to my body and baby than I ever thought possible.

    Dr. Amy’s “science” is junk. It’s embarrassing to other physicians. And she’s just a plain horrible human being.

    • Posted January 3, 2012 at 6:14 pm | Permalink

      I am sorry that you had bad hospital experiences, and I agree that Dr. Amy is mean. However, it does not necessarily follow that the science that she cites is junk, nor that women who choose to have birth in a hospital are being anti-feminist, nor that all hospitals are horrible places to give birth.
      Likewise, the fact that you had a safe homebirth (wonderful!) does not mean that all homebirths are safe, nor that any pregnancy, regardless of risk factors, is safe to finish at home. A close friend of mine (the ER clerk at the hospital where I work, and the wife of my colleague) had a safe, normal hospital delivery (her 3rd child, after 2 deliveries with no problems), followed by a placenta that tore her uterus; even though she was literally 5 minutes from the OR and an emergency hysterectomy, she still ended up taking several units of blood just to get her up to a ‘safe low’ level. If she had had that child at home, even half an hour away, she would have died.
      I work in a rural hospital in an area where many women choose homebirths, and in the 10 years or so that I’ve worked there I’ve seen about half a dozen women dragged in from failed home births. Sometimes they and the baby are ok after receiving adequate medical care; sometimes they’re not. Once the mother had brain damage from having been without oxygen for too long after going into full-blown ecclampsia, attended by a lay (read: barely trained) midwife who didn’t want to ‘medicalize’ the birth by so much as taking her blood pressure (an hour out from the nearest hospital, natch); twice, the mothers have bled out from abruptions (once resulting in a dead mother, the other time in a nearly dead mother and a dead baby). Once there was a baby with permanent brain damage from a shoulder dystocia. Now, during that same time, there must have been literally hundreds of homebirths that went off without a stitch, but that doesn’t mean that homebirths are ‘safe.’
      I’d also like to point out that not all hospitals are the patriarchal hellholes that many homebirth advocates paint them as. At my hospital the birthing rooms are basically bedrooms, complete with big beds and wallpaper and decorations; we have one male Ob-Gyn, one female Ob-Gyn, and a couple of female CNMs. Off the top of my head, I’d say that our ceasarian rate is 20% (I’m erring on the side of more here) or less – mainly, because that’s what the women who give birth here want. We do have a high rate of epidurals (>50%, I think), again because that’s what the mothers want. Likewise, we have a very high rate of inductions because it means that the mom gets to choose which midwife/Ob-Gyn she wants to have attending her and when she’ll have her baby. Inductions are not pushed on a mother unless she’s post-due, because later delivery is worse for both the mother and the baby, not because it’s some patriarchal conspiracy.
      Up at the nearest private hospital, I’d guess that they have a much lower rate of epidurals and a somewhat lower rate of ceasarians, but a less homey atmosphere.

      Women should get to choose where and how they give birth, and they should be informed of the issues before they make that choice by the professionals they deal with. Home births have a much higher risk of death and serious injury for both mother and infant (though still less than 10% for both); hospital births have a much higher risk of precautionary and/or chosen medical interventions for both mother and infant (greater than 50% all told), and a much lower risk of death or serious injury. Pretending that one side or the other is perfect and completely without risk is a disservice to everyone, and is simply not in congruence with reality.

      As a final note I’d like to point out that many lay-midwives have very minimal training and take zero precautions prior to delivery; something as simple as taking the mother’s blood pressure on a regular basis is essential, but often left out; likewise, too few lay midwives recognize warning signs like turtling, blood/meconium in the amniotic fluid, headache, and extreme pain. A more formal training and licensing program for midwives (ie, allowing CNMs to practice outside the hospital) would benefit everyone.

    • Posted January 4, 2012 at 5:44 pm | Permalink

      Gina (aka Feminist Breeder), Amy Tuteur never “publically wished” your baby would die. What a bizarre claim to make! Why do you want to libel her?

  13. Posted January 3, 2012 at 3:27 pm | Permalink

    Dr. Amy is not a practicing OB. Her “career” exists solely of trolling pro-natural/homebirth articles so she can copy and paste her usual, biased opinion on why those of us who choose to give birth naturally and in the privacy of our home — as countless mothers have before us — are endangering our lives and those of our babies. It’s insulting, it’s despicable, and her “facts” are skewed. Ignoring her will serve you well.

    As a feminist, a mother, and a homebirther, I could not be more pleased that Feministing shared this piece on Ina May. Reproductive choices are not and should not be limited to pre-birth issues alone. Our rights as women and as mothers are in jeopardy thanks to people like Amy Teuter, whose ultimate goal is to make homebirth illegal and to drive Certified Professional Midwives like Ina May into hiding and out of legitimate practice. This, dear friends, will not do much to curb the incidence of homebirths, however. Women like me who have vowed never to birth our children in a hospital again, where we’ve been subject to humiliation, belittling, even birth rape, will still birth at home. Except without legal, available options these homebirths will start to become unassisted ones if the opposition is successful. This is risky for mothers and babies alike and we should all join in the fight to prevent such a future from happening. (Is this starting to sound like any other reproductive choice-related issues for which we fight? Are they really that dissimilar?)

    Legalizing CPMs, legitimizing homebirth in the eyes of insurance companies, and putting an end to the fear-mongering from the medical establishment (and its trolls) will ensure that mothers will have safe options to birth however they choose. Because ultimately, that’s what it comes down to. Choice. Homebirth may not be right for you and nobody should force you to have one. The same, though, can be said for a hospital birth.

    Thanks, Feministing, for connecting the dots.

    • Posted January 3, 2012 at 4:41 pm | Permalink

      “Dr. Amy is not a practicing OB.”

      How does that affect the validity of my claims? Oh, right, it doesn’t. It’s what is known as an ad hominem attack, a typical ploy used to attack a person when there is no evidence to attack that person’s claims.

      How about addressing the actual claims? Do you have any evidence to rebut the following empirical claims?

      1. Homebirth isn’t safe. All the existing scientific evidence, as well as state, national and international data show that homebirth has an increased risk of newborn death.

      2. The only scientific study of The Farm (Durand, 1992, reprinted in full on Gaskin’s website) compares homebirth to a study of HIGH risk births. That was the only way to make the appalling death rate at The Farm look acceptable.

      3. Ms. Gaskin is a feminist anti-rationalist.

      4. Ms. Gaskin claims that modern obstetrics is misogynistic and patriarchal, but seems to have missed the fact that most obstetricians are now women.

      5. Ms. Gaskin’s claims about Semmelweis are nothing more than nonsense.

      I will also additional empirical claims.

      The CPM credential was made up by Ms. Gaskin and colleagues to give themselves a “degree” in the absence of any midwifery education or training.

      The CPM credential is does not meet the education or training requirements of ANY other first world country. ALL other industrialized countries require a minimum of a college degree in midwifery. The CPM requires only a high school diploma.

      To this day, a major proportion of women who receive the CPM have never attended ANY midwifery educational program. They receive the credential by submitting a “portfolio” of births they have attended.

      Finally, Ms. Gaskin lost one of her OWN children at homebirth because she refused to seek appropriate medical care.

      Homebirth leads to preventable neonatal deaths. Ms. Gaskin knows this from personal experience and from the published findings of perinatal deaths at The Farm. In addition, all the existing scientific evidence, and statistics show that homebirth has an increased risk of newborn death.

      There is nothing feminist about letting babies die preventable deaths while ignoring science in favor of women’s “intuition.”

      • Posted January 3, 2012 at 7:10 pm | Permalink

        Sorry, “doctor,” but the onus isn’t on me to disprove your claims; it’s on you to prove them. So let’s see some citations. Specific, current ones, please. Oh, and preferably not those who lump all homebirths — including those that were unplanned and/or were unassisted, as they obviously skew the numbers — together.

        • Posted January 4, 2012 at 9:25 am | Permalink

          Suzanne,

          You don’t have to disprove my claims, but you do have to prove yours. YOU made the claim that my comment is “her usual, biased opinion on why those of us who choose to give birth naturally and in the privacy of our home … are endangering our lives and those of our babies.”

          If I am biased and wrong, as you claim, you must offer some scientific evidence to support that claim, and thus far you’ve offered none. Therefore, it’s just a basic ad hominem attack, the classic ploy used to attack a person when there is no evidence to attack that person’s claims.

      • Posted January 4, 2012 at 2:32 pm | Permalink

        I really feel like your points should be addressed individually.

        1. You claim homebirth isn’t safe for newborns. Prove it. Cite something, link something. What I have read proves otherwise. Also, you mysteriously don’t mention how safe or unsafe it is for mothers. Hospital birth is notoriously unsafe for mothers in the USA (maternal mortality has doubled in the last 20 years, and most women still have their babies in the hospital — where the C-section rate is over 30% nationwide): http://abcnews.go.com/WN/changing-life-preventing-maternal-mortality/story?id=9914009 (See how I did that?)

        2. You claim the The Farm has an “appalling death rate.” I would really like to know how you determined this. Again, prove it. Were these neonatal deaths that happened before the mother even went into labor, for example? Were these neonatal deaths due to genetic deficiencies? Were these miscarriages? You cannot make such a scandalous claim as this one and not back it up.

        3. You claim Ina May Gaskin is a “feminist anti-rationalist.” That is your OPINION. I have actually had the pleasure of meeting Ina May and have read her books and I can tell you from everything I know about her, she is a very rational person. Just because she doesn’t immediately dismiss human emotion doesn’t make her “anti-rationalist.”

        4. “Ms. Gaskin claims that modern obstetrics is misogynistic and patriarchal, but seems to have missed the fact that most obstetricians are now women. ”

        Guess what, Amy? Women can be misogynistic and patriarchal, too! *gasp*

        Modern obstetrics IS misogynistic and patriarchal, and even if OBs are female, they are working within a patriarchal and misogynistic system. Perhaps with more women in it, it will slowly change over time to better accommodate the needs of women. I have witnessed a little bit of that myself… However, that does not change the fact that RIGHT NOW modern obstetrics is misogynistic and patriarchal.

        5. “Ms. Gaskin’s claims about Semmelweis are nothing more than nonsense.”

        Why would you even bother to write this here? Upon perusing the web, it’s easy to see that Ina May’s version of Semmelweis’ story is correct: http://semmelweis.org/about/dr-semmelweis-biography/ Why would you try to discredit Ina May like that when you’re not even right?

        Additionally you write: “Finally, Ms. Gaskin lost one of her OWN children at homebirth because she refused to seek appropriate medical care. ”

        That baby was born too soon, and NO amount of medical care would have been “appropriate” enough to save it, especially back then. I am thoroughly APPALLED at how heartless and unprofessional you are. Just, wow. You know she’s a REAL HUMAN BEING, right? I feel sorry for your patients. Is this how you’d treat them when something went wrong with their pregnancies? If being a cruel, cold-hearted, inaccurate robot is what makes a person an “rationalist” in your eyes, then I guess you’re right because Ina May is the opposite of that.

  14. Posted January 3, 2012 at 3:33 pm | Permalink

    Thank you for interviewing this amazing woman! Birth is not acknowledged enough as an issue that needs dire attention from the Feminist community.

  15. Posted January 3, 2012 at 3:49 pm | Permalink

    Love the article. Thank you. Ina May helped me form my thoughts in how I perceive myself as a woman and a mother and a feminist.

    As for home birth safety I have analyzed WA state’s data on home-birth myself, though some may say I have no business doing so (same as they would say Ina May has no business delivering babies as she is self-taught) http://bangerlm.blogspot.com/2011/11/is-home-birth-safe.html and it is safe in prudent conditions. Having a hospital back-up is what makes it safe. No, it isn’t for everyone, but women SHOULD have the choice and SHOULD have the information.

  16. Posted January 3, 2012 at 4:01 pm | Permalink

    I had a natural birth on The Farm in November 2010 with Ina May in attendance, and it was one of the most wonderful, peaceful, incredible experiences of my life. I’d had one birth in a hospital prior to that and even though I loved (still love) my OB and respect her tremendously, the hospital experience was immensely disappointing. The unnecessary cover-your-ass hospital protocols were part of what made the hospital experience unnecessarily unpleasant. One really bitchy post-partum nurse is another part of that. I have no complaints about my OB, but her hands were tied by having to kowtow to the rigid hospital policies and her own malpractice insurance.

    I learned better for my second birth, did my research, weighed the risks (hospital birth has its own risks, btw, which I took into account in addition to the risk of natural birth outside a hospital) and decided what was best for my situation and family. Turned out wonderfully. My 8 lb, 7 oz son was born with an Apgar of 10/10, and I was very well taken care of post-partum (by Ina May herself). She really walks the walk. The disparaging words hurled at her so unfairly are not even based in fact, and frankly, I’m appalled that a doctor is the one spewing them.

    Ina May is indeed a feminist. Giving birth is DEFINITELY, without a shadow of a doubt, a feminist issue. Fact is, women do not have much choice in how they birth when they do it in a hospital. They are at the mercy of arbitrary protocols, unnecessary procedures, and an unfamiliar, often frightening and overwhelming environment — not exactly a great place for labor and birth. If only the medical establishment would truly honor and respect the wishes of their laboring patients and not cater instead to the whims of hospital protocol and insurance (or, even worse, their own convenience — which I will point out, my OB did not do this last; she actually treated me very well)… Perhaps then women wouldn’t feel such a strong pull to avoid them like the plague, which, btw, hospitals are great breeding grounds for.

  17. Posted January 3, 2012 at 4:33 pm | Permalink

    Any time a right is not applied to men and women equally, it is a feminist issue. The Patients Bill of Rights is NOT being applied in much of maternal care today, including, but not limited to, informed consent and refusal. The standard of care for maternity care is also not up to other parts of the American healthcare system, as demonstrated by our abysmal mother/baby outcomes compared to the rest of the developed world. And when an exclusively women’s branch of care does not measure up to other branches of care, that is a feminist issue. As I see it, Ms. Gaskin acknowledges that, fights to end the disparity, and offers a valid alternative (which patients voluntarily seek) that has excellent outcomes. Why would any feminist fight that? If you don’t choose her care, vote with your wallet and go somewhere else. But we need to unite in advocating for women to have full rights as human beings in the birthing process.

  18. Posted January 3, 2012 at 4:53 pm | Permalink

    Stella — you rock! Your points are definitely those that I agree with!

    There are plenty of people in the medical community that have opted for homebirths — I’m one! I initially earned a degree in biology but found my calling as a nurse. One of my good friends planned a homebirth, but went into labor early. Her midwifes, along with an OB, assisted her at the hospital to have as close to the birth she wanted (she squatted, and walked and used a birthing pool). (This OB’s wife has had three homebirths by the way)

    I have supported my friends and family that have had hospital births and those that have had c-sections. Encouraging them to look at all their options and sharing with them the reasons why I did what I did is far from shaming. It’s just letting them know about my journey.
    I had to find support from other homebirther/natural birthers because there were plenty of people that had no problem telling me that I wasn’t going to be able to do it without painkillers especially since it was my first child. (I still consider some of these naysayers friends and even feminists — sometimes we all say things that can seem shaming or un-empowering, but we learn)

    Here’s a beautiful story about a homebirth — I don’t think these women can be accused of ignoring or not understanding scientific evidence

    http://www.avivaromm.com/grandbaby%20birth

  19. Posted January 3, 2012 at 5:58 pm | Permalink

    Thanks for this great article! I hope women will be inspired to examine all their birth choices, and not simply accept the fear-mongering statistics thrown around by the anti-homebirth crowd. I have had one birth in a midwifery clinic and three homebirths, all healthy and safe, all assisted by ‘uneducated’ women, and those experiences have been the most empowering, life-changing events of my life. It is true that many OB’s are female now, but the medical industry as a whole has been directed by males for the entirety of modern history, and is now also heavily influenced by insurance companies and pharmaceuticals. And while I don’t have an issue with male doctors per se- but, as my first midwife pointed out, men don’t have babies. It is difficult for a male-dominated industry to truly support and understand what is an implicitly female activity. Instead, they view it as a disease (like the kidney stone comment) to attack and defeat and survive, rather than as a beautiful, well-designed function of the female body. Thanks again for posting this!

  20. Posted January 3, 2012 at 6:11 pm | Permalink

    I first want to say that I’m really happy to see this post. I definitely think that birth is a feminist issue.

    My own experiences giving birth had a tremendous impact on my feminism. The thing that frustrates me the most (and it’s happening here in these comments) is the stark dichotomy that birth gets thrown into. Either you have a hospital birth full of interventions or a home birth without any. When people fight for women’s rights to choose a “natural” birth, that often gets boiled down to home births. While I ABSOLUTELY support a woman’s right to choose a home birth and completely understand why someone would make that choice, it wasn’t the right one for me.

    I was most comfortable giving birth in a hospital. I appreciate medicine and medical advances (as I suspect most people do). I wanted to have access to those if something went wrong, and I know things can go wrong. I had a medication-free birth in a hospital, but I had to fight for it. I had to fight to be able to stand up out of the bed. I had to fight to not have an IV full of unnecessary medications thrust into my vein the second I was admitted. I had to fight not to be induced because my baby was “measuring big” (even though there were no other signs of complications and the ultrasound ended up being over a pound off). I had to fight to have control over my own body, and I was treated like I was ridiculous for wanting it. If that’s not a feminist issue, I don’t know what is.

    I read Ina May’s book to help prepare me for that fight, and though my birth was in a much different setting than the Farm, I appreciate her work immensely and credit it with giving me the courage and the voice to stand up for myself.

  21. Posted January 3, 2012 at 6:14 pm | Permalink

    Those who say that statistics show homebirth as being dangerous need to realize that those statistics are usually including UNPLANNED homebirths. This means that they are emergencies, to moms who are unprepared, unwilling or unable to birth safely at home and shouldn’t be there in the first place. Planned homebirths and unplanned emergencies at home should not be counted as the same thing, yet they frequently are.

  22. Posted January 3, 2012 at 6:57 pm | Permalink

    I’d like to respond to the claims that the empirical data on home-birth has shown it to be less safe than a hospital birth. Here in the UK a comprehensive, widely published and peer reviewed study was conducted by the clever people at Oxford University (perhaps you’ve heard of it?). Here is a link: https://www.npeu.ox.ac.uk/birthplace

    It makes for interesting reading. The conclusions were that home-births and births in free standing midwifery units were JUST AS SAFE for low risk mothers as births in hospitals. Not only were they just as safe, but they offered considerable benefits in that women ended up with less interventions and less c-sections. The study showed that there was a slight increase in neonatal deaths for first time mothers planning a homebirth. Unfortunately, we are not told how many of these women actually gave birth at home and how many transferred and ended up giving birth in hospital. Interestingly the study does warn of the dangers of conducting certain interventions at home (such as ARM) when there is no medical backup. This has led to some speculation that this was a contributory factor in the increase . For women who’d had babies before there was no increase. Neither was there any increased risk for mothers or their babies (regardless of how many times they had given birth previously) who planned their birth in a free standing midwife centre.
    Of course our medical model is very different here in the UK to yours in the US. We have access to free nationalised healthcare that is not driven by profit (although the constant cost cutting can be an issue). However this seems to be a good thing for maternity care since successful home births are considerably cheaper than failed hospital ones! Our doctors and midwives have a duty of care, which means that if you demand that they attend you at home they cannot refuse. That’s not to say our own system doesn’t have its problems, because it certainly does, but I won’t go in to those here.
    I would also add that other Northern European countries such as Denmark and Holland have far more impressive statistics than ours concerning both maternal and neonatal morbidity and health. Approximately a third of all women give birth at home with a midwives in these countries . Their midwives are highly trained, better paid, well respected and up to date with the latest in evidence based study. They know that all pregnancies, all births and all women are unique. They recognise that for MOST women a natural birth is both healthier and psychologically more satisfying and understand how best to facilitate that. They know that SOME women require potentially life saving medical interventions. most importantly they know how to tell the difference between the two and that is the key to being a good maternity care provider.

    I am a feminist. I believe that women should be told the truth about birth. I believe that profit has no place in healthcare. I believe that all women should have access to skilled highly trained midwives if that’s what they want. I believe that they should also have access to skilled highly trained obstetricians if that’s what they need. I believe that not only should they have the right to choose where they give birth, but that their choices should be full supported. I believe that many women are being harmed unnecessarily by the current model of care both physically and mentally. I believe that we need to work towards making home births safer, and making hospital births safer and more satisfying. I believe that it is both possible and highly desirable (for the sake of our physical and mental health) to drastically reduce the number of routine and unnecessary interventions that typically take place in birth. I have no interest in spirituality or intuitions and certainly don’t believe that something which is natural is always necessarily better. I get irritated when people use a language of spirituality to talk about birth (seriously guys, it does us no favours)! What I do believe in is EVIDENCE BASED care. That is why I support home-birth.

    • Posted January 4, 2012 at 3:44 pm | Permalink

      Thank you, Tracy!

    • Posted January 4, 2012 at 3:55 pm | Permalink

      Tracy Sealey, nice of you to mention the Birthplace study. It really is a very good study, but a few points need to be made.

      The first is that the “slight increase” in neonatal death for first-time moms was actually a DOUBLING of the death rate. If you want to call a doubling a “slight increase” I question your ability to read the study, but no matter.

      Secondly, the midwives were REAL nurse midwives, not CPMs like most American homebirth midwives, highly trained, following strict protocols. No prior pregancy complications, no breeches, no vbacs. There were also strict protocols for transports, resulting in a transport rate of OVER 40 per cent. And because the midwives have hospital credentials (unlike CPMs who don’t have enough training to get hospital credentials) transport was fast and care seamless.

      In short, the Birthplace study represents homebirth in the best of all worlds: highly trained midwives, protocols strictly followed, rapid transport. None of those things, not one, is prevalent on the homebirth scene in America, which is why we have the miserable homebirth statistics (as the CDC Wonder database shows) that we do.

      The problem isn’t the place, it’s the Certified Professional Midwives. They are not uniformly well-trained, and they fail to follow reasonable protocols. And Ina May Gaskin is the driving force behind their “credential.”

    • Posted January 4, 2012 at 11:58 pm | Permalink

      Tracy, thanks for mentioning the “language of spirituality.” I’m an atheist science-minded feminist. I want to talk about birth as an evidence-based process, not some kind of spiritual awakening. I’m not spiritual. My son’s birth wasn’t spiritual. It was really cool, and amazing, and at times terrifying, but I didn’t have some kind of spiritual journey. We do ourselves a disservice by couching birth in those kind of vague, spiritual terms.

  23. Posted January 3, 2012 at 8:59 pm | Permalink

    Thank you for including birth as a feminist issue! There is plenty of evidence that planned homebirth is a safe option for most women, and at the end of the day, it’s her body, her birth, her baby, her choice!

  24. H
    Posted January 3, 2012 at 9:59 pm | Permalink

    I am so thrilled to see this article because I think that childbirth issues should get much more coverage from the feminist community than they do. While homebirth may not be a good or even desired choice for everyone, it’s essential to all of us that we have alternatives in childbirth options. Hospital birth is practically the epitome of managing women’s bodies, exposing them to often unnecessary and risky procedures that are proven to have little benefit to either mom or baby. Most hospital interventions are done for financial/insurance reasons to protect OBs from lawsuits. They give you a maximum of 12 hours to be in labor because OBs can’t be at the hospital all day and the hospital needs the beds free, not because all labors should take <12 hours or because going longer is a sign of something wrong. Women's bodies are designed to push out babies, but we're supposed to be more upright; when you lie flat on your back, strapped to fetal monitors, you're working against gravity.

    One of out of three babies are now delivered by c-section. As much as women are told and like to believe that their c-sections were "emergencies" and that their babies would've died without them, in most cases it isn't true but the hospital has to present it that way to justify the surgery. You can't tell me that suddenly 1/3 of women can't give birth naturally; the human race would've died out long before now.

    Hospital birth is needed in high-risk cases, true emergencies and for women who prefer it. However it should never be our only option. If you truly want to find out why this is a feminist issue, I recommend reading books like "Pushed" by Jennifer Block or watching "The Business of Being Born." You might just change your mind; I did.

    • Posted January 6, 2012 at 1:20 pm | Permalink

      You can’t tell me that suddenly 1/3 of women can’t give birth naturally; the human race would’ve died out long before now.

      Actually, in history, before medical care became standard, it was not uncommon for 1/3 of women in any given area to die in childbirth. I understand WHY you said this, but it is dismissive. I am pro-homebirth and midwife, but that is because most midwives ARE medically trained (I wouldn’t trust one who could not display basic medical, biological and physiological knowledge). But go to a really old graveyard sometime and look at how many gravestones there are for women who died in their childbearing years. They’re there for a reason – because childbirth IS dangerous and needs to be assisted by somebody. Diminishing the need for medical services doen’t help your argument.

  25. Posted January 3, 2012 at 11:20 pm | Permalink

    I am APPALLED that this woman is being glorified on a feminist blog. As a 30 year practicing RN in one of our nation’s top NICUs I cannot begin to count the number of ‘low risk’ pregnancies that suddenly become obstetric emergencies to save the lives of the infant and/or mother. People who say ‘I feel comfortable, because the hospital is (X) min away… That is DRIVING distance, it doesn’t take into account that you cannot transport a woman in the middle of childbirth complications in a car. It doesn’t take into account the amount of time it takes the ambulance to get there, place you into the rig, and drive off Code 3. People don’t realize how little time it takes for asphyxiation of the infant to take place or how little time it takes to bleed to death. People don’t realize the complications of a meconium aspiration from a stressful birth process, all things we are both trained for and have the equipment to deal with. I can tell you that several times a year, we do get transports to the NICU of home births gone bad, and most of the results are preventable, and some are tragic. Before the modern era, childbirth was the most dangerous time during a woman’s life. Gaskins is NOT working to prevent infant/maternal mortality/morbidity, she is adding to the problem.

  26. Posted January 4, 2012 at 3:39 am | Permalink

    If homebirth is not safe, then what are we doing in the Netherlands? Homebirth is the norm here, only when there is a medical need do you give birth in a hospital. Women with normal pregnancies will probably never see a gynaecologist theire entire pregnancy, they go to a trained midwife and she delivers the baby. Homebirth would certainly not be the norm is it was not safe to do so.

    If there is an increased rate of neonatal deaths in homebirth, then this should be attributed to the rigth causes. The absence of a trained midwife for example.

    • Posted January 4, 2012 at 9:17 am | Permalink

      “If homebirth is not safe, then what are we doing in the Netherlands?”

      The Netherlands has one of the highest perinatal mortality rates in Western Europe and a high and rising rate of maternal mortality.

      A recent study in the BMJ, Perinatal mortality and severe morbidity in low and high risk term pregnancies in the Netherlands: prospective cohort study (BMJ 2010;341:c5639), is a stunning indictment of Dutch midwifery. The study showed that Dutch midwives caring for low risk women have a HIGHER mortality rate than Dutch obstetricians caring for high risk women.

      An even more recent study, Planned Home Compared With Planned Hospital Births in The Netherlands (Obstetrics & Gynecology: November 2011, 118:5, p 1037–1046), noted:

      “… The data from an otherwise very similar country such as Flanders suggest that more favorable results may be expected in low-risk women in general from a hospital-based system. In Flanders, perinatal mortality is approximately 33% less than in The Netherlands, whereas the cesarean delivery rates show little difference.”

      The homebirth rate in the Netherlands is currently 27% and falling. One of the reason that the homebirth rate is declining is that women fear the high perinatal mortality rates of Dutch midwives.

      • Posted January 4, 2012 at 12:27 pm | Permalink

        I’ve just looked up the most recent study that Amy refers to. Here is a link in case anyone is interested in doing the same: http://journals.lww.com/greenjournal/Abstract/2011/11000/Planned_Home_Compared_With_Planned_Hospital_Births.11.aspx

        It says:
        “RESULTS: Intrapartum and neonatal death at 0–7 days was observed in 0.15% of planned home compared with 0.18% in planned hospital births (crude relative risk 0.80, 95% confidence interval [CI] 0.71–0.91). After case mix adjustment, the relation is reversed, showing nonsignificant increased mortality risk of home birth (OR 1.05, 95% CI 0.91–1.21). In certain subgroups, additional mortality may arise at home if risk conditions emerge at birth (up to 20% increase).

        CONCLUSION: Home birth, under routine conditions, is generally not associated with increased intrapartum and early neonatal death, yet in subgroups, additional risk cannot be excluded.”

        In other words Amy Teuter is talking out of her arse. The results quite clearly show that planned Home birth for low risk women in the Netherlands is just as safe as hospital birth.

        • Posted January 4, 2012 at 12:36 pm | Permalink

          Also The Netherlands has a perinatal mortality rate of about 3.5 per 1000 live births compared with a rate of 6.23 in the US. I’m not sure therefore on what basis Amy can claim that Dutch midwives have a “high” perinatal mortality rate.

      • Posted January 5, 2012 at 1:00 am | Permalink

        The abstract of the first study:
        http://www.ncbi.nlm.nih.gov/pubmed/21045050
        Infants of pregnant women at low risk whose labour started in primary care under the supervision of a midwife had a significant higher risk of delivery related perinatal death than did infants of pregnant women at high risk whose labour started in secondary care under the supervision of an obstetrician (relative risk 2.33, 1.12 to 4.83). NICU admission rates did not differ between pregnancies supervised by a midwife and those supervised by an obstetrician. Infants of women who were referred by a midwife to an obstetrician during labour had a 3.66 times higher risk of delivery related perinatal death than did infants of women who started labour supervised by an obstetrician (relative risk 3.66, 1.58 to 8.46) and a 2.5-fold higher risk of NICU admission (2.51, 1.87 to 3.37).
        CONCLUSIONS:

        Infants of pregnant women at low risk whose labour started in primary care under the supervision of a midwife in the Netherlands had a higher risk of delivery related perinatal death and the same risk of admission to the NICU compared with infants of pregnant women at high risk whose labour started in secondary care under the supervision of an obstetrician.

        So the abstracts contradict each other; without access to the articles themselves, it’s difficult to say more than that.

        Wrt. the high American morbidity and mortality rate, a significant proportion of that is assoicated with the fact that a huge segment of our population (especially our minority population) is extremely poor and/or has no health insurance and thus access to neither hospital prenatal care nor midwife care, and thus gives birth in near 3rd-world conditions; in addition, we have a greater-than-average obesity and diabetes rate, leading to larger-than-average infants and thus more difficult births. Direct comparisons of US morbidity/mortality rates with those of any other western nation serve no purpose but to further the very general point that we’re doing healthcare wrong.

    • Posted January 4, 2012 at 10:09 am | Permalink

      I would add to Rosa’s comment that the Netherlands has a maternal death rate of just 7.6 per 100,000 live births compared to 8.2 in the uk and a massive 16.7 in the US and is ranked as one of the safest countries in the world in which to give birth.

  27. Posted January 5, 2012 at 1:36 am | Permalink

    There’s a point that I’m seeing a lot that I’d like to address, exemplified by H’s comment, “Hospital birth is practically the epitome of managing women’s bodies, exposing them to often unnecessary and risky procedures that are proven to have little benefit to either mom or baby. Most hospital interventions are done for financial/insurance reasons to protect OBs from lawsuits.”
    Firstly, hospitals plan for the worst possible outcome from the outset. Just as an example, every single woman who comes in to labor and delivery has a tube of blood drawn to hold in the hospital’s blood bank (the sole exceptions being when she delivers so fast that it’s a moot point by the time that the lab tech arrives in her room), so that blood can be crossmatched right away if she does start to bleed or need a transfusion. For the vast majority of women, this is an ‘unnecessary medical intervention;’ for a few, it’s what keeps them from receiving a bunch of uncrossed O- blood in the case of an emergency (though it’s called ‘universal donor,’ it isn’t quite universal – just lower risk, and not as good as crossmatched blood).

    In contrast, most of the lay midwives and homebirth advocates whom I speak with assume that everything will be fine, to the degree that they sometimes fail to deliver a reasonable standard of care, miss warning signs, and are unprepared when things do go wrong. Most of the time they’re right, and the medical care provided in a hospital would have been “unnecessary intervention.” However, when they’re wrong, that intervention becomes more than just a matter of convenience.

    Secondly, to echo a point made by rc above, all health care is about managing people’s bodies. Whether you’re a man or a woman, in a critical situation the doctor has a legal presumption of consent to keep you alive. Just as an example, it’s very routine for ER docs to cut a hole in the side of a trauma patient’s chest, while the patient is conscious, without any anesthesia, and then shove a tube into their chest cavity. This is done without much explanation to the patient besides, ‘YOU’RE GOING TO FEEL A STING OVER HERE!’ (all caps because the doc is shouting). It’s done because it’s part of saving the patient’s life. We poke people with needles regardless of gender, we insert urinary catheters regardless of gender, we give sponge baths regardless of gender, and we strap demented/incoherent/ patients to their beds regardless of their gender and hold children down for necessary procedures regardless of their gender (for those of you thinking ‘hippocratic oath!’ at this moment, please see http://en.wikipedia.org/wiki/Hippocratic_Oath).

    I will be the last one to claim that there isn’t still bias in both diagnosis and care. In too many hospitals (not all of them), the focus is placed too much on the fetus/infant rather than on the mother. But healthcare is about managing bodies, whether it’s the mother’s or the infant’s.

    • Posted January 10, 2012 at 2:07 am | Permalink

      You know, it’s kind of disingenuous to talk about admissions blood workups (which in a good hospital are done as part of pre-admissions so that no one is making a woman in active labor have a draw “just in case”) when discussion the medical interventions that make hospital birth the contentious thing that it is.

      Why not talk about electronic fetal monitoring? Almost every hospital will require it, if not continually, occasionally until birth is complete. And yet the person who invented EFM and developed the standards for its use never intended for it to be used for every pregnancy. And more importantly, EFM has never been shown to improve outcomes, and has, instead, been shown only to increase the number of c-sections performed.

      Why not talk about pitocin, the synthetic hormone that pops up in some hospitals in as many as 80% of births, artificially lengthening and strengthening contractions and often causing fetal distress, but “necessary” to make sure birth happens within the cookie cutter schedule required by the hospital. Individuality of birthing people’s bodies notwithstanding.

      Why not talk about epidurals? Artificial rupture of membranes? Episiotomies?

      Why go to one of the most benign and obvious interventions, one that has almost no downside whatsoever (save for those with needle issues or bleeding problems) rather than addressing the actual practices of intervention that actually cause women to look to birth outside of the hospital environment?

  28. Posted January 5, 2012 at 7:43 am | Permalink

    Thanks so much for this interview of Ina May–who was indeed one of the midwives of modern midwifery. I can’t call her THE midwife of modern midwifery, but I honor both her own work and her contributions working with many other courageous womyn who brought homebirth and midwifery back to life in this era. I think of her, in terms of feminism, as an important bridge between the scholarly theorist feminists and those who have chosen to live their feminism via primary work in family and life.

    Thanks, too, to those commenters who have worked here to clarify the confusion brought to bear upon homebirth by people such as AT…a person who, with her deep misogyny and thoroughly manipulative, thoroughly anti-science position, has made it her life’s work to undermine homebirth. Her reasons for this singleminded and even obsessive quest remain unclear although she likes to throw around words like ‘safety’ that too often snare the unwary. In any event, any womyn who values reproductive choice and empowered, informed consent in health care can take a look at all the evidence and perform their own rhetorical critique upon it, in making birth choices.

    As for those who claim that Ina May is not a feminist, I suggest that you think again. The great majority of womyn, even those who are self-identified feminists, will have a child/ren during their lives. While it is important that womyn remain solely empowered with respect to reproductive freedoms, and we all do best to respect the choice to remain childless–and while I have been grateful indeed for feminists who choose to focus their creative urges upon feminist scholarship and feminist activism without distraction family making–the fact is, most womyn do have babies. And all womyn, whether or not they identify themselves as feminists, must have the right to choose birth care from an informed, empowered postition.

    Feminism is not just about oppression-critique and political activism. Any feminism worth it’s salt to all womyn, is one that attends to the realities of womyn’s ordinary lives. I for one have been deeply disappointed that modern feminism has focussed ‘reproductive rights’ work upon abortion and birth control to the exclusion of birthing matters/rights. Abortion and birth control are indeed hugely important to us! And they are simply NOT more important than a womyn-centered, feminist approach to childbirth. How much more feminist does it get than to focus one’s sights and work upon actual living womyn, on our physical, mental and spiritual health in childbearing and family making, as Ina May has done?

    That said, I don’t consider Ina May to be my primary example of feminism within midwifery. As I said earlier, I think she has been an important bridge–and I deeply honor her work even if I don’t see her as much a feminist as I’d like her to be. Her work as a womyn, for womyn, has helped childbearing womyn and midwifery to make great strides, whether or not she personifies anyone’s philosophical brand of feminism.

    And I agree with the previous poster who noted that the ‘Gaskin Manuever’ is a misnomer and one that I wish she’d avoided. This birthing postition to relieve stuck shoulders during birth was something she was taught in Guatemala, by midwives who had been using this method for many many generations. I am somewhat dismayed that she chose to name it after herself, instead of calling it The Mayan Manuever or something more historically correct and appropriately respectful of the womyn who actually did invent it. Her defense of this (years ago, anyway, as I heard it from her) is that ‘I do this because in medical practice, male doctors also name things after themselves–we midwives can create standing and legitimacy within the medical world by adopting their habits in this respect’. I have no interest in creating standing for midwives within the male-dominated and relentlessly misogynist medical world…and it greatly offends me that so many aspects of pregnancy and birth are named for men doctors. Most of this doesn’t simply refer to their personally invented methods, but even to womyn’s physiologic processes that some male doctor happened to discover. In Ina May choosing (or accepting) Gaskin Maneuver, I see an example of what I call ‘feminists trying to be more like men in patriarchy’, something that will never serve womyn IMO. However, again Ina May may not be everyone’s feminist cup of tea, but the value of her work for womyn otherwise cannot be underestimated.

    Thanks to feministing for posting this, and to all commenters who helped clarify homebirth safety with appropriate research references.

  29. Posted January 5, 2012 at 1:21 pm | Permalink

    To address LK Lowe’s points:

    First, to say ‘all health care is about managing people’s bodies’ is correct ONLY insofar as reference to Allopathic (western) Medicine is concerned. To clarify–any MD is an allopath. The kind of philosophy and methods they practice is allopathy. Because Allopathic Medicine has managed, through more than 100yrs of advertising campaigns along with intensive political lobbying, to gain a stronghold over healing practices generally along with medical law and social opinion, we tend to think as Lowe does: that “ALL health care is…:this, or that”, but we are in fact talking about all ALLOPATHIC care, which is quite specifically founded, philosophically, upon Dr management of a patient who is literally and legally subordinate to the Dr. The fact is, there are numerous healing modalities in the world, some of which (such as Chinese and Ayurvedic) have been around for a lot longer than Allopathy. They are not all based upon management of people’s bodies with practitioners having legal authority over people’s lives, although all of them certainly have a philosophy of health and illness which they employ. Midwifery as a specialty is not based upon ‘management’ of birth, or birthing womyn–it’s based upon support and assistance, a partnership in care. Because while it’s true that only a doctor can do surgery, only a pregnant womyn can give birth.

    Also, Lowe’s comparison of a birthing womyn to a trauma patient is apples to oranges but nonetheless she makes an important point–just not the one intended: pregnancy and birth are seen within allopathy as pathological in nature. Now, an infection, cancer or trauma from injury (to name some)–these are pathologies. Pregnancy and birth are NOT pathological, but what we call ‘physiological’ –natural processes. A great deal of the problems that womyn birthing in hospitals encounter, are caused directly and indirectly by the very treatment they are receiving from modern obstetrics. Rather than go into this here, I will suggest a read of Henci Goer’s works, and also Enkin et all’s Guide to Effective Care in Childbirth (book available PDF online). And check out the Cochrane Database–the late Dr Archie Cochrane established this database sometime back specifically for the examination of obstetrical practices because–as he said (in effect) of all the branches of medicine, obstetrics is the one most founded upon unproven myths. He wanted obstetrical theories and practices held up to close scrutiny!

    There is no doubt that homebirth can be made safest if womyn can receive a continuity of care with midwives and doctors/hospitals as needed. This is sorely lacking in most areas of the US. Not because homebirth activists and midwives have not worked tirelessly for the licensing of midwives and otherwise gaining legitimacy for homebirth from med practice. The fact is, the AMA and ACOG have both fought vigorously against midwifery and homebirth, and have continuously presented policies against homebirth as organizations. Because of this, it is local doctors and hospitals, often overtly hostile to homebirth families and midwives, who strenuously reject the continuity of care that can make homebirth safest.

    So, should birthing womyn and homebirth midwives just accept this misogynist, and utterly profit motivated behavior to interfere with birthing choice? Oh gee, sure docs, we womyn will wait around hopefully while you get good and ready to grant us respect? I think not!

    As for Lowe’s statement that ‘most of the midwives and homebirth advocates I speak with’…oh please. I’ve been a midwife since 1980, and I am certain that I know way more midwives, homebirth families and advocates than you do. Hundreds of midwives, thousands of families and advocates. Yes, there are some pollyanna types who are not sufficiently aware/educated among midwives and families both, and who do indeed assume everything will go well with birth when clearly this is not always the case. However the vast majority of womyn involved on both sides of the midwife/mama equation are highly informed and highly aware of what birth is about. In fact, homebirth mothers in general are enormously more informed about pregnancy, birth, testing options, possible complications and treatment alternatives than the average hospital birth consumer. They want to be sure of their choice to give birth at home, they want to be prepared for all eventualities, they almost always have to persuade family and friends not to think they’re crazy–so they do their homework. Whereas most families checking into OB/hospital care simply go in and turn themselves over to the Dr/Nurse gods, and assume they know what they’re doing. I can’t tell you the number of womyn who have come to me for a homebirth after a hospital birth or 2, saying “I learned the hard way why it is bad to turn myself over to med care without being informed about it. I learned the hard way that in a hospital, it is extremely difficult to have a natural birth because Drs/Nurses are trained for intervention/drugs/control of birth” Some of these mothers come in with physical scars left from needless surgical interventions, many of them arrive with emotional scars, and talking about ‘birth rape’ at the hands of controlling medical personnel. Some have babies who died, or were put at great risk, as a direct result of medical routines based on the medical notion that birth is pathology and womyn in birth must be saved from themselves.

    Birth is a physiological process, and in reasonably healthy womyn who are prepared for natural birth at home, and who further have reasonably skilled, alert midwifery assistance, most often birth goes just fine. It is true that complications can arise unexpectedly, but when birth is not interfered with at every turn, emergency complications are very rare. We will probably never find a way to prevent all death/injury around birth–life has risk. Staying home to give birth has some risk, because birth itself has risks. And going to the hospital is even riskier, because the hospital introduces MORE RISKS to birthing womyn and their families. So, we see very little difference between infant/maternal mortality rates between home and hospital, in low risk moms with competent care. But every good study out there shows that in hospitals, womyn and babies both are at considerably higher risk than at home, for infections and various injuries that arise from the medications and tools of obstetrics which are not used at home.

    Birth is very much a feminist issue. If you’re planning to have a baby, then do be sure to research these issues thoroughly so you can make the choice that makes the most sense to you.

  30. Posted January 6, 2012 at 11:52 pm | Permalink

    @ Hari: I stand corrected wrt. saying “all medicine.” I should have said, ‘allopathic medicine,’ ‘western medicine,’ ‘evidence-based medicine,’ ‘medicine that works,’ or ‘medicine worthy of the name.’ While there are indeed other modalities out there, western medicine’s dominance in the field is based on the fact that it works far better than any of the other ones for the vast majority of health isssues (and by “works,” I mean, “prevents, ameliorates, or cures health problems”).

    I wrote, “most of the lay midwives and homebirth advocates whom I speak with assume that everything will be fine, to the degree that they sometimes fail to deliver a reasonable standard of care, miss warning signs, and are unprepared when things do go wrong. To which Hari responded, oh please. I’ve been a midwife since 1980, and I am certain that I know way more midwives, homebirth families and advocates than you do. …Yes, there are some pollyanna types who are not sufficiently aware/educated among midwives and families both, and who do indeed assume everything will go well with birth when clearly this is not always the case.” While I’m sure that Hari has known more midwives and advocates than I have (I’ve conversed with maybe a dozen, though some were fairly high-up in the homebirth heirarchy), she herself displays the attitude that I was talking about in this very post, writing, “Pregnancy and birth are NOT pathological, but what we call ‘physiological’ –natural processes. ” I’m reminded of Catholic Bishop Thomas Olmstead, who excommunicated a nun for allowing a life-saving abortion at her hospital, and commented, “”An unborn child is not a disease.”
    Hari and Olmstead are both right: pregnancy and childbirth are not pathologies, and are not diseases – but they are among the most dangerous natural things that women can do, and pretending otherwise is displaying the anti-science bias that Dr. Amy accused the homebirth movement of displaying.

    Wrt. women being scarred by their childbirth in a hospital: again, I refer to rc. Women and men are both scarred by events in the hospital when their health or lives (or those of their children) are in danger. There are times, including in childbirth, were seconds count, and the health care providers must take over the situation without taking a great deal of time to get the patient used to the idea. I’ve sat and talked to patients for half an hour to get them comfortable with the idea of a relatively minor blood draw, and I’ve stabbed people with a needle without even mentioning the fact that I was going to do so. In which situation do you think that drawing the blood was actually more important?

    Women have the right to choose to risk their lives, and even their fetus’ lives, if they want to. To say otherwise would be to infantalize women and to relegate them, at least a little, to the role of an ambulatory uterus. However, they should be informed of the very real, if statistically unlikely risks that they assume for both themselves and their offspring without the rosy assurance that everything will go just fine. Ideally, they should be presented with the actual statistical odds of adverse events from homebirths and the rate of success for any given midwife they employ (such information for hospitals is public information).

  31. Posted January 7, 2012 at 12:10 pm | Permalink

    “Hari: I stand corrected wrt. saying “all medicine.” I should have said, ‘allopathic medicine,’ ‘western medicine,’ ‘evidence-based medicine,’ ‘medicine that works,’ or ‘medicine worthy of the name.’ While there are indeed other modalities out there, western medicine’s dominance in the field is based on the fact that it works far better than any of the other ones for the vast majority of health isssues (and by “works,” I mean, “prevents, ameliorates, or cures health problems”).”

    This is all such a load of patently absurd and uninformed bull that it scarcely bears a response. But I will tell you a story: some years back I was diagnosed (by an allopath) with Grave’s Disease–an auto-immune disorder that causes hyperthyroidism. Once hearing that allopathy considers Grave’s to be ‘incurable’, and then hearing about (and researching) the toxic, immune-system damaging, liver-damaging and potentially life-threatening medications/procedures involved in allopathy’s ‘management plan’ for Grave’s, I first recoiled in horror. Then I went running to my friend, the Fully Qualified Doctor of Traditional Chinese Medicine. And in the course of a few weeks, my rampant symptoms were receding. Within a couple months, they were nearly gone. Within a year, I was cured. The treatment included accupuncture and taking Chinese Herbal formulations mainly meant (tho not exclusively) to restore the depleted nutritional reserves of my body and otherwise rebalance my body energetically as well as physically. It also included my adherence to a diet and lifestyle plan that was particularly suited to my constitution…nothing crazy strict or anything, and in fact much of it I’d already learned about myself, but I had (during a period of intense chronic stress and depression that likely led to the Grave’s to begin with) stopped taking care of myself in those personally suitable ways. When I went back to the endocrinologist for testing, he was amazed…but of course, still believed Grave’s is incurable and that I’d simply had a sort of miraculous remission that had NOTHING to do with Chinese Medicine.

    Allopathy has some wonderful features, for sure. Some of the diagnostics is great–though not greater than diagnostic methods of homeopathy (another system I’ve used, to cure something that, hey guess what, was also deemed ‘incurable’ by allopathy!) nor superior to Chinese Medicine’s diagnostics nor that of any of the other healing modes. But allopathic diagnostics has indeed been useful to me in certain ways over time of caring for myself, children and birth-clients. Also, if I experience a traumatic accident, I will absolutely want good allopathic surgical care to patch me up (so long as no extraordinary measures are involved–just stitches, bone setting, stuff like that). Again, there are some ways in which allopathy, in my opinion and experience, has truly excelled. But to call it ‘the one that works’ and the rest of that tripe, is to do nothing so much as to demonstrate A) a vast ignorance of other modalities, an ignorance I consider unforgivable in ANYONE who claims to be interested in ‘health, healing, prevention, amelioration’ when so much information is now available about ALL the helpful healing modes and B) it also demonstrates a deep prejudice for your chosen field, with the same mindless hostility toward ‘other’ that characterizes all prejudice.

    As for the rest of your post, it is so hugely burdened by the above named ignorance and prejudice–and once again so closely links birth and trauma/pathology in almost completely inappropriate ways– that I won’t address it. The one thing you say that I can fully respect and totally agree with in theory and practice is this:

    “Women have the right to choose to risk their lives, and even their fetus’ lives, if they want to. To say otherwise would be to infantalize women and to relegate them, at least a little, to the role of an ambulatory uterus. However, they should be informed of the very real, if statistically unlikely risks that they assume for both themselves and their offspring without the rosy assurance that everything will go just fine. Ideally, they should be presented with the actual statistical odds of adverse events from homebirths and the rate of success for any given midwife they employ (such information for hospitals is public information).”

    I agree with this sentiment wholeheartedly. However, I cannot agree that ‘such info for hospitals is public info’–because while it well may be so, under LAW, it is only very rarely available in PRACTICE. Drs individually, and hospitals as institutions, do not readily supply informed consent info when asked. To me this is a huge travesty, not the least because it is upon this foundation of secrecy that people are tricked into taking treatments without full knowledge of the risks of those treatments, or any knowledge at all about all the real alternatives to those treatments (including NON ALLOPATHIC treatments, which may well cure what allopathy calls incurable, or at least cause far less harm than allopathic meds and surgeries do to people every day). ESPECIALLY where birth is concerned!

    Again, to all readers concerned with making sensible, empowered choices in childbirth, do the research on all sides. Talk to all kinds of care providers and all kinds of womyn who’ve received that kind of care. Try to understand the biological design of birth in all it’s glory and with respect to its natural fallibility (same as the rest of life). Then, do what makes the most sense to yourself, knowing that only womyn and their babies will live forever with the consequences of that birth care, in body and mind, and for better and worse.

    • Posted January 8, 2012 at 6:50 pm | Permalink

      Wrt Chinese medicine, I will only say that anecdotes =/= data. There are many, many anecdotes out there from people who claim that traditional Chinese medicine ‘cured’ them, but when the same cures are put into placebo-controlled, double-blind studies, they ususlly don’t perform. When they do perform (ie, Aretmesia for malaria), they are adopted by evidence-based medicine. Traditional Chinese medicine is responsible for the ideas that rhino horn or tiger penis can cure impotence, for horrible farms where bears are imprisoned in tiny cages, catheterized, and harvested for their bile, and has ‘cures’ such as ground ‘dragon bones,’ which are actually ancient human bones with etchings that would otherwise be archaeologically valuable. The entire premise behind Chinese medicine – the flow and blockage of chi – has failed every test it’s been put to.

      • Posted January 9, 2012 at 4:43 pm | Permalink

        Ok, point taken on anec-data. Also, I do not mean to imply with my story that I hold Chinese Med above all others. More than anything else, I wanted to show how your reference to allopathy as ‘medicine that works…prevents, ameliorates or cures’ was erroneous. There are things that allopathy does well. There are things it does not do well at all. “prevention” is a really curious thing to toss in, because only ‘good health’ prevents illness, and allopathy doesn’t do much in that line. Its methods of ‘preventing’ heart attack with meds that are toxic and likely to cause new problems (just, perhaps, not as severe as a heart attack) is not the same thing as real prevention. Just for example.

        Again, there are numerous healing modalities available, and they all have value in some situations–some work better for some individuals than others, who knows why. But all of them work well enough for enough people, or your local homeopath, naturapath, herbalist, midwife, etc, would not be able to continue working. This is especially so since very few of them are able to receive insurance reimbursement and people must pay cash for services. Allopathy got to be front and center and protected by law, NOT because it is actually more evidence-based or worthy than any other–but only because allopaths essentially unionized (AMA, ACOG and other guilds) and have spent countless billions on lobbying over the years. Read up on your history of modern medicine to find out about the very real war the AMA has been waging for more than 100yrs, solely based on greed, not science.

        btw–there are many things over the years that allopathy could not ‘prove’ one way or another, and so, would not believe in it. With so much of this, it was not because something was untrue, only because at the time, allopathy simply did not have the methods to measure it yet. This is sloppily written but I’m in a hurry…just saying, it really does not concern me that allopathy’s scientific methods can’t ‘prove’ the worth of Chinese Medicine, homeopathy or any other non-allopathic healing modality. Maybe one day allopathy will figure out how to see/measure things that it’s not currently able to. Meantime, I’ll believe the empirical data readily available from the many people–and more every day–who are using these modalities. And many of them are going to these other kinds of practitioners expressly because allopathy is NOT ‘preventing, ameliorating or curing’ them at all–or is only doing so with a highly toxic cost that people are no longer willing to take on.

        • Posted January 9, 2012 at 4:45 pm | Permalink

          oops, bottom of 2nd paragraph I should’ve said: ‘the very real war the AMA has been waging for dominance in the healing arts field’.

        • Posted January 9, 2012 at 11:50 pm | Permalink

          So, question: are we considering western medical research a part of allopathic medicine, or not? If so, then there’s the ‘prevention’ part: data, for example, that tells people not to load up on nothing but hamburgers and fries, to abstain from tobacco and alcohol, and to get some regular exercise. If not, then the ‘prevention’ is weaker, merely being GPs encouraging their patients to be healthier.

          Wrt. the AMA, it’s for physicians, not ‘Western Medicine’ as a whole. It has done some good things, but as you said, it’s a union and its primary goal is to promote the working conditions of its members.

          Wrt. ‘proof,’ I agree that ‘absence of evidence is not necessarily evidence of absence,’ but in general the stronger and more consistent the effect, the easier it is to prove. The weaker and less consistent the effect, the more pointless the treatment.

          I move that we transfer our discussion to the more recent ‘Gaskin’ thread, since paging back 8 pages is getting to be a little annoying :)

  32. Posted January 9, 2012 at 2:45 pm | Permalink

    I finally got around to reading this. I like the work that Ina May and others like her are doing to inform women of the risky drugs used on pregnant women.
    Like the off label use of Cytotec to induce labor.
    I had this used with my first labor and had a bad reaction and nearly died. see package insert here: http://www.accessdata.fda.gov/drugsatfda_docs/label/2009/019268s041lbl.pdf

    Women need to make informed choices as to what birth is best for them. So long as you know the risks and are willing to live with the outcome for good or for ill. Just because you birth at a hospital doesn’t mean that you are 100% safe. The same goes for home birth. We do need to do something about the rise in maternal deaths in our country. The US rates have become so bad (currently 39th: Source:http://www.guardian.co.uk/news/datablog/2010/apr/12/maternal-mortality-rates-millennium-development-goals) that Amnesty International call on Obama to do something about it: http://www.amnestyusa.org/news/press-releases/usa-amnesty-international-calls-on-president-obama-to-establish-office-of-maternal-health

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