We caught up with Ina May Gaskin after our annual conference in March 2017, where she was our keynote speaker. This interview appears in the summer issue of The Doula magazine, published in July 2017.
What was your understanding of midwives before you had your first baby?
I knew nothing about how or why the profession of midwifery had been destroyed early in the 20th century in North America. The reality was that there weren’t any midwives, except in a few rural pockets that no one outside of them knew about. The only women allowed to work in U.S. maternity wards were obstetric nurses, who weren’t supposed to allow a baby to be born before they could get a doctor into the delivery room. Home birth was unthinkable.
I did know that my great-grandmother had been a midwife in rural Iowa during the late 19th century and that her children and grandchildren were very proud of her reputation.
I had some idea that there might be midwifery in England because Grantly Dick-Read referred to midwives in his book, Childbirth Without Fear, and I was aware that poor people in Malaysia (where I lived for two years) had their babies with traditional midwives, but I never met one.
You have spoken before of experiencing PTSD after the birth of your first baby. How did it affect you, and later, your work?
I managed to get into a trance during my labor by visualizing that I was a large mountain lion. (I used to pretend that I was an animal when I was a little kid; I guess that I just drifted into doing that while in labor). While in that state, glowing lights of different colors pulsated on the plain walls of the hospital room. I was hungry and thirsty but not in pain. I had previously told my obstetrician that I didn’t want any pain medication during labor and birth and thought that he would recognize that I could do without it if I didn’t complain, unaware that he was a devotee of forceps deliveries for every first-time mother. The nightmarish part began when I was close to full dilation, before I felt any urge to push. Several people in masks (my obstetrician, an anaesthetist and a nurse or two) suddenly surrounded me, put my wrists in leather straps and administered a caudal (a kind of spinal anaesthesia that paralyzes and causes a spinal headache that lasts for weeks if you lift your head at all for twelve hours after its administration). This was terrifying. I kept my head down for the full twelve hours. It was twenty-four hours before my daughter was brought to me for the first time.
Whereas I had labored for many hours without fear, the way they treated me left me in a frightened state. I wasn’t used to having irrational fears and horrific visions of what might happen to my baby. Those persisted for months.
How can doulas and midwives best minimise the long term effects of a traumatic birth?
Probably the best thing they can do is to make mothers aware of discussion circles formed by other women who have had traumatic birth and have found ways to come to terms with any long-term effects that they experienced. Exchanging stories can lead to healing.
What inspired you to refrain from the system with your second baby and stay home to birth?
The birth stories told by women who did just that were what inspired me. The first of these stories shocked me so much that I forgot it, until I was reminded of it twenty-five years later by the person who told it. But when I heard the second story, I listened closely and thought that sounded a lot less scary than repeating the experience I had had with my first baby.
Tell us about your midwifery training
I started attending births after I had heard a few birth stories from women who stayed at home for some reason. I didn’t call myself a midwife and didn’t know of any way to get training. A friendly doctor gave me some emergency birth training after I had witnessed three births. I found a few other doctors who served as mentors of one kind or another. Mainly, though, I learned from observing and listening to women and responding to their needs. It was good not to have a boss or overseer.
How did you find the courage to be so bold about the essence of your work, especially the spiritual aspects, in a culture that can be so negative towards midwifery?
I had a very strong sense that how and where I would give birth was my business—my choice. It didn’t enter my mind that any government should take that choice away from me. I wasn’t going to repeat my first experience, because I knew there had been something seriously wrong with having scheduled forceps.
The helpful obstetrician kept me from viewing obstetrics as some monolithic force. I learned to look for the best and not to be afraid to ask for help if I needed it.
How do you deal with people who might try to discredit or challenge you?
I keep doing what I think is right.
How can a woman best find her empowerment in the birth room?
Different tips seem to work for different women, so it’s good to hear stories from a variety of women who learned helpful lessons about what got them through labor and birth.
How do you think that doulas and midwives can support each other better?
They should try to see each other socially: have tea or go to a pub together and see if they can improve the situation in a way that works for each of them. I’m not sure there’s any way to generalise about this relationship.
What is the ultimate support you can give a woman when she is birthing?
To be with her and let her know that what she’s feeling is part of the physiological process and give her feedback (if she wants it) about how it’s going. Sometimes the best thing is to let her go on with it and keep her from being interrupted when she’s doing well.
How do you enable women to enjoy and welcome the rawness of birth rather than fear it?
I sometimes remind them to enjoy the pauses between contractions that they might not be noticing and appreciating. I try to do what makes them grateful.
What is the most significant personal development you have experienced as a result of serving women?
It’s been a privilege to learn how mind and body affect each other.
What is your favourite self-care tip?
I exercise every day.
What is your guilty pleasure when you’re not working?
I seem to be able to find pleasure in activities that don’t cause me to feel guilty.
What gives you the greatest joy in attending women during labour?
That comes when a healthy baby arrives to parents who wanted that baby very much and worked together in a way that made them appreciate each other at a deeper level than they had imagined possible.
Ina May Gaskin, MA, CPM, PhD(Hon.) is founder and director of the Farm Midwifery Center, located near Summertown, Tennessee. Founded in 1971, by 2011, the Farm Midwifery Center had handled approximately 3000 births, with remarkably good outcomes. Ms. Gaskin herself has attended more than 1200 births. She is author of Spiritual Midwifery , now in its fourth edition. For twenty-two years she published Birth Gazette , a quarterly covering health care, childbirth and midwifery issues. Ina May’s Guide to Childbirth was released in 2003 by Bantam/Dell, a division of Random House and has been translated into Italian, Slovenian, German, and French. Ina May’s Guide to Breastfeeding was published in 2009 by Bantam/Dell, and her newest book, Birth Matters: A Midwife’s Manifesta , was published in 2011.
She has lectured all over the world at midwifery conferences and at medical schools, both to students and to faculty. She was President of Midwives’ Alliance of North America from 1996 to 2002. In 1997, she received the ASPO/Lamaze Irwin Chabon Award and the Tennessee Perinatal Association Recognition Award. In 2003 she was chosen as Visiting Fellow of Morse College, Yale University. In 2009, she was conferredw with the title of Honorary Doctor by the Faculty of Health and Human Sciences of Thames Valley University in London, England. In 2011, she was chosen as one of four recipients of the Right Livelihood Award (also known as the Alternative Nobel Prize), given in an award ceremony before the Swedish Parliament in Stockholm.