Ina May Gaskin has been called “the most famous midwife in the world”. A pioneer in a millennium-old profession on the brink of extinction in her country, she combines scientific evidence and analysis with her own broad experience in exercising natural medicine. Ina May Gaskin is a role model for midwives who still dare to think in different paths, trying to implement more humane obstetrics in their countries, and providing women with the chance to choose the way of giving birth that seems right for them.
Ina May Gaskin was born on 8 March, 1940. She is the wife of the first Right Livelihood Award Laureate Stephen Gaskin, who received the Prize with his organisation PLENTY International in 1980.
Ina May Gaskin’s first midwifery experience was in 1970, when she assisted at a birth in a schoolbus on Stephen's speaking tour of universities and churches prior to the establishment of The Farm, an intentional community in Tennessee, and the subsequent development of Plenty International. This experience inspired her to study midwifery as a way of providing birth choices for women in her country, where the profession of midwifery had been eliminated early in the 20th century, because obstetrical leaders at the time saw no reason for its continued existence, and because of the benefits medicated birth and caesarean sections provide to for-profit hospitals, insurance companies and the drug industry, though often not to the women.
The Farm Midwifery Center
With a strong motivation to become a midwife in a country that lacked opportunities for such an educational path, Gaskin founded The Farm Midwifery Center in 1971. The Center became well known during the 1970s as a place where authentic midwifery was practiced and taught.
When the U.S. caesarian rate was 5% in the early 1970s, the Farm Midwifery Center reported a 1.7% rate. When the U.S. caesarian rate had risen to over 30% in 2005, the rate at the Farm Midwifery Center was still about 2%, even though the practice delivered many twins and breech babies, as well as births by mothers of more than six babies.
Achievements in teaching & campaigning
Over all these years, Gaskin has assisted some 1200 unmedicated births and together with her partners, more than 3000. Her work and expertise have pioneered midwifery education for decades, preserving knowledge mostly forgotten in technically dominated births. Her “Gaskin Maneuver”, an obstetrical procedure she learned from traditional Guatemalan midwives, is now taught internationally. Birth videos have helped promote her techniques for the prevention of protracted labours, routine episiotomies, and for successful breech and twin births.
For more than a decade, Gaskin has led a campaign to promote awareness of the dangers of the use of Cytotec (generic name: misoprostol) to induce labour for reasons of convenience. Her 2000 article published by the online journal Salon.com has been credited with prompting the drug’s manufacturer, G.D. Searle, to issue a letter to all U.S. maternity care providers warning against its use in pregnant women.
Setting standards for midwifery and maternity care
In 1982, recognising the need for high standards for midwifery practice and education, Gaskin became one of the founding members of the Midwives Alliance of North America (MANA). She served on the MANA Board of Directors from 1982 to 2002, and as its President for six years.
MANA later gave rise to the Midwifery Education and Accreditation Council (MEAC), and to the North American Registry of Midwives (NARM), an organisation which created a national competency-based certification credential for U.S. midwives. These developments have led to the passage of laws recognising the NARM midwifery credential in more than half of the states so far. Gaskin and her colleagues have been deeply involved in this process for more than 25 years.
Analysing maternal death rates
In the late 90s, in order to build a valid case for policy recommendations, Gaskin began her study of maternal mortality rates. While anecdotal evidence suggests that rising death rates are at least partly – if not even to a significant degree – due to the rise in caesarean sections and the use of misoprostol to induce labour, autopsies after maternal deaths are rare even in the U.S. In addition, the lack of any mandatory federal standard death certificate makes collecting data difficult and incomplete.
In April 2011, the Maternal Accountability Act got introduced into Congress, which would make mandatory the use of a standard Death Certificate allowing the extent of birth-related deaths to be recorded. Ina May Gaskin has been a fierce supporter of this Act.
Current main fields of activity
In 2011, Ina May Gaskin’s main mission was:
The Safe Motherhood Quilt Project, in which a quilt is made of patches, each with the name of a woman who died in childbirth in the US since 1982. The Project aims at summoning the national will to take the first step toward lowering the currently rising maternal death rate by creating a consistent, mandatory system for reporting, classifying, and counting the maternal deaths in the US and reviewing and analysing their causes.
An information campaign, aiming at women, midwives, nurses and physicians, about the potential “side effects” (maternal and fetal death) of using misoprostol to induce labour.
Teaching. Gaskin has lectured to physicians and midwives throughout the U.S., in Argentina, Canada, Mexico, Brazil, Costa Rica, Sweden, Norway, Denmark, Iceland, Germany, Switzerland, Israel, Italy, Austria, France, the Netherlands, Slovenia, Russia, Hungary, the Czech Republic, Spain, Australia, New Zealand, and Japan.
She also promotes breastfeeding and fights against hospital routines which unnecessarily separate newborns from their mothers, as well as puritanical attitudes which discourage many women from breastfeeding. In some U.S. states it is still unusual for breastfeeding mothers to be seen in public, and some mothers have been threatened with arrest for doing so.
Books & Publications
In 1975, Gaskin’s Spiritual Midwifery was an immediate bestseller and soon became regarded as the bible of home birth and woman-centred midwifery. Having been translated into Dutch, German, Danish, Russian, and Spanish, the book has convinced countless women that labour and birth can be approached without fear, and with confidence that most women’s bodies are still perfectly capable of giving birth. Recent books include Ina May’s Guide to Childbirth (2003), Ina May’s Guide to Breastfeeding (2009), and Birth Matters: A Midwife’s Manifesta (2011). Ina May Gaskin also contributed to an anthology of U.S. midwifes that pioneered the return of that profession in the USA called Into These Hands. Wisdom from Midwives (2011).
In 2009, Gaskin received an Honorary Doctorate from Thames Valley University in London. In 2011, Gaskin was given the Right Livelihood Award (also known as the Alternative Nobel Prize) for “her whole-life’s work teaching and advocating safe, woman-centred methods that best promote the physical ad mental health of mother and child.” The Award was presented before the Swedish Parliament in Stockholm.