Ina May Gaskin, author of Birth Matters, is dismayed by the high rate of cesarean births in this country, and in her new book, she takes the medical community to task for putting women’s lives in dangers by these often unnecessary operations. About one in three women in the U.S. have c-sections instead of giving birth vaginally, but the World Health Organization says that “The best outcomes for mothers and babies appear to occur with cesarean section rates of 5% to 10%” (Childbirth Connection). Gaskin asserts that maternal mortality in the U.S. is rising along with the number of c-sections.
In 1990 I was one of the many women in South Florida who had a c-section to deliver my baby. I was happy to have a healthy baby, but I also felt that my baby and I had been cheated out of the full birth experience. Simply put: my birth experience sucked. I want better for my daughter.
After reading Birth Matters, I drove to Tennessee to interview Ina May for the Sun Magazine. Ina May lives in an intentional community called The Farm that she and husband Stephen Gaskin established in the 1970s. The Farm is home to a birth center where women -- even women who have a baby that is breach -- choose to have a completely natural childbirth. The philosophy at The Farm is that love, compassion, and humor are the best drugs you can give a woman in labor.
Ina May told me that many obstetricians have no idea that a breach baby can be born vaginally but that it is actually common in the Amish community, where the doctor who taught her and the other midwives on The Farm learned it.
“But,” I told her, “my baby wasn’t breach. Why did I have to have a c-section?”
This was her answer: “Many women like yourself ended up with C-sections because of perceived or real stress on the baby from their medically inhibited labors. In the seventies the use of electronic fetal monitors became routine in most hospitals. Electronic monitoring usually doesn’t work well unless the woman is flat on her back. Women used to be up walking around the maternity ward, which makes most labors move along faster.
“Once you have the woman lying flat on her back, she’s in a lot more pain. If she moves to get more comfortable, then the monitor indicates the baby is in trouble, and the nurses get upset with the mother for moving. This painful back-lying position can also be dangerous because of the weight of the uterus on the major blood vessels, which can interfere with the circulation of blood between the mother and the baby. Sometimes a baby can go into distress because the mother is in that position instead of on her side. Because lying flat causes more pain, women quickly opted to get epidurals as soon as possible. One of the side effects of the epidural is that it slows labor. If given early, it can double the length of labor.” (Full interview in The Sun Magazine, January 2012)
I thought I was well informed when I went into the hospital to give birth. Like a lot of other would-be mothers I had laughed and said, “Yeah, give me drugs!” even though I dutifully went to my Lamaze classes. I had no idea how the medicalization of childbirth had transformed what should have been the most natural thing in the world into a nightmare.
What struck me most about my conversation with Ina May was her emphasis on treating a laboring mother with loving kindness. When I was pregnant, I was on my own. I had no husband at my side. I went into the hospital a week early thinking my water had broken but I was wrong. They sent me back home. When I came back the next week and my water really had broken, the nurse sneered at me and said, “Are you sure this isn’t just another false alarm?” Later the anesthesiologist spoke to me in a voice dripping with disdain about my lack of pain tolerance. My doctor was on vacation so a doctor I didn’t even know came in to deliver the baby. A girlfriend came with me but she’d never had a baby, and she was as clueless about the whole process as I was. So we were bullied by the hospital staff, and although my cervix was fully dilated, the baby stayed firmly put. There was no encouragement to try to have the baby naturally; instead they strapped my arms in a crucifix position and cut me open.
I can’t help but wonder what the outcome would have been if I’d been in a warm, comfortable environment surrounded by encouraging women who would let me eat food and drink water and who would laugh with me and hold my hand during the hard parts. One woman I met at The Farm told me she’d had an orgasm while giving birth. An orgasm!? Other women have spoken about the spiritual transcendence they’ve experienced during childbirth. They acknowledge that there is pain but nature gives us ways to cope with it.
Ina May Gaskin’s book should be on the nightstand of every woman who is or ever will be pregnant. It should also be required reading for obstetricians. One of the most famous lines from the movie Gone with the Wind is Butterfly McQueen’s statement: “I don’t know nothin’ bout birthin’ no babies.” Maybe it’s time we learned.