Ina May Gaskin, Midwifery Activist and Author, in North Carolina

Birth, Death, and Poop were some of the major themes of a workshop and lecture led and delivered by Ina May Gaskin on Saturday, December 5 in Durham, NC on the Duke University Campus. A group of Cape Fear area birth activists, and workers (including doulas and midwives), and Where’s My Midwife (WMM) members, traveled with excitement to attend the events.

The workshop and lecture, brought to North Carolina by NCMA (North Carolina Midwives Alliance) and NCFOM (North Carolina Friends of Midwives) and other groups promoting licensure for Certified Professional Midwives (CPMs) in North Carolina, covered many broad ranging topics.

The evening lecture was extremely well attended and will be a boon for efforts to license CPMs in our state. The auditorium on the Duke campus held about 250 seats and was packed. The evening was made possible by the fact that a North Carolina midwife, Marnie Cooper-Priest, won a contest sponsored by The Big Push for Midwives Marnie came up with the winning slogan for the campaign to gain licensure for Certified Professional Midwives: “Midwives, the Light at the End of the Tunnel.” The prize was an evening with Ina May as a fund raising event for midwives in North Carolina. For two and a half hours Ina May engaged the audience with information and personal anecdotes. 

Ina May presented some sobering information and statistics about maternal death in the United States. As she explained, in 2005, the U.S. reported 15.1 maternal deaths per 100,000 live births, up from 7.5 per 100,000 in 1982. Additionally, we learned that the Centers for Disease Control (CDC) estimated in 1998 that the US maternal death rate is actually 1.3 to three times that reported in vital statistics records because of underreporting of such deaths (as many as a staggering two thirds may not be reported), that reporting of maternal deaths in the U.S. is done via an honor system, and that the CDC estimates that more than half of the reported maternal deaths in the U.S. could have been prevented by early diagnosis and treatment. These facts prompted Ina May to begin collecting quilt squares commemorating the victims, much like the quilts created for AIDS victims, to higlight the scandal of the maternal death rate in the United States. She not only shared many tragic stories– more than one of mothers sent home too early from the hospital after c-sections without appropriate post partum care–, but she also had audience members unravel the quilt. The impact was palpable. The call was clear: we must do more in the United States to remove the existing barriers (legal, economic, social, etc.) to accessing the Midwifery Model of Care, and the providers who follow it.


audience members hold up Ina May's Safe Motherhood quilt


During the four hour long workshop, Ina May spoke to a group of 50 + attendees (including midwives, nurses, doctors, doulas, lactation and childbirth educators, and others) of her personal history and development as a midwife. She shared her vision for normalizing birth and techniques for handling birth complications, including breech birth and shoulder distocia. 

The workshop fliers originally announced a focus on these two birth complications, and Ina May discussed them in the same conversational style as she had delivered the rest of the material for the workshop. She showed (and used as models) attendees the “Gaskin Maneuver,” the technique that helps mothers to get onto all fours to resolve a shoulder distocia. Although Ina May learned the technique from Guatemalan midwives or comadronas, she made it famous in the U.S. and it has entered medical lexicon and texts using her name.

Ina May also called for the training of obstetricians and midwives to perform and normalize vaginal breech births in the US, given that breech births will continue to occur, and given new studies that vaginal breech birth is safe. The Society of Obstetricians and Gynaecologists of Canada –SOGC– has collected data in a June 2009 study showing that vaginal breech birth is safer than breech birth by cesarean section. They found that vaginal breech birth as compared to breech birth by cesarean section reduced perinatal mortality, short-term neonatal morbidity, long-term infant morbidity, and short- and long-term maternal morbidity and mortality. She showed statistics compiled from the first births through 2005 at The Farm and how they had safely delivered many breech babies vaginally. Ina May also shared techniques for vaginal breech birth and emphasized that waiting, never rushing, is key.

As Anna Van Wagoner, one of the attendees from Wilmington, commented, the workshop was “like hanging out with Ina May for the whole day.” Ina May told us a bit about how she had come to be a birth practitioner on the “caravan,” a cross country journey from San Francisco to Tennessee taken by hippies that ultimately culminated in founding The Farm, a cooperative community in rural Tennessee. She learned to help women give birth by doing, as she attended many of the women who had babies along the way. Although Ina May had never witnessed a birth before then, she instinctively knew that providing love and kindness could only help women give birth.

She highlighted how for her, as for many birth activists, her feelings and ideas about birth were a result of her personal history and experience. She was the daughter of a midwest farmer, and though she hadn’t grown up on a farm, she was profoundly convinced that mammals know how to give birth. Her views also developed as a very visceral reaction to her own first birth experience and to how she had been treated by an out of touch and hostile nurse in the hospital. From these experiences, Ina May came to the knowledge that human mothers know how to give birth and that she could help them to do so in a postive way by showing them “love and kindness,” as she did on the caravan.  

Several times during the workshop Ina May reminded us that we need to become more comfortable with our “butts” and with our sexuality. She referred to several key points that she makes in her books Spiritual MidwiferyIna May’s Guide to Childbirth, and Ina May’s Guide to Breastfeeding:

1. humans, like other mammals, have the ability to deliver their babies normally, without interventions.

2. like other mammals, we need privacy to give birth, just as we need it to perform other bodily functions like pooping. 

3. the cervix acts much like a sphincter: when women relax other parts of their bodies, especially their mouths, it makes it easier for the cervix to open and to give birth (just as it makes it easier to have a bowel movement.)

To highight these key points, Ina May showed two youtube videos. “A Historia Do Coco,”  a Brazilian video aimed at children and at normalizing poop, shows a singing turd who laments his marginalized status. For Ina May, it’s a great example of how we in the U.S. could learn from other cultures about becoming comfortable with all of our bodily functions. Through personal slides of births she had attended, Ina May also presented the idea that dancing, another natural and often spontaneous human activity, can connect us to our bodies and to our sexuality during labor and birth. We witnessed a beautiful Brazilian woman as, supported by a walking staff, she danced her way to birthing her son (Ina May’s grandson!)

 Another youtube video, “The Dramatic Struggle for Life,”  showed the birth of a baby elephant in captivity.

 The video underscored Ina May’s point that an elephant mother, just like a human mother, can give birth normally, without interventions, and that mammals have natural instincts to protect their infants. In the video “Nikki,” the elephant mother, opens her mouth wide, bears down, delivers a glorious splash of a baby (eventually named “Riski”), then gently kicks him and prods him to ensure that he takes his first breaths. The dramatic video made an impact on Ina May as it did on all of us not only during the workshop, but also during the evening lecture when she showed it again. 

WMM members and Cape Fear area birth activists are grateful for the opportunity to have shared the day with Ina May Gaskin and with other committed and passionate folks in the North Carolina birth community. We have come home energized to continue the important work of fighting for greater access to midwives. We are renewed in our commitment to ensure that women and their families have the freedom –the RIGHT– to birth as they want to, where they want to, and with the practioner that they choose. Please visit the WMM website for more information about upcoming WMM events, including a car painting day on Friday, December 18th at Hugh McRrae Park. Help us to continue to fight for all of our birthing rights and for greater access to midwives! 



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