Ina May Gaskin, Ina May’s Guide to Childbirth

[originally posted at my old blog on 31 July 2008]

In her 2003 Ina May’s Guide to Childbirth, midwife Ina May Gaskin (of The Farm) begins with 125 pages of birth stories composed by mothers who birthed with Farm midwives (and a few by other people present at these births). Transitioning into the second, less narrative and more technical, part of the book, Gaskin writes, “What I love about stories the most is the power the have to teach us of possibilities that might not occur to us without them” (137). I believe that these stories are worth reading no matter where you plan to give birth (or support someone who’s giving birth), if you’re even a little bit interested in the possibility of a low-intervention or unmedicated birth (even as a theoretical ‘why would anyone do that?‘ possibility), because they offer a rich, vivid sense of the range of labors that emerge when women’s bodies are left largely to their own devices. The stories help answer that ‘why-would-anyone-do-that?’ question. And they raise lots of tiny, great ideas that could become useful in the midst of your own particular labor.

I don’t agree with every word Gaskin writes here. Her spirituality is unlike mine … Like, way unlike mine. Her use of words like “natural” and, ahem, “the female principle” don’t sit well with me. But this book is excellent, and I’m so glad I got over my initial resistance to give it a go.

This passage, for instance, conveys Gaskin’s straightforward style and use of everyday examples:

Sexual intercourse may be extremely painful or ecstatically pleasurable, depending upon the skill and sensitivity of the sexual partner and the willingness of the female involved. The size of the object inside her vagina actually has less to do with the physical sensations she experiences during the act than do the factors just mentioned. The same can be said of the sensations experienced upon the insertion of a tampon [... which] may be inserted in a painful or painless fashion, depending on whether the woman had too much coffee that morning, how cold it is, or the speed with which she tries to insert it. A lot depends upon how ready she is for the experience. Looked at from this perspective, it should be somewhat less surprising that there is such a wide variation in the way different women describe the sensations of labor and birth. (150-1)

Gaskin’s distaste for the techno-medical (as opposed to midwifery) model of care will likely prove more annoying or depressing than helpful for a person who has already chosen to birth in a hospital (or who has no viable alternative)–though, of course, Gaskin does not direct that distaste toward every single obstetrician or hospital-based midwife. But her descriptions of the processes involved in labor are better than any others I’ve read and offer a great, non-threatening introduction to what a body needs to do to grow and then release a baby. For instance:

The cervix (the word means neck in Latin), the circular opening like a bottleneck at the lower end of the uterus, is a powerful band of muscles that holds the uterus tightly closed until labor begins. Picture a knit purse with a gathered opening held tight by a string. This thick cervical muscle has to be strong enough to hold the uterus shut despite the pressure of approximately fifteen pounds of baby, placenta, and fluid against it [...]. (144)

And, on the uterus:

The three layers of muscle fibers of the main body of the uterus are amazingly powerful yet stretchable and flexible. They must expand to contain even a multiple pregnancy and still be able to expel everything inside when labor time comes [...]. (144)

Gaskin recounts old news–how uterine contractions thin and then open the cervix, and then how they push the baby through the birth canal; how the uterus then contracts to the size of the placenta and expels that, too; how the maternal pelvic bones and the bones of the fetal skull are held together with ligaments that can move and stretch rather than unyielding solid bone, such that both the pelvis and the head shapeshift to accommodate each other. But as she describes this process, some of the magic and awe of actually giving birth or witnessing a birth come through. I admire her clear language and the way it communicates her respect for the beauty of a process we’re so often taught to regard as icky and unbearably painful.