Spiritual Midwifery

by Ina May Gaskin

Here is the 4th edition of the classic book on home birth that introduced a whole generation of women to the concept of natural childbirth. Back again are even more amazing birthing tales, including those from women who were babies in earlier editions and stories about Old Order Amish women attended by the Farm midwives.

Also new is information about the safety of techniques routinely used in hospitals during and after birth, information on postpartum depression and maternal death, and recent statistics on births managed by The Farm Midwives.

From the amazing birthing tales to care of the newborn, Spiritual Midwifery is still one of the best books an expectant mother could own. Includes resources for doulas, childbirth educators, birth centers, and other organizations and alliances dedicated to improving maternity care at home and in hospitals.

Genres: Nonfiction, Parenting, Health, Feminism, Spirituality, Womens, Medicine

482 pages, Paperback

First published January 1, 1975

About the author

Ina May Gaskin, MA, CPM, is founder and director of the Farm Midwifery Center, located near Summertown, Tennessee. Founded in 1971, by 1996, the Farm Midwifery Center had handled more than 2200 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. Her new book, Ina May’s Guide to Childbirth was released 4 March 2003 by Bantam/Dell, a division of Random House. 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.

Ms. Gaskin has lectured widely to midwives and physicians throughout the world. Her promotion of a low-intervention but extremely effective method for dealing with one of the most-feared birth complications, shoulder dystocia, has resulted in that method being adopted by a growing number of practitioners. The Gaskin maneuver is the first obstetrical procedure to be named for a midwife. Her statistics for breech deliveries and her teaching video on the subject have helped to spark a reappraisal of the policy of automatically performing cesarean section for all breech babies. As the occurrence of vaginal breech births has declined over the last 25 years, the knowledge and skill required for such births have come close to extinction.

Ms. Gaskin’s center is noted for its low rates of intervention, morbidity and mortality despite the inclusion of many vaginally delivered breeches, twin and grand multiparas. Their statistics were published in “The Safety of Home Birth: The Farm Study,” authored by A. Mark Durand, American Journal of Public Health, March, 1992, Vol. 82, 450-452. She was featured in Salon magazine’s feature “Brilliant Careers” in the June 1, 1999 edition.

Reviews

[lov2laf · Rating 4 out of 5]

My purpose for reading this book is to brush up on childbirth and strategies to support my partner during her pregnancy and labor. For that, I got less out of this book than I did with Ina May's other book, "Ina May's Guide to Childbirth".

"Spiritual Midwifery" was Ina May's first book and there's no doubt that it and she have been seminal in bringing midwifery and home births back to the fore of modern society. This book is groundbreaking in its own right but it ended up being more of a biographical and historical account then my personal how-to guide.

This book was autobiographical on how "The Farm" came to be, how and why Ina May ended up in a midwifery role, and the things she and her midwifery partners learned along the way.

In addition to the stroll down memory lane, we also get a large amount of personal essays and the different experiences from women and men regarding the labors with their children in the hands of the midwives. They actually started sounding redundant so I skimmed past many of them.

While the first half of the book is accessible to everyone, the second half of the book reads more like a how-to manual for midwives and seems less relevant to anyone not interested in being a professional midwife or doula. It is interesting though and is basically a medical manual of the woman's body, the baby, and goes into the nitty-gritty medical details of it all.

The "spiritual" aspect I was a bit surprised by. Any familiarity with Ina May and "The Farm" definitely gets you plugged into the hippy vibe especially since their caravan and commune rose in the 60s and 70s. But, the mention of spirituality is also in reference to a more traditional belief in god. Surprisingly, Ina May's husband was a minister and the leader of the commune. They and the rest of the people on "The Farm" strongly believed in god, mentioning praying, the miracles of god, and the like. I don't recall any specifics (ex, Jesus isn't mentioned) so it comes across as more of a general belief but it definitely makes its presence in the read.

And me, reading it as atheist? I wasn't bothered. I'd more or less move past any mentions and stick to pulling out of the book what I could use. Mainly, the themes being to make the mother comfortable in a number of different ways, the importance of the father (or partner, in my case) and what he can bring to the birth experience, and that childbirth is natural, powerful and not always the horror story we see on tv. Just know god is mentioned often in the book whether that's a pro or a con for you.

It's an interesting read but I enjoyed Ina May's other book and Penny Simkin's "The Birth Partner" book more. I'd recommend this if you were more interested in learning about the midwifery movement or wanted to be involved in childbirth care.

3.75 stars

[Forrest · Rating 4 out of 5]

"Why," you surely ask, "is a man reviewing Spiritual Midwifery?"

Frankly put, I delivered two of my children at home. Yes, there was a midwife looking over my shoulder, but I did all the dirty work with my wife. From start to finish, these pregnancies were ours.

Ina May Gaskin's book is . . . well, groovy is the word. It's not a real how-to, nuts and bolts guide to home delivery, though it does explain in great (and graphic, not for young children) detail the mechanics of it all. It also offers sage advice on nutrition, circumcision, prenatal visits, and so forth. The most intriguing aspect of the book, however, are the vignettes recounting the stories of various pregnancies on The Farm. From a multitude of viewpoints, life and the giving of life on The Farm is dissected and observed, examined and appreciated by those who lived it. Would I choose to live there? Heck, no. But I see the attraction. And just like living at the farm, this book isn't for everyone, but it's definitely worth considering. Again, not for the faint of heart, but for the open heart.

[Vanessa · Rating 5 out of 5]

This book changed my life. I had no idea what I wanted to do with my life. I was lost, I was tired of trying to find direction. One day at the health food store I wandered to the book section and I was drawn to the cover of this book... When I opened the pages it was like the clouds parted and a beam of light spread over me...

At that point I knew I would someday be a midwife. Now I'm in my first year of nursing school with a 5-10 year plan of going back after my BSN to get a master's degree in certified nurse-midwifery. Although I applaud "lay-midwives" or "direct-entry midwives" for the services they provide to people, I believe the route I'm taking will allow me to serve a greater number of people and expose them to high quality holistic health care that they may not get from your run-of-the-mill obgyn doc.

[Chris · Rating 5 out of 5]

I first read this classic, beautiful handbook for home birth while writing MIDWIVES in 1995. I reread it this week because rehearsals of my stage adaptation of the novel begin December 26 at the George Street Playhouse. Hoping some of you get to see it. Starring as Sibyl Danforth? Ellen McLaughlin, the original Angel in ANGELS IN AMERICA. The play is directed by the brilliant David Saint.

[Danger Kallisti · Rating 5 out of 5]

It's books like this that really make it clear to me that mainstream culture is completely ass-backwards, especially when it comes to healthcare (and most specifically, OB/GYN). 20 years of successful natural, positive, non-damaging childbirth on The Farm goes a long way toward proving that routine hospitalization of healthy laboring mothers, with its accompanying sexual assault and dehumanization, is in desperate need of re-evaluation.

This book presents the subject of midwifery in a gentle, fun, and unbelievably energetic manner. It combines a variety of honest case studies with sound medical information, and never loses sight of the profoundly beautiful and cosmic experience of delivery.

[Ariel Raspa · Rating 3 out of 5]

My biggest takeaway from this one is that maybe I should do more acid in preparation for birth.

[Elizabeth · Rating 4 out of 5]

Laura found this first edition (1975) at the flea market next door. How could we turn this down? It's the first hand account - told by the mothers and fathers and midwives - of about 200 of the 372 births (thus far) on a giant culty hippie baby making farm in Tennessee. Followed by instructions for prenatal and neonatal care for parents and midwives. The hippie slang is unreal. A good example:

"'We could use some of your energy in here, Clifford.' I sat up and helped get it covered. It was right up in my thing, because I always tended to be a little lazy about spending my energy. But this was my kid being born, too, and my lady in labor and my Universe, so I had to cop to the responsibility of keeping it stoned."

Basically a few hundred pages of rushes being groove and getting heavy while they were real telepathic with each other and getting stoneder on that. This book was definitely stoned ("charged with spiritual energy"). I started reading it this morning and finished it this evening. And I'm surprised to see further editions published as recently as 2002. I never would have thought - when we saw this dusty old thing forgotten in a flea market booth - that more than 200 copies had ever gotten out or been read. I am going to have to find out the current status of Ina May and this crazy hippie farm - old fashioned and conservative in its family values - and all its sister farms.

[Emily Marks]

My husband and a pregnant and beaming I, were attending a very moving Greek/Kiwi wedding on Waiheke Island and we met a radiant couple who taught Yoga among other esteemed things. She recommended this book to me.
When borrowing it from the local Library I was heartened to view its 70s cover. Ina May Gaskin and her 'faith' intrigued and perplexed me. Does anyone know - is she Christian with a smidgin of Buddhism? Her faith was never explicitly explained I guess cos it's not the point of the book, but her extreme warmth for humanity, her generosity, her faith and her gentle strength streamed through her words on these pages.
I will admit it's not a book I read or would recommend reading from cover to cover, and also not one I'd recommend at the end of your pregnancy, because I believe there comes a point where one should disengage from others' experience of birth and focus on the birth, you, your baby and your birthing team are creating.
This book is essentially a collection of stories from the 70s? about births. There's greater romance than I'm telling here, because the book tells the story also of how this collective of midwives grew from Ina May to a raft of 'disciples' who lived in housebuses in a large community together and served the greater community.
The strongest thing I took from this reading, is that I don't have to be an angry birthing mother-to-be. I can be loving and gentle with my partner. As Ina May says "What put the baby in there, can bring the baby out." So, being loving and even 'smoochy' with your partner (I personally didn't quite make it to the smoochy stage in my 8 hours of birthing) can aid the process. She illuminated the fact that not all birthing stories are challenging or unpleasant and that some people genuinely (they're not lying) ENJOY birthing.
She also suggested the conscious use of language, so converting 'contractions' into 'rushes'.
Ina May Gaskin is a taonga.

[LM · Rating 2 out of 5]

The hippie language turned me off. I can't help it if I grew up in San Francisco in the '80s
and am programmed to roll my eyes at terms like "turned on" (even though I just used
"turned off" - they are completely different!), "getting high" without drugs, "being
telepathic", etc. The making out while in labor stuff both interested me and grossed me
out depending on the story, but it also made me feel like I'll never learn how to relax my
mouth properly because my husband and I won't be kissing much less touching while I am in
labor. It was so weird to read how invasive, intervention happy, and in your face the
midwives are when I pictured the return to homebirth pioneer(ess) of America would be
more hands off. Aside from all that I enjoyed reading it for the most part and learned
some things. It did take me a long time to get through, because I kept picking up other,
more interesting things to read. I also started to feel like Ina May Gaskin and her husband
were quite idolized by the commune and probably influenced women and men in the
same way birth activists claim doctors intimidate women. Googling about The Farm
supports my theory. I thought I would identify more with some of the Amish clients, but I
didn't.

[Elizabeth · Rating 5 out of 5]

Holy wow, where do I even start? I guess I have to start by saying two things:

1) This book changed my life.

2) I think every single woman should read this book.

Although the central theme of the book is midwifery, in essence, it's just this really, really amazing book that makes you feel incredible and powerful about being a woman. I think there needs to be a lot more of that in the world today. Woman are brought up to feel bad about being a woman. We're taught that our bodies are ugly and unhealthy and that they will turn on us. We're taught that our feminine energy is somehow wrong and inappropriate. We need to learn to rejoice in our bodies and our femininity and to claim our power as women... and I think this book, through an explanation of the ideas that constitute what Ina May Gaskin calls "spiritual midwifery" and a plethora of positive, joyful birthing stories, helps one to do just that. I strongly recommend that EVERY woman read this one!

Ina May Gaskin is absolutely my hero.

[June · Rating 5 out of 5]

I read this book before the home births of each of my three children. Yes, it's hokey. Yes, it's dated. There's a lot of long hair, beards and wire-rimmed glasses. BUT the pictures and birth stories are worth it. When I was looking for information on healthy, involved births, Ina May Gaskin provided a variety of experiences in this book. I did find the lack of racial/ethnic diversity to be a turn off, but oh, well. If you're looking for open, positive, and detailed stories about births, this is a great book to have.

[Sharon E. · Rating 5 out of 5]

O MY GOSH you have to read this book if you are going to or have given birth at home or just want to have a wide awake natural childbirth!!! It left me with the confident knowledge that I wasn't the first, I won't be the last, and birth first and foremost belongs to women, not doctors.

[Анна Bilenka · Rating 5 out of 5]

Після всіх тих страшилок про пологи, яким, здавалось, просякло тіло, і тільки терапія помогла випльовувати, ця книга - як кокосове масло після душу, - пом‘якшує рубці і дає місце надії, спираючись на досвіди в героїнь, що все буде гаразд.

[Voracious_reader · Rating 3 out of 5]

My husband and I were of divided minds on this one. I was able to get past the sort of hippie-go-lucky language and tone of the book to the meat of it--namely, that childbirth is a wonderful natural process that can go much better for the mother when she is surrounded by supportive individuals who are acting on her behalf and the baby's in a personal way rather than in a institutional, impersonal, intervention focused hospital. Obviously if a woman feels cared for and relaxed and at ease, anything, including childbirth would be easier to get through. My husband could not, however, get over the hippie nature of the book. While the book did not convince me to have a home birth, it did reinforce my intuition that the female body is made for birthing and that the focus of childbirth should be to support the body in doing what it normally does on the bodies' time table and in a way that works for that particular mother, rather than trying to hasten events with multiple medical interventions that carry with them side effects that may prolong labor and endanger the mother or child. The book is a collection stories from various individuals at a commune with topics concerning miscarriage, childbirth, postpartum depression, c-section, breach births etc... It's worth reading if you are unfamiliar with childbirth and would like read something that is insightful but not medical in an institutional way. It is female/human ability focused without being totally against medical interventions when they are needed; it just has the point of view that they're used far more than needed.

[Astrid · Rating 5 out of 5]

Don't be turned off by the outdated language and fashion in this book. It has the potential to change your whole outlook on birth and pregnancy. Even just reading the first half, which is all birthing stories, is very inspiring. There is also information for parents and midwives. I would highly recommend this book to current or future parents, midwives, or those who want to be supportive of a friend or family member's birthing.

[Nicole Bimber · Rating 3 out of 5]

Oof, I expected to thoroughly enjoy and love and marvel at this book. It’s the second Ina May book I’ve read, first being Childbirth Without Fear (edit: whoops, this is not Ina’s book, I think she just wrote the forward, hah). I read that while heavily pregnant with my second baby, it gave me whatever strength I needed to have a fast and ferocious homebirth.

Reading this as a student midwife has me both marveling and painstakingly pressing on to get through a lot of messes and walk away with some very important tidbits.

The birth stories are both odd and inspiring, leaving me wondering if the hippie women and midwives in these stories were on some kind of drug that caused all of the “trips” and “psychedelic” journeys that these births seemed to provide for all involved. They are interesting and intriguing to say the least.

There is a lot of outdated/inaccurate information to sift through. My opinion is this should not be a standard for NARM (North American Registry of Midwives) for passing due to the inaccurate information inevitably required to sift through.

While widely recommended to pregnant women, I would only recommended this with a hand of caution that there’s a lot to ignore in this book and some very beautifully helpful information despite the bad.

I had to force myself to get through this, and think it could be a much smaller and more current book that could help a lot of midwives and women. The last update was evidently 2002, so I suppose a lot has changed in 23 years. What hasn’t changed is the truth of the matter that the United States maternal mortality rate and medical intervention in childbirth is unacceptably high, and this simply should not be.

[Anjanette · Rating 5 out of 5]

I love the charm of this particular edition. 😃

[Kennon Casper · Rating 4 out of 5]

Amazing read for all expecting mothers out there!

[Linda Vituma · Rating 5 out of 5]

Šo grāmatu lasīju, lai stiprinātu sevi un iedvesmotu. Tomēr noslēgumā nejūtu nedz spēku, nedz iedvesmu. Sajūta, ka kaut kāda liesma manī ir apdzisusi. Vai pārvērtusies. Jūtu mieru un vieglumu - divas sev tik svešas izjūtas. Miers un vieglums, lūkojoties hipiju attēlos, klausoties viņu stāstos, ticot viņiem. Un klusums prātā - klātesoša, nevērtējoša sajūta, klausoties vecmāšu pamācībās un pārspriedumos. Klusi klātesoša sajūta, apstaigājot atmiņu apcirkņus un kavējoties novērojumos, kas gūti redzot, kā grāmatas idejas dzīvo dzīvi ne-hipiju vidē. Tepat līdzās.
Esmu pārdomās, ko un kā darīt tālāk.

[Jami · Rating 1 out of 5]

I imagine that if I considered myself "spiritual" in any way, I'd be another 5-star reviewer. But I am a skeptic, a scientist, and an atheist -- basically, the opposite of spiritual.

My Kindle notes turned from "ugh" (the Buddhist monk rolling around in the pink baby blanket... a photo of a wise older man in a white coat and stethoscope punctuating a story about God helping out midwives) to curses when one mother says that she, her husband, and Ina May "prayed" over a blue, motionless baby while someone ran to get Ina May's husband, who did some goddamned CPR to finally start saving that kid's brain function.

My midwife recommended I read this to prepare for my second birth, citing positive birth stories. But I must read too much between the lines. Gaskin's own extremely premature baby died, apparently never seen by medical professionals, as Gaskin diagnosed him with "probably" something or other.

Having given birth once, I straight up don't believe another gal who says she didn't feel any pain and was thrilled to have 30 people watching. Even if that was really her experience (sure it was), no amount of spiritual midwifery could make it mine.

I do appreciate that Ina May Gaskin has helped improve the way childbirth can happen in America. The ongoing theme that childbirth takes the time it takes is extremely resonant to me, after a doctor rushed my first birth (she complained so I could hear it twice that my 20-hour labor, precisely on my due date, was making her late for other appointments, before deciding I "needed" a vacuum extraction). And as a woman-centered story of Vietnam-era counter-culture, I suspect I could enjoy this book immensely.

But the "spiritual" part of this book has nearly scared me off the midwifery part. My midwife seems like a very responsible person who would send me for a C-section if I really needed one. But this book, instead of being frank about when surgery and advanced medical care result in a much healthier baby, seems to gloss over the long-term outcomes for babies born not breathing in the hands of people who consider prayer an important part of the solution.

[Antoinette Maria · Rating 4 out of 5]

Loved the birth stories even though sometimes the hippie-ness of it is a little off putting. E.g., there are people who've had amazing natural childbirth experiences who don't need to live in the middle of nowhere, prefer the word contraction to rushes and would never use the word "psychedelic" to describe anything and I wish there were more of those so that women considering non-medicated birth could have that "Aah, she's just like me" moment of recognition. But overall the stories were inspiring. I also like the practicality of a lot of the advice. My biggest complaints are that:
The author herself seems to be very particular about what she wants from clients and seems to put a lot of the burden on the laboring woman to "be nice," and I don't believe that that's necessarily the energy that works for everyone
The Farm as the epitome of a great environment but the percentage of women who are actually going to birth there is negligible so why not talk a little more about some other great birthing environments or ways to make a birthing environment great.
She makes a lot of pronouncements such as: We have a very low incidence of post partum depression here on the Farm. We've never circumcised a male baby on the Farm.

All in all, I liked it but would be very particular about to whom I recommended this book.

[Beth · Rating 5 out of 5]

This is the greatest book...in it I found a lot of the inspiration I needed to be able to birth at home. Ina May Gaskin is one of the greatest midwives of our time, I do believe. She is a pioneer in the field, and the Farm still provides services for those who wish a natural birth in more diffcult circumstances like breach or multis.

The talk is real hippie as the women tell their birth stories in the beginning of the book, and I love the spirit of the community and women as they gather together to support each other during birth. The black and white photographs are beautiful and lend such a depth to the stories.

Love this book...

[Anna Sallee · Rating 5 out of 5]

i fully believe that birth is the sacred transition from heaven to earth. its supernatural and purely divine. it’s a miracle, its natural, its holy, and it should not be feared. the fact that God designed such a powerful process, and that simply laughing or saying “I love you” literally softens and calms the body to create a PAINLESS birth?!? GLORY.

every choice you make, what you put in your body, what you feed your mind, how much you educate yourself, your mindset, all has either a negative or positive affect on the sacrament of birth. if only more women knew!

“when you give birth, you are really opened up from being the passageway for another soul into the world. the baby is still linked to you, affected by your moods and feelings, so you are both very opened up, vulnerable to what is around you.”

I will in fact be having an unmedicated, home, natural, painless, heavenly, Holy Spirit filled, sacred, supernatural, free birth. hallelujah amen.

[Anne · Rating 4 out of 5]

I have been drawn to The Farm since I first heard of its existence in the late 70s and have gradually read many books about it.
The first half of the book is the personal stories of the births of many babies born on The Farm and nearby with the help of the Farms midwives. These stories are, to me, stories also of the positivity of relationships of the people living on the Farm and of the real spiritual nature of giving birth.
The second half is a technical, educational medical manual for midwives.
I enjoyed the entire book, learned from it and it increased my admiration for the midwives of The Farm

[Robyn · Rating 4 out of 5]

Ina May is a unique voice in the medical world that most pregnant women are forced to navigate these days. It’s old and much of the context has “dated” in the same way as lime green kitchens have, but that just makes for great entertainment! The heart of what is communicated is still true and more relevant to the politics of birth (and women’s bodies) than ever. I read it for the positive (and unique) birth stories to prepare my psyche for my own birth. Even if you don’t agree with everything Ina May says, and I don’t, it’s still a brilliant read. Geared at inspiring would-be midwives, but relevant to anyone interested in birth.

[Allison Wolff · Rating 3 out of 5]

2.5 stars. I did not find this as helpful as her Guide to Childbirth. The birth stories were really "hippy dippy" but also showed a surprising amount of interventions in the births (tons of cervical checks, enemas, hands on techniques, almost universal use of the semi-reclined seated position during pushing). Some of the information was just plain wrong/outdated - like suggesting babies should be put to sleep on their sides to avoid choking on spit up. And the last section was more technical than the information I'm looking for about birth - geared toward learning and practicing midwives.

[Alexandria Irwin · Rating 5 out of 5]

This book is super interesting! My version (4th) was complete with photos from the farm and families involved which is really cool. So many positive birth stories which was my favorite part! I definitely skipped most of the midwife education but it was a good skim. It’s not spiritual as in new age but it more talks about birth being a spiritual experience, which it definitely can be. It’s basically historical nonfiction and I really enjoyed it!

[Shamyra Felix · Rating 5 out of 5]

This book is amazing. I’ve done separate research on different topics relating to pregnancy and childbirth, but I also owe it to Ina May for the reason why I’ve heard comments at my appointments that I’ve “done my homework”. Great read if you want to be well informed and equipped with tools to feel empowered during your pregnancy and childbirth.

[Jillian · Rating 5 out of 5]

An excellent resource. I especially love the birth stories.

[Jenny · Rating 3 out of 5]

Love me some Ina May. Guide to Childbirth remains the more down-to-earth, accessible read.