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Nacer importa: Un manifiesto de partería

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Upbeat and informative, Gaskin asserts that the way in which women become mothers is a women's rights issue, and it is perhaps the act that most powerfully exhibits what it is to be instinctually human. Birth Matters is a spirited manifesta showing us how to trust women, value birth, and reconcile modern life with a process as old as our species. Renowned for her practice's exemplary results and low intervention rates, Ina May Gaskin has gained international notoriety for promoting natural birth. She is a much-beloved leader of a movement that seeks to stop the hyper-medicalization of birth-which has lead to nearly a third of hospital births in America to be cesarean sections-and renew confidence in a woman's natural ability to birth.

360 pages, Paperback

Published October 15, 2021

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About the author

Ina May Gaskin

26 books455 followers
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.

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Displaying 1 - 30 of 158 reviews
Profile Image for Mona.
22 reviews3 followers
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April 6, 2011
Of course she makes perfect sense. Ina May is the Mother Teresa of the birth world. Why doesn't everyone else "get it". Women, we need to take back our birth !!
299 reviews
August 11, 2011
This book is Ina May Gaskin's "Manifesta." I picked it up after hearing her on the Diane Rehm Show. Although it is very pro-midwife/anti-hospital, it is more about how we need to reform the maternity system in our country. She delves into how we should be compensating OBs and how we need to overhaul how Maternal Deaths are recorded so we can get an accurate idea of why we have such a poor record of mother/baby deaths compared to other industrialized countries. She does a nice job of showing the problem, but she draws a very clear picture of what needs to be done to get us on the right track. This is the first book I have read of hers, but I loved the way it empowers women and will be reading more.
Profile Image for Abby.
1,641 reviews173 followers
March 24, 2019
Ina May Gaskin, patron saint of birth! She is the midwife America needs. This little book is in her customary fiery but loving style: a series of chapters on her most strongly held convictions around birth and maternity care, closing with cogent, practical recommendations for how women can be better cared for—and respected and trusted—in pregnancy and delivery.
Profile Image for Sophie.
45 reviews
December 9, 2025
This book is of course very US focused and Ina May Gaskin has a lot of good things to say about the maternity system in the UK in comparison. At the time of publication, UK C-section rates stood at 15-30% across hospitals, and now stand at 42%. The World Health Organisation recommends a rate of 10-15% is ideal for population health, while the rate of C-Section at The Farm Midwifery Center between 1970 and 2010 was 1.7% (of 2844 pregnancies).

I loved reading about the history of feminism and how equality feminists, including Simone de Beauvoir (who never gave birth), displayed disgust for the female body and often encouraged “the supremacy that the medical profession wielded over women’s bodies” during pregnancy and birth. This seeming contradiction made me think of an incredible essay by Wendell Berry - Feminism, The Body, and The Machine - which reminds me that feminism came too late to a party where the fun had already stopped for both women and men decades prior.

The birth stories are kind of the best bit though. I could read them forever. I especially loved reading ones where complications arose and the midwives guided the mothers through these complications with skill and tenderness, towards successful vaginal births.

But my main takeaway, as is always the case when I read about midwife led natural birth, is that labour is not a pathological event to be feared, it is a natural physiological process that has been perfectly designed to provide a transformative initiation into motherhood. Thank goodness for books like these, and midwives like Ina May, that have been able to undo all the fear-based conditioning I had around birth and instead make it the life event I am most looking forward to. I see a midlife retraining in midwifery in my future. You heard it here first!!
Profile Image for Shana.
1,369 reviews40 followers
September 26, 2012
(I originally wrote this review for Elevate Difference)

When I saw Birth Matters by famed midwife Ina May Gaskin, I jumped at the opportunity to read and review it. Gaskin has contributed to the field of midwifery and childbirth education in vast and meaningful ways. She serves as an icon for many, and I, for one, was eager to learn what she had to say in this new book.

Having already read extensively on the subject of pregnancy, labor, and birth, I found that Gaskin’s book did not reveal anything completely new. However, where other authors have had to rely mostly on secondhand knowledge and data collected elsewhere, Gaskin was able to insert personal stories and years of experience into her writing. This obviously added quite a bit of authority to what she had to say.

Besides the strength in her convictions, Gaskin brought to her writing a powerful feminist stance and a tremendous feeling of sisterhood. She does not only claim to believe in women; she lives this message. Her unwavering trust in women’s bodies and capacities to make the right choices for them based on unbiased, accurate information felt every bit as empowering as I’m sure she meant it.

The issue at hand, however, is that women in the United States today are being fed a host of half-truths and even outright lies that directly affect their decision-making when it comes to pregnancy and childbirth. For instance, Caesarean sections are being promoted as easier, pain-free means of giving birth. But are they really? How come we rarely hear about the risk factors involved in this serious abdominal surgical procedure? Why is it that the United States has higher infant and maternal mortality rates than other developed countries?

According to Gaskin, Americans are relying too much on modern technologies and not enough on the wisdom passed down through generations or the innate knowledge that women’s bodies have about giving birth. Instead of fetoscopes, there is a higher reliance on electronic fetal monitors. Rather than allowing the baby to emerge in its own time, medical professionals are utilizing Cytotec to induce labor even though the drug is not FDA-approved for this purpose. Some feminists believe that reproductive technologies will help even the playing field, or even erase biological differences that could potentially hold them back in the fight for equality. For Gaskin, this perspective fails to see the beauty and strength that a birthing woman exudes, not to mention the natural mechanisms that are in place to assist a laboring woman during this life-changing time.

Besides the wealth of information that Gaskin provides, the parts of Birth Matters that touched me most were the birth stories that were interspersed throughout. Each account shares extensive detail about the mother’s sensations during the entire process of labor and delivery. I couldn't help but tear up as I read them because they captured so much warmth, power, and love. In the end, it is exactly this that Gaskin wants to share with the world.
Profile Image for Logan.
1,664 reviews56 followers
April 7, 2014
I believe Gaskin has written other books that address home birth specifically, this book seemed to be more of a last hurrah toward addressing home birth, women's rights, second-wave feminism, and problems in the way the US treats birth choice.

There was an ample amount of feminism (as even the title suggests) but it was refreshing to see someone who advocated women being women and not treating childbirth as a form of slavery. I appreciated her stance that it is a natural process and find it very unfortunate that it has become increasingly medicalized, to the point where it is often treated as surgery. With rates of C-sections rising (and alarmingly, most of them occurring between 5pm and 6pm, when the doctor wishes to go home), I do believe that people need to be informed that there are risks and that it doesn't need to be this way. Even more alarming is that most obstetricians or nurses have apparently never witnessed a live birth before beginning their career. The time of apprenticeship and learning through experience has been ditched in favor of textbook learning and being under instructors who themselves may never have witnessed such a thing.

I was surprised to find out that a good portion of Europe is not like the States. C-section rates are dramatically lower and midwives (though the term may have a different connotation there) are accepted medically, sometimes to the point where insurance assumes one will use a midwife and a obstetrician is not covered.

There were lots of good things in the book, informing the choice of where to have one's baby and the risks involved. As I expected, home births have less risk than hospital births (though there could be many factors involved, including less at-risk women choosing home births). Hospital births are in a sterile, unfamiliar environment, with strangers (who are replaced by more strangers when their shift ends), monitors, uncomfortable positions, bright lights, rote probing, it's no wonder that it can be a very stressful time. Home births can certainly still be painful but have the potential to be much less stressful. For example, I am confident that our first child would have been a Caesarian if we had gone to the hospital first. Hospitals, though sterilized as much as possible, also have the potential to introduce sicknesses or germs not familiar to the mother and baby. A home environment actually tends to have less sickness, possibly because the family is already used to what they are exposed to.

So there were many good things in the book, but I would take many of the statistics with a grain of salt and it is not from a Christian world-view. Correlation does not equal causation and there may be many, many factors that account for differences in home vs hospital birth. I do wish regulations would relax so that informed people could have a choice. The book was good and I would recommend at least the first half for people considering home birth as an option. The latter half tended to be more political, or more of a "manifesta" concerning the midwifery movement.
Profile Image for Sally.
1,244 reviews37 followers
April 17, 2012
Ina May is passionate about birth. She also probably knows more about *normal* birth than any living soul. I've just realized though, that she's leaning towards a place of "legislate this, legislate that." It's completely understandable: not only are birth practices these days NOT evidence-based, but they're dangerous, and she's spent her entire life trying to support and educate women AND doctors about the wonder and power and safety of normal birth (and the dangers of typical hospital birth), and no one is listening.

I can get behind the legislation of assessing and recording maternal deaths. Such an untold travesty that women die more than is necessary due to birth in "developed" countries like the USA these days, but that there is no reliable system for recognizing causes and recording actual numbers?!

Her "Vision for the Future," chapter 8, is impressive in its scope. I don't see it happening anytime soon, sadly. It illustrates, to me, the importance of each of us engaging in kind, thoughtful dialogue with those around us on the issues we hold dear to our hearts. That's where change occurs, in individuals who consider a new point of view because a brave friend showed them a new idea.
Profile Image for Liz.
965 reviews
November 7, 2014
I really love Ina May Gaskin. This book outlines her vision for maternity care and details how the US can lower maternal mortality and provide better humanistic care in pregnancy and birth. It's far less "hippie" than her other books, taking on a style similar to Pushed: The Painful Truth About Childbirth and Modern Maternity Care. I loved it and will probably buy it to add to my birth books collection.
Profile Image for Karīna Liepiņa.
111 reviews19 followers
March 22, 2021
Kā vienmēr Ina May Gaskin sarakstījusi lielisku grāmatu. Es noteikti šo ieteiktu kā obligāto literatūru ikvienai vecmātei, ārstam, dūlai, kas ikdienā strādā dzemdniecības jomā!!!!! Arī ikvienam vecākam, kurš grib piedzīvot dabīgas dzemdības, un kurš tic, ka Dievs mums devis visus resursus, lai sieviete to izdarītu pati ( te neietilpst ārpus kārtas gadījumi ar sarežģījumiem utmldz.)
Profile Image for Julie Salvo.
7 reviews
August 7, 2011
Loved it. I've read Ina May's other books, but this one was more streamlined and "easier" for my pregnant brain to handle. Ina May's overview of birth's modern history is shocking, yet empowering.
Profile Image for Elise Reding.
18 reviews2 followers
June 30, 2016
Such an empowering and informative book to read during pregnancy!
Profile Image for fancy cheese.
5 reviews
February 1, 2024
This is one of the most enlightening and empowering books I have ever read. I believe that every woman, whether contemplating motherhood or not, should take the time to read this book. Reading about the inherent strength of women's bodies and their remarkable endurance was incredibly empowering to read about. I feel powerful in knowing the deep connection to nature and the innate capabilities my body holds. However, It saddens me that the medical industry and birthing practice in America frames pregnancy and birth as an illness and emergency rather than a natural and enlightening experience that most women are more than capable of doing. The prevalence of misinformation and fear-based practices pushing women towards surgical births and leading to, in most cases, unnecessary interventions is concerning. I recommend this book to everyone, as I will forever hold the knowledge I have gained close to my heart.
Profile Image for Brenna.
158 reviews1 follower
October 13, 2025
Ate this up. I love everything she says. Quick and easy read that just boggles the mind about how far we are from women-centered obstetrical care.

Only downside: she criticizes that not every nurse graduates nursing school with working knowledge of how to assist a woman in labor. So many nurses have no interest in that area, and in all of my nursing jobs you really learn on the job, in orientation. As an L&D nurse, it was my only time NOT loving having a student because birth is such a special, sacred time and really doesn't need to be shared with a random nursing student that wants to do ED for the rest of their life anyways.
Profile Image for Eva.
186 reviews
July 19, 2025
such an important book that i would recommend to everyone and anyone. i was pleasantly surprised to read so much data from and information about the birth system in the netherlands. even though i still think we have a long way to go with encouraging natural birth and dispelling the fear surrounding giving birth. i really hope giving birth naturally and intervention-free, possibly in my own home, is in the cards for me someday
Profile Image for Lexie Rich.
130 reviews1 follower
September 16, 2025
This book outlines how we need to make strides towards better maternity care in our country. With a focus on midwifery care, Ina May speaks to empower women through the pregnancy and birthing process. There were parts of this book ai could have done without, but overall felt it was informative. I enjoyed the uplifting birth stories along with the history of Ina May’s journey into midwifery that were an added bonus to this book. (Would have rated 3.5 ⭐️)
Profile Image for Tara.
33 reviews2 followers
November 13, 2024
Great source of information! Ina May constantly fighting the good fight in advocating for women and their rights to proper medical treatment. This book really highlights the areas in which we need to do better for women and maternity care in general. Loved this one!
Profile Image for Sena.
268 reviews6 followers
October 26, 2023
5/5 okul için aldım ama çok beğendim cidden her genç kız aynı zamanda erkekler de okumalıymış
1 review
May 25, 2024
must read for expecting mothers

All women and men should read, but especially birthing mothers. Insightful, scientific, and based in modern day science and ancestral wisdom.
Profile Image for Sherri Anderson.
146 reviews1 follower
June 27, 2024
3.5 stars. Somewhat repetitive of the content from Ina May’s guide to childbirth. I enjoyed the birth stories, wish a few more current ones had been included.
Profile Image for Jorgina.
247 reviews4 followers
April 10, 2025
Mucha teoría, no es lo que ahora buscaba para leer, pero es importante darle visibilidad a lo que se hacía anteriormente y cuestionar más de una cosa que se hace hoy en día.
Profile Image for Taylor.
47 reviews22 followers
June 8, 2016
I would recommend that anyone read this book, but it is an absolute must-read for any woman who is a mother, wants to be a mother, or is pregnant and in the process of becoming a mother. I feel really fortunate that a family friend gave me this book when she learned I was pregnant, and I finished it in my ninth month, just when my pregnancy had reached full term and I was ready for my little bundle to arrive. When I started the book, I was planning on having a natural, intervention- and drug-free, out-of-hospital birth, but I was nervous. The idea of going through labor was scary (just the name we've given it -- "labor" -- says something of the process!), and I had heard so many horror stories from women who gave birth in hospitals with pain medication about how painful it was despite the meds they were on that I wasn't sure I wouldn't just fall to pieces, that I could push through to the end (no pun intended). This book totally allayed my fears, and gave me the confidence I needed in my own body's ability to give birth the way women have been since the dawn of time (with the insurance of modern medicine in case of emergency).

Now, with my due date just around the corner, I don't have a single fear about the labor. I feel as if Ina May has given me and my husband a toolkit to utilize throughout the labor process that will help to make it as painless and stress-free as possible. The more of the book I read, the more I actually looked forward to labor, in spite of the nail-biting anxiety I'd had for months about the big day!

The book itself is a very informative look at the ideal scene for labor and maternity care, maternity care that treats every woman and infant as an individual. It looks at the bleak history of maternity care in America and the state of it in the many countries to which Mrs. Gaskin has traveled, and she gives a very clear-cut path towards repairing women's confidence in their body's ability to give birth naturally and changing the way medical practitioners are taught about and how to handle pregnancy and birth. She also very clearly explains, in a way laypeople to the medical industry can understand, why natural birth and proper maternity care is so crucial. Some reviewers have said that her approach is imbalanced and a tirade against modern medicine, but I would totally disagree. Instead, Gaskin is reducing our cultural fear of birth and replacing it with factual information. She describes what she and other midwives and medical practitioners have experienced in the realm of intervention-free birth (like startlingly low rates of C-sections and maternal and infant deaths compared to national averages), and how this compares to what she and others have seen and experienced in hospitals. Interspersed among these facts and observations are birth stories from women who strove to have the births they wanted, including from one woman who had to be induced at a hospital but who refused pain medication. Prior to reading Birth Matters, I was pretty squeamish about reading birth stories and didn't see the point of sharing them, but I am really happy that they were included in this book and that I read them, because they really reinforced that budding confidence I was developing thanks to Ina May in my ability to survive and actually enjoy my labor experience.

My own baby's arrival is imminent, and I know I would still be approaching it with fear, trepidation, and doubt in my ability to survive the experience if not for this book.
Profile Image for Vanessa.
23 reviews
November 6, 2012
Over the past decade, I have read just about every birth related book on the market. I was not excited to have to read another, especially since I just gave birthi for my third and final time and I have been pulling away from birth work for the past few years. So when reading my review keep in mind that I am particularly jaded at this point in my life!

So, I was not impressed with Ani De Franco's forward. I know she is supposed to be the hero of all freethinkers of my generation, but I never got the appeal of her music or persona. Maybe it was because my husband's girlfriend prior to me meeting him was really into her? I have no idea, but her gushing about the need for women to surround each other at births to heal the world was a bit much. My logical mind was screaming that no, we don't need intuitives at births, we need more properly trained midwives who are held to the same accountability as doctors.

As I got into the text, it was a chore to read each page. I had to bride myself with the promise of tracking my progress on Goodreads. Seriously. This book added nothing new to the conversation. It was more of a rehashing of Gaskin's two other birth books with some new birth stories thrown in. I winced when she described a father experiencing labor instead of his wife. And so much of what she wrote is based on her own experiences and intuitions. The skeptic in me was demanding more data, less demonization of the "masculine" medicalization of birth and less of the whole "woo" stuff. So much of what she writes is impractical, impossible to prove and would not be manageable outside of a very small, insulated community environment, like her commune. Many of the previous reviews call for this to mandatory reading for medical and nursing students. Why? They would cringe at the unscientific nature of this book. And as someone who has had two out-of-hospital births with midwives, one at home, I would not want this book to represent the movement. It points the finger too harshly at doctors and hospitals and refuses to look into the heart of the problems of the profession of non-nurse midwifery in the U.S. Which isn't being caused by doctors, but by the lack of regulations and standards.

There is very little new ideas or information in this book. It was a tired rehashing of the battle of female midwives against the male oppressors, the hospitals. And this is so far from where we need to be to improve birth choices that it was laughable that she devoted a chapter to a vision of "working together."

I do admire what Ina May has achieved in her career. But this is not the 60s or 70s, when she came of age. We have much better information, technology and training available. She should no longer be pushing a message of oppression, it isn't relevant to her new audience of young women who have come of age with as much information accessible to them as they wanted to avail themselves. While she points the finger at feminism needing to evolve to include mothers, I think it is her vision that is lacking. And it is very clear in this book.
14 reviews5 followers
January 19, 2019
I was simply delighted when I received a request to review Ina May’s new book Birth Matters. As a fan of her work, I wondered if this book would just rehash information and ideas from her previous books. I hoped that we would finally get a better glimpse into her thoughts on the current state of birth in our culture and a better understanding of her teachings and findings. In the back of my mind, I feared that this would be just another book about natural childbirth.

I applaud the title of this book, Birth Matters; It seems so clear and simple. It sums up perfectly the message that Ina May and many other influential voices have dedicated their lives to bring to the world. In this manifesto, it will be made clear to you that Ina May does not do this work for money or fame, but because she cares about women and babies, whose lives are on the line.

Ina May has a vision. That vision is that outcomes for women and babies would be put first and foremost in America and that US maternal outcomes would be reported accurately. It doesn’t seem like too much to ask, does it? Ina May tells us why this isn’t happening, and more importantly what needs to be done to fix it.

Birth Matters tells the story of how we view birth. At the core of who we are as a society is the way in which babies are being born and how women feel about the process.

Ina May stresses the importance of passing on birth stories, and how this simple act can help shape a healthy birth culture. She includes birth stories in this book as well; What Ina May book would be complete without them?

She gets straight to the heart of the problems in our birth culture, e.g., our shame at the intimacy of birth, our ignorance and willingness to ignore the simple physiology of natural birth and it’s connection with other innate bodily functions, and our denial of midwifery’s impact on healthy birth outcomes and family relationships.

Dedication and research shine through in her attention to detail. She offers insights into the history of midwifery in the United States and those she refers to as “medical men”; How this history has shaped our current views and practices in maternal care. References are cited well, but it’s Ina May’s thoughts and opinions, not facts and figures, that make this book worthwhile.

While reading, one question remained. What did Ina May propose that we do about all of this? She presented a lot of problems, but did she have a solution? I am happy to report that Ina May does propose real solutions so that you and I can take action immediately. Read this book only if you want to shed light on the problems with our current birth culture and want to see real, lasting change.

Read more: http://nerdymillennial.com/book-revie...
Profile Image for Lisa.
186 reviews
December 17, 2013
Wasn't sure if this one deserved four stars or five, since it's the first of its kind I've read. By kind, I mean a manifesta on the importance of birth and women's rights regarding how they birth. Okay, never mind, it's a five star just for that.

I went into reading this book with a very bad birthing experience behind me, and also pregnant with my second, wanting to have a home birth while my husband was pushing for a hospital birth--which blew my mind, considering the danger the hospital personnel put me and our baby in last time. No, I knew I needed to birth this time in a place where I felt safe, and that would NOT be a hospital (unless there was a real medical reason for it). So as I started reading this book, I kept saying, "Yes! YES!" to what Ina May had written.

Ina May Gaskin advocates in this book for women's rights. The right to birth where we want, and why that is so important. Why feeling safe can actually make birth safer. Also the right to know the side effects of drugs and other interventions used in the birthing process, why intervention-free birth is often safer. Women should be the ones in control of their births, not doctors, nurses or midwives.

Gaskin also shares many birth stories to illustrate that births can all look very different, progress very differently, and yet still have a good outcome without medical intervention. I find the stories empowering...to know that I can listen to my body to get my baby out safely. If there is a problem, a well-trained midwife can spot it and give me appropriate advice. In my first birthing experience, I was not allowed to listen to my body. I was barely allowed choices. I had a traumatic experience that became dangerous, which I am not sure was necessary.

In the end Gaskin proposes solutions to the problems of maternity care in the US. Her greatest concern seems to be unnecessary maternal deaths (and rightly so, I should say). Whether her propositions are the best ones, I cannot say (though if anyone was qualified to have an opinion on the topic, it would be her), but I am with her that there do need to be changes made in our maternal health care system. It's absolutely deplorable the way women are treated in regards to giving birth here, and our options are not very good. Just for example, in order for me to get the kind of care I want for my current pregnancy, I had to find a home birth midwife who is also an ND. If I were to give birth at a hospital or seek prenatal care from an OB, my experience is that the quality of my care would be so much less, and it shouldn't be that way! So many women just do not have accessibility to the options they want or need. I thank Ina May Gaskin for standing up for women's maternity (and health care in general) rights.
Profile Image for Tamlynem.
178 reviews
April 15, 2015
Ina May Gaskin has a point: why is childbirth so medicalized and why does it seem like the hospitals are just treating to turn a profit? On the other hand, if you think The Farm has only motives of good intentions and altrusim, I encourage you to at least go read the wikipedia page about it.

The problem she identifies of not using evidence-based medicine is not just a problem for women and for the area of child birth; it is a problem in all aspects of medicine. I can't cite you a source for it, but I'm pretty sure the mandate for using evidence-based medicine is not in the Affordable Care Act, either. Your a federal employee and you want to know why your health insurance does not generally cover abortion but it will pay some Christian Scientist to pray over you? Look to the special interests that shaped the employee health coverage.

But I do give her credit for bringing awareness to the problem that the health care industry does not always have the average women's best interest at the forefront. Yes, we should have more large, randomized, controlled, peer-reviewed related studies regarding best practices for childbirth in the U.S. Now, who will pay for it?

Also, to her point about more accurate cause of death documentation for cases where women died in childbirth: There is a fantastic PBS Frontline documentary on the topic of causes of death on death certificates. Examining death certificates is part of my job, so I was horrified to discover that in many places in the U.S. the coroner is an ELECTED position, not one that requires special skills and training. And autopsies are exceedingly rare, even in cases where they should be completed. After awhile, you realize most of the time whoever signs the death certificate is typically just phoning it in. Also, in most cases involving disease, you really need complete medical records to get at the root cause of etiology.

Finally, while I ultimately really like Ina May Gaskin and I believe she is a fantastic midwife, she really lost credibility with me when she criticized Gardasil. Her arguments about it were not persuasive to me and seemed akin to the loser arguments regarding immunization generally in this country. When you look to the CDC to see how this drug was tested I think they did their job.
Profile Image for Stephanie.
231 reviews
November 7, 2011
This book is a must-read for anyone concerned about human rights. Ina May's vision for the future of woman-centered maternity care includes revising medical education so that obstetricians understand the normal process of labor and birth and how to encourage it; establishing maternity care standards to address C-sections and other interventions performed without medical justification; creating birth centers with economic and legislative protection; and setting up a national system to count and review every maternal death. Before outlining her vision, Ina May addresses at length our culture of fear surrounding birth and assures the reader that birth is a normal physiological process that is highly linked to a woman's emotional state (think beta-endorphins and oxytocin versus adrenaline). I appreciate the title of her book alone--Birth Matters--because I too agree that birth is not an insignificant process (consider the phrase, "Oh as long as I have a healthy baby..."); rather, it is a life-changing event that can be empowering and transforming or conversely, degrading and humiliating. This is not a book meant to be divisive--consider the words of Ina May here:
Most US women today have become used to feeling judged by each other--used to hearing endless polarizing arguments between mothers and women who have no children; those who stay in their homes with their children on a full-time basis and those who work outside the home; those who give birth with or without pain medication; those who favor home birth or hospital birth; those who breast-feed and those who bottle-feed... What a delicious thing it would be to take this issue that we could all agree on and make the solution happen. What a life-affirming and lifesaving campaign this would be (206).
And lest you're still unconvinced that Ina May has something important to say, consider the following: "A woman who gives birth in the US today is more likely to die in childbirth than her mother was. With one in three babies born via cesarean, the US ranks behind thirty-three other nations in neonatal mortality rates, and forty other nations in maternal mortality rates."
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425 reviews14 followers
October 20, 2012
Ina May Gaskin is such a leader for women that are giving birth! This book is somewhat of a manifesto and details what she wants to see for the future of birthing in our country. Basically the United States performs C-Sections WAY too often and goes to medication (epidural, pitocin) as more a routine rather than just when truly necessary. We also have way too many physicians aiding birth when trained midwives would be much more effective and safer for women. In our country you would like to think that women do not die in childbirth, nor babies. But because of the unecessary practices hospitals have developed as the norm, our mortality rate is way higher than any other industrialized country. I'm so lucky to live in a big city where there are birh center options but many places in our country women have no choice and don't think twice before letting the medication and doctors take over. Did you know that lying on your back is actually one of the most ineffective ways for a woman's body to give birth? Yet this is the way birth is always portrayed on television in the USA and the way most women think about delivery. We are entrusting our OBGYN's with something that many are not effectively trained for. It is really fascinating and scary at the same time that millions of women allow for the an easy decision of drugging themselves and their newborn babies up the day of birth. This is crazy to me that most women think it's necessary. We were built to be able to withstand birth- just like all other mammals.
If you are looking for an into. into these ideas, I recommend the book Your Best Birth. If you already have a lot of knowledge on the topic, this book digs deeper and was a smooth read.
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