Ina May Gaskin

Awarded 2011

USA

For her whole-life's work teaching and advocating safe, woman-centred childbirth methods that best promote the physical and mental health of mother and child.

Ina May Gaskin, who has been called “the most famous midwife in the world,” has brought new life to midwifery in the US and beyond, combining scientific evidence and analysis with her broad experience with natural medicine. Gaskin is a role model for midwives who still dare to think of different paths. She has sought to inspire midwives to implement more humane obstetrics in their countries and provide women with the chance to choose the way they would like to give birth.

With a strong motivation to become a midwife in a country that lacked opportunities for such an educational path, Gaskin founded The Farm Midwifery Center in 1971, at an intentional community in Tennessee. The Center became well known during the 1970s as a place where authentic midwifery was practised and taught.

She has pioneered midwifery education, preserving knowledge mostly forgotten in the modern era of medically-aided births. Her “Gaskin Maneuver,” an obstetrical procedure she learned from traditional Guatemalan midwives, is now taught internationally. Birth videos have helped promote her techniques for the prevention of protracted labours, routine episiotomies, and for successful breech and twin births.

Her work and campaigning have led to the creation of the North American Registry of Midwives (NARM), an organisation that established a national competency-based certification credential for US midwives.

A society that places a low value on its mothers and the process of birth will suffer an array of negative repercussions for doing so.

Ina May Gaskin, 2011 Laureate

Ina May Gaskin is the former wife of the first Right Livelihood Laureate Stephen Gaskin, who received the Prize with his organisation PLENTY International in 1980.

Ina May Gaskin's first midwifery experience was in 1970 when she assisted at a birth in a schoolbus on Stephen's speaking tour of universities and churches prior to the establishment of The Farm, an intentional community in Tennessee, and the subsequent development of Plenty International. This experience inspired her to study midwifery as a way of providing birth choices for women in her country. In the US, the profession of midwifery had been eliminated early in the 20th century because obstetrical leaders at the time saw no reason for its continued existence, and because of the benefits medicated birth and caesarean sections provide to for-profit hospitals, insurance companies and the drug industry, though often not to the women.

The Farm Midwifery Center

With a strong motivation to become a midwife in a country that lacked opportunities for such an educational path, Gaskin founded The Farm Midwifery Center in 1971. The Center became well known during the 1970s as a place where authentic midwifery was practised and taught.

Achievements in teaching and campaigning

During these years, Gaskin has assisted some 1,200 unmedicated births, and together with her partners, the number is at more than 3,000. Her work and expertise have pioneered midwifery education for decades, preserving knowledge mostly forgotten in technically dominated births. Her "Gaskin Maneuver," an obstetrical procedure she learned from traditional Guatemalan midwives, is now taught internationally. Birth videos have helped promote her techniques for the prevention of protracted labours, routine episiotomies, and for successful breech and twin births.

For more than a decade, Gaskin has led a campaign to promote awareness of the dangers of the use of Cytotec (generic name: misoprostol) to induce labour for reasons of convenience. An article she published in 2000 has been credited with prompting the drug manufacturer G.D. Searle to issue a letter to all US maternity care providers warning against its use in pregnant women.

Setting standards for midwifery and maternity care

In 1982, recognising the need for high standards for midwifery practice and education, Gaskin became one of the founding members of the Midwives Alliance of North America (MANA). She served on the MANA Board of Directors from 1982 to 2002, and as its President for 6 years.

MANA later gave rise to the Midwifery Education and Accreditation Council (MEAC), and to the North American Registry of Midwives (NARM), an organisation that created a national competency-based certification credential for US midwives. These developments have led to the passage of laws recognising the NARM midwifery credential in more than half of the states so far. Gaskin and her colleagues have been deeply involved in this process for more than 25 years.

Analysing maternal death rates

In the late 1990s, in order to build a valid case for policy recommendations, Gaskin began her study of maternal mortality rates. While anecdotal evidence suggests that rising death rates are at least partly - if not even to a significant degree - due to the rise in caesarean sections and the use of misoprostol to induce labour, autopsies after maternal deaths are rare even in the US. In addition, the lack of any mandatory federal standard death certificate makes collecting data difficult and incomplete.

Gaskin has campaigned for legislation making mandatory the use of a standard Death Certificate allowing the extent of birth-related deaths to be recorded.

Current main fields of activity

Currently, Gaskin focuses on:

The Safe Motherhood Quilt Project, in which a quilt is made of patches, each with the name of a woman who died in childbirth in the US since 1982. The Project aims to summon the national will to take the first step toward lowering the currently rising maternal death rate by creating a consistent, mandatory system for reporting, classifying, and counting the maternal deaths in the US and reviewing and analysing their causes.

An information campaign, aiming at women, midwives, nurses and physicians, about the potential "side effects" (maternal and fetal death) of using misoprostol to induce labour.

Teaching. Gaskin has lectured to physicians and midwives throughout the US, in Argentina, Canada, Mexico, Brazil, Costa Rica, Sweden, Norway, Denmark, Iceland, Germany, Switzerland, Israel, Italy, Austria, France, the Netherlands, Slovenia, Russia, Hungary, the Czech Republic, Spain, Australia, New Zealand, and Japan.

She also promotes breastfeeding and fights against hospital routines that unnecessarily separate newborns from their mothers, as well as puritanical attitudes which discourage many women from breastfeeding. In some US states, it is still unusual for breastfeeding mothers to be seen in public, and some mothers have been threatened with arrest for doing so.

Books & Publications

In 1975, Gaskin's Spiritual Midwifery was an immediate bestseller and soon became regarded as the authoritative text on home birth and woman-centred midwifery. Having been translated into Dutch, German, Danish, Russian, and Spanish, the book has convinced countless women that labour and birth can be approached without fear and with confidence that most women's bodies are still perfectly capable of giving birth. Recent books include Ina May's Guide to Childbirth (2003), Ina May's Guide to Breastfeeding (2009), and Birth Matters: A Midwife's Manifesta (2011). Gaskin also contributed to an anthology of US midwives that pioneered the return of that profession in the US called Into These Hands: Wisdom from Midwives (2011).

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