BIRTHIN' BABIES: Spiritual Midwifery & Ina May Gaskin...

The wife of "The farm" founder Stephen Gaskin, Ina May Gaskin, C.P.M., is the founder and director of "The Farm Midwifery Center" in Tennessee (USA).
She is the author of "Spiritual Midwifery" (1975) and "Ina May's Guide to Childbirth" (2003).
She was president of "Midwives' Alliance of North America" (MANA) from 1996 to 2002, and is a prominent national and international speaker.
She has been a homebirth midwife for more than thirty-four years.

...The Farm is a famous spiritual Intentional Community in Summertown, Tennessee, based on principles of nonviolence and respect for the Earth.
It was founded in 1971 by Stephen Gaskin and 320 San Francisco hippies.
In the time since its founding, The Farm has fashioned itself as an Ecovillage. It has approximately 250 residents as of 2004.

The Farm is home to the famous "Farm midwives", led by Ina May Gaskin, the mother of modern midwifery.

The following article is from salon.com-June 1, 1999

From her Tennessee commune, Ina May Gaskin almost single-handedly inspired the rebirth of midwifery in this country.

June 1, 1999 | With her long, graying hair, often in braids, and her flashback '60s clothes, Ina May Gaskin isn't as glamorous as many other pregnancy and childbirth "experts" seen frequently on television and in the glossy parenting magazines.
Instead, Gaskin looks like what she is: a hard-working, grandmotherly ex-hippie who still lives on the Farm, the legendary Tennessee commune that she and several hundred others founded in 1971.
Yet despite her relative personal anonymity, Gaskin's influence on U.S. birthing culture has been profound. She's widely credited with having created the modern home-birth movement, as well as with almost single-handedly inspiring the renaissance of midwifery in the United States. And her 1976 book, "Spiritual Midwifery," a smallish trade paperback with a psychedelic cover design reminiscent of the Indian-print curtains on a '73 VW bus, is in its third printing, with more than a half-million copies sold.

"Ina May's contribution to the culture of childbirth in the U.S. has been enormous," says Robbie Davis-Floyd, Ph.D., a research fellow in the department of anthropology at the University of Texas and author of "Birth as an American Rite of Passage." "I have known for years that she is the most famous midwife in North America; now I can say without hesitation that she is also the most famous midwife in the world."

Although this sort of professional recognition from academics, physicians and researchers has become routine for Ina May Gaskin, it is somewhat unusual, considering that this "most famous midwife in the world" has neither a Ph.D. nor any formal medical training. Instead, Ina May Gaskin's road to prominence has been decidedly nontraditional.

The woman called "the mother of authentic midwifery" by Midwifery Today editor Jan Tritten began life 59 years ago in Marshalltown, Iowa, as Ina May Middleton, the daughter of what she describes as a "stable, Midwestern, Protestant family." She grew up a tomboy, wrestling with her brother, delivering newspapers and reading voraciously. Although Gaskin claims she never imagined she'd one day become a midwife -- planning instead to become an engineer -- she does remember checking out of the local library the early natural-childbirth classic "Childbirth Without Fear," by Grantly Dick-Read. Gaskin concedes that this was an unusual reading selection for a 16-year-old Iowan in 1956.

"Birth just always fascinated me," explains Gaskin. "As a teenager, I could always tell you every detail of the birth stories in the historical romances I read."

An excellent student, Gaskin graduated from high school in Marshalltown in 1958 and decided to turn her academic aspirations to English after being denied a scholarship to study any of the "men's subjects" she was interested in. Married at 19, Gaskin attended community college before transferring to the University of Iowa, where she earned her English degree. After graduation, she joined the Peace Corps with her husband and lived in Malaysia teaching English, later returning to the Midwest to obtain her master's in English from Northern Illinois University in 1967.

While she was a graduate student, Gaskin gave birth to her first baby in a hospital with an obstetrician in attendance. Despite her confidence that she could have the natural, unmedicated birth she wanted within the strictures of the medicalized childbirth system, her experience wasn't a pleasant one. "During birth at the hospital, I was left alone and treated like I had done something nasty. Then I was approached by a gang of masked attendants who came in the room and treated me like a ritual victim. They used forceps, and then I wasn't allowed to see my baby for 18 hours," remembers Gaskin.

Not long after becoming a mother, and radicalized by her own childbirth experience, 27-year-old Gaskin and her husband and daughter packed up and left for California -- the epicenter of the cultural universe in the late 1960s -- to, as Gaskin succinctly puts it, "become hippies."

There Gaskin's transformation from mother to mother of midwifery commenced in earnest. She began attending a lecture series given by the man she would later marry, San Francisco counterculture guru Stephen Gaskin, in which he spoke to groups of up to 2,000 young hippies on everything from religion to politics to sex. At these classes, Ina May Gaskin was exposed for the first time to a variety of women relating tales of their own unmedicated, outside-the-hospital births, an experience she found so affecting that to this day she remembers virtually every detail of the stories she heard a generation ago. For the first time, recalls Gaskin, she understood how beautiful a birth could be, given the right setting and support.

In 1970, a pregnant Ina May (who by this time was involved in what she describes as a "group family situation" with her husband and Stephen Gaskin and his then-wife) set off with approximately 250 other followers of Stephen Gaskin on what came to be known as "the Caravan" -- a five-month-long speaking tour across the United States. Traveling in colorful converted school buses, the group stopped in towns, cities and on college campuses so that Stephen Gaskin could lecture. One evening, while the buses were parked at Northwestern University, a pregnant woman from among the Caravan group went into labor. The sojourners had no money to pay doctors, and according to Ina May, their beliefs didn't allow them to accept welfare. Thus, with no physician in attendance, and with the woman's own husband catching the baby, she easily gave birth to a healthy boy. This turned out to be the first of 11 babies born on the buses during the Caravan.

"When each birth took place," writes Gaskin in "Spiritual Midwifery," "we all parked in a sort of protective formation around the bus in which the birth would take place, and everyone waited for the baby's first cry."

By the third birth within the group, Ina May Gaskin had emerged as a natural at attending births. Mothers began to request her presence during their labors and deliveries. She knew she was feeling a calling to become a midwife. But Gaskin still had had no medical training, until a Rhode Island obstetrician, having read in the local newspaper about the visiting hippies' bus births, took the trouble to visit the Caravan and offer her and a few other women some training in the essentials of midwifery.

"He gave [us] a hands-on seminar on how to recognize any complications we were likely to encounter, and what to do if we did, demonstrating how to stimulate a baby to breathe, what to do if the umbilical cord was wrapped tightly around the baby's neck, what to do if the mother hemorrhaged. He taught us sterile technique and provided us with some necessary medications and instruments, my first obstetrics textbook and gave us instructions on how to provide good prenatal care," remembers Gaskin.

With this rudimentary start to her education as a midwife, Ina May Gaskin was present for each of the next births that took place on the Caravan. Sadly, the 10th birth -- that of her own child -- ended with the death of her two-months-premature son, born on a bus in Grand Platte, Neb. At only 3 pounds, the baby lived a mere 12 hours and died in Gaskin's arms. Her grief over her loss only strengthened her resolve to continue helping other women to achieve empowering births with healthy babies.

Shortly after the Caravan returned to San Francisco, the group of 250 Gaskin-ites decided to establish a commune in the rolling farmland of middle Tennessee. Named the Farm, the commune flourished during the '70s and early '80s, eventually reaching a population peak of 1,500 in 1980. Since the early '80s the Farm population has held steady at more than 200 residents.

With a thriving community of men and women of childbearing age living on the Farm, pregnancy and childbirth became common occurrences. Soon after the commune's founding, and with the support of a sympathetic local doctor, Ina May and several other women established an on-site midwifery clinic to which Farm residents could come for prenatal and childbirth care. Births took place wherever the mother wished to be -- usually in her home. Women from outside the community were also able to hire the Farm's midwives as birth attendants at a cost of less than half that for OB care. Today, the majority of the 100 births a year the Farm midwives handle are of women living outside the community.

With the publication of "Spiritual Midwifery," in 1976, Ina May Gaskin's work on the Farm began to receive wider notice. A mix of first-person homebirth stories, black-and-white birth photography and information on caring for women in pregnancy and childbirth, the book laid out Gaskin's philosophy that birth is a spiritual event akin to making love, and that women could take back the power to give birth without excessive and unnecessary medical intervention. These were revolutionary ideas at a time when the ancient profession of direct-entry or "lay" midwifery -- in which midwives receive the majority of their training through apprenticeship with other skilled midwives rather than in medical or nursing school -- had all but died out in the United States under intense pressure from physicians' groups such as the American Medical Association and the American College of Obstetricians and Gynecologists.

Gaskin's book introduced an entire generation of young women to the possibility of homebirth and midwifery. Passed from mother to daughter and from friend to friend, the book's impact stretched far beyond its actual sales figures. Many of today's midwives and midwifery advocates report having discovered their career calling in the pages of "Spiritual Midwifery."

Susan Hodges, the president of Citizens for Midwifery, says of Gaskin's book: "I first heard of Ina May Gaskin when my Bradley Method childbirth educator loaned me her copy of 'Spiritual Midwifery' when I was pregnant the first time. This book had an enormous impact on me and changed the way I thought about childbirth."

Karen Lupa, who went on to become a certified nurse-midwife, remembers, "I was first exposed to 'Spiritual Midwifery' while riding on a train in the '70s. A fellow passenger had a torn-up copy that I got to read various pages of ... enough to see that it was way different from what I learned in nursing school. It seems like 'Spiritual Midwifery' has been such a milestone in the natural birth movement that it couldn't have quite happened without it."

As women read and talked about "Spiritual Midwifery," demand for midwifery care began to grow, and by the early 1980s, despite the fact that the practice was illegal in many states, the number of midwives in this country was again slowly on the rise. Awareness of midwifery in the United States has been increasing ever since: The American College of Nurse-Midwives reports that while only 6.14 percent of this country's total births are attended by midwives, preference for in-hospital, midwife-attended births in the United States grew from about 20,000 in 1975 to almost 239,090 in 1996. Currently, approximately 30,000 women each year give birth in planned homebirths, and there are now approximately 10,000 midwives, both direct-entry and nurse-midwives, practicing in this country -- still many fewer per capita than in other Western nations.

In addition to her writing, Ina May Gaskin's renown has spread through her clinical midwifery skills, developed entirely through independent study and apprenticeship with other midwives around the world. The statistics for Gaskin's midwifery practice, which has delivered more than 2,300 babies, tell the tale. In contrast to the national Cesarean rate of over 22 percent, the Farm's midwives have a rate of only 1.8 percent. And in 1992, a peer-reviewed study of the work of the Farm midwives in the Journal of the American Public Health Association compared over 1,700 planned, direct-entry, midwife-assisted home births with approximately 14,000 statistically matched hospital births. Only 2 percent of the women who gave birth at home experienced such interventions as forceps, vacuum extractors or C-sections, while 26 percent of those giving birth in the hospital encountered these outcomes.

Additionally, Gaskin is now credited with the development and growing use of the Gaskin Maneuver, a revolutionary approach to dealing with the life-threatening obstetrical complication known as "shoulder dystocia," in which a baby's shoulders become stuck in a laboring woman's birth canal. In collaboration with Dr. Joe Bruner, a professor at Vanderbilt University College of Medicine, the Gaskin Maneuver has now been written up in the May 1998 issue of the Journal of Reproductive Medicine, as well as presented at medical conferences. This marks an extraordinary achievement for a direct-entry midwife.

According to Robbie Davis-Floyd, Gaskin's ability to bring together the sometimes hostile opposing camps from the worlds of medicine and midwifery has been perhaps her greatest achievement. Ina May is "warm, funny, good-hearted, brilliant, politically savvy and aware -- a postmodern hippie who holds a very strong space for her alternative knowledge system yet moves with fluidity and ease in the professional, political and medical realms," notes Davis-Floyd.

As one of the founders and the current president of MANA -- the Midwives' Alliance of North America -- Gaskin has been at the forefront of legalizing and credentialing direct-entry midwifery while maintaining a "separate but equal" status with certified nurse-midwives. She has been instrumental in the development of the rigorous Certified Professional Midwife (CPM) certification process, which is rapidly gaining momentum within the midwifery community. And Gaskin also acts as publisher of Birth Gazette, a respected quarterly magazine for midwives and others, and conducts training for other midwives both at the Farm and around the world. Lastly, she has just written a book, tentatively titled "Ina May's New Birth Book: Breaking the Spell of Fear," which has attracted interest from several major publishers. Currently, however, she says that her favorite activity is spending time with her newly born grandaughter, born at home on the Farm with Gaskin and the baby's other grandmother -- also a Farm midwife -- in attendance. Gaskin says that if people take one message from her life's work it should be that birth is normal. "As a culture we really have to figure out how we got so afraid of birth and why, of all places in the world, we got rid of midwives here."

http://www.inamay.com/

Have your baby at the Farm...The Farm Midwifery Center
http://www.farmcatalog.com/birth.htm

The North American Registry of Midwives
http://www.narm.org/mission.htm

http://www.midwiferytoday.com/

Quoting "N.H."..."One afternoon I was out on the sidewalk...and here came Mother Teresa herself along with some other sisters.
First she put her hand on my son Kyle's head and blessed him.
Then she took my hand and said, "Oh, The Farm and Plenty, You are the heroes of the world."
She had tears in her eyes when she said that, so I started crying too."

"In all fairness there is more than enough to go around..."
http://www.plenty.org/

http://www.thefarmcommunity.com/


Ina May was and is a true pioneering visionary, (and all around Nice person.)
She has done some incredible good in her life.
The definition of "hands on activism", that gal... I Thank God for her and "her kind." Without question, imho, she is truly one of the of the greatest women/minds to have come out of the "Hippe back to the land Movement."
A true credit to the human race that Ina May, may God Bless her..
If ICMAG had a women of the year/ lifetime accomplishment award, she would be my nominee.

IMB

An Interview With Ina May Gaskin

An Interview With Ina May Gaskin

article was originally published in The Practising Midwife, January 2002.


Ina May Gaskin has been described as “the most famous midwife in the world”. A self-taught 'lay' midwife, she has practised midwifery for over thirty years, written books about her experiences and lectured all over the world. She is the immediate past President of the Midwives Alliance of North America and recently visited the UK, where she gave the following interview.


Ina May, you've been a midwife for thirty years this year. How has midwifery changed in the thirty years that you've been practising?

For me, in the US, midwifery didn't exist thirty years ago. And so many women didn't even know there was such a thing. Of course, there were a few nurse-midwives, but they hadn't got their message out. But then this sort of eruption happened, of people who just suddenly became midwives overnight, because their friends just demanded, “stay home with me”. These midwives got their skills and knowledge base out of books, from midwives who were trained in Scandinavia, Britain, other countries. Sometimes there was a kindly doctor - of course, women need other women - but they would help. And there were hippy doctors; residents, SHOs, doctors-in-training who became part of the movement too, they came out and taught us things, things to look out for.

People expect there will be midwives now, a good section of the people anyway. Just under ten percent of the population have a midwife-attended birth in the US now, it doesn't sound like much, but that's up from nothing. A lot has been done there, and we have a whole generation of people born at home, and of course they have their effect too. That makes it stronger, so we've got a little hardy plant that's starting to grow. And we've certainly helped the growth of nurse-midwifery because all those people who empowered the home birth movement made the hospitals have to try to keep people in. That swelled the ranks of the nurse-midwives. There were a lot of people who didn't want to be a midwife outside of the system, they saw the need for midwives in the system.

There's still not an awareness in the US that a national health insurance system is a necessary component in changing the demograpy of birth attendants. For many years we've had a huge oversupply of obstetrician-gynecologists, of doctors attending births. They might not actually be there during labour but they swoop in at the last minute, catch the baby and take all the credit. And then we have a large number of 'labour and delivery' nurses that take the slots which in other countries are filled by midwives. These professions have their own need to remain there. So how do you change these demographics? You can't just let the system do it for you or you continue to have no midwives.

Are there any differences in the women's labours and births on The Farm today then when you started practising midwifery there?

Well, yes. In the beginning, I think probably because we started out giving birth in school buses and trucks, very small places, people didn't stand up much. They didn't kneel or get upright very much, it was just physically hard to do it. And I think the fact that photographs in those days showed women in those positions meant that women went into those positions. I did it myself. I don't remember having an urge to get up. I know I prowled around some in the early part of labour, and I know when I got fully dilated I had to stand up and I had to move the baby down well, but then sitting down to let the baby come out was pretty common among us. A lot of us used to do that.

Then there were some exceptions, we learned to attend birth on all fours, and we certainly used the all-fours manouvre for babies whose shoulders were stuck, but not everybody spontaneously went to that position. Now more and more they're doing that. Certainly the younger women, those who were born at home, born at The Farm, they're just wild! We have to chase them around, keep up with them. You never know where they're going to give birth, on the stairs, in the bathtub, sitting on the toilet, sitting on the floor right next to the toilet, they're all over the place, sometimes outside! They're quicker too, so I'd say that was the big change.

Can you identify one moment in your midwifery career which stands out above all others?

I'd have to say that night in the parking lot at Northwestern (University, where Ina May attended her first birth). If it had gone differently, my life would have been different. The fact that she had such a quick, beautiful, easy birth, opened up a whole huge vista before me, I became very excited… Here I was, just thirty years old, I having wondered for a long time what I would do when I grew up - and suddenly I knew. It was that “in the bones” feeling of it. I'd have to say that was the moment, because that made everything else possible.

You clearly have an incredible passion for midwifery. What is it about midwifery that you love the most?

I think it's because I spent so much time as a kid feeling cheated by being female, because I saw that this was not the powerful sex. And how could that happen?! Because (laughing) I wanted power! I had a brother who was two years older than me and all the women in my family just sort of accommodated men. I mean, these women were strong in their way, but I saw that it was a man's world. Then when I began to get older and become reconciled to being female, I thought about birth. I think Grantly Dick-Read's book was significant in my thinking because I read that when I was sixteen. All of this was in my mind and I saw that it took some sort of gathering of courage to go ahead and have a baby and I thought, “Ok, maybe there's some sort of power in that”. And that little hunch certainly turned out to be true.

What are you passionate about right now?

I've been doing some very patient work over many years, just collecting data from the births I've attended and comparing and studying how we ever got to the point we are at. I think I understand quite a few things now, and I've discovered some things that I really was naïve about, and I think people in the US and other countries are naïve about it too. This has to do with the dread subject of maternal death. Of course, the ranking of the US in the world in nothing to be proud of, we're only 21st. But even then we're only talking about reported deaths and the Centre for Disease Control (CDC) admits it's likely they are collecting as few as a third of the maternal deaths that actually occur. And they're only counting til six weeks after the end of pregnancy, so they're missing those that happened between six weeks and a year, that could be an awful lot of deaths. In a for-profit system there's hardly much incentive to report maternal deaths, there's no audit, it's really a poor system to put any stock in. It's a wildly optimistic guess. Of course, they don't state the rate for the US and then put in parentheses - (wildly optimistic guess)!

Also you have in the US an obstetric profession that's used to making decisions which aren't based on evidence and not informing women that they are making some wholesale change. Women just assume that because they're doing it, it's alright. I'm looking at the use of misoprostil for cervical ripening and labour induction, I know of at least four or five maternal deaths associated with that.

Then there's a new way of suturing the uterus after cesarean that seems to have some dangers associated with it. That's where they are stitching the uterus in one layer instead of two, I think you call that mass closure. Two layers have been used for 75 years. It's pretty plain to me that this change did not come about because the other way was found to be wanting, it's more a matter that money can be saved by stitching in one layer. But I know of three women who have died from it, two from placenta percreta and one from bleeding around the wound that wasn't detected until it was too late. There's a Montreal study - the abstract appeared in the Journal of Obstetrics and Gynecology supplement in January 2000. That involved 1650 women and the people who had one layer closure showed five times the rupture rate in subsequent births. They did control for induction in both groups, that was factored in.

Frustrated by all of this, and haunted by the number of women I've found out about who have died, and also about the fact that the US maternal death rate has not gone down since 1982, and may in fact be going up, we have a problem. I just want to warn people not to follow the US obstetrical trends and I'm mindful that there may be some maternal deaths associated with these trends that there may not be a way to know about.

So, inspired by the AIDS quilt, I've thought up a project that maybe could make a difference here. I've decided to make, or ask somebody else to make a quilt piece to commemorate each women who has died of causes directly related to pregnancy or birth since 1982. We are counting the full one-year period so that we'll be more in-synch with the rest of the world. This might be thousands of women. Twenty are now completed. I just continue to work on it, I've been working on this since February 2001 and I see that it has power.

There are people within the CDC who were very nice, they had me display it at the National Summit for Safe Motherhood in September, that's the first meeting of that kind we've had in the US. They're not holding me at arm's length and I'm very encouraged by that. A lot of my focus in 2002 is travelling around the US, visiting women's groups to get the names of the women - they have to come from families and friends because people who work at the hospitals are not permitted to divulge those kinds of details.

You clearly have an international perspective on midwifery.
From that perspective, what do you see about the current situation of midwifery in the UK?

I've been watching you all here for about twenty years. Morale was very high twenty years ago, you were getting some things done, there was a lot of excitement. Then there was excitement about Changing Childbirth, the Winterton Report, having a Member of Parliament, Audrey Wise, who was really on your side. I know it had to be a huge loss, her recent death.

I think also I might have an idea of what would help you get back up on your feet again, and that would be to look at New Zealand. That helped me, I've been watching them for twenty years too and they are way ahead of where they were twenty years ago. They're independent now, and that's something that midwives in all countries should aspire to. They've actually pulled it off. They got their early inspiration from a US organisation called NAPSAC (National Association of Parents and Professionals for Safe Alternatives in Childbearing). They still publish good work (see www.napsac.org).

Joan Donnelly - the key figure in the early days who midwifed the midwifery movement in New Zealand - borrowed a lot of stuff from NAPSAC. When she and only two other midwives attended all of the home births in the country, they knew that they needed some soil to grow, and saw that as the home birth mothers. So they got those mothers involved and they got them passionate. Joan Donnelly has got a brilliant strategic mind, she's a first-class politician and also a great midwife. She had the loyalty of the women, understood the midwives' needs and yet she's also a broad thinker, quite a visionary. She brought those mothers and midwives together, they had home birth associations all over New Zealand before they had the New Zealand College of Midwives, they only formed that around 1990.

The New Zealand midwives were able to win their autonomy with doing political work, writing letters to the media, witty letters, they took on all these fights and won so much, they even had the cartoonists on their side, they had their own cartoonist doing work. They won their independence, their autonony, got out from under nursing around 1990. Now they've had ten years to show that, because of doing this, their perinatal mortality went down. It's hard to counter that argument.

If you didn't have The Farm and were working in a situation where you were surrounded by the constraints which British midwives work within, how would you work within or try to change the system?

I'll be honest and say it's a little bit hard to imagine myself working within a system, because I've been so steadfastly not doing that for thirty years! I've watched some of my friends do things effectively, they get to know everybody and stay connected to all the groups. I would hang around independent midwives and try to observe them, I would try to bring my friends who worked in the same hospital, including my boss. I would associate and socialise with those people who didn't agree with me - try to have social time with them and make friends with them. I would keep my data, get interested in research. But I think you have to not just hang out with those people who already agree with you. Introduce people who are maybe far apart and see if we can pull some of this entrenched “we must keep it this way” stuff into free-thinking things.

I'd be grateful for small things. Work gently and patiently to make things better for women. I would do what I could to get these home birth associations going, that can be really powerful. I would probably do yoga, knit and work in my garden to try to recover from the hard days! Take study days. And think success! I can't wait til you guys really get some big time changes going, changes that satisfy you!

If you could tell all student midwives one thing, what would it be?

Never stop learning; keep your mind open. Women have so much to teach us, and I don't think we can ever come to the end of that.


Ina May's new book is called "Ina May's Guide to Childbirth." She is also writing two other books and continues to attend births. For more details on the quilt project, see www.rememberthemothers.com
For information on visiting The Farm and attending a midwifery workshop with other British midwives, click this link...
http://www.withwoman.co.uk/contents/workshops/farmtrip.html

Number Of C-Sections Questioned

Number Of C-Sections Questioned

Advocates Of Natural Childbirth Question Rise In Surgeries
BOSTON,May 4, 2005 --

The number of babies delivered by C-section has reached an all-time high -- up 6 percent in the last three years.

Local midwives sounded an alarm Wednesday, saying many C-sections are done without medical need, and they're calling on Congress to look into the matter.

After two days of labor, Ethan made his way into this world by C-section. When it was his sister's turn, mom (Ms.) Reynolds followed the advice of her doctor and had a planned cesarean.

"I did it because I felt at least this way maybe I'd have some control. My first experience I felt totally out of control," she said.

It's happening a lot. According to new national statistics, 28 percent of women are now having C-sections.

Anew survey released at a national conference shows many women who have aren't considering a vaginal birth the next time.

"Forty-seven percent of those mothers said they would have a repeat cesarean, which is intriguing. It's not clear they can envision in the world we're living in now whether you have the option of not have a C-section after you've had the first one," Boston University School of Public Health Dr. Gene Declercq said.

Massachusetts General Hospital Dr. M. Greenjeans said that the rate is rising for a number of reasons -- including the increasing age of pregnant women and underlying conditions like diabetes and hypertension. But he acknowledges liability is a big factor. Doctors don't want to be sued when something goes wrong.

"If you attempt a vaginal birth after C-section and you are ultimately successful, you do great. And women recover quicker and its great. On the other hand, if you attempt a vaginal birth and you're unsuccessful, those are the women who, for themselves suffer significantly greater morbidity," Greene said.

Midwife and author Ina May Gaskin warns repeat c-sections have their own dangers -- a message she says is lost in a surgery-happy society.

"Think of piercing, think of tattoos and think of cosmetic surgery. This has taken away the fear of surgery and abdominal surgery carries all the risks of other surgeries, plus it's your vital organs," Gaskin said.

Everyone agrees the rate is too high -- when there's a choice, the decision should be carefully weighed by moms to be.

"I'm happy. I made the decision that was right for me," (Ms.) Reynolds said.

[From TheBoston Channel]

wow! Great read IMB!! I second the women of the year/ lifetime accomplishment award for Ina!! i cried, and smiled though out the read,,, wonderful.

There was a time when I considered being a midwife .....

I have had 3 children, the 1st, naturally, the 2nd was an induced labor (he didn't want to join the party, lol), natural birth as well & my 3rd I had an epidural....

If I had an epidural the 1st time, I think I would have 20 kids!!

I made the decision to have my tubes tied after delivery of my 3rd so

I won't be having any more....besides, at 38, the kids are now at a great age

and NO DIAPERS!!!

Ina Mae and Stephen are the bomb! I met them on the way to CC 2000 where they were inducted into the Cannabis Culture Hall of Fame and i think they were celebrity judges as well......love those two cats......-gp

Wondeful read. Hippie Mama...I also considered being a midwife.
I have two, both csections (could not be helped) and I nursed them both.

I loved being pregant and would have had a whole brood if my hubby would have agreed.