Book Review: Birth Matters, by Ina May Gaskin

Ina May’s new book is a manifesta setting out the philosophy of natural birth, and therefore nothing that has not been said by wise women (and men) countless times before. The value of this work is its comprehensive, detailed, and clear presentation of the information, such that surely no rational human could disagree. It is The Politics of Breastfeeding for birth, and it is a scientific celebration of what nature has achieved and what women are capable of.

The first chapters set the subject in its global context, and birth stories are scattered through the text to remind the reader that while these are global, political issues, they have personal, individual impacts.

I have learned about the cultural loss of breastfeeding knowledge, and it makes a sad kind of sense to me to be reading the same description of society’s attitude to birth: the loss of skills among health professionals and the consequent loss of positive birth stories. This cycle will be perpetuated and added to, and will spread beyond the US increasingly rapidly, as we lose touch with and confidence in our own bodies.

Ina May Gaskin discusses the role of feminism in driving an ‘escape’ from pregnancy and motherhood, a push towards equality between men and women instead of a celebration of the important differences between us. Why should power be measured only in masculine terms and defined by the choice NOT to do something? Ina May’s positive, empowering feminism offers a far wider range of choices.

It seemed crazy to me to take on the belief that the human female is the only mammal on earth that is a mistake of nature… it’s our minds that sometimes complicate matters for us. (p.23)

She quotes Simone de Beauvoir describing the pregnant women as inciting fear in children and contempt in young people, ensnared: “life’s passive instrument.” De Beauvoir, the great feminist intellectual, writes as though she believes what men have said for centuries about women’s bodies: that we are disgusting, inefficient, and inferior to men (who cannot, normally, grow or feed babies); and seems unaware that historically speaking, medical men who profit from managing birth have had personal and financial interests in telling women that it is a dangerous and painful process, that requires the presence of a qualified doctor. Again the parallels with the unethical practices of formula manufacturers undermining women’s knowledge of and confidence in breastfeeding are clear.

Some of the practices resulting from this basic assumption of women’s inferiority and ignorance are barbaric, and many persist in 21st Century western healthcare. The book describes a bleak outlook for maternity care and motherhood in a world where politics and economics are everything. Yet the short-termism of the idea that labouring women must be cured or rescued from themselves costs far more in terms of money, life, and quality of life. How can this be an acceptable situation?

I was struck by the anecdote in which a couple kissed to raise oxytocin levels and aid relaxation and the progress of labour. It helped me to think about the way I talk to antenatal groups about the role of oxytocin in breastfeeding. And also of the way the idea of sex to bring on labour has been reduced to the role of prostaglandin, when everything about it promotes skin contact, eye contact, and a feeling of well-being. In this, I find yet another example of the big picture being reduced to one male-orientated detail.

I was aware that birth in the US was highly medicalised, but the details and the implications of that, as clearly laid out by Ina May Gaskin, are horrifying and depressing. At the same time, the positive birth stories are affirming, empowering tales, a contrasting picture of the good that is possible when women are informed and respected.

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To order Birth Matters with a 25% discount, just follow the link and use the discount code KH25 at the checkout.