The Missing Chapter to Ina May's Guide


The Missing Chapter to Ina May's Guide

When I was pregnant, I was terrified of childbirth. I told that to my midwife, and she suggested that I read Ina May Gaskin’s manifestoes on natural birth: Spiritual Midwifery and Ina May’s Guide to Childbirth.

I loved Ina May’s story—a hippie living on a caravan of school buses, who learned to be a midwife by delivering other hippies’ babies on those school buses. I loved her message—that we do not have to be fearful of childbirth, and that laughter and kissing and politeness can help reduce pain. And I loved her statistics—there is an incredibly low rate of medical interventions for births at the Farm Midwifery Center, which Ina May founded on the Tennessee commune, where the aforementioned caravan of school buses landed. After a good dose of Ina May, I was confident that I could give birth naturally. It was going to be a challenge, but I was prepared.

Ina May led the midwives at the Farm

Ina May led the midwives at the Farm

Her husband, Stephen Gaskin, was the commune's spiritual leader

Her husband, Stephen Gaskin, was the commune’s spiritual leader

And then I actually gave birth. And it was nothing like what Ina May said it would be. I felt like I had failed. But I also felt mad at Ina May. And the whole natural birth industry, actually. For making me believe that natural birth was not only possible, but that it had the potential to be an ecstatic experience. And for not telling me what you were supposed to think if you didn’t get to have it.

Ina May with a fetuscope in the 70s

Ina May with a fetuscope in the 70s

Ina May with a fetuscope now

Ina May with a fetuscope now

In this episode, I tell Ina May how I felt betrayed by her. And her answer is truly stunning. I’ll let you listen to what she says, but once you’ve heard the episode, please come back to this page. If you wound up feeling like I did after having a baby, Ina May wants to hear from you. Tell your story in the comments below, or just let her know what you think is missing from her book. She will be watching!


More on Ina May Gaskin

Here is Ina May’s TEDx Talk, which I excerpt in the story:

And this movie about Ina May’s life has great footage of the Farm, past and present, including a scene of a 10-pound baby being born to an unmedicated mother. I could see my own reflection in my computer screen as I watched this, and my jaw was literally dropped. The film also shows in action an example of the Gaskin Maneuver, an obstetrical procedure named after Ina May.


All photos except blue/green portrait: David Frohman; Blue/green portrait: Sara Lamm

297 thoughts on “PODCAST #28: The Missing Chapter to Ina May’s Guide

  1. Without too many details, my 2nd planned water homebirth progressed differently than my 1st, and daddy caught babe before midwives or. Doula arrived. It was perfect, everyone fine but I still feel like I failed and I endangered ourselves and our midwives practice. I felt irresponsible and unsure how to share our birth story without embarrassment for our choices. One counselling session has helped. Further conversations with my ‘team’ will help. But here I am, didn’t do it ‘right’ and now I’ve got birth issues. Unmet Expectations doesn’t mean failure, but it feels like it!

  2. While I understand the feeling of not getting the birth you wanted (I’ve been there myself), I think anger towards the natural childbirth community is misdirected. There has to be someone holding up an ideal. If anything, perhaps anger should be directed at care providers who didn’t respect your wishes, or a system that doesn’t give women enough support (I’m thinking OB led care vs midwifery model, not enough nurses to go around).

  3. My son just turned 18 months old and I remember the pain from his childbirth as though he was a newborn. I was all set with meditations and a midwife, calming essential oils and mantras, but nothing, nothing prepared me for the pain of childbirth. My child was face-up and after 24 hours of labor and 3 hours pushing, we used the vaccuum 4 times to no avail. His heart rate plummeted and we had to have an emergency Cesarian. I was knocked out. Honestly, the worst pain was from having him in the NICU for 3 days because I felt like a part of me had gone missing. I was also depressed because I’d missed the Golden Hour. I have several friends who’d had natural child births. They are proud. And me… I feel ashamed. Or at least, I had felt that way. Thank you, Hillary and Ina for this conversation. I feel like I can start to really heal.

  4. This episode was meant for me! I took hypnobirthing classes, read Ina-May’s books, had midwives, psyched myself up to “go natural” and not medicate myself during my birth. I went into my 40th week of pregnancy with no fear of birth, only excitement. I was excited to meet my baby, and I was excited to be “tough” and “natural.”

    I progressed to 8cm fairly quickly and then stalled, contractions coming on top of each other with not even a few seconds’ break in between. My whole body started to panic and shut down. I was physically shaking and the room was spinning and the only position that offered the tiniest amount of reprieve from the pain was to stand up with my head resting on my husband’s chest. Once my legs started to give out, I knew that I couldn’t go on and I asked for the epidural. Nobody shamed me at the time, not even my midwife whom I know championed “natural” birth. Despite everyone being supportive of my decision, I immediately felt sad and lost the confidence and pride in myself that I still needed to help me get through not only the rest of the birth but my first few weeks post-partum as well. I felt as though I had given up, that I hadn’t tried hard enough, that I wasn’t tough enough to do it. I felt as though others who had gotten through their births without pain management were better than me, tougher than me, stronger than me. I was embarrassed to tell people that I’d had an epidural, even though no one cared. Part of this was the standard I had set for myself, but the other part was that in all of my pre-natal birth research and hypnobirthing course work, the stories that were held up as “ideal” were those in which those interventions were not chosen. “Yes! You will be laughing!” “Just breathe the baby down!” “I felt like the baby just slid out of me!” The stories of slow-downs showed they were caused by mental blocks I didn’t have. Not one person mentioned overlapping contractions, what they were, that they exist, that they’re so overwhelmingly painful that no amount of breathing techniques, hot baths, yoga ball bouncing can help.

    I appreciated this conversation so much, and am so thankful that Ina-May is reflective and open to updating her teachings. Thank you.

  5. I wanted to say that I think there is a nutritional dimension to successful intervention-free childbirth that has been growing in significance over the past century that even the best pill form nutritional supplements cannot completely overcome. There’s not enough room here to go into all the details but please read the work of Weston A Price and Dr. Natasha Campbell McBride. I discovered their work between pregnancies and experienced dramatically different labors. This is not to negate the cultural influence toward unnecessary interventions (I shudder to think how my first natural birth would have gone if I had not hired a doulah to go with me into the hospital) but I believe a majority of women today do not have the nutrition history necessary to effectively give birth. If they manage to avoid the common interventions they can still give birth naturally but very slowly and painfully.

    I also suspect that any woman who spends a significant amount of the day sitting most likely has a compromised pelvic floor ringed by short, tight painful muscles, which leads to suboptimal fetal position and inhibited expansion of the birth canal both leading to more pain. Three blogs have a wealth of information on this topic: spinning babies, katy says, and core walking.

  6. My doula said it is simply not reasonable to expect a woman who has been given pitocin to go pain medication-free. This interview really confirmed that for me.

  7. When we were expecting our first baby we wanted to go all natural, in a hospital, but still all natural. We took the 13 week Bradley Birthing Classes, watched the documentaries on why natural is better, and were convinced we could do it. 10 days before my due date I woke up and did not feel the baby moving. I went to the doctor and they could not find a heartbeat. My midwife told me that I would have to be induced (a big no-no in the natural world) and that it could take up to 3–4 days of labor since I was not dilated at all. Once we decided to have an autopsy (in order to collect any answers we could as to WHY this happened) we were told we would only get to spend 3 hours with our son after he was born before they needed his body for the autopsy. With all that in mind, I knew there was no way I could go natural. We ended up having a very medical induced labor and delivery but ended with a peaceful vaginal delivery.

    When I contacted our natural birthing teach, I told her we did not go natural but still had a peaceful delivery. I never heard back from her-nothing. It only confirmed that I had failed to get my baby out alive, but I had failed again because I had chosen drugs. I guess I was hoping to get the “well of course you had to have drugs, given your awful circumstances,” but no such free pass was given.

    Its been 3 years since our son’s stillbirth (never found answers) and I have distanced myself from the natural birth community. It was refreshing to hear your podcast speak out against the community because I also feel that so many people can get swept up in the ideal of it all. For me all that matters now is getting the baby out alive. We have had one living child since then, induced at 36 weeks 5 days-had pitocen, had epidural and achieved goal of leaving the hospital WITH my child. We are due with another boy this January and again my birth “plan” consist of “mom and baby leave the hospital alive and well.”

    If there is one chapter I would like Ina to add or write about it would be “when everything goes wrong.” Id like to hear more stories of women who did not have the IDEAL birth, but gave birth nonetheless. Maybe then it would take the pressure off of so many to have this “ideal” birth story.

  8. I am so sorry you lost your son. And so sorry you were ignored by your Bradley teacher. That is most certainly not in Bradley teacher best practices. Your teacher failed you.
    You were right to choose medication in your situation for many reasons. The first if which would be if it felt right to you. Also, when a baby passes inutero they no longer have the ability to help out the birth process in their end, and it can be a much harder delivery. I wholly stand by natural birth, but as an educated professional in the field I would have made the same choice as you. You most certainly did not fail and I would never blame a women who has gone trough what you have for changing her priority for her birth to ” let’s just both make it home”. I hope others have since told you that or that you are comfortable know it for your self.

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