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Gaskin was born to an Iowa Protestant family (Methodist on one side, Presbyterian on the other). Her father, Talford Middleton, was raised on a large Iowa farm, which was lost to a bank not long after his father’s accidental death in 1926. Her mother, Ruth Stinson Middleton, was a home economics teacher, who taught in various small towns within a forty-mile radius of Marshalltown, Iowa. Both parents were college graduates, who placed a great importance on higher education.
Her maternal grandparents ran a Presbyterian orphanage in Farmington, Missouri, a small town in the Ozarks. Her grandmother, Ina May Beard Stinson, directed the orphanage for many years after her pastor husband’s death. She was an avid member of the Woman's Christian Temperance Union and a great admirer of Elizabeth Cady Stanton, Susan B. Anthony, and Jane Addams. Gaskin’s paternal grandparents were all farmers. Adam Leslie Middleton, her grandfather, traveled and worked with farmers from Iowa, Illinois, Minnesota, South Dakota, Nebraska, and Kansas in cooperative grain marketing, organizing communities, as well as larger outlets in Chicago and other large cities, to establish local cooperative grain elevators. His work as an organizer took him to Canada to work with wheat growers, and to Washington, D. C., on the invitation of the Secretary of Agriculture under President Warren G. Harding, Henry C. Wallace, father of Henry A. Wallace, President Franklin Delano Roosevelt’s Secretary of Agriculture.
In 1971 Gaskin, with her husband Stephen, founded a commune called The Farm in Summertown Tennessee. There, she and the midwives of the Farm created The Farm Midwifery Center, one of the first out-of-hospital birth centers in the United States. Family members and friends are commonly in attendance and are encouraged to take an active role in the birth.
According to Carol Lorente (1995), the work of Gaskin and the midwives might not have had the impact it did, if it hadn't been for the publication of her book Spiritual Midwifery (1977):
Gaskin has been credited with the emergence and popularization of direct-entry midwifery (i.e. not training as a nurse first) in the United States since the early 1970s. Between 1977 and 2000, she published the quarterly magazine Birth Gazette. Ina May’s Guide to Childbirth, her second book about birth and midwifery, was published by Bantam/Dell in 2003. Her books have been published in several languages, including German, Italian, Hungarian, Slovenian, Spanish, and Japanese.
Since the early 1980s, she has been an internationally-known speaker on maternity care independently and for the Midwives Alliance of North America (MANA), lecturing throughout the world to midwives, physicians, doulas, expectant parents and health policy-makers. She has spoken at medical and midwifery schools in several countries and at both the Starwood Festival and the WinterStar Symposium, discussing the history and importance of midwifery.
She is the founder of the Safe Motherhood Quilt Project, a national effort developed to draw public attention to the current maternal death rates, and to honor those women who have died of pregnancy-related causes during the past twenty years.
She has appeared in such prominent films as Orgasmic Birth (2009) (directed by Debra Pascali-Bonaro) and The Business of Being Born (2008) (directed by Abby Epstein and produced by Ricki Lake). She also appears in With Women: A Documentary About Women, Midwives and Birth (2006).
A study of home births assisted by the midwives of The Farm (Durand 1992) looked at the outcomes of 1,707 women who received care in rural Tennessee between 1971 and 1989. These births were compared to outcomes of over 14,000 physician-attended hospital births (including those typically labelled as high risk) in 1980. Comparing perinatal deaths, labor complications, and use of assisted delivery, the study found that "under certain circumstances (low risk pregnancies), home births attended by lay midwives can be accomplished as safely as, and with less intervention than, physician-attended hospital deliveries.".
The Gaskin Maneuver, also called all fours, is a technique to reduce shoulder dystocia. Gaskin introduced it in the U.S. in 1976 after learning it from a Belizean woman who had, in turn, learned the maneuver in Guatemala, where it originated. In this maneuver, the mother supports herself on her hands and knees to resolve shoulder dystocia. Switching to a hands and knees position causes the shape of the pelvis to change, thereby allowing the trapped shoulder to free itself and the baby to be born. Since this maneuver requires a significant movement from the standard lithotomy position, it can be substantially more difficult to perform while under epidural anesthesia, but still possible, and can be performed by an experienced delivery room team.
On June 14th, 2008, Gaskin led a workshop called 'A Guide to Natural Childbirth' at the New York Open Center in Manhattan. She served as President of Midwives' Alliance of North America from 1996 to 2002. She received the ASPO/Lamaze Irwin Chabon Award (1997), and the Tennessee Perinatal Association Recognition Award. She was featured in Salon magazine’s “Brilliant Careers” in 1999. In 2003, she was made a Visiting Fellow of Morse College, Yale University. Ina May was awarded the title "Honorary Doctor" in recognition of her work demonstrating the effectiveness and safety of midwifery by the Thames Valley University, London, England, on November 24, 2009. On September 29, 2011, Ina May Gaskin was announced as a co-winner of the 2011 Right Livelihood Award.