Download Ina May Gaskin's Presentation to SMH

On Friday, October 30th, Ina May Gaskin presented a closed clinical conference to the medical staff of Sarasota Memorial Hospital. Her presentation was entitled "Combining the Best of Modern Obstetrics with Respect for Nature and Traditional Midwifery Approaches." Ms. Gaskin has been internationally credited with reintroducing legalized direct-entry midwifery in the United States. The presentation is available via podcast on the SMH Continuing Education website. View a PDF of the accompanying power point presentation, in both English and Spanish, here.

Her objectives were threefold: to explore the knowledge base and skills common to traditional midwifery; to understand the need for both modern obstetrics and (authentic) midwifery; and to build positive relationships between the two professions (especially with regard to home birth midwives). Present at the conference were SMH Director of Maternal-Fetal Medicine Dr. Washington Hill; Sarasota County Health Department OB/GYN Dr. John Abu; Licensed Midwives Christina Holmes and Alina Vogelhut; and several members of the hospital staff and the community, including childbirth educators, nurses and retired physicians.

In her introduction, Ms. Gaskin told attendees "I just want to show what someone who births at home teaches us," and proceeded to show still images of the dancing birth of her own grandchild. She then discussed everything from her world-famous Gaskin maneuver for delivering babies with shoulder dystocia, to the rapid decline in vaginal breech birth, to the benefits of allowing the baby to clear his or her own air waves. She talked about the 1-2% c-section rate at her renowned midwifery center, The Farm, in Summertown, Tennessee. "We did allow eating and drinking during labor; we never would have had such a low c-section rate had we not." When discussing positive, unmedicated, ecstatic birth experiences, Ms. Gaskin said, "We can only achieve that if we keep the labor room calm and sweet...because we find the mother's feelings really do matter a lot."

Ina May Gaskin then gave those present a brief history of American midwifery and its resurgence, and talked about her own tutelage from a family physician, and subsequent collaboration with several obstetricians. She asked the question, "How do we then lower a c-section rate when it is up so high?" She suggested alternative methods for labor induction, specifically discussing her concerns about the use of misoprostol for induction, a drug which has never been approved by the FDA for this purpose and has been directly linked to an increase in amniotic fluid embolism, a potentially fatal condition for both mother and baby. She also discussed alternatives to medical pain relief, different positioning and movement, and the need to reverse an overall "cultural unfamiliarity" with unmedicated birth.

In conclusion, Ina May Gaskin talked about the need for healthy relationships when transferring patients from midwifery care to the hospital. "Above all, what the women who come to us (midwives) want, if we have to take them to hospital, is that they don't want to be punished or judged for having made that choice. That's probably the number one thing that needs to be conveyed."

Dr. Washington Hill, Medical Director, Labor & Delivery, SMH with Ina May Gaskin

MHC Panel Wrap-Up from Sonia Fuentes

It was an absolute joy to co-plan Maternal Health Care in the 21st Century: Sarasota and Beyond with Sonia Pressman Fuentes, the co-founder of the National Organization for Women (NOW). Here is the letter she is sending to the editor of the Sarasota Herald-Tribune about the event.

On Sunday afternoon, Nov. 1, Sarasotans had a unique opportunity to learn about maternal health care issues and available resources in Sarasota County, Florida, and the U.S.—and about 250 of them took advantage of that opportunity.

Starting at 3:00 p.m. and for two hours afterwards, Laura Gilkey, vice-president, Florida Friends of Midwives, and I presented a top-notch panel of experts on Maternal Health Care in the 21st Century: Sarasota and Beyond in the ballroom of the Sarasota Hyatt Regency. Our panelists were: Ina May Gaskin, the most renowned midwife in the United States; Dr. Washington Hill, Maternal-Fetal Medicine Director, Sarasota Memorial Hospital; Jennifer Highland, executive director, Healthy Start Coalition of Sarasota County; and Representative Keith Fitzgerald, who represents Sarasota in the Florida House of Representatives. The panel was moderated by Kelly Kirschner, vice-mayor of Sarasota.

After the formal presentations, there was a question-and-answer period followed by refreshments. Available to all attendees was a 28-page Program and Resource Guide containing a glossary of terms, a listing of resources available in Sarasota, a list of people with expertise available at the program, and a list of recommended readings. Our program was sponsored by the Sarasota-Manatee chapter of NOW (National Organization for Women), SCSW (Sarasota Commission on the Status of Women), and FFOM (Florida Friends of Midwives). All at no cost to the attendees. That was made possible by the generous donations in money and in-kind by Sarasota businesses, organizations, and individuals.

Laura and I made this educational program available because the U.S. ranks 35th in maternal mortality and 33rd in infant mortality in the world. The U.S. spends more money on mothers’ health than any other nation in the world, yet in America women are more likely to die during childbirth than they are in most other developed countries.

We learned a great deal from our panelists. We learned about the problems caused by women in poor health, and those who are smokers, alcoholics, and drug addicts, becoming pregnant. We learned about the problems caused by induced labor and the performance of unnecessary Cesarean sections. We learned that statistics and other information on the incidence of induced labor, the rate of Cesareans, and maternal deaths in our community by obstetrician and hospital are not readily available. We learned about the success of special interest groups in preventing the passage of needed legislation in the Florida Legislature and the U.S. Congress. We learned about the system of postnatal care in The Netherlands where every new mother in the first eight to ten days after the birth of her baby is entitled to the services of an assistant, who will aid in the recovery of the mother and provide her with advice and assistance to care for her newborn. We learned that the maternal death rate in the US has not gone down since 1982 and the rate for African-American women has been three to four times higher than for whites since 1940.

As if to point up the timeliness of our program, two days later, on November 3, The New York Times published an article entitled “Premature Births Worsen US Infant Death Rate.” The article referred to the fact that about 1 in 8 U.S. births are premature and that early births are much less common in most of Europe. Among the reasons given for the high rate of prematurity in the U.S. were some of the very reasons discussed by our panelists, including the induction of labor and the overuse of C-sections.

Because of what we’ve learned, Laura and I now plan to build on this panel discussion and form an advocacy group to address these issues for Sarasota County, Florida, and the U.S. We welcome participation by anyone interested in working with us to achieve the goal of a healthy mother and a healthy baby in the case of every pregnancy.

The Safe Motherhood Quilt on SNN6

Ina May Gaskin presented three panels of The Safe Motherhood Quilt Project on Saturday at the Selby Public Library. About fifty people attended the leading midwife as she explained why it is so important for the United States to begin accurately counting and accounting for the rising maternal deaths in our country.

Please watch the video of Ina May's interview with Sarasota's own SNN News Channel 6.

If you would like to sew a quilt square for a mother who has died of pregnancy or childbirth related causes in America since 1982, please email me. Sadly, there are many women still to be honored.