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."