Book Review: “Ina May’s Guide To Childbirth” by Ina May Gaskin

Many childbirth books offer a picture of the birth process that has been influenced by the medical model as a standard. “Ina May’s Guide to Childbirth” describes birth as a physiological process, with respect to the many variations of natural (unmedicated) vaginal birth. I consider this book to be a must-read for anyone who desires such a birth.

Let’s take a quick look at the author’s formidable track record…

Ina May Gaskin is seen as something of a master midwife, being dubbed “the mother of authentic midwifery.” In 1971 she and her husband founded The Farm, one of the first midwifery centers in the United States. She saw the art of midwifery as spiritual work, perfectly crafted for guiding natural labors. She encouraged women to be active participants in their births; to be fearless; and she taught that birth is a family event.

If you’ve ever had a baby with shoulder dystocia, you might have heard of The Gaskin Maneuver — a clever positioning technique used to reduce this type of critically obstructed labor. Ina May learned of this maneuver in Guatemala and is credited for its much-needed introduction to the United States.

A well-encompassed study of homebirths at The Farm compared outcomes with physician-attended hospital births. This drew public attention to the impressive outcomes and decreased occurrence of unnecessary intervention that can be achieved by lay midwives for low-risk pregnancies.

My favorite parts of this book:

Sphincter Law

Here we learn how to open the cervix by applying what we know about sphincters. Sphincters don’t obey orders and they may suddenly shut with fright or surprise. They can be opened with laughter, familiarity in setting, slow and deep breathing, gentle pelvic exams granted with mother’s permission, warm water immersion, open mouth/throat, and other factors.

“The state of relaxation of the mouth and jaw is directly correlated to the ability of the cervix, the vagina, and the anus to open to full capacity.”

Avoid stimulating the neocortex to allow the primitive brain to release hormones normally. Several ways in which the neocortex is provoked: asking the mother questions requiring thoughtfulness, bright lights, lack of privacy, feeling of exposure, lack of intimacy (including getting too close).


Much of Ina May’s writing is infinitely quotable and can be plenty useful for those who love verbal affirmations.

“[B]irth is something women do, not something that happens to them.”

“Let your monkey do it.”

“There is no other organ quite like the uterus. If men had such an organ, they would brag about it. So should we.”
“Remember this, for it is as true and true gets: Your body is not a lemon. You are not a machine. The Creator is not a careless mechanic.”

“Even if it has not been your habit throughout your life so far, I recommend that you learn to think positively about your body.”

“It is important to keep in mind that our bodies must work pretty well, or their wouldn’t be so many humans on the planet.”

Law of Gravity

This can be utilized to help with positioning, opening the pelvic outlet, easing baby downward or slowing a fast descent, maximizing blood flow between mother and baby by keeping baby off arteries, etc. Ina suggests trying a pelvic press movement with mother in an upright position for moving a baby who “gets stuck” in the pushing phase.

Honesty about birth as nature intended

Ina gives us a reality check about the birth we see on television and the true landscape of birth (p 164) — a section not to be skipped! From the birth stories that open the book, we learn about the full range of possible sensations, from orgasmic pleasure to pain, and what contributes to their likelihood. The obvious sexuality of birth is largely ignored in modern medical culture, but Ina reminds that when the sexual nature of birth is shamed or its expression is restricted, problems occur.

Notes on routine procedures

In the chapter on labor, Ina details which routines are scientifically based, which ones are scientifically questionable, and which have alternatives that may be negotiable in hospitals. A pretty handy section!

Following at book’s end are a collection of helpful, solid references to assist with further research.


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