Interviews with Ina May Gaskin
Interview conducted by Lyndsey Unwin in September 2011
In your view, how dangerous is it for a woman to have a caesarian?
It’s probably safe to say that a large proportion of women do not know that death from caesarean surgery is three times greater than for vaginal birth. In the case of emergency caesarean, this figure rises to four times greater.
Most maternal deaths from pulmonary embolism follow caesareans. That’s a well known fact. According to figures published by the UK’s Confidential Enquiries into Maternal Deaths, it’s possible to see how the number of pulmonary embolisms has risen with the increase in caesareans: 32 maternal deaths were recorded in the period of 1985-87, 48 were recorded in 1994-96, and 41 were recorded in 2003-05.
Most women are probably unaware of problems in subsequent pregnancies, with complications such as placenta previa, placenta accreta, and abruption.
Are natural births on the increase in the US or is it still seen as an alternative experience?
The US caesarean rate reached 34 percent in 2008 (the last year for which we have national data). I’m sure that natural births would be on the increase here if most women had choices in regard to how they will give birth, but we have such a small number of midwives, (10,000 at the most—consider that 4.3 million births take place every year) that choices for most women don’t exist. Keep in mind that those midwives working in hospitals are usually responsible for caring for several women at a time—far from an ideal situation. As for home birth, even after a 20 percent increase in home birth between 2004 and 2008, still only 1 percent of women can have a planned home birth. This means that a larger number of women every year are having home births that are not assisted by a qualified midwife.
Are things getting worse for women in terms of information about the benefits of natural birth?
Actually, I think that US women are beginning to get a little more information of this kind from films such as Ricki Lake and Abby Epstein’s The Business of Being Born and their new More Business of Being Born and Debra Pascali-Bonaro’s Orgasmic Birth. More and more women are wanting to become doulas and more and more are hiring doulas. But if we look at the mainstream media and how it reports on birth, I see no improvement yet in that sphere.
Are you still delivering babies?
Yes. I’m waiting on a woman in early labor as I write. Although I still travel quite a bit, I schedule in blocks of time to be spent at home, and during these times, I continue to attend births (usually being a co-midwife with one of my partners). I get most of my writing done while I’m at home.
Your husband was the first recipient of the Right Livelihood Award in 1980. What does becoming a Laureate in 2011 mean to you and how will it help your work?
I can’t express how grateful I am to become a Laureate. The previous recipients of the award are some of the bravest, most visionary, selfless, and most effective people in the world. To be in their company is quite an honor.
(…)
This award will give me a chance to warn people in the UK and in many European countries that it is a great mistake for countries with lower maternal and newborn death rates to imitate maternity care practices that had their origin in the US. The US maternal death rate is underreported to a large but unknown degree, and it is currently rising rather sharply. At least 49 other countries reported lower maternal death rates than we do in the US (despite our underreporting). Our newborn death rates also do not compare favorably with innumerable countries, all of which spend less on maternity care than is spent here.
According to the Centers for Disease Control (CDC), US women today face more than twice the chance of dying from causes directly related to pregnancy and birth than their mothers did. The myth that we have the greatest maternity care system in the world pervades most media coverage of birth issues in the US. Yet, in some states the maternal death rate has more than doubled what it was years earlier. In 2010, California, for instance, reported a tripling of the death rate between 1996 and 2006, attributing a significant part of the sudden rise to an excess of caesareans. I have been writing about these issues for more than a decade, but the mainstream media has not yet seen fit to report anything on this shocking situation, despite my attempts to spoonfeed it. Perhaps the award will bring these important issues before the US public. I certainly hope so.
Interview in Time Magazine, 2011
