To say that I am thrilled about the Mother's Day release of Birth Story: Ina May Gaskin and the Farm Midwives would be the Understatement of the Year. I'm referring to the 90-minute documentary about the work of our midwifery team that filmmakers Sara Lamm and Mary Wigmore and colleagues have just made available. It has been a three-year "pregnancy" with this documentary, and the labor to bring it into being is finally over. At last, we can give the world a look at four different births that took place at various birth cottages in our rural Tennessee community over a span of 30 years.
Some of the graphics in Birth Story go back to the late 1970s, when portable cameras were gigantic compared to current models, and cameramen had to wear heavy battery packs. When a willing mother went into labor, our camera guys would drop whatever they had been doing, don those packs, quietly set up lights and then fade into the background, just like wildlife photographers who dare not disrupt the flow of the primal biological process unfolding before them. We were all aware that the unmedicated births they were seeing and recording were examples of rapidly vanishing behavior in U.S. maternity wards. When certain behavior vanishes, a culture can quickly forget that it was ever possible, let alone a good idea.
Several women who traveled to our midwifery center to avoid an automatic cesarean because their babies were breech asked to have their births recorded, because they wanted physicians and midwives to relearn breech skills that had once been considered essential. I hadn't anticipated that I would soon be invited to show videos made at our midwifery center at various medical schools. An obstetrical newspaper reviewed our video programs in 1979, quoting an obstetrician who observed that the women in the film seemed to be "treated like prima donnas." Another doctor remarked that the common thread among the women who came to home birth midwives was "fear of childbirth as it occurs in hospitals." He considered it the task of obstetricians to eliminate that fear. It's too bad that they didn't succeed, but that is actually too big a job for obstetricians alone. We're going to need a lot more midwives and doulas to help with this task.
Fear of having a repeat of what I experienced during my first birth in a hospital was what prompted me to figure out a way to learn to be a midwife. I was blessed to have the opportunity to be mentored and trained by several knowledgeable, kind physicians, who recognized that optimal maternity care requires skilled midwives caring for women during pregnancy, birth and the postpartum weeks -- with the backup of the physician in case of complications. While my midwifery partners and I have been able to work in an atmosphere that is free of fear, others in most of the rest of the country can't say the same. For historical reasons, we lack a sufficient number of midwives working in all settings (homes, birth centers, and hospitals) to be able to answer the needs of most pregnant and laboring women. Historically, most highly developed countries have recognized that midwives are needed in greater numbers than physicians, because when women are properly cared for, the need for medical attention, including surgery, is reduced, costs are lowered, and fear of birth is greatly reduced.
Recent reports show a 30 percent increase in the rate of planned home births between 2004 and 2009. Even with this increase, planned home births account for less than one percent of all births. I believe that Birth Story will help more people understand that the option of giving birth at home or in a birth center is important not just to the women who choose this but to those giving birth in hospitals as well. Skilled midwives who attend out-of-hospital birth play an essential role in the maintenance of knowledge and understanding of women's true needs during pregnancy, labor, birth and the postpartum period, because we put the woman at the center of our attention. Home is often the "laboratory" where common sense techniques that facilitate birth are developed, even rediscovered. The possibility of giving birth without episiotomy or tearing (especially with first-time mothers) was brought to the awareness of hospital staff via Spiritual Midwifery and birth videos, not from the leadership of obstetrical societies. The need for free movement during labor and the ability to adopt the most advantageous birth position for the mother (not the convenience or habit of the doctor) is another element of home birth midwifery philosophy -- another example of the concept of the laboring mother as the "prima donna", rather than just another body on the industrial conveyor belt.
Just as the women in my community were able to be pregnant and give birth without an undue amount of fear, I think that "Birth Story" will help women outside of our community feel more confidence that their bodies are perfectly designed for giving birth and better understand how to prepare for this female rite of passage, wherever they decide to give birth. I salute all mothers, midwives, nurses, doulas, obstetricians, and family doctors who work hard to créate loving birth experiences. Happy Mother's Day!
Watch the movie at www.birthstorymovie.com or iTunes.