Ina May Gaskin
Ina May Gaskin
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by Katie Allison Granju
Ina May Gaskin, Certified Professional Midwife, has been described by Jan Tritten, editor of Midwifery Today, as "the mother of authentic midwifery." As the founder of the seminal out-of-hospital birth center in the United States, located in Summertown, Tennessee, and the author of Spiritual Midwifery (The Book Publishing Co., 1977), Gaskin has had a profound impact on the resurgence of direct-entry midwifery in the United States since the early 1970s. Today, Gaskin serves as editor and publisher of the periodical Birth Gazette and is an internationally known speaker on maternity care issues in her role as spokesperson for Midwives Alliance of North America (MANA). KAG: What is the role of MANA and how many members does the organization have? IMG: We have 1,000 members. MANA's goals are: to expand communication and support among North American midwives; to form an identifiable and cohesive organization representing the profession of midwifery on a regional, national, and international basis; to promote guidelines for the education of midwives and to assist in the development of midwifery education programs; to promote competence in midwifery practice, midwifery as a quality health care option, research in the field of midwifery care, communication and cooperation between midwives and other organizations concerned with improving perinatal outcome; and to support a woman's right to choose her care provider and place of birth and further public education and advocacy. KAG: What is your position on the CPM credential? IMG:I am a Certified Professional Midwife. I believe that certification is one important way of helping the public to know that the certified (direct-entry) midwife has passed an examination created by experienced, knowledgeable midwives and that she has demonstrated her mastery of requisite midwifery skills, and can document a minimum level of experience previous to certification. While I am in favor of decriminalization of all midwifery (for public health reasons), I believe that it makes sense for certification to be required for insurance reimbursement and licensure. KAG: Why do you feel the American College of Nurse Midwives has instituted the certified-midwife credential for non-nurses? IMG:I would rather not speculate on this. KAG: Do you feel that the increasing visibility of certified nurse-midwives in the United States has had an effect--positive or negative--on the practice of midwifery in this country? IMG: Yes, and I believe that this effect has mostly been positive. KAG: What are the best and worst states for a direct-entry midwife to practice in the United States today? IMG: The best would be: Washington, Florida, Oregon, California, New Mexico, Arizona, Arkansas, South Carolina, Alaska, Colorado, Louisiana, Montana, New Hampshire, Texas, Tennessee, and Kansas. The worst? New York, and now, Illinois. KAG: Can you comment on what is happening to direct-entry midwives in New York state and Illinois right now? IMG:These are states in which there are large numbers of physicians who oppose any significant expansion in the number of midwives available to childbearing women. Unfortunately for the women, economic considerations [of physicians] are being placed before the needs and desires of birthing women. KAG: Are pregnancy and childbirth "medical conditions?" IMG: No. Normal physiological processes are not "medical conditions." KAG: Why do the American Medical Association (AMA) and American College of Obstetricians and Gynecologists (ACOG) continue to insist that home birth is unsafe in the face of large amounts of medical research to the contrary-- and what are the ways you see the medical establishment working against midwifery in this country? IMG: ACOG has an obvious vested interest in maintaining the status quo vis a vis childbirth. ACOG has openly spread disinformation about home birth and the midwives who attend birth at home. ACOG maintains a superior position vis a vis certified nurse midwives, since CNMs are not accepted as autonomous practitioners. Instead, they are required to work under the supervision (according to signed agreements) of obstetricians. When CNMs work at or run birth centers, their work is subjected to a standard much harsher than those by which obstetricians are measured. KAG: Do you see parallels between the witch trials and the persecution of midwives in the United States today? IMG: Yes. Some midwives have been charged with felonies after births which turned out well--something that does not happen to obstetricians. There is a California case in which a CNM was charged--taken from her home in handcuffs and chained to wall for 4 hours--after a birth, a good outcome, that took place in her birth center when she was out of the country. KAG: Do you believe that nursing is a necessary background for midwifery? IMG: No. Nursing and midwifery are very different professions, although there are some skills and some knowledge that are common to both. Forcing midwifery students to complete nursing training raises the cost of midwifery education at the same time that it weakens the integrity of the profession of midwifery in the United States. |