Nonfiction, Literary Nonfiction
Birth Matters: A Midwife's Manifesta
by Ina May Gaskin
Seven Stories Press, 2011
Home/Birth: a poemic
Arielle Greenberg and Rachel Zucker
1913 Press, 2010
Reviewed by Ursula Ferreira
When I was eighteen I read Ina May Gaskin's Spiritual Midwifery, and like many self-professed birth junkies before and after me, I was hooked. Seventeen years later, I'm both a doula and a mother. I still read books about birth, and am always interested in the kind of books capture women's attention. Two recently published books speak to many mothers and stir the proverbial pot in different ways. Ina May Gaskin's Birth Matters: A Midwife's Manifesta is rally-cry to improve the abysmal maternal and neonatal mortality rates in the United States. Arielle Greenberg and Rachel Zucker's Home/Birth is a fierce affirmation of homebirth.
Ina May Gaskin, a midwife, published the now seminal Spiritual Midwifery in 1977. The book chronicles the establishment and growth of a free-standing birth center in Summertown, Tennessee. Thirty-five years later Gaskin brings her considerable influence to the subject of maternal and neonatal mortality rates in the United States. As a technologically-advanced country, one might assume that US mortality rates - indicators of the quality of pre- and postnatal care - would rank among the world's best. In fact, we rank behind forty other nations in maternal mortality, and behind thirty others in neonatal. Gaskin's manifesto successfully educates the reader as to why this is so: lack of necessary experience for both doctors and nurses; hospital policies dictated by insurance policy rather than evidence-based practices; non-existent and inconsistent documentation of maternal mortality from state to state. Her writing is compelling because it is both compassionate and frank: "I have lost count of how many newly graduated nurses have told me in recent months that they had never been in a room with a laboring woman before they were hired as a hospital maternity nurse."
Yet Gaskin does not demonize doctors or nurses. In fact, she calls for coalition-building, for doctors, nurses, midwives, doulas and ordinary citizens to commit to the safety and health of our mothers and babies. Many maternal and neonatal deaths are preventable, she says, especially in a country so rich in resources, if we bring together our collective wisdom toward a common goal.
While Gaskin calls for coalition-building, Home/Birth, affirms a birthing woman's individual knowing, and the right to birth where she feels safest and most empowered. Arielle Greenberg and Rachel Zucker are friends, established poets, and mothers with a variety of birthing experience. Home/Birth is a call and response that weaves together threads of conversation: birth stories (their own and others); legalities and politics; bumper stickers and slogans; humor; sadness; anger; and joy. The spiraling and fragmented quality of their polemic reminds me of holding an adult conversation with small children nearby. The poopy diaper, the toddlers squabbling over a toy, the need for snacks now trump whatever is being said. But once the little ones have been tended to, you pick up the thread of conversation once again or allow it to be lost.
Greenberg and Zucker do not shy away from difficult topics. In speaking honestly about homebirth, they acknowledge that it is also necessary to speak of death. At thirty-one weeks Greenberg's second child died in utero: "I felt devastated, but also at peace with our baby being gone. But letting go of a homebirth, putting myself at the mercy of a hospital birth and having to say goodbye to my baby in that environment, to try to feel connected to myself and my dead child in that environment, felt like the start down a long, bad road I wasn't sure I could find my way back from." She chose to wait until labor started at home, with her midwife. Both Greenberg and Zucker speak of a radical commitment to the fullness of their experience in a manner that honors wholeness and the sanctity not only of their bodies, but the bodies of their children as well.
I read these books under many hats: mother of a homebirthed daughter, doula to women in diverse birthing situations, bodyworker, somatic sex educator, and feminist. In each of these realms, I've witnessed a powerful shift over the past few decades, a shift toward "health" defined as emotional, reproductive, sexual, environmental and spiritual. Birth Matters: A Midwife's Manifesta and Home/Birth present these shifts in terms of birth practices. Through poetry, prose and polemic, the authors call for a reclamation of personal choice and collective voice in the most intimate human realm: conceiving, carrying and birthing a child.