Birth Matters: A Midwife’s Manifesto Review

Your mother had a better chance at a safe birth with you than you have with your baby now. In fact, you have more than double the chance of dying during childbirth than she did. What's wrong with this picture? Isn't birth supposed to be safer?

That's the topic of Ina May Gaskin's latest book Birth Matters: A Midwife's Manifesta.

Ina May is arguably the most famous midwife in the world and has made great advances for midwifery in the United States and worldwide. Her books on birth, Spiritual Midwifery and Ina May's Guide to Childbirth, are recommended for all mothers preparing for birth. She doesn't disappoint with Birth Matters – it's written in her familiar, friendly style – yet it also has her confident, unapologetic wisdom about birth, mothers, babies, and the world of midwifery and obstetrics.

You'll find a sprinkling of birth stories in Birth Matters – as empowering as you'd expect from one of Ina May's books. But the meat of this book focuses on the reality of childbirth in developed countries – and how that reality came to be.

Where We've Gone Wrong (and how to fix it)

Ina May begins and ends the book with a call for women to come together, overcoming differences in viewpoints and lifestyles to help bring about change that will benefit every woman. She starts her appeal for this call with a chapter on the importance of birth stories – stories help us to know a wide range of what can and does happen during birth. Stories of normal birth show women that their mothers, sisters, and friends have uncomplicated, successful births. They empower women and create a normalcy for birth that modern culture is lacking. She urges us to listen to the stories – no matter what joys, or sorrows, they may contain.

The second chapter of Birth Matters examines where the second wave of feminism went wrong, as it came close to literally “throwing the baby out with the bathwater.” The intense focus on equality for women often sought to remove motherhood as a woman's burden – at times even downplaying the physical differences and realities of women from men. Ina May argues that though equality and women's rights are important priorities, removing motherhood, childbirth, and women's health issues from focus has been a mistake. It's an imbalance that has actually cost mothers and left women with far fewer rights than they should have in childbirth. This chapter covers many important topics about the physical realities of birth and hormones, as well as exploring what a culture that accepts motherhood and empowers women for childbirth can look like.

Sordid History and “Wonderful” Technology?

Ina May tackles the almost unheard of interplay of sexuality with birth in the next chapter. It seems strange that modern cultures don't acknowledge this connection; after all, every mother understands that babies are a natural result of sex. Separating these can rob women of a true understanding of the birth experience and how their bodies function. This chapter focuses seriously on sexuality, birth, and implications of denying a connection. You may be tempted to brush it off, thinking it only applies to those “other” women (whomever they are!). I encourage you to read about the very real physiological effects of the connection – and how it argues for the tender (or just basically humane) treatment of women who are laboring and giving birth.

Birth Matters continues on with a “brief history” of midwifery and the entry of obstetrics (and men) in the realm of childbirth. In the scope of childbirth history Ina May's recounting is indeed brief, however she is very thorough in her overview and includes extensive references (if you like references, Ina May has filled the entirety of Birth Matters with them). You'll get a clear picture of just how much childbirth has changed for women in recent centuries – and not always for the best. Ina May also critically examines how medical “statistics” are manipulated in favor of hospital and obstetric agendas – and how those statistics are then used to fight against midwives and choices for birthing women.

You hear a lot about birth technology today, and many women simply accept that various interventions are best for their babies. They never realize that such technology is making their obstetricians less skilled, removing their options for labor and birth, and in some cases causing the very complications they are desperate to avoid. Birth Matters covers the sticky issue of technology and how it has profoundly impacted the way women give birth. Ina May reviews technology such as fetal monitors and, in this chapter and later chapters, cesarean sections.

Ina May has no issue with detailing the problems in the modern trend of skyrocketing cesarean rates. She explores problems with the surgery – and outlines reasons she feels the trend towards more surgery is growing. In the latter chapters she again urges women to come together for good of each other – mothers, sisters, friends. She outlines trends that have led to the fear and dissatisfaction with the female body (breast implants, elective cesarean, the “menstruation as a plague” mentality) She explores a history of untested and/or “fashionable” drugs and procedures – many of which are done on women. All of this comes together for a compelling argument for more awareness – and more unity.

Change is Possible

Birth Matters does not leave men out of the picture. Ina May includes a chapter for dads full of practical advice. And she closes the book with notable advocates for birth (including male obstetricians) – and with her vision for the future. This vision calls for all to band together and make many things part of “normal” childbirth. She urges standardized record-keeping of maternal death, which some countries (such as the United Kingdom) have implemented with great success and realization of the goal to lower maternal death rates. She advocates for proper treatment during childbirth and support postpartum – and she calls for the recognition of mothers in various “risk groups” to receive the attention, support, and fair treatment they deserve.

I could not possibly overview even half of the topics that Ina May covers in her book. It's masterfully written and flows well. It's an easy read for all mothers – but full of references and solid, research-based logic that will compel every medical professional to consider Ina May's points.

Birth Matters is truly a picture of Ina May Gaskin's vision, benefiting from her long career as a midwife and from her unique position in international childbirth issues. It shows her continuing passion for mothers and babies, as well as her commitment to advocating for women's rights in all areas. Birth Matters is a must read for every woman – before they become mothers, after they fall pregnant, as their children grow – and even if they choose never to become a mother. It is a powerful book you will read and pass on to your mother, sister, midwife, and obstetrician. This book has the potential to open awareness and usher in change that brings a better future for mothers, babies, and families everywhere.

Click Here to get your copy of Birth Matters

About the author 


Kristen is a pregnancy coach, student midwife, and a mama to 8 - all born naturally! I've spent nearly two decades helping mamas have healthy babies, give birth naturally, and enjoy the adventure of motherhood. Does complete support for a sacred birth and beautiful beginning for your baby resonate with you? Contact me today to chat about how powerful guidance and coaching can transform your pregnancy, birth, and mothering journey <3

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