Review: Ina May’s Guide to Breastfeeding

by Angie Sonrode

As a self-professed lactivist and lover of midwife Ina May Gaskin, I picked up  her book, Ina May’s Guide to Breastfeeding, with high expectations and a curious mind. Thankfully, and not surprisingly, I was not disappointed.

I have read many books on lactation and this one may have just taken the top spot on my bookshelf. This book is well-written from a warm, tender voice and chock-full of helpful, easy-to-follow information that is very reader- (and tired mother)
friendly. In addition, it is peppered with real
women’s stories and experiences.

Ina May knows how to grab your attention. On the first few pages she states, “You probably wouldn’t have picked up this book if you didn’t already have some idea of the benefits of breastfeeding and the possible undesirable consequences of feeding artificial milks to babies as a first choice.” This statement sets the tone of the book, as one clearly in favor of breastfeeding but it is also not her intention to pass judgment on mothers. She has found a way to promote breastfeeding with honest, well-rounded facts, while breaking down the components of breastfeeding so anyone giving it a go does so well informed.

One of the reasons I liked this book so much is that Ina May clearly understands not just the biology and physiology of breastfeeding, but also the social, economic and emotional factors that go into a woman’s breastfeeding experience. She touches on women in the workforce and their pumping dilemmas, sexuality and breastfeeding (yes, it’s possible to have a very normal and active sex life while lactating), and the connection of sleeping arrangements and the success of breastfeeding. While other books on parenting and breastfeeding have included some of these topics, none that I have read have managed to complete the puzzle— meaning that there are many, many factors that contribute to a mother/baby duo’s success or failure with nursing.

My favorite chapter in the book is titled “Shared Nursing, Wet- Nursing, and Forgotten Lore.” In this gem of a chapter Ina May discusses the benefits of community involvement in breastfeeding no matter the size of the community. She discusses induced lactation which is when someone that has lactated in the past re-lactates— including grandmothers and aunts, and also sympathetic lactation, which is when someone who has never lactated before can begin to produce milk if there is a need or she is in situations that raise her levels of oxytocin (a doula or midwife are examples).

Ina May also talks about the importance of recognizing that when a family suffers an infant loss, the effects of lactation need to be addressed and incorporated into the healing process. This is something often left out when helping parents in this unfortunate situation.

The book ends with Ina May talking about America’s “Nipplephobia” and the ramifications this has had on our breastfeeding rates and success stories. She goes into detail about how the U.S. was the only country in the world to vote against the WHO/Unicef Code of Marketing of Breast- milk Substitutes and that this decision has had an escalading effect on our meager breastfeeding rates. This is something we are still paying dearly for, with long-term effects.

When a society works hard to hide all aspects of nursing and breasts it in turn hides the primary reason women have breasts at all. If a culture of women and men grows up only seeing bottle-feeding it makes sense that this would be their perception of “normal.” Likewise, if a woman struggling with breastfeeding (as many new mothers do before they get the hang of it) is sent home from the hospital with formula samples she is much more likely to use

them than had the samples not been introduced.

I recommend this book to anyone interested in learning about the wonders of breastfeeding as well as those looking to further their lactation education—couldn’t we all?

Angie Sonrode is a birth doula and lactivist whose business is called Continuum Birth Services because she truly believes it takes a village. She is the mama to four wonderful children. 

Birth Matter’s: A Midwife’s Manifesta, by Ina May Gaskin — A Book Review

By Hope Lien CD(DONA)

In her influential new book, Ina May Gaskin, the godmother of natural childbirth and world renowned midwife, writes of the harsh realities of the maternity care system in the United States– with some of the highest maternal morbidity in the developed world. She compels readers to consider that every woman should have the right to positive and safe birth. Gaskin’s evidence -ased work, rigorous examination of past, present, and future maternity practices, and intimate writing style all made this a delightful read.

There were many parts of this book that resonated with me, both as an advocate for women to receive better care, and personally as a female consumer. In the beginning of the book, Ina May reflects on the way she reminds women to trust their bodies to birth. “Let your monkey do it,” is a phrase Gaskin refers to in the book, and often encourages women to remain in a sort of primal state that their body will best progress in during labor.  By staying in tune with their natural birthing state, and when placed in a comfortable environment, such as their home, women are able to avoid many interventions imposed on them by the obstetrical system today.

Birth Matters is peppered with birth stories from the Farm Midwifery Center where Ina May lives and works as a midwife. These tales of the great strength of women who have birthed their babies without the use of pain medication or surgical measures give power to the opinions expressed throughout her book. Gaskin devotes an entire chapter to discussing technological advances in the obstetrical realm and the ways in which women may have been better off without. She educates readers about the effective and safe options that were previously available before the invention of ultrasound to predict a baby’s weight, widespread c-section for breech babies, and electronic fetal monitoring, to name a few.

One of my favorite sectionsof the book speaks directly to fathers-to-be. In this section, Gaskin gently encourages partners to be familiar with the sphincter law, the idea that the cervix opens best in privacy and to follow a mother’s cues to show you how to move through the labor process. She also suggests how to help the laboring woman tune into her “monkey” or most primal state, and keep her adrenaline or fight or flight response low, while boosting her oxytocin and beta endorphins which keep labor moving and reduce pain levels. Gaskin does an excellent job of encouraging fathers and reminding them that birth is a normal process, although the media may tell you otherwise.

At the end of the book, Ina May shares her vision for subsequent births here and around the world. She maintains a hope that one day medical personnel will be more properly educated to assist birthing women, and that maternity care standards would be revised. Most importantly, Gaskin is optimistic that we can develop a better way to keep track of all maternal deaths taking place in the US, and that we could develop better practices based on the outcomes.

Birth Matters is a persuasive and enticing look at birthing standards in the US, with many traditional and non-invasive ways to improve upon them. It is certainly one of Ina May’s most far-reaching call to women and maternity care specialists everywhere to improve the care we offer to expectant mothers, both here and around the world.