Ina May Gaskin and the Safe Motherhood Quilt Project
I walked down the sloping aisle to the front of the auditorium and my eye caught the sign. The Safe Motherhood Quilt Project and below in italics: Did you know that no improvement has been made since 1982 in reducing the maternal mortality rate in the United States? As I got closer I made out the small print across the bottom. I discovered it had been inspired by the AIDS quilt. Each block belonged to a woman who had died in childbirth.I felt my heart grow heavy as I mounted the stairs on to the stage where the quilt was displayed. The artist's easels were arranged in a serpentine fashion. The colors and textures of each 18" x 12" block were unique. Some were decorated like children's art with appliqué and sequins; others with a muted respectful style. A bright blue block with indigo stitching caught my eye and the cross-stitching spelled out “Karen” and below “Hannah”. “January 20, 2002” noted the day this young mother and her unborn daughter died.
As a mother who had lost a grown child, although in different circumstances, I knew the unspeakable grief each block represented. The wound in my heart never heals completely and as I walked from square to square I felt the pain in my chest begin to fill my whole body. I thought of the mothers of these young women. My imagination filled with pictures of the empty-handed Dads who perhaps only hours before had been filled with the eager promise of launching into fatherhood with a partner. I thought of the newborn babies starting life without a mother.
The presentations were about to begin and as I found a seat, my heavy- heartedness became laced with a sense of horror. As a doula, I work daily with expectant and postpartum families, but had not known death in childbirth was so common. Each year facts intrude to ruffle our complacency—but we Americans love our cultural myth that we are modern and spot-on efficient. We cling to it with zeal proportionate to the dark underbelly that our denial holds at bay. The faces of the moms I had seen break down in tears as they recounted their birth stories turned over in my mind. I was quickly connecting the dots. Were these young mothers fortunate to have escaped with their lives?
The moderator rose to introduce Maddy Oden. A hip, well-dressed woman with cropped gray hair crossed the stage. Maddy's daughter, Tatia Oden French, was a savvy Northern California woman with a PhD. She was 32 years old, in perfect health, and her pregnancy had been one of glowing wellness. In December of 2001, she was a little under two weeks overdue. Her doctor recommended the drug Cytotec (misoprostol) be used to induce labor. Ten hours after the drug had been administered, Tatia suffered hyperstimulation of the uterus which led to an amniotic fluid embolism. Mother and baby were quickly spiraling into acute distress as the doctor scrambled to perform an emergency Cesarean section. Tatia and her baby girl, Zorah, died in the operating room.
The crowd leaned forward, listening to every word. I felt a deep bond of kinship with this mother who had also lost a grown child. I understood why she was becoming an advocate for change and not retreating into seclusion with her pain. I had always considered myself spiritually-inclined but my son's death had awoken a reverence for life I had never dreamt possible. It had morphed my career of working with children and infants into a passionate quest to bring non-violent care and a sense of the sacred to mothers and newborns passing through the portal of childbirth which stands at the gateway of life.
As Maddy concluded her heart-wrenching story, I saw Ina May Gaskin approach the podium. Central Casting could not do a better job of creating the impression of a warm and competent midwife. Ina May slid in and out of anecdotes as she delivered national and global statistics of birth data that seemed to be endlessly at her fingertips. Her thirty-five years of copious documentation regarding her and her sister midwives outcomes at their birthing center at the Farm in Summertown, Tennessee sets the stage for her authority. They have created one the safest and most humane places to birth on the planet.
In stark contrast to the scene at the Farm, vignettes detailing maternal death were then fired like bullets into the room: Evelyn, a 20 year old second time mother bled to death after an unnecessary 27 minute Cesarean-section, done so her attending physician could depart for a European vacation; Tameka, a 22 year old Jamaican born soldier, and her newborn daughter were released from the hospital on the 19th of December, to an empty apartment in Watertown, New York. Tameka was discovered dead on Christmas Day. Danasia Elizabeth must have died not long after her mother, dehydrated, starved and alone. No one will ever know exactly but she died sometime between her 6th and 11th day of life. Our health care system has no provision for a woman facing the postpartum period alone with her new baby.
Ina May is careful with her statistics and explains the meaning of each. The United States is 31st in the world in terms of maternal death; from 1991 to 1999 there was a 61% increase in mothers who died in childbirth. The Center for Disease Control (CDC) says this may be the tip of the iceberg as the fear of lawsuit and the corporate politics of HMO's do not encourage full disclosure. Unlike all other industrialized nations, we have zero system in place for formal review.
Most of these deaths are iatrogenic, Ina May explained. Iatrogenic means the treatment of the physician, the drugs administered and the surgeries performed harm rather than heal. The danger warned about in the Hippocratic Oath, which says “First Do No Harm,” is as freshly applicable today as it was thousands of years ago.
Ina May told us in conclusion she felt compelled to become a voice for these women who could no longer speak for themselves. I was eager to get back into the night air. As I emerged I felt I too was passing through a portal. Touching the quilt, hearing the speakers, my dream of a loving birth passage and my raw knowledge of death were fusing into a new dedication. My passion to bring tenderness, care and conscious awareness to birthing women and newborns was fueled by the bracing reality of how much we as a culture need to learn to bring this dream into manifestation. I realized it can be done but we need to start now.
