I first learned of the Farm while reading Spiritual Midwifery during my first pregnancy. Further research brought me to understand the origins of the Farm, which certainly encouraged me to learn more. Ina May Gaskin has an impressive history as one of the most famous midwives in all of the world. She heads the Farm midwifery center in Summertown, Tennessee. She served as president of the Midwives Alliance of North America for six years. Among other awards, Ina May was chosen as visiting fellow at Yale University in 2003. She is quite simply a hero to many women, including myself.
Aaron and I have recently visited the Farm midwifery center. Although I did not meet Ina May herself, we spent about 2 hours with one of her 5 midwife associates, who has also been at the Farm since its beginning. Here are my reasons for driving over 9 hours to TN to see a midwife:
My first pregnancy was an emotionally and physically traumatic experience. I was not allowed to remove the fetal monitoring device, which is proven to be no more effective than listening to the fetus every fifteen to thirty minutes with a fetoscope. Furthermore, electronic fetal monitoring has not reduced infant deaths, nor has it reduced the incidence of cerebral palsy. In fact, there is a slight increase in cerebral palsy among babies who have been electronically monitored.
During my first pregnancy, I was not allowed to move from my bed while laboring. Movement during labor is vital to a faster delivery. It is, however, inconvenient to a hospital staff who do not have the time/patience to deal with women in all sorts of positions.
However, the real trauma began when the nurses found that my fetus was breech (bottom first), and they immediately ordered a cesarean without my consent. Not only did they not have my consent, but I specifically said that I did not want the operation. I was fully aware that breech births are delivered safely all over the world, with extraordinarily good results in Europe and Japan. I was ignored and shoved off to the operating room for a cesarean section.
Here are a list of complications that can and do arise from cesarean sections:
- increase in hemorrhage requiring transfusion
- hysterectomy for uncontrollable hemorrhage
- accidental cutting of the bowel, leading to peritonitis, possible colostomy, or death
- accidental cutting of the uterine artery
- surgical trauma to bladder and ureters
- increased postpartum infection, scar breakdown
- scar pain, numbness
- long-term severe back pain following epidural block
- increased pulmonary embolism
- anesthesia mishaps, including paralysis and death
Luckily, I only walked away with two checks on the above list. One of every five women suffer from lower back pain after an epidural block. I am one of them. Also, my scar was numb for quite some time after the surgery. And, with this new pregnancy, I find my scar to be particularly painful, as the tissue breaks away with my growing womb.
Risks after a cesarean section include:
- decreased fertility
- abdominal adhesions leading to bowel obstruction
- increased tubal pregnancy
- increased placenta previa (the placenta lies over the cervical opening)
- increased placenta accreta (the placenta attaches too deeply into the uterine wall to separate normally; profuse and often fatal hemorrhage is the result)
- increased placental abruptio (the placenta is prematurely separated from the uterus, cutting off the baby’s only source of oxygen)
- increased uterine rupture
Again, I’m lucky to not have these above complications, but I still have a delivery to undergo. Whether or not I’m in a hospital may not help me or the fetus to survive from some of these dire complications.
When talking to people about delivering in a hospital versus a birthing center or a home birth, most people have the same argument. We have less maternal and fetal deaths today than we did in the past. This is somewhat true. The US maternal death rate is currently rising. First of all, there has been no decline in our national maternal death rate since 1982. The US maternal death rate declined every year between the 1930’s to 1982. In most wealthy countries, maternal death rates have continued to decline since 1982. Between 1982 and 1996, US maternal death rates occurred at a ratio of about 7.5 deaths per 100,000 births. In 2005, the US rate increased to 11 deaths per 100,000 births due to increased cesareans and maternal obesity. What’s worse, the US Center for Disease Control and Prevention (CDC) warned in 1998 that even after substantial improvements had been made in our national reporting system, there is still so much under reporting that the number of actual deaths “is estimated to be 1.3 to three times that reported in vital statistics records.”
Because of the under reporting, we don’t have enough information to conclude exactly why our maternal death rate is so poor. Four key points to consider are inducement drugs that are known to cause severe complications and many maternal deaths, amniotic-fluid embolism, a new single layer technique for suturing the uterus after cesarean, and the many complications that arise from cesarean sections.
So, the last place I want to be for my current pregnancy is in a hospital, mainly because the push for cesareans is so high. But, even if I have a successful vaginal birth in a hospital, I will still be forced in a bed and strapped to fetal monitoring devices. I will be denied food and water and the basic freedom to birth my child the way my instincts will allow.
Delivering in a birthing center would be a happy medium for some, but no birthing center in my area allows VBACS (Vaginal Birth After Cesarean Sections). I had a difficult time finding an independent midwife in my area, let alone one that was willing to do an H(home)BAC. So, my only option was the Farm.
Driving through the 3 square miles of the Farm is certainly reminiscent of my time in Olympia, WA. They experiment with hip alternative building styles, and house many projects, like the soy factory and mushroom farm. The on-site publishing company, along with the pricey organic store, compliment the midwifery center. Despite all that goes on there, the Farm is humble. For example, the midwifery center is just a small little building with one examination room. Only one day a week is reserved for pre-natal checkups, and most of their deliveries are home births in the surrounding Tennessee/Georgia area. The Farm is home to 5 birthing cabins, which can be rented for $1,000 per month. These are usually full, but they aren’t overflowing. Speaking of prices, it costs $4,500 to have a baby at the Farm, which is on par with a lot of home birthing prices in the US. The main reason that the Farm is so famous is because of all the outreach to the global community. The Farm midwives are constantly hosting midwifery events, as well as making their presence known in global venues. What they do is a dying trade in the US. Midwives are being stamped out by obstetricians, and Ina May makes waves where she can, advocating women’s rights while unveiling nasty truths and dangers about current US birthing trends.
Consequently, after my visit to the midwifery center, which was nothing short of inspiring, I have found a midwife in Pennsylvania who will give me my much wanted HBAC. I cannot deny the fact that I fell in love with the Farm, my midwife there, and their practical yet rustic facilities. But, it’s more practical for me to have a home birth. Driving over 9 hours with a newborn is not my idea of an ideal situation.
Aaron and I have not made a final decision. I suppose you can put your vote here, that is…if you’ve read this far!!
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