SUMMERTOWN, Tenn. -
A Middle Tennessee woman remains at the forefront of a movement that encourages women to give birth with the aid of midwives.
Ina May Gaskin is a founding member of The Farm, a former commune in Summertown, about 90 miles from Nashville.
Over the past several decades, she and her team of midwives have delivered more than 3,000 babies at The Farm, a community started in the early 1970s.
Gaskin is also a well-known author on midwifery and natural birthing and the subject of a "Birth Story," a new documentary receiving critical acclaim following last month's Los Angeles Film Festival.
She was also recently honored with the Right Livelihood Award for her work in the United States as a midwife and an advocate for childbearing women.
Gaskin told Nashville's News 2 she frequently travels all over the world at the request of doctors who want to learn her craft.
"I travel a lot and am in a lot of other countries that produce far better outcome than we do in the U.S.," Gaskin said. "One feature of those societies that goes across all of them is they have more midwives than obstetricians."
She said she is also especially concerned about the rising percentage of babies born by Cesarean section, because of the risk of infection and complications for the woman.
In the U.S., roughly 30% of babies are born by Cesarean.
"Most hospitals have a time limit and if you can't get under the wire and can't give birth to a baby vaginally you are bound for a C-section," Gaskin said.
According to Gaskin, breech babies, or infants born feet first instead of head first, and multiples are typically delivered via C-section.
In the future, Gaskin predicts fewer physicians will have the skills to deliver a complicated birth without performing a cesarean.
Dr. Stephen Staggs has decades of experience in the delivery room and has worked with midwives. He told Nashville's News 2 the cesarean rate in the United States is high for several reasons.
"One reason we have multiple births in the U.S. [is] our reproductive technologies here raised the rate of triplets, twins [and] quads. [It's] much higher than usual." Dr. Staggs said.
He also added that the U.S. has a more diverse population than other countries and an older population of women having babies.
Dr. Staggs also concedes the fear of litigation influences some physicians to deliver babies surgically rather than risk injury to the mother or child with a vaginal delivery.
"Obstetricians pay really high rates of malpractice. How far that's in each doctor's mind and in each hospitals mind is hard to calculate," he said.
If a woman decides to deliver her baby at home, insurance usually becomes a moot point.
Gaskin, for example, requires mothers who deliver at The Farm to sign an informed consent waiver.
Her fee ranges between $4,000 and $7,000.
Gaskin told Nashville's News 2 a mother has never died in her care.
Nevertheless, she feels a sense of duty to dozens of women all over the country whose deaths are in some way linked to child birth.
She honors each woman with a quilt square and says dozens of them died due to complications from C-sections and induced labor.
According to the new state medical examiner, Dr. Karen Cline, about eight women die each year from complications related to child birth in Tennessee.
She said that number may not be accurate because of the way maternal death has been reported in the past.
Just this year, Tennessee started requiring a box to be checked on death certificates to indicate if a woman had been pregnant within a year of her death.
"It could increase the number of cases that wouldn't ordinarily be recognized if it's a delayed death due to complications of pregnancy," Dr. Cline explained.
According to the CIA's World Factbook, the maternal mortality rate in the United States is high compared to other developed countries.
In 2008, there were 24 deaths for every 100,000 births, which is the same statistic that was reported in Saudi Arabia.
Greece had the lowest mortality rates in 2008 with two deaths for every 100,000 births.
Though the vast majority of women will never consider a home birth, many are seeking an alternative to traditional physician care.
Linda Hughlett is a certified nurse midwife trained through a nationally recognized program at Vanderbilt University Medical Center.
Hughlett said her training allows her to deliver babies, but she does so at the hospital.
"I've got the coolest job in Nashville," she said. "For the most part, they [mothers] love the safety of the hospital."
Hughlett said she and other specialized nurses delivered around 1,200 newborns at Vanderbilt in 2011, which makes up about 25% of all the babies born at the hospital.
Gaskin said the midwife option available at Vanderbilt is the kind of option she has been seeking in her decades of work.
She told Nashville's News 2 it is a gratifying combination of physicians and midwives working together, sharing knowledge and trusting in the wonder of the human body.
"Your body is not a lemon. It's as well made as other mammals. We just worry more," Gaskin said.
The Vanderbilt midwives do not deliver twins or babies in the breech position.
For more information on Vanderbilt midwives, visit VanderbiltNurseMidwives.org.
Ina May Gaskin has delivered or helped deliver more than 3,000 babies.
