The Little Pink Book: A Guide For Home Birth

Mueller was pregnant with her third child when she met Ina May Gaskin, who’s been called the most famous midwife in the world, in 2009.  

“If you’d have told me with my first child that I would have home births down the road, I wouldn’t have believed you,” Mueller tells Evie Magazine. “Ina May’s Guide to Childbirth is the first book I recommend to moms because it institutes a realistic look at birth. The birth stories in it are real women telling their stories and saying yes, it’s hard, but it’s also amazing what your body is capable of.”

Ina May’s Guide to Childbirth, Gaskin’s primer for women who want to give birth naturally, turns 21 years old in 2024. In that time, the number of women interested in out-of-hospital birth has skyrocketed, especially after hospitals instituted draconian policies in response to Covid-19. Home births in the U.S. rose 19% from 2019 to 2020, according to Pew Research Center analysis of National Center for Health Statistics data. 

Gaskin – the first midwife to have an obstetrical procedure named after her – entered the world of birth in an unorthodox way. Ina May’s Guide to Childbirth draws from her experience delivering babies on The Farm, a Tennessee commune she and her husband helped found in 1971 (for the full story, watch the 2013 documentary Birth Story: Ina May Gaskin and the Farm Midwives). 

But you don’t need to join a commune in order to learn about the benefits of natural birth. Women are defecting from medicalized obstetrical care for numerous reasons: being treated like a number instead of a whole person by their provider, worrying about a cascade of interventions leading to an unnecessary C-section, or realizing nurses and doctors failed to warn them of the risks of what they said were routine procedures. Most of all, they want to be able to bond with their newborns and care for them with as little physical discomfort as possible.

When avoidance of pain becomes the major emphasis of childbirth care, the paradoxical effect is that more women have to deal with pain after their babies are born.

“When avoidance of pain becomes the major emphasis of childbirth care, the paradoxical effect is that more women have to deal with pain after their babies are born,” Gaskin writes in Ina May’s Guide to Childbirth. “The woman who gives birth without interventions, on the other hand, is more apt to be through with pain when her baby is born.”

It’s no secret that maternal care in the U.S. is shockingly bad. The U.S. maternal mortality rate is estimated to be 10 times higher than the rates in other developed countries like Austria, Japan, and Spain. American women are roughly twice as likely to have C-sections as women in the Netherlands, where midwifery care is the norm. 

Carol Nelson, a certified professional midwife at The Farm Midwifery Center and president of the College of Traditional Midwifery, has spent her career advocating for increased midwifery care to combat these dismal statistics. She’s featured in Ina May’s Guide to Childbirth as both a mother and a midwife.

“What I know from my 54 years of experience in delivering babies is I trust women, and I trust birth,” Nelson tells Evie Magazine. 

The number of women choosing out-of-hospital births is going to keep growing, says Nelson, who worked as a labor and delivery nurse before moving to The Farm.

“Women are more educated. They want better care, for one thing,” she says. “They should be where they feel comfortable. Sometimes that’s going to be at home, sometimes that’s going to be a birthing center, sometimes it’s going to be the hospital, and that’s okay as long as they have the choices.”

Critics of home birth point to the risks – why be anywhere other than a hospital in case things go wrong? Helen Roy, who’s had three home births, says she appreciates Ina May’s Guide to Childbirth for tackling this topic head-on.

“Gaskin’s not mincing words when it comes to things that can go wrong. Sometimes in home birth communities, people can get really high on their own supply and think that so long as you’re doing everything naturally, nothing bad can ever happen,” Roy tells Evie Magazine. “You’re going to develop an appreciation for the profundity of giving birth, but you’re also, by reading this book, going to develop an appreciation for risk. The confidence that you’re going to gain from knowing more is probably going to give you the strength to approach risk with an even hand.”

It’s a very ancestral, natural way of giving birth that we’ve lost in Western society with how individualized we are and how much we’ve given everything over to the medical system. 

Like Mueller, West Virginia mom Izabel Saville recommends Ina May’s Guide to Childbirth to every pregnant woman she can. She’s bought the book over and over again after giving away her own copy several times. Saville’s experiences giving birth in 2016 versus 2019 could not have been more different, she tells Evie Magazine. She felt like her body was going to break in half when laboring in the hospital with her daughter in 2016 and asked for an epidural – but after reading Ina May’s Guide to Childbirth before her son’s birth in 2019, her unmedicated labor at a birthing center felt “exhilarating.”

“My complete demeanor, perspective, everything had changed, so I went with my body,” Saville says. “I didn’t fight my contractions, and I still think that is the best labor I’ve had, and I would even say the least painful, if that is believable.”

She didn’t realize how fear-based her view of birth was before reading Ina May’s Guide to Childbirth.

“It was a completely new world to me that God had made my body to give birth. That’s something as a Christian I knew and I believed, but I wasn’t living it,” Saville says. “It’s the wisdom that used to be passed on from grandmothers and mothers, and it’s a very ancestral, natural way of giving birth that we’ve lost in Western society with how individualized we are and how much we’ve given everything over to the medical system. That really is something that used to belong to women.”

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