Ina May Gaskin and medical colonialism

17149617 - abstract word cloud for colonialism with related tags and terms

It’s not up to me to accept or reject Ina May Gaskin’s apology for her racist comments:

…[M]y answer to a Texas Conference Q & A question has caused a great deal of hurt, and was insulting and demeaning to many, especially Women, and People, of Color. While the intent behind my answer was anything but racist or demeaning, I understand that impact is more important than intent, and I personally offer my genuine and deepest apologies. I have spent a great many years of my career shining the spotlight on the massive racial disparities in maternity care, and my comment at the conference is not a true reflection of my belief, and what I know to be true – that racism, and its denial, are the true root of the egregious inequalities in maternal and infant healthcare for people of color…

It seems to me, though, that it’s a non-apology apology. Why? Because Gaskin failed to apologize for, indeed did not even mention, her entire career of medical colonialism.

[pullquote align=”right” cite=”” link=”” color=”” class=”” size=””]Gaskin stole the midwifery knowledge of indigenous women and presented it as her own.[/pullquote]

Colonialism is the practice one country occupying another country or region and exploiting it for the benefit of the occupier. Medical colonialism is the practice of gaining control over black bodies, knowledge and practices and exploiting it for the benefit of the white majority.

Classic examples of medical colonialism come, not surprisingly, from medicine. The Tuskegee experiments, when black men with syphilis were deliberately left untreated, are the most egregious example, but medicine has plenty more including the story of Henrietta Lacks and the use of her HeLa cells for research, and the work of gynecologist J. Marion Simms, who practiced on female slaves to perfect his techniques for repairing obstetric fistulas.

But midwives have enthusiastically embraced medical colonialism, too. As I wrote yesterday, Ina May Gaskin has built her career on it, including:

1. Her embrace of the racist foundational lie that indigenous women have painless labors

2. Her shockingly cynical exploitation of high rates of maternal mortality in general (her Motherhood Quilt), and black maternal mortality in particular, to critique modern obstetrics without doing anything to address it.

3. The profoundly disturbing trend of white homebirth midwives learning their trade (getting “catches”) on the bodies of women of color in developing nations.

4. Gaskin’s appropriation from Guatemalan midwives of a shoulder dystocia maneuver that, in the tradition of Columbus “discovering” America, she named for herself.

Considering that natural childbirth is a philosophy of white privilege, it comes as no surprise that many white women are acting as apologists for Gaskin. Their defense is that she isn’t racist and either didn’t mean what she said or is being deliberately misinterpreted.

As Arthur Chu has written, that’s the classic defense of “Mighty Whitey.” Chu was not writing about natural childbirth advocates, but he could have been:

We repeatedly tell stories about a white protagonist who goes on a journey of self-discovery by mingling with exotic brown foreigners and becoming better at said foreigners’ culture than they themselves are…

The frustrating thing about being annoyed by the Mighty Whitey trope … is that it’s so frequently employed by the well-meaning “good guys.” The whole point of “going native” is that the familiar Western civilization is portrayed as inauthentic, ugly, broken, flawed…

But when it comes to the tragedies of black maternal (and perinatal) mortality, it’s hard to see how Gaskin is one of the “good guys.” It’s not merely that she failed to understand the implied racism of her own comments; it’s that she has made a career of medical colonialism, exploiting the knowledge, practices and fantasies about black women for the benefit of privileged white women.

The tragedy of black maternal mortality puts Gaskin in a bind for a variety of reasons. First, it threatens the fantasy that “unhindered” birth in indigenous women is inherently safe; obviously it’s deadly. Second, it involves racism, which Gaskin’s philosophy has never bothered to address. Finally, it is not a tale of too much intervention in childbirth, but too little. Black women die from lack of access to the very lifesaving technology that Gaskin routinely decries. That’s not something that she wishes to acknowledge.

As I said above, it’s not up to me to accept or reject her apology, but as a bystander I seriously doubt her sincerity. No doubt she is not intentionally racist, but her career is built on medical colonialism. If Gaskin wants to show that she understands that, she could offer a meaningful gesture — going forward she could insist that the Gaskin maneuver be renamed the Guatemalan maneuver in acknowledgement that she stole the knowledge of indigenous women and presented it as her own. But that’s a sacrifice she is very unlikely to make.