The Gaskin Maneuver is a classic example of medical colonialism

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The racism of natural childbirth advocacy is usually covert, but back in 2017 Ina May Gaskin inadvertently showed hers.

According to birth workers of color who attended her talk, when asked about the problem of extraordinarily black maternal mortality, Gaskin blamed women of color for their own deaths:

Gaskin appropriated the maneuver from Guatemalan midwives and in the tradition of Columbus “discovering” America, named it for herself.

Gaskin responded with anecdotal stories about Black women who lost their lives as a result of provider negligence, and blamed the Black women for not being more informed of their life-threatening symptoms. Moreover, Gaskin stated that “drug overdose” and the use of illegal drugs was the cause of the massive amount of Black maternal death rates. She also mentioned that communities “don’t pray as much as we used to” as a reason contributing to maternal death rates.

I’m not sure why people were so surprised. Gaskin has always trafficked in the language and habits of medical colonialism. Colonialism is the practice one country occupying another country or region and exploiting it for the benefit of the occupier. Medical colonialism involves control over black bodies, knowledge and practices and exploiting them 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. And 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. The Gaskin Maneuver. In a classic example of medical colonialism, Gaskin appropriated a shoulder dystocia maneuver from Guatemalan midwives; then in the tradition of Columbus “discovering” America, she named it for herself.

Natural childbirth is a philosophy of privilege. Political scientist Candace Johnson explores this phenomenon in The Political “Nature” of Pregnancy and Childbirth. Johnson asks:

[W]hy do some women (mostly privileged and in developed countries) demand less medical intervention in pregnancy and childbirth, while others (mostly vulnerable women in both developed and developing countries) demand more …? Why do the former, privileged women, tend to express their resistance to medical intervention in the language of “nature,” “tradition,” and “normalcy”?

And answers:

It is a rejection of privilege that simultaneously confirms it…

The fantasy of Third World women’s natural experiences of childbirth has become iconic among first world women, even if these experiences are more imagined than real. This creates multiple opportunities for exploitation, as the experiences of Third World women are used as a means for first world women to acquire knowledge, experience and perspective on ‘natural’ or ‘traditional’ birthing practices, while denying the importance of medical services that privileged women take for granted.

To be clear, I have seen no evidence that Gaskin herself discriminates against individual women of color, but that does not make her innocent of mobilizing racist stereotypes and practices. 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 racist fantasies about black women for the benefit of privileged white women.

  • expat

    That is so funny. In post ww2 physics, if someone has an equation of concept named after them, you can be almost certain that they stole credit from someone else. It is almost a joke or mark of shame. The students never know this, but eventually, if they study long enough, they figure it out. By tracking published estimates of the temperature of empty space, you can see the physics commuinity forget something fundamental for a hundred years and slowly rediscover the lost knowledge. https://kirstenhacker.wordpress.com/2019/11/09/keeping-warm-with-star-light/

  • no longer drinking the koolaid

    MANA had a Midwives of Color division. Not sure if they still do. At one point every midwife in the division resigned because of racism shown by the white midwives. It remember reading the letter and it seemed to come down to the midwives on the MOC section saying we’ve tried to work with you and explain the problems but you are unwilling to learn.

    https://midwivesofcolor.wordpress.com/2012/05/23/interesting-conversations-in-north-american-midwifery/

  • yugaya

    “The Gaskin Maneuver. In a classic example of medical colonialism, Gaskin appropriated a shoulder dystocia maneuver from Guatemalan midwives; then in the tradition of Columbus “discovering” America, she named it for herself.”

    Dr Tuteur please start a petition to ACOG/ACNM to have this ugly racist name for that maneuver removed and changed officially. It ought to be renamed The Guatemala Maneuver. You have the online presence and influence to see this through.