Ina Mae Gaskin (1940 - )

Ina Mae (née Middleton) Gaskin (1940 – ) is an American midwife.

Gaskin is author of numerous books on childcare, labour and delivery including Spiritual Midwifery (now in its fourth edition). For 22 years she published Birth Gazette, a quarterly covering health care, childbirth and midwifery issues. Eponymously affiliated with the Gaskin (all-fours) manoeuvre (1977).

Gaskin founded the Farm Midwifery Center located near Summertown, Tennessee in 1971. The ‘Farm’ is noted for its low rates of intervention, morbidity and mortality despite the inclusion of many vaginally delivered breeches, twin and grand multiparas. Their statistics were published in “The safety of home birth: the farm study” in 1992.

  • Born on March 8, 1940
  • 1971 – Founder and director of the Farm Midwifery Center located near Summertown, Tennessee
  • 1996-2002 President of Midwives’ Alliance of North America (MANA)
  • 2003 – Visiting Fellow of Morse College, Yale University
  • 2009 – Honorary Doctor by the Faculty of Health and Human Sciences of Thames Valley University, London
  • 2011Right Livelihood Award for her ‘life’s work teaching and advocating safe, woman-centred childbirth methods that best promote the physical and mental health of mother and child

Medical Eponyms
Gaskin (all-fours) manoeuvre

Gaskin adopted the all-fours manoeuvre for shoulder dystocia from indigenous midwives while visiting the highlands of Guatemala in 1976. Gaskin first documented the manoeuvre in the second edition of Spiritual Midwifery (1977), and expanded in an informal article on a series of shoulder dystocias in which the maneuver had proven to be extremely effective (1988).

This position works very well to widen the pelvis in just the way that is required when the shoulders are stuck: instead of the mother’s coccyx being pushed towards the symphysis pubis in the way it is in the seated position, there is no pressure on the coccyx and the baby’s weight is pushing on the symphysis pubis, thereby widening the anterior to posterior diameter a little.

Gaskin 2002: 354

1991 – Gaskin collaborated with family physicians to publish a formal review 32 cases of shoulder dystocia, all of which had been resolved with the all-fours position.

1998 – Bruner et al analysed 82 consecutive cases of shoulder dystocia with 68 patients (83%) having successful delivery of the fetus with the Gaskin manoeuvre alone. Rates of maternal and neonatal morbidity were 1.2% and 4.9%, respectively [one case of maternal postpartum haemorrhage; one infant with a fractured humerus; and three neonates with low Apgar scores]. The average time needed to assume the all-fours position and complete delivery was 2-3 minutes.

Major Publications

Eponymous Shoulder Dystocia management techniques



Eponymous terms

Graduated from Cardiff Medical School in 2017 with MBBCh and BSc in Psychology and Medicine. Currently working as a doctor in the emergency department at Sir Charles Gairdner Hospital in Perth, Australia.

Fourth-year MBBS student at Curtin Medical School. Conducting penultimate year of medicine with the Rural Clinical School of WA in Kalgoorlie. Passionate about women's health, emergency medicine and rural health care.

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