Ina May Gaskin and her “Sphincter law”

Declaration: I Love Ina May, her spirit, her passion, her tenacity in the face of critics, her sheer will power to fight the existing status quo and above all her ability to believe in womankind at a time when it wasn’t so cool to do so. Still isn’t, is it?

Ina May’s book Guide to Childbirth was one among many resources that helped me become confident about my first birth. I was a terrified 30 something year old, too busy with my life and career when I got pregnant in 2013. At this time, since my adolescence I had struggled with period pains so bad I couldn’t attend school and college for the first day or two every month. Then in the big bad world of career progression, I started taking stronger and stronger painkillers to get me to work when I couldn’t manage. So the thought of giving birth was a most terrifying one. I too like most women assumed this will be the mother of all period pains to endure in order to receive the gift of a child. Maybe that’s what people called the “passage”.

So I set upon preparing for this mammoth task like the way I approach practically everything, reading as much on the topic I can lay my hands on. Slowly, very slowly I realised my fear could be tamed as there was another way. In that journey was a gem I discovered, “your body is not a lemon, It is important to keep in mind that our bodies must work pretty well, or there wouldn’t be so many humans on the planet.” Now this sort of thinking; simple, logical and linear appeals to the scientist in me a lot.

I started reading more Gaskin. Then, I came across something termed, “the sphincter law” what this law proclaims is that all spinchters in our body behave the same way, are voluntary in their opening. Particularly these statements below describe Ina May Gaskin’s sphincter law –

  • Sphincter muscles of both anus and vagina do not respond on command.
  • Sphincter muscles open more easily in a comfortable intimate atmosphere where a woman feels safe.
  • The muscles are more likely to open if the woman feels positive about herself; where she feels inspired and enjoys the birth process.
  • Sphincter muscles may suddenly close even if they have already dilated, if the woman feels threatened in any way.

The issue with this “law” is that there are hundreds of sphincters in the body. Some voluntary, as the anus (actually even here the internal anal sphincter is a smooth muscle and not under voluntary control, only the external anal sphincter is under voluntary control) and a lot of them involuntary like in the blood capillaries. Not all open at the same time (well you would certainly not want that!) and not all care for privacy.

Another issue is that, neither your vagina or cervix is a sphincter. I will simply repeat this for clarity and confirmation, not effect… your cervix is not a sphincter. The cervix dilates as an effect of the cervix contracting and effacing from its top end.

The cervix cannot open and close like the anus. However, the idea that dilation may reverse is a possibility that has been documented. This is true even in animal kingdom where a potential threat may slow/stop and in some cases even reverse labour.

This threat and its effect on labour is not associated with any sphincter. It’s a physiological response to threat that is also rather involuntary in action. The outcome of course is detrimental in that the beautiful high oxytocin drenched physiological response to childbirth will now be taken over by the flight or fight hormonal cocktail of adrenaline and cortisol.

It’s not that Ina May is wrong on the outcome of fear and threat based childbirth journey, it’s just that her limiting and erroneous use of medical terms means this wonderful message of birthing from a place of love and security gets discarded by medical professionals who get more stuck up with her inappropriately used terminology.

So let’s stop calling this the “sphincter law” and perhaps just spread the message on birthing from a physical, emotional, mental and physiological safe, secure, warm and above all loving place.

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