Ina May Gaskin is a certified professional midwife, or CPM, in the US during the late twentieth and early twenty-first centuries. She worked at the Farm Midwifery Center in Summertown, Tennessee, a center well known for its low rates of intervention, which contributed to low rates of maternal and fetal mortality. One technique Gaskin used when assisting women with delivery helped resolve a complication called shoulder dystocia, which is when a part of the infant’s body is delivered, but the rest of the body is stuck in the birth canal. Her work served as an example for midwives and obstetricians, physicians who specialize in a woman’s reproductive system, childbirth, and pregnancy, to use a low-intervention approach without medication or a cesarean section. Through her work in developing different birthing techniques, Gaskin provided women with alternative ways to deliver infants without the need for hospitals, medication, or surgical intervention, even in the case of complicated births.

In 1999, Joseph Bruner, Susan B. Drummond, Anna L. Meenan, and Ina May Gaskin published, “All-fours Maneuver for Reducing Shoulder Dystocia During Labor,” in the medical journal, Obstetrical and Gynecological Survey. In the article, the authors described a birthing technique named the all-fours maneuver, or the Gaskin maneuver, and explained its effectiveness in treating fetal shoulder dystocia as compared to other maneuvers. Shoulder dystocia occurs when the neonate’s head has exited the vaginal canal, but the shoulders get stuck behind the woman’s pelvic bone, which prevents the birth of the neonate’s body. Healthcare practitioners’ use of previous methods to dislodge the fetal shoulders sometimes resulted in fetal and maternal injury. The all-fours maneuver differed from previous methods by positioning the laboring woman on her hands and knees rather than on her back. Through the article, the authors established the all-fours maneuver as a safe, fast, and effective technique for reducing shoulder dystocia.