Giving birth at home more natural, OU prof says

by Liz Shirey
THE POST

Editor's note: Because of the sensitive nature of this article, some names were changed to protect sources' identities. Margaret is the professor's middle name, which she prefers to use. Because practicing direct-entry midwifery is not legal, Jane is a fictional name for the direct-entry midwife.

Naked and pregnant, a woman immerses herself completely in a pool of warm water set up in her home. Her husband and son stand beside the pool, and with awe and wonder in their eyes, they gently squeeze her hands in encouragement and support.

Also near the expectant mother is another woman, a direct-entry midwife. She is there to provide assistance and support to the woman and her family.

This is similar to the manner in which Margaret, a professor at Ohio University, gave birth to her second child. She said her physician was aware of the legal questions surrounding direct-entry midwifery but still encouraged her to pursue a natural birth with a midwife.

Margaret said she didn't make the decision to have a home birth until her sixth month of pregnancy. Her decision was motivated by her total lack of desire to be in a hospital.

"I chose not to go to a hospital because birth is about choice; it's a manner of style and where you are most comfortable," Margaret said. "I am most comfortable in my own home."

Margaret's first pregnancy was harder because of the unfamiliarity of the people and the surroundings in the hospital, which made her labor longer and more difficult, she said.

"Every time I thought of going to the hospital during my second pregnancy, I immediately felt a negative physical response," Margaret said. "I would cry excessively and get very claustrophobic. Once I made the decision to go with a home birth, I no longer had any fear."

Jane, a direct-entry midwife practicing in Athens, said mothers and babies do best when the mother's stress level is low. She described water births as beautiful and relaxing.

"When you raise the relaxation of the mother, it is extremely soothing," Jane said. "If the mother is relaxed, she can meet the pain with confidence."

Giving birth in a hospital is not natural or normal, Jane said. "Most delivery processes don't honor the fact that the mother is the one having the baby, and that they are only there to offer assistance," Jane said. "There is a way to safeguard the birthing process, but hospitals mistrust it.

"I have come to believe very strongly the only way for anyone to understand that a hospital birth is unnatural is to witness a home birth firsthand," she said. "The medical profession views pregnancy as a condition that needs to be treated, and our society has been greatly impacted by this belief."

Angela Cross, a direct-entry midwife apprentice and doula at various hospitals in Athens, said there is a tremendous difference between home births and hospital births. A doula is a woman experienced in childbirth who provides continuous physical, emotional and informational support to the mother before, during and after birth in a hospital.

"In hospitals, the support person's and the mother's attention is on the monitor, not on the body and the birthing process," Cross said. The monitors allow nurses to look after many women at the same time without actually having to be in the room with them.

"Nurses tell the mother to push. They do not encourage or support them. In a hospital setting it is more likely mothers have a hard time making sounds because they are embarrassed. When they are at home, the sounds the mothers make when they are pushing is very natural and beautiful. It is like music," she said.

"Doctors are not experts in midwifery care. Yet they feel justified in criticizing the practice of midwifery and have even gone so far as to express their disbelief and doubt in statistics that show lower death rates and interventions with midwives than with doctors in hospitals," Cross said. "It would be wonderful for the mother if we could all work together."

Three gynecologists and two family physicians in Athens County declined to comment on direct-entry midwifery.

Midwifery is about continuing care, Jane said. Midwives recognize patterns in the mother's behavior and can tell if something is wrong because they have been there the entire nine months, she said.

"There is a matriarchal circle that surrounds the mother throughout the birthing process. It is sacred ground," Jane said. "If you step inside the circle and treat it like sacred ground then you can reduce all of the unnecessary intervention that happens in a hospital. You'll have the golden standard."

Midwives screen people to make sure they do not have conditions that might cause complications during the birthing process, Jane said. She was an assistant for almost 10 years, and in 1981 she started a solo practice. She attends mothers only in their homes and works with a great deal of Amish mothers.

"I don't have patients. I work together with parents and family members to give maternity service care," Jane said. "There are skills and knowledge involved, and I am prepared to handle most problems if they should occur."

The most common problems are hemorrhages and stuck shoulders, Jane said. Of 240 births she assisted, she said only one woman suffered an infection. She said a woman in her own environment is exposed to germs she already is immune to, as opposed to new germs in the hospital.

Margaret said she was not worried about her safety under her midwife's care.

"I did a lot of research to make certain statistically that a home birth wouldn't be of any danger to me," Margaret said. "I trusted my midwife and her training, and I knew her very well. I was absolutely convinced that she was competent in every way."

The national average cost of hiring a midwife is $1,400 to $1,700, Jane said. If someone can't afford the price, Jane will provide care for what they can afford, which could range anywhere from $100 to nothing.

"What people don't realize is some of these women want home births and will have one without anyone present if they have to," Jane said. "I provide my assistance so that these determined women are not alone if a problem should arise."