By Lucy Balch
Midwife. Centuries ago that word brought to
mind a venerated woman, one who was
summoned to deliver royalty if she was renown.
But in this day of hospital protocols,
pharmaceuticals, and symptomatic approaches, the physician
has largely replaced the midwife. Or has he?
A new era of hospital-connected midwifery is revolutionizing
the way women view their pregnancies, from start to
finish. With a midwife, a woman can now have a birth plan,
built-in community support, and a delivery room advocate--
all with a back-up physician’s blessing.
Leslie Fehan and Nicole Carlson are two such midwives
at Bon Secours St. Francis Medical Center. They work in
close conjunction with Ob/Gyn physicians, who are always
available in the event of an emergency, but who otherwise
stay behind the scenes. With non-emergent births, Leslie or
Nicole see the labor and delivery through to the end, and
are able to follow the important choices made during birth
planning sessions. Doulas, midwife assistants, are brought in
for additional support.
A few examples of decisions made for a birth plan are:
whether or not to have an epidural, whether or not to have
an episiotomy, and whether or not to attach a fetal monitor
(many women do not realize that the fetal monitor is actually
attached to the baby’s head inside the uterus; its placement
can restrict a woman’s ability to move around during the
birth process).
In order to make the decisions required for a birth plan,
women connected with St.Francis’ midwives may attend
CenteringPregnancy classes. Started by Sharon Schindler
Rising in 1993, CenteringPregnancy pulls women of a similar
gestational age
together to learn
everything there is
to know about pregnancy,
labor, delivery,
and the post partum
period. At St. Francis,
a woman first meets
with a midwife on an
individual basis, but at
approximately 16 -
20 weeks she begins
the eight Centering-
Pregnancy sessions.
The usual monitoring activities--listening
to the fetal heart tone and measuring
the fundal height--take place at the
beginning of each session, but the rest
of the two-hour period is spent learning
and discussing. In the third trimester, after
the eight classes are completed, a woman
returns to individual sessions with
the midwife. Once the babies are born,
the women in each CenteringPregnancy
group reunite to introduce their little
ones to each other, and to discuss their
birth experiences. Not surprisingly, many
a playgroup is formed in just this way.
Another excellent source of information,
and one ecommended by midwives
everywhere, is the movie, “The Business
of Being Born.” In it, Rikki Lake compares
her first birth experience, during which
she followed strict hospital protocols, to
the birth of her second baby, delivered
more “normally” by a midwife-led team.
Nicole Carlson states the motto of
modern-day midwifery care, “Midwives
are the guardians of normal.” Sybil Karjala,
a local doula, says that it’s important “to let (the birth process) unfold naturally.”
Too often in the recent past, the “norm” was for a woman to schedule an
induction to fit her doctor’s busy schedule,
perhaps her own busy schedule as
well. Would she have chosen this forced
birth method if she’d known that elective
induction can increase the risk of
caesarean section by 60%? Probably not.
Nicole also reports that 90% of hers and
Leslie’s clients opt not to have an epidural.
They want to experience childbirth,
one of the most momentous events of
their lives, without the restrictions of
drugs and monitors. They know that the
nurturing, supportive environment that
a midwife provides is the best way to
achieve that goal.
Virginia currently has a low midwifeattended
birthrate. It’s at about 4%,
which is low compared to New Mexico,
which is one of the highest at 25%. But
that number is changing. More and more
women are hearing about the benefits
of a midwife-assisted birth. They, too,
want to have more of a say in how their
baby will be born. Yes, the midwife business
is booming these days, and there’s
good reason for it!
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