If you’ve noticed a homemade trend lately, you may not be surprised to see it’s not just canning jam that’s being done at home — many women are choosing to give birth at home with the help of direct entry midwives.
Of course all births were once home births, or in the fields, wherever women happened to be when it was time — but by 1939, 50 percent of women and 75 percent of Urban women were giving birth in hospitals, according to Midwifery Today’s timeline. By 1950, 88 percent of all births were in hospitals. It wasn’t until the late 1990s that, on a state-by-state basis, direct entry midwives were legally allowed to deliver babies at home, though many states still ban it.
“I think a lot of women want choices, they want to be informed, regardless of where they’re having their baby,” said midwife Lorna Mazoff.
Another direct entry midwife, Debbie Gillespie agrees that it’s all about choices.
“I don’t go out and tell people that they should be doing their birth differently than they want to do it,” Gillespie said. “I feel strongly about women having choices, having options.”
And for some women, a home birth is the right option.
“I decided to do a home birth because I wanted to be comfortable,” Traci Goetz said. “I wanted as little fear surrounding me as possible.”
And for Goetz, hospitals don’t give her a warm fuzzy feeling.
“They’re full of sick people and unwell people,” Goetz said. “When you’re giving birth, it’s life, you should be in a place that’s healthy and positive.”
Goetz had a home birth with Gillespie and had only great things to say about the experience and her relationship with Gillespie, who is still frequently in touch with Goetz, her husband Jeff and their son Fisher.
Angelina Healey Church had a home birth with Mazoff.
“Having my son at home was the most empowering experience of my life. I knew that I had to trust my body and baby to do the work and that the more I relaxed the quicker and easier the labor and birth would be. Being at home allowed me to relax my mind and body to have a quick birth,” she said.
“I was in labor for less than seven hours and pushed for less than 10 minutes,” Church shared. “He was born in the water and weighed 8 lbs. 13 oz. My first child, in contrast, was born at the hospital after 28 hrs of labor that was augmented with pitocin. Birth is such a sacred experience, I knew it would be respected at home.”
Goetz said, “It seemed really unnatural for me to be anywhere but my home,” and added with a laugh, “And I’m lazy.”
The home birth experience has a lot of perks, according to Goetz and Church. Goetz’ son was born with a channel view and they were able to take a nap directly after the birth in their own bed. The timing of things can be more relaxed, as well, Goetz said. Fisher was weighed after the nap.
Gillespie, assisted by Johanna Koranda, took care of things like meals during labor. And they took care of any cleanup afterward.
“When we leave, it will look like nothing happened,” Gillespie said.
Goetz said she called Gillespie when the labor started, around 11 p.m., and Gillespie came with everything in order and stayed through the 6:25 a.m. birth and beyond.
But midwives like Mazoff and Gillespie can be part of the pregnancy and birth process as early as a woman knows she is pregnant and for at least six weeks after the birth — regardless of where that birth happens.
Gillespie said the majority of home births go off without a hitch — she estimates 90 percent — she’s had only two patients transferred to the hospital in the past five years. But Gillespie and Mazoff both said they will take patients to the hospital or call an ambulance and stay with the mother, acting as a doula, if that’s the safest and healthies birth option for mother and child.
Direct entry midwives do show up with the tools to handle a normal birth, including certain medications and instruments. Mazoff listed off oxygen, certain medications to manage bleeding, medications for baby, tools and everything to do stitches after birth, bed pans, catheters, equipment to monitor the baby and to insert an IV, though that’s not common to do — she has several bags.
Another thing Mazoff or Gillespie might show up with? A portable hot tub, essentially, for water births. Goetz chose to have a water birth with Gillespie as her midwife and said it was wonderful to sit in the tub during labor, and that the birth experience was “awesome.”
There are other birth options aside from the tub, though that’s popular it seems, and the goal is to have the mother be as comfortable and relaxed as possible. During the meetings with the mother, which Mazoff and Gillespie said will often be similar to a meeting with a doctor in their purpose, but generally significantly longer, mother and midwife will discuss a birth plan, how, where and a contingency plan. They also keep track of the health of mother and child. And after the birth, Gillespie guarantees six weeks of visits and contact, to check on the wellness of mother and child, and to be sure breast feeding is going well.
Both women agreed that it’s all about choices. And that for many women, a home birth may not be the best option, though many common fears may be allayed with a quick chat.
For example, a sterile environment isn’t required for a birth — “It should be clean, but it doesn’t have to be sterile.”
Both Mazoff and Gillespie talked about the safety of giving birth to a child in the environment that it will live in, with all your own familiar flora and bacteria. Hospitals, they said, may have foreign bacteria and flora, which could pose a different risk.
“You’re going to take your child there right after, anyway,” Gillespie said.
Mazoff said it’s nice for women to be able to have choices in things like lighting and sound, and also to have a choice in who is around you during the birth. She said it’s all about trust.
Goetz said “You want to be with who you trust, and if your trust is in the doctors and nurses, then the hospital might be the right place for you, but for me, it was at home. I didn’t have to wear clothes, I could have it dark and pick music.”
She started with the Beatles, but ditched the music when she got closer to the birth.
Everything is done with the purpose of comfort, because the more relaxed the mother is, the easier the birth.
“Women’s bodies know how to birth babies,” Mazoff said.” Just like any other function that we do.”
When trying to decide what kind of birth experience to have, there are some pretty big questions to ask, but Gillespie said “there aren’t really bad options for birthing here in Juneau.”
Whether at home, the Juneau Family Birth Center or the hospital, Gillespie said there were many capable practitioners out there.
“I recommend that every woman look into her options and different providers they could have and seek out person they feel the safest with,” Mazoff said.
She also said that “a lot of people have this image of birkenstocks. I might dress a little alternative but I don’t wear birkenstocks.”
So don’t rule out a home birth with a midwife based on misconceptions.
Mazoff is a direct entry midwife practicing as MotherWise Midwifery. Gillespie is a direct entry midwife and naturopath practicing as Inside Passage Midwifery (you can laugh, it’s clever). Both women went through training and apprenticeships and have many years of experience with births in birth centers and at home. They are licensed to practice and offer a full complement of care and lab work, from pre-natal to post-natal care.