My Turn: Experiencing home birth

Posted: Monday, February 03, 2003

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Last Sunday, I read with interest Melanie Plenda's account of Jadey and Scott Grimmett's surprise home birth. I was particularly touched by their two comments, "... I feel almost more bonded to him because we had that time alone with him where it was just us and no one else was around. It was so special. I'll never forget any part of it" and "The experience was totally awesome. Just to be there for my wife in her time of need ... it was such a spiritual moment."

I was so pleased to hear this couple appreciated what home birth is all about - a spiritual and bonding experience with a new life. Many couples today are choosing to birth their babies safely and privately at home or in birth centers with midwife attendants they know and trust because they want this same experience for their families. Instead of calling an ambulance, a couple in these circumstances would have called their midwife. And then the answer to a father's query, "We have this baby in our home. What do we do now?" would be, "Rejoice in the miracle you have just witnessed, and settle into the security and serenity of your own home."

In our culture we operate from two different childbirth models: the dominant medical model where childbirth is regarded as a medical emergency and the midwifery model where pregnancy and birth are regarded as normal life processes. Unfortunately, we spend tens of billions of dollars on medical birth each year in this country and still rank a dismal 22nd among developed nations when it comes to infant mortality. The countries that operate on the midwifery model rank the highest and have much lower incidence of birth injury, trauma and cesarean section.

The World Health Organization for years has advocated the midwifery model as a means of achieving healthier outcomes. Japan, the country ranked first in the world for healthy birth outcomes, uses midwives for 90 percent of its births and has a C-section rate of 7 percent. The U.S. uses midwives for 5 percent of its births and has a 33 percent C-section rate. Are our bodies so different? Or could it be our approach?

Three factors have been identified that coincide with the healthiest births: early and consistent pre-natal care, reciprocity between the medical and midwifery communities and universal health care coverage. In Alaska we have trained, regulated, licensed and monitored midwives whose board includes an obstetrician and a nurse midwife. Midwifery services are covered by health insurance and by Medicaid.

Many families in Juneau have reaped the benefits of midwives' services in home and birth center settings. Midwives attended approximately 20 percent of this city's newborns last year. The midwifery model of care is available through the Juneau Family Birth Center and at Wellspring under the care of nurse midwife Joanna Goldman.

The midwives model includes:

• Monitoring the physical, psychological and social well-being of the mother throughout the childbearing cycle;

• Providing the mother with individualized education, counseling, and prenatal care, continuous hands-on assistance during labor and delivery, and postpartum support;

• Minimizing technological interventions; and

• Identifying and referring women who require obstetrical attention.

During the seven years I served on the Alaska State Board of Direct-Entry Midwives, I witnessed the remarkable dedication and expertise of the women who choose this profession. I like to think of midwives as experts in natural birth - guiding pregnant women and their families through a safe, healthy child bearing experience. Thank you to the Empire and the Grimmet family for demonstrating how normal and natural and truly miraculous this experience can be and for allowing me to point out that home birth is a safe and viable childbearing choice in our community.

• Marilyn Holmes served as public member and secretary on the Alaska State Board of Direct-Entry Midwives from 1995-2002. She was a charter board member of the Juneau Family Birth Center.

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