By Carleigh Kate Knight
Marietta Daily Journal Staff Writer
Laura Fields felt the push of two little feet against the inside of her body. She was in labor, but she knew she wasn't the only one laboring.
As her daughter moved through the fluid of her stomach, Fields was moving between water and earth, standing, sitting, squatting - whatever it took.
There were no drugs, no doctors - only midwives and the desire to see her daughter's face for the first time.
"I wouldn't have missed that feeling for the world. It felt so empowering, like I could do anything after that," said Fields, a mother of two and a resident in Powder Springs.
"It's not an injury pain. It builds up and then lets go. You have breaks and you know there is an end to it - and with such a great reward."
Fields, who had both daughters underwater, is one of the founder's of Baby Steps, a birthing education center in Marietta. She and her co-founders, Melissa Casserly and Becky VanNote, teach women about all things pregnancy, from prenatal care to the birthing process.
"We want women to make an informed choice about what they want for their pregnancy and child birth process," said Casserly.
Most of the public discussion about choice and women's health is directed at one topic: abortion, something the women of Baby Steps are not interested in talking about. What they are interested in talking about are what choices women have when it comes to having a baby.
In Georgia, which is 42nd in infant mortality in the U.S., home birth is illegal and midwives are only legal if they are Registered Nurses and work in a hospital setting. Epidurals, an anesthetic injected into part of the spine, are used in around 60 percent of women, and one in four women have Cesarean (C-section) surgeries, which takes the baby out through the abdomen, according to a report released through the U.S. National Library of Medicine.
The World Health Organization has said that no region of the world is justified in having a C-section rate above 10 to 15 percent.
"There are lines being drawn in the sand and families are caught in the middle. The mom is the expert on what's best for her," said Casserly.
Baby Steps is premiering the movie, "The Business of Being Born," a documentary produced by Ricki Lake that explores and questions the way American women have babies, on Nov. 1 at Life University. Susan Hodges, president of Citizens for Midwifery, and Dr. Linda Mullin of Life University will host a discussion afterwards.
C-Sections, epidurals, natural births, homebirths, hospital births, midwives and obstetricians all have advantages and disadvantages for women and babies, and education is key.
"We'd like to see more patients become educated before labor, which is not the optimum time to teach about choices when they are already in pain," said Dr. Paula Greaves, an OB/GYN physician with Wellstar North West Women's Care.
Natural Birth
Epidurals do carry some risks, said Greaves, but they are minor. She said blood pressure drops some after an epidural and that hypertension and spinal headaches can occur. She said the woman's medical history is important in determining risks.
"The myth is that if you have an epidural, it's not natural. But you can push, and sometimes with greater comfort and control," said Greaves.
"The patient relaxes and it aids in dilating and delivery."
Casserly said any risk wasn't worth it, and she chose to have a drug-free birth. "I wanted what was 100-percent safe. I didn't want to make a political statement, but after looking at the facts, it seemed a natural birth was safer," she said.
Beth, a local midwife who doesn't want to use her last name because of legal issues, said that epidurals, IV's and other monitors constrain a woman to lie down during pregnancy, which can cause more pain.
"With a midwife, women can do whatever their body wants to do as long as the baby's heart beat is normal. I encourage them to let their body do its work. They feel the flow in their hips, and can move all around and it helps the baby move down the pelvis. It's really amazing," she said.
"Women's bodies were de-signed to have babies," she said.
Fields said she "wouldn't have made it," if she had to lie on her back the whole time. "I spent a lot of time in the water, and I walked around, squatted and got on an exercise ball."
Midwives and homebirths
Since homebirths are illegal in Georgia, Greaves said she simply couldn't encourage it.
But the reality is women are still having babies at home, said Beth, who does home deliveries.
"Women who want to have their babies at home are going to do it with or without a midwife. It's in the best interest of women to allow home births. They say they are trying to protect women by outlawing it, but is it safer in the hospital? Well, look at the infant mortality rate in Georgia. Statistics prove it's safer to have at home."
The British Medical Journal published a study of U.S. direct entry midwives, who apprentice in areas where homebirth was not well integrated into the health system.
They found that low risk women had less medical intervention than in the hospital, but that neonatal mortality was similar to that of low risk hospital births. About 12 percent of women were transferred to the hospital, and that epidural and C-section rates were lower than women who started labor in the hospital.
Women who have babies in the hospital can still have a midwife, but they must have a background in nursing. Both lay midwives and nurse midwives are responsible for all prenatal and postnatal care.
"Lay midwives can have a lot of education and experience and some states are set up for that. Georgia is not," said Jordan.
Midwives are typically more hands-off and give women the freedom to move around during labor. They spend time connecting with the patient long before the birth.
They can be better listeners and are more in touch with what's going on in the family, said Jordan. Beth said she spends one hour with each of her clients during checkups, and Jordan said she'd spend as long as the woman wants; though low-risk births tend to be shorter check ups.
"We'll get into things or talk about what's going on socially or in the family. It's good to get into things to make sure the whole pregnancy is a healthy one," said Jordan.
"Doctors want midwives in the practice because it frees them up for surgeries."
Beth is doing 36 births this year, and Jordan is pushing 1,000 births over 10 years.
"Our job is to make sure it's special and right for each individual woman … I am not as overwhelmed with feelings at the miracle of birth as I was when I first began, but bringing joy to families and bringing babies into the world is a blessing," said Jordan.
cknight@mdjonline.com
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Posted Comments
I have experienced 4 homebirths in the state of Georgia with a qualified, certified midwife who allowed my body to birth as needed...not according to her time schedule or preconcieved ideas on birth. Homebirth is a viable, safe option for Georgia moms and should be encouraged! "Doctors want midwives in the practice because it frees them up for surgeries." This quote is right on. Doctors are trained surgeons...they have no need to be at normal, low risk births. Midwives have the training in normal birth and should be the ones invited to attend a normal birth with a family. My thoughts...I did not want surgery...so I did not go to a surgeon.
I had a home birth with my first child, and will with this one as well. We chose a home birth after reading the statistics. It's a shame the laws are so strict in Ga (our son was born in a state where laws were more flexible). To have to go "underground" to have a home birth is an outrage. It should be up to me and my husband to decide how to birth, not the state.
I am truly having a hard time wrapping my head around Dr. Greave's comment. Her quote "The myth is that if you have an epidural, it's not natural. But you can push, and sometimes with greater comfort and control," said Greaves. "The patient relaxes and it aids in dilating and delivery." Where to begin? Well, let me start with the first part of her comment and define the 3 words myth, epidural, and natural. Myth: an invented story, idea, or concept Epidural: An injection [with a very large needle] of an anesthetic [drug] into the epidural space of the spine Natural: containing no chemical additives; happening in the ordinary or usual course of things without intervention; true to or closely imitating nature; Characterized by spontaneity and freedom from artificiality; Faithfully representing nature; of or produced by nature not made by men Keeping those definitions in mind, the only conclusion is that the opposite of Greaves quote is correct. An epidural is in fact NOT natural. To move onto the second part of her comment, I'd like to break it down into two pieces. "The patient relaxes" - Actually, the patient is paralyzed from the waist down, making her unable to move or feel anything. She is completely vulnerable and under the complete control of the hospital staff. She has put herself at risk for numerous complications and is vomitting because of the drug's side effect. How can anyone relax under those curcumstances? "it aids in dilating and delivery." - Several studies have indicated that another side effect of an epidural is that it slows labor. The body gets confused with the foreign drugs in its system and doesn't produce the natural chemicals it's designed to. The doctors will then administer Pitocin (another drug) to speed dilation. Because the woman cannot feel anything, she is instructed to push when her body isn't ready, which causes stress on the baby. Fetal distress may lead to a C-section (a very risky and dangerous surgery for both mother and baby). Women should also keep in mind that the aforementioned drugs do reach the baby through the placenta and have many consequences for the newborn and has detrimental effects on the bonding between newborn and mother. I can't help but wonder what bizarro planet Greaves stepped off of, and to feel sincerely sorry for the women who give birth under her care, or under the care of those who are like-minded. These doctors very much need to study the abundant material available to them for the sake of the women who put their trust in their hands. But also, as women, we all need to educate ourselves on what is the most important and miraculous event to ever happen in our lives: giving birth. I myself am pregnant and after reading mountains of studies, articles, and books on the subject of birth I have decided to have a home birth. ~Jeana Powder Springs, GA
Yay Melissa & Calla-Bug!! So Proud of you!
Dear Ms. Knight, please check your facts: homebirth is not illegal. It is a complex legal subject for GA midwives, but most definitely not illegal. (How could the courts attempt to control the laws of mother nature--babies come when and where they decide to.)
Way to go girls. Its a great story.
Good stuff here. Go women!
Thank you for reporting on women's options. Very interesting article and it opens the door to conversations about improving the health and birth experience for women in Georgia.
As a doula and childbirth educator it is about time we covered the aspect of choice in childbirth! It is nice to see an article that focuses on the mom's ability to make the right choices for her. I have seen the Business of being Born at a conference recently in Portland and have to say- it is a must see film for anyone who is considering having a baby. Thanks for a great article!
Very proud of you for providing a healthy way for women to give birth. Way to go,cuz!
This information is beautiful. Thank you all for getting it to women everywhere. I so wish I had been able to be free of mind-altering and body incapacitating drugs when I gave birth. I was told "this is THE way its done". Thanks for bringing real, informed choice back to us.
OK,I see lots of comments here praising all the benifits of home deliveries with these LAY midwives.How many of you have worked in a hospital to see the casualties of these home births that have not gone so well? I have worked labor and delivery for 18yrs and I have.The baby that was brought in brain dead after the LAY midwife did not know how to care for it at delivery and did not preform the basics of CPR.But the mother was soooo happy she had not had a c/s.Two weeks later her worst fear was that her brain dead baby was not going to die anytime soon.This is one of many home birth stories I could tell you. As for Jeana's comments about Dr greaves,You have no right to be critizing this physician .I have worked with Dr Greaves for years and would trust mine and my families (which has happened)life in her hands any day. Yes women have a choice as to how they wish to have their babies and because some cannot tolerate the pain an have an epidural does not make them less of a woman,you get no rewards for natural birth and we have never had a baby die from an epidural or meds given in labor.We are more than willing to let you do as you wish in the hospital setting as long as you and your baby are not at risk.No one got into the medical field to harm anyone as your article and commentators seem to imply.I pray that those of you having home births with these home trained lay midwives have healty babies and no postpartum hemorrhage....if not then come on up to labor and delivery and we will do our best to help you. Kathy Baswell RNC/Labor and Delivery AND I"M NOT AFRAID TO SHOW MY NAME
As a Doctor of Chiropractic I fully support natural birthing for both the mother and child. Not only is it much safer to have an un-interfered with birth, but it is also highly beneficial for the future health of mother and child alike. Keep up the good work; the well-being of our world depends on it!
Dear Nurse Baswell, I went into the hospital twice with two different groups of birth "experts" with the desire of a natural birth. With my first I was threatened with C/S to the point that I was in tears and scared into an epidural because I was told if I didn't get it I would have to go thru the inevitable c/s and feel every cut. At 5:30 they told me I had until 7 and then I would have to go to surgery, no the baby was not in distress, I had "been there to long". they came and drew my blood and At 6:30 they started to roll in a stracher, I sent them and told them that I was not going anywhere until 7. At 7 suprize I was fully dialated and I pushed 3 times, she was born at 7:10. With my second daughter I was told that I need to rest and given a "cocktail" of pills that I questioned but was told it would only last about 4 hours. 12 hours later I was giving labor half asleep and it took me week to remeber even a little of the birth. The baby was born and then a swarm of doctors and nurses rushed in calling out floopy baby, floopy baby her reflexs were severly delayed, and she did not nurse well all because they thought I needed to rest. I deceided then that the next baby would be born out of the "Baby Factory". I had friends that had done home birth, but I was not sure it was for me. After finding a wonderful home birth Midwife, I deceided that I would have a home water birth. The visits to the office were something I looked forward to. They gave me their full attention for an hour, I did not get pooked or put in sturups - because i was not sick I was pregnant. Their confidence in me was the key, I knew that this was what my body was designed for and believed that I could do it. My husband and I took one of Miss VanNote's Classes, and we learned more in that class ten we had going thru two hospital births. It was so very helpful because Becky was able to relate to the Homebirth experence, and knew what would be most important for us to learn. My home water birth was amazing!!!! It was of coarse not painless, but even during the hard labor I could look up and see sun light and trees out the window, hear birds, and my baby was alert and I remember it all. I have a renewed confidence in myself that I could not have found in the "Baby factory". So in my case there absolutly IS a reward for natural birth. My point is their is so much psychology involved in hospitals, women are allowing themselves to be leed by people that we beleive will do the best for us and the stats prove that wrong. These women want to educate and empower women so that they have the confidence and the knowledge to tell a nurse or doctor NO, so that they are incontrol of what happens to them and so that they get have the best chance of getting the birth that they want. I would not want to have a nurse that went around preaching the goodness of Drugs. Women were designed to have babies, stop treating Pregancy as a disease to be cured. And please know that the majority of Home birth midwives are very well educated in their craft and do not let one Tragic story become the banner that you wave against the freedom to choose.
Ms. Baswell, it took me about 2 seconds on Google to find an incident where a healthy, 31 year old mother and her baby both died from epidural complications. And they weren't the only ones. Epidurals are not evil, but neither are they risk-free and you do women a huge disservice when you do not inform them of the possible risks and complications they may encounter when they receive an epidural or other drugs for labor. You may not be aware of this, but every valid study ever done on the subject has found homebirth to be at least as safe as hospital birth, with lower rates of cesareans, interventions, and morbidity. You speak as if women who choose homebirth deserve to be injured and that you poor, mistreated hospital workers will clean up the mess. The fact is, birth is a normal life event that rarely requires medical intervention. The *purpose* of hospitals is to treat sick or injured people. The system that makes the most sense, and results in the lowest mortality rates for mothers and babies, involves midwives as the default providers for low-risk mothers, a high percentage of homebirths, and obstetricians and hospitals doing what they do best: taking care of the high-risk mothers and birth complications. There is no need for such an adversarial relationship between those who homebirth and medical professionals. Medical professionals who are confident in their abilities and supportive of a woman's right to make her own decisions will not feel threatened by the option of homebirth. While "you don't get a prize for a natural birth" is a common thing to say to women who valued their experiences of giving birth without medications, it's not actually true. I chose natural birth with my children because it is safest, period. I wasn't into the idea of pain for the sake of pain; I just wanted to do what was safest for my babies and myself. What I discovered is that there IS a prize. You come to a place in labor where you think you can't go on, where every fiber of your being is focused on the task at hand, where you feel that this might never end and you think you can't possibly go on. And then you DO. You go on. You make it through to the other side, and the confidence gained from knowing that you could do it, even when you were sure you wouldn't be able to, lasts forever, in everything you do. This was totally unexpected for me, but has been an incredible asset for me as a parent, and something I value more than I'd value any medal.
I gave birth to my son, who is now 3 years old, at home with a midwife. His birth would have ended in a C-section or at the very least the use of Pitocin or other drugs simply because it was a very long labor and my water had broken 20 hours before he was born. Having a homebirth was the best choice I ever made. I was respected, empowered, and felt like at all times I was in control. I will be having my second baby at home with midwives this February. I am thankful that there are brave women who will attend the women of GA who want a safe, midwife attended homebirth even though it puts them at legal risk. It is a true shame that politics has made a wonderful choice illegal and the day has come for lawmakers to give the women of GA a choice! We will continue to make the choice of homebirth regardless of legality.