June 7, 2011 in Features

Personal pregnancy

Midwives bring friendship, give control to expectant mothers
Robin Erb Detroit Free Press
 

Steve Lucero drew in his first look at his baby girl under the ripples of water of the birthing tub at Hutzel Women’s Hospital in Detroit, her thick, dark hair wafting gently as she began the descent from her mother’s body.

The lights were dimmed in the delivery room. Jess Lucero dipped her fingers into the 100-degree water, until – at 10:20 p.m. March 12 – Aviana Cessalee’s feather-soft 6 pounds and 15 ounces eased into the world.

There was no rush from attending staff. No bright lights and bustle. Nothing – except for the soft blue light inside the tub and Avi’s intake of air as she lay on her mother’s chest.

Jess Lucero, a 26-year-old doctoral student at Wayne State University, was ecstatic: “I gave birth, I delivered my baby. It wasn’t delivered for me. It was wonderful.”

Jennifer Kelley, 32, a bubbly nurse-midwife who had monitored and encouraged the Luceros in the last hour, cleaned out Avi’s nose and mouth, then stepped away from the new family of three.

The Luceros are among a steady percentage of moms who each year choose a midwife-assisted birth over a traditional medical approach. They can offer mothers more control over the delivery, a more personal relationship between patient and caregiver, and the option of fewer medical interventions.

Midwives attended 317,626 births in the United States in 2008, or about 7.5 percent of overall births. Of those midwife-assisted births, nine of 10 were delivered in hospital settings, according to the National Center for Health Statistics.

Jess Lucero said the midwife who helped her through her pregnancy, Mary Lewis, 68, was “warm and wonderful.”

“She always took time in my appointments to really sit with me and answer questions and make me feel like I’m not being paranoid. She was very maternal,” Lucero said.

The mother-midwife partnership is often forged in first names and easy conversations about health and nutrition and pregnancy rather than through titles and quick conversations on an examination table.

LaCynthia Davis, 41, who gave birth to her fifth child May 12 at Hutzel, carried her midwife’s personal cellphone number with her.

The relationship between mom and nurse-midwife feels more like a friendship, said Davis and her midwife, Mary Milkey.

“This is the difference for me” between midwives and a delivery room doctor, said Milkey, 36, a mother of three.

During her own prenatal visits, Milkey said, “ I felt like I was going to chat with a friend. … When all my prenatal visits were over, I felt like we were breaking up.”

Certainly, there are doctors who provide that type of personal interaction. But midwife philosophy is based on it. It’s a holistic, personal approach to pregnancy rooted in the belief that birth is one of the most empowering moments for parents.

That understanding and control, in turn, brings the baby into a calmer world – whether the mother is on a hospital bed, being soothed by a warm shower, or trying to relax in a birthing tub, as the Luceros chose.

Some moms want more control, fearing they’ll be simply a number in a traditional medical setting. Or they worry they’ll lose control against what they see as unnecessary drugs and medical interventions.

With one in three babies now born by cesarean section, many believe that traditional medicine is too quick with drugs and a scalpel.

“The evidence supports that many interventions today are overused. Births in the United States are over-medicinized,” said Eileen Ehudin Beard, senior practice adviser at American College of Nurse-Midwives.

“As women become more educated consumers and evidence comes out at the normalcy of birth,” she said, they feel many interventions are “not only not necessary but also deleterious.”

Though the philosophy of midwifery hasn’t changed a lot over the years, much has changed in practice.

Starting this year, national standards require certified nurse midwives to be recertified every five years, eliminating a clause that let some midwives have a lifetime certification and others an eight-year cycle.

And because most midwife-assisted deliveries are in hospitals, doctors and operating rooms are close by in an emergency.

But what about the pain?

First, midwives can deliver pain meds. From time to time, a woman does opt for pain relief, especially first-time, anxious mothers.

For Davis, her midwife helped control anxiety and pain.

“I guess it was all natural. It was a mind thing. When the pain comes you just made a noise, breathed and go with it,” she said.

“I made a decision, and everyone knew I was going to stick with it.”

Milkey provided Davis’ prenatal care, so both were thrilled when Milkey was available for the birth.

Inside the Hutzel delivery room, Davis’ partner, Ali Watson, pulled up a stool at her side and held her hand throughout the pain. Milkey stepped in only when necessary, offering words of support and progress reports.

“There’s a saying that midwives catch babies,” Milkey said later. “And we do. Really, Mom is in control.”

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