An alternative to hospital births

STORY BY KATIE HEATH | PHOTOS BY GRACE SCHRATER

(above) Russell Warren Engell hangs out on his mom’s lap after being breastfed. Brownell often stops in at Birthroot when she is in town running errands, because they offer a warm and inviting place to breastfeed, as opposed to having to do it in the car, Brownell says. Grace Schrater | Klipsun Magazine

It was hour 25, and the transition phase — the most challenging phase of delivery, the crest of the wave, the climax of the movie, the last hill to climb — when Shayna Wilson, in labor with her first child, felt like she couldn’t keep going. There, in the secluded room of a birthing center, she felt like she would succumb to the pain that was raging throughout her entire body and never see the life she had nurtured for 9 months.

So she began to beg for drugs, any kind of drugs that would stop the pain, to be taken to a hospital, for it to be over and done with. Her midwife and multiple midwife assistants didn’t give her drugs however. Instead, they told Wilson that it was hour 25, the crest of wave, the climax of the movie, the last hill to climb, and that she could do it.

Across the United States, more and more scenes like Wilson’s are occurring as the number of out of hospital births rise. Up to 1.36 percent of babies in 2012 were born in places such as a birthing center or at home, a rise from the 1.26 percent of 2011, according to the Center for Disease Control. Although the movement is small, it’s gaining traction in places like Bellingham, with the presence of the Bellingham Birthing Center.

Established in 2004 by licensed midwives Catriona Munro and Christine Gibbs, the Bellingham Birth Center has seen over one thousand births take place in its three birthing rooms. According to Bellingham Birth Center’s website, the center “facilitates a woman’s innate ability to give birth without intrusive interventions while providing an appropriate amount of technology to insure safety,” so women in labor are not given drugs to induce or dull the pain of delivery. The center offers seven different midwives clients can choose from to guide them in their pre-natal, delivery, and post-partum care of themselves and their child. It is one of the two birth centers in Bellingham, along with Birthroots Birth Center.

Conception

Munro’s interest in midwifery came from her experience witnessing a friend’s home birth. “It just totally blew my mind,” she says. She got her pre-requisites for midwifery school at Fairhaven College, then completed three years of midwifery training and got her license in Seattle at Bastyr University. It was after that she realized she wanted to bring her skills to a larger group of people, leading her to co-found the birth center.

“A lot of people don’t like the idea of home birth, they think it feels dangerous or too uncontrolled,” says Munro.

Although Wilson, who gave birth at the Puget Sound Birth Center in Seattle, wants her next child to be delivered at home, she wanted a birthing center because of the extra security it gave. “You’ll always have some fears,” she said.

Munro sees many different women come through the center- — from attorneys to women who would be homeless if they weren’t pregnant. Yet together, across the three rooms that make up the birthing center, these women share a moment of birth that connects them all.

“So many people come to us with a history of sexual abuse or needle phobia or we get a lot of folks who have had traumatic hospital experiences as a child. They might not want a natural childbirth- but they don’t want a hospital,” she says.

Munro’s voice is everything one would want in a birthing coach- soft, controlled, caring- a voice of strength and encouragement that countless women have heard as they move through the stages of labor. She has walked through the three rooms the center offers as “birthing suites” many times. Each have a bed, a bathtub and a bathroom- the only clues to what exactly goes on in the rooms are sparse. In one, a birthing sling hangs from the wall, a soft, padded piece of fabric that women can hang on to release tension that gravity may bring during labor. In another, tucked neatly in the corner next to an oxygen tank is a birthing stool, which helps women maintain a squatting position as they push. In the third, an exercise ball for sitting and moving on. What looks like a TV cupboard holds various tools for birthing, including everything from official medical supplies to a jar labeled “Olive Oil.”

Cascade of Interventions

It doesn’t seem like a place to have a baby, but for an increasing number of women, it’s the place they would pick over a hospital. [3:14] Munro says that many clients come to the Birth Center after having negative hospital experience. At hospitals, she says, there’s often what is called the “Cascade of Interventions.”

“In the hospital, one intervention leads to another, so you’re laying in bed and they can’t cope, because it’s hard to cope with labor when you’re just laying in bed,” she says. Hospitals usually discourage women from walking around, she says, so the pain becomes enough to where women are administered pain medication, which makes it even harder to move around.

“Then it’s harder to push, so when it comes time to push sometimes you need forceps or a C-section,” she says. “Each ‘thing’ increases the chance of a next ‘thing.’”

During Wilson’s delivery, she was able to walk around as much as she wanted, and take whatever position felt comfortable for her to birth in. “I could take a shower five times a row if I wanted,” she laughs.

The Birth Center also chooses to protect the immediate newborn post-partum bonding experience, giving clients more time with the infant, something Munro says is uncommon in hospitals.

“People feel like birth just kind of happened to them and there were all these tubes and wires coming out of their body. They feel like they didn’t have a sense of autonomy over the process,” she says.

While the Birth Center may be different from a hospital room, the preparedness for any emergency is just as strong. As a midwife, Munro carries a variety of medications, including one that can stop post-partum hemorrhages, three different emergency medications that hospitals also carry, a drug that stops labor, oxygen, magnesium sulfate for blood pressure, a catheter and an IV, even a local aesthetic. The Birthing Center is exactly five minutes away from St. Joseph Medical Center.

The Birth Center does not deal with high-risk births, which is what many people don’t realize, says Munro. “So people are thinking about the scary things that happen during childbirth and not differentiating between high risk and low risk.” High-risk births include births like twins, a delivery that can often require medical interventions.

The use of modern technology has undoubtedly helped in the birthing process says Munro- the United States has a mortality rate of six babies for every one thousand born, while in places like Afghanistan 117 babies are lost, according to CIA Factbook. But many midwifes still use techniques that have helped women give birth for hundreds of years, combining the new and old. From simply standing or squatting, an ancient technique that helps with delivery to using a rebozo, a practice coming from midwifes in Central America where a scarf is wrapped around the mother’s belly and used to jiggle her abdomen and possibly shift a baby so it can be ready for birth, Munro says.

Strengthening Relationships

But for midwifes, birth is just one part of the process. Munro spends much of her client’s pregnancy getting to know them on a personal level. Pre-natal visits usually last 30–45 minutes- “The medical stuff probably takes about five minutes”- the rest is nutrition and exercise counseling, or even just talking about what’s going on in the patient’s lives. In their practice, says Monroe, people get to know each other “pretty well,” a phrase she says with a smile.

And while Munro has had her own experience with birth- she and her husband have two children together both births out of the hospital- she doesn’t feel like her experience changed her as a midwife as much as people think it did. Munro stresses that while parts of her experience were similar to those that she helps- the pain, the joy- every labor she sees is ultimately different than hers in many ways.

So when it comes time to help a woman through a two-day labor, believing what people say is the key factor in helping her, says Munro. “Trusting that people have reasons for their experiences,” she says, and this sentence hangs importantly in the air, resonating. If someone’s scared, they’re scared. If they’re in pain, they’re in pain. If they don’t want to be touched, don’t touch. This is what helps her understand experiences that don’t match her own.

Although each birth is unique, different, challenging in its own way for Munro, there is one thing that never looses its effect. “That moment when the baby comes out- it’s amazing and it doesn’t stop being amazing even though I’ve seen it many, many times,” she says with a smile. “It’s ridiculous really. That a baby would come out of someone’s vagina and breathe and cry and nurse. It’s a miracle.”

It’s hour 26. Shayna has climbed the hill. She has a baby girl, Lyla, who breathes and cries and nurses. Her miracle.