By Alan Prendergast
By Michael Roberts
By Michael Roberts
By Amber Taufen
By Patricia Calhoun
By William Breathes
By Michael Roberts
By Melanie Asmar
In 80 percent of all births, everything goes fine and the kids come out healthy. It's the other 20 percent that Ryan worries about. "You know, if I had an 80 percent chance of winning the lottery, I'd buy a ticket," she says. "But this is not the lottery we're talking about; we're talking about your kiddo's life. And when things go bad, they tend to go bad really quick. And usually not just one thing: The baby doesn't breathe and the mother is bleeding badly. It gets hairy and scary."
Mountain Midwifery is located across the street from Swedish Medical Center; Ryan says they take mothers to the hospital about 15 percent of the time. Insurance covers such trips, because the $1,800 birth-center fee is a lot cheaper than the $6,000 the hospital charges as its facility fee.
Ryan has counseled women who are planning on unassisted childbirths, particularly on the risks involved in such births, and she always states right away that she will not be able to help if things go wrong. "Do not call me during unassisted birth," she'll say. "I cannot help you. Call 911."
Although Ryan has tried to smooth the birth process at Mountain Midwifery, she's still uncomfortable with the idea of unassisted birth. "It's absolutely true that women have been giving birth throughout time unassisted. And babies have been dying, too," she says. "If you want to get totally natural about it, death is natural, too. So a very small number of babies and mothers will die, and that's totally natural. But in our especially litigious society, I'm always afraid of the extremes of both sides of the pendulum."
Dr. Michael Hall, who has a private practice in Englewood, has been a obstetrician for thirty years. He has testified as an expert witness in many cases of alleged medical malpractice -- for both plaintiffs and defendants. Though he says he's never heard of the unassisted childbirth movement, he's dealt with cases in the emergency room when homebirths haven't gone well.
"We're there to pick up the problems," he says. "Anyone can deliver a baby. You could deliver the baby, paramedics could deliver the baby -- anyone can deliver a baby, and most of them do fine. But we're not looking at the ones that have no problems at all; we're there to assist the problems that occur." Complications occur in at least 10 to 20 percent of all deliveries, he notes.
"Look to the 1900s or before, and go back to the East Coast and look at the graveyards," Hall says. "You find hundreds of women and babies dying because of hemorrhage, primarily, and then because of postpartum depression. Now we have antibiotics. We have a lot of simple things that we take for granted nowadays, such as medications that assist with the contractions of the uterus after birth so that they don't hemorrhage to death. That's probably more important than the delivery of the baby -- the management of the placenta. And if it's not managed well, they die."
Though Hall is supportive of natural births -- his wife is a midwife -- many obstetricians are not. According to the guidelines of the American College of Obstetricians and Gynecologists, the organization "strongly opposes" any birth not performed inside a hospital. A spokesman for the ACOG has a one-word assessment of freebirth: "dangerous."
On January 25, the baby hugs were no longer playful. By four in the afternoon, they were so intense that Elizabeth had to cut short her planned walk down the road. By six, Jason was pressing on her lower back to alleviate the pressure of the baby's head pushing against her spine. Though she had no way to check, Elizabeth figured her dilation at that point was about three inches.
It felt good to keep moving around the house. She took a few showers, and the warm water did wonders to alleviate her pain. At eight that night, they filled the birthing tub and Elizabeth climbed in, wearing only a loose tank top. Immediately she felt more relaxed as the water eased the pressure. As each contraction came, she'd squat while Jason held her hands, and they'd look into each other's eyes. Hours passed. By midnight or 1 p.m., she wasn't sure of the time anymore, she could reach down between her legs and feel the baby's head poking out, with little wisps of hair on top.
Elizabeth tried to concentrate on her birth affirmations, but it was difficult. She was tired and she wanted the baby out. She didn't care if she woke the neighbors with her screams.
Even then, she knew she was "looking at life pessimistically, and it's so much in your mind," she says. "If you have a good mindset going into it, you're saying, 'With every contraction I have, it's getting me closer to the good thing' instead of 'Oh, I hate these contractions, not another one.' And that's what I regret doing in my mind. The more you embrace it, I guess, the more it will come."
Finally the head was fully out, but the shoulders were stuck. Elizabeth pushed hard and out the baby came, like a seal pup into the water. Jason grabbed the baby, a girl, and lifted it to Elizabeth's chest. They had already chosen a name. Now Ani breathed.