Birth in a Hotel Room?

Why would a woman decide to give birth in a hotel? Yesterday WGN News reported 0n a birth that took place in a hotel. The midwife called 911 because the mother needed additional treatment after the baby was born (the baby was healthy). The police were wondering why and how this could happen.

I have some thoughts about this. After working in hospital labor/delivery units for many years, I took weekend call for a home birth practice staffed by doctors and midwives. I learned about different approaches to birth care.

In the hospital I worked within the medical model of birth care. When I assisted the home birth practice, we worked with a physiological model of birth care. Certified nurse midwives or CNMs are trained in the medical model. Certified professional midwives or CPMs are trained to support physiological birth.

In the medical model of birth the doctor or midwife manages the birth process, sometimes aggressively. It includes electronic fetal monitoring, induced or stimulated labor, artificial rupture of membranes, pain control with narcotics and/or epidural anesthesia. All of these interventions have some risk and may lead to more interventions.

The physiological model of birth allows labor to progress without intervention. The baby’s heart rate is monitored intermittently by doppler. The mother’s blood pressure and temperature is monitored. The birth attendant makes sure that the laboring woman stays hydrated with water, juice, tea or broth. 

In the home setting I learned that pain was a signal that helped to direct both the mother and attendant. Simple measures to relieve pain were employed—compresses, massage, change of position, a warm shower, a birth tub. The type of pain could be a sign of the baby’s position or the stage of labor and helped with decisions.

In Illinois certified nurse midwives can attend home births if they have a doctor backing up their practice. But CNMs mainly practice in the hospital and CPMs are illegal in Illinois. It is difficult for a woman to find a midwife for home birth. Perhaps the hotel was a meeting place for midwife and client that lived a distance from each other.

Illinois does not license certified professional midwives, although neighboring states do. CPMs receive their certification through classes and apprentice training (different from nursing school).

Some women prefer to deliver in a home setting instead of the hospital—they prefer to avoid or limit interventions. The prefer the privacy and quiet of home. They want to respond to cues from their body with support and guidance. When I worked in home birth, many of the women had previously delivered in the hospital. Some had been traumatized by the experience.

For years the midwives in Illinois have lobbied for regulation and licensure for CPMs. Licensure would set standards for CPMs. It would insure that the midwife was qualified to attend births and set guidelines for hospital transfer.

Pediatricians in Illinois are against home birth. My observation was that infants had less blood sugar and temperature problems at home than what I saw in the hospital. In the home infants were placed immediately skin to skin with mother. The immediate contact with mother assisted the establishment of breastfeeding.

Hospital or home–each place has advantages and disadvantages. Some women prefer to give birth in the hospital. Others prefer to give birth at home with a midwife. I think women should have a choice. 

This post is part of #Write28Days. To view the other posts in this series click here.

Midwife: With Woman

With my third pregnancy I chose a new medical practice. I chose a practice that included an ob-gyn doctor and a certified nurse midwife. Even though my previous births were cesarean sections, followed by complications I wanted the perspective of a midwife in my care.

During my prenatal visits I saw the doctor a couple times, but the majority of my appointments were with the midwife. We talked about my history and the current pregnancy. We discussed whether I should go into labor (some benefits for baby) or schedule the cesarean section (optimal for having all medical personnel ready).

Unfortunately I had both a horizontal and vertical scars on my uterus. At one time I was advised to avoid another pregnancy. We talked through the risks and eventually I agreed with the midwife that it would be better to schedule the surgery.

The day of surgery my midwife was in the operating room with me. Her role was emotional support. My husband was there too.

Midwives have a special place in childbirth care. Their training, skills and practice are focused on the health of women and infants. They are more sensitive to the emotional aspects of labor and birth.

The term midwife originated in Middle English, the combination of mid [with] and wife [woman]. To be a midwife is to be with woman.

Midwife: With Woman
Midwife gives Virgin Mary first bath: courtesy of http://welcomecollection.org

The prompt for the Five Minute Friday community is: WOMAN

A Good Neighbor

Every Friday the FMF community writes for five minutes on a prompt given by Kate Motaung. To visit this inspiring community of writers, click here. Today’s prompt is: NEIGHBOR

Like so many I have been watching the photos and videos of Hurricane Harvey. The floodwaters and misery are overwhelming—but so is the kindness of people as they help strangers. The Cajun Navy has volunteered their time and their boats to rescue thousands of people.

My favorite story is about a midwife. As floodwaters rose on her street she was unable to leave her house with her supplies. A neighbor helped her onto an inflatable swan and pushed her to dry ground. She was able to attend the birth of a client.

Natural disasters create situations where the needs of people become obvious. A community spirit develops. It would be wonderful if this spirit became a constant.//

When we were traveling in Finland I was impressed by the kind attention offered to us. So many times a bystander noticed that we were studying a map or looking at street signs, and then offered assistance.

Attentiveness is part of being a good neighbor.

The Gospel of Luke records a question that was posed to Jesus.  Who is my neighbor? Jesus responded with the parable of the Good Samaritan. The man who saw the wounded Samaritan and acted with mercy was a neighbor.

We are called to pay attention to the needs of others. Perhaps it involves asking good questions or being available. And then stepping up to help. I can improve in this area.

Raquela: Book Review

Flag of Israel

Raquela Levy’s family had lived in Palestine for nine generations. Did you know that Palestine, referring to Israel, is a name derived from Philistine? Historically the Philistines were enemies of Israel. Raquela was a nurse midwife during the final years of British rule in Palestine.

Ruth Gruber spent nine months with Raquela, gathering information and insights into the life of this remarkable woman. The resulting biography is a story of the babies born to holocaust survivors—and the birth of the nation of Israel. Raquela was sent to refugee camps as a midwife to minister to women that were refused entry into Palestine.

The vivid detail describes life in Israel during the war years: Israel’s War of Independence (1948), Six-Day War (1967) and Arab-Israeli War (1973). The book describes events through the experiences of Raquela and her family.

I could picture Hadassah Hospital on Mount Scopus,  the scene of       Raquela’s developing romance with Dr. Brzezinski. The description of the delivery room at the Hadassah Hospital reminded me my first        experiences as a labor & delivery nurse.

I could feel the sadness when Mount Scopus was lost to the Arabs of     Jordan. The hospital was lost, and Israel had to build a new medical     center.

Perhaps the most moving was the description of the ships filled with Jewish immigrants fleeing Europe. They were refused entry to Palestine by the British. One of the refugee camps that Raquela served at was on the Island of Cyprus.

I have a much better understanding of Israel’s modern history from reading this book. The book engaged me—it was hard to put it down.

* Ruth Gruber, Raquela: A Woman of Israel, New York; Open Road Integrated Media. 1978.

Linking with Christian Blogger link-upSeasons, Literacy Musing Monday,  Booknificent Thursday and Thought Provoking Thursday