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By Charles Lam
I Want my Midwife!
The list of OC hospitals that allow midwife-assisted births just got shorter—but moms-to-be and midwives aren't taking it lying down
About a month from now—possibly during some still-black predawn hour, as it was with her first two children—Robin Parker's water will break. Parker, her belly taut and engorged, will grab her bags, pack her two young sons into the car, and depart Mission Viejo with her husband to begin the hour-long ride north. Before she leaves, she will phone the person who's been with her since the beginning of her pregnancy.
During her 50-mile trek, she'll cross the Los Angeles County line; she'll end at a birth center in Whittier.
When Parker arrives, B.J. Snell will likely be waiting for her. Snell is Parker's primary prenatal-care provider and a certified nurse midwife. She will spend as many hours as it takes with Parker until the baby is born.
This wasn't the Parker family's original plan. They were going to drive about 10 miles west to Laguna Beach's South Coast Medical Center, where Parker would give birth under Snell's care. But since the June closure of that hospital's maternity ward, the only facility in South County that granted midwives the privilege of delivering their patients' babies, Parker and dozens of other women have had to either give up their midwives, change doctors or find places, like the birth center in Whittier, where midwives can deliver their babies.
While midwives have long been a topic of debate and controversy among medical professionals in the United States—especially when it comes to home births—midwife-assisted deliveries are increasingly seen as a mainstream choice for healthy women with low-risk pregnancies. Midwives have been proven, in research study after study, to have as good or better outcomes (for example, lower C-section rates, lower infant-mortality rates) than physicians working with the same patient population. Midwife-assisted hospital births are widely available in both Los Angeles and San Diego counties.
But the closing of South Coast's maternity ward has left Orange County women with precious few places to get what some see as the best of both worlds: The hands-on, supportive care of a midwife, with the medical expertise of an obstetrician/gynecologist (OB/GYN) and full hospital facilities standing by in case of emergency.
In response to the closure, a group of former South Coast patients has banded together to educate women about their various birth options, dispel some of the myths around midwifery care and push for midwifery as a delivery option at all county hospitals. "The Community Alliance for Birth Options [CABO] was developed in response to the fact that so many of our patients were left disenfranchised and without recourse," says Lisa Sherwood, a certified nurse midwife who shares her practice with Snell. "They came to B.J. and me and said, 'What can we do? How do we try to make the community aware and make hospitals aware and also look at alternatives?'"
Angelique Boynton, a Costa Mesa mother who has had two children under Snell's care and is active in CABO, stresses that they're not trying to tell any woman the right or wrong way to have a baby. "We're not saying don't see an OB/GYN or don't have an epidural or a C-section," she says. "I had an epidural during my second birth with B.J. We just want women and families to know what their options are. And we believe natural birth with a midwife should be an option that's offered in a hospital setting along with everything else."
For mothers-to-be like Parker, giving up Snell and transferring her care to only an OB/GYN was a compromise she says she couldn't make.
Her first son was born at Mission Hospital, where Parker was under the care of an obstetrician. Parker arrived at the hospital with a doula, a specialized birth attendant who advocates for and supports women in labor. "I was really determined to have a natural birth," she says. "But it was a disaster."
Parker says she couldn't get any doctor to come in and see her for five or six hours. When the doctor did arrive, Parker was in heavy labor; she was told to wait on her pushes until he changed and came to her room, she says. "But the body does what it does when it's in labor. I'm pushing, and they were saying, 'Don't push!'"
The delivery itself was difficult, Parker recalls. She experienced a third-degree tear, losing a lot of blood and needing stitches.
"My husband unfortunately overheard the staff talking, and they said, 'Well, that's what you get when you decide to have a birth that way [natural childbirth].'" She later fainted in her room.
Three months later, she returned to the hospital with a severe infection from her stitches. She asked for help with her wound, since by now she was having trouble sitting and standing up. She was told she would be responsible for the coverage since the stitches were considered "elective surgery."
Two years later, when she considered having another child, Parker says she wanted to try a different approach. She wanted something more personalized and friendlier toward natural birth, she says, but she still wanted to deliver at a hospital in case anything went wrong.