Susanna's Birth Story, Part I

Susanna’s birth story really begins with Lea’s birth, when a kind and fiercely talented midwife with a long grey braid delivered my first baby in a quiet green room at a birth center near Philadelphia. It would be hard to overstate the transformative nature of that experience, and not only because it brought me my beautiful daughter and made me a mother; Lea’s birth also transformed my sense of what is possible when it comes to maternity care, as I enjoyed one-on-one attention and guidance from midwives with exactly the kind of expertise and demeanor I needed. Simply put, I fell in love with midwifery, and with the concept that until conditions indicate otherwise, pregnancy and birth are normal events, not medical ones.

Of course, I wanted medical expertise in the event that something did prove more complicated than normal, and that’s what I found from the Certified Nurse-Midwives on staff at the birth center. And that’s what I was looking for when I got pregnant again, this time 500 miles away in rural Virginia.

The options for maternity care are quite limited here in Appalachia, so the beginning of my pregnancy was spent searching for midwives while getting early prenatal care from an OB practice, one that came highly recommended but still felt hugely anonymous and would approach my pregnancy and birth in ways far removed from what I was used to and preferred. Still, they were perfectly nice, delivered high quality care, and would have been a fine option for me if my search had ended there.

I hadn’t really considered a homebirth until I heard about DeEtte, a CNM from Tennessee (about an hour away) who maintained a homebirth practice. She answered all my (many, many) questions about how she handled various complications and emergencies, and further reassured me as she ran through her resume: many years in a hospital setting as an obstetric nurse, and then working in a NICU; running a free-standing birth center of her own—much like the one where I’d had Lea—in another state, delivering 900 babies there before changes at her backup hospital forced her to close down; and finally, beginning her homebirth practice with the goal of operating like a traveling birth center, which meant maintaining solid, consistent working relationships with nearby backup physicians at all the local hospitals. As a CNM, she could prescribe and administer drugs if necessary, and traveled with all the medical equipment that had been available at the birth center. She and her assistant, an RN, had worked together at homebirths for 16 years.

Toward the end of our initial phone call, DeEtte promised me, upon my urging, that if I ever changed my mind or felt like a homebirth wasn’t a good fit for me, she could swiftly transfer my care to her backup and it would be fine. I told her that I needed to know that, that I needed an “out” if I panicked, that I planned to spend the rest of my pregnancy educating myself as much as possible about the risks presented in any setting, and that homebirth was a new concept for me that I needed to wrap my head around. “That’s good,” she said. “You absolutely need to do that. But you also need to know how confident I am. I know, that I know, that I know, that this works.” After all the medical technicalities and statistics we had discussed, that one statement made the biggest impression on me, and I realized what an experienced and professional caregiver I was dealing with. I ended the call feeling like I wouldn’t find a more qualified birth attendant anywhere.