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Empowered at birth

For many MT women, midwives naturally deliver

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In Joseph Campbell’s book The Power of Myth, Campbell and journalist Bill Moyers discuss the nature of heroes. Typically, heroes are more often men because they play a more conspicuous role in most cultures, whereas women more often stay at home. “But among the Aztecs, for example, who had a number of heavens to which people’s souls would be assigned according to the conditions of their death, the heaven for warriors killed in battle was the same for mothers who died in childbirth,” Campbell writes. “Giving birth is definitely a heroic deed, in that it is the giving over of oneself to the life of another.”

For many midwives—whose job it is to guide a woman through the 40-week gestation period and then through the birthing process in the most natural way possible—International Midwives Day (May 5) is more about the woman giving birth than the midwife.

“Midwives are there to help, to guide, to counsel. But giving birth should always come back to the mother and what is best for her and her child, as long as it’s safe,” says Sandhano Danison of Missoula, a practicing midwife since the mid-1980s. “It should not be about the midwife, or doctor, our opinions, our judgments. I have always been rather put off when I hear OB-GYNs—or midwives—cite how many babies they’ve delivered. The fact is, they have delivered zero, unless, of course, they have carried their own baby and given birth to it.”

For a woman and her husband or partner, there are countless choices to make once they learn she is pregnant. One of their first choices is whether to have a midwife or a physician oversee the pregnancy and birth. Does she want to give birth at home or in the hospital? Lying flat on a table, sitting in a birthing chair, kneeling, or under water? Does she want to make use of modern technology, pre-birth genetic testing, or anesthetics, or does she want to go natural the whole way, relying solely on the nuances of touch, sound, and sight?

When Dolly Browder of Missoula was pregnant with her first child in the mid-’70s, there were no midwives or birthing rooms in hospitals. In fact, at the time husbands were more often relegated to the waiting room with a pocket full of anticipatory cigars than allowed in the delivery room.

“My husband and I didn’t like the idea of going to the hospital to have our daughter. We wanted something more natural, less clinical. Frankly, I was scared to go to the hospital,” says Browder, a midwife for more than 24 years. “My husband and I educated ourselves. We read a lot. We had the baby ourselves, just the two of us, at home.” She readily admits, however, that they were taking a big risk. “We were naïve. Lucky.” People soon heard what Browder did and asked her to help with their home births. A year after she gave birth to her daughter, she took the first steps to becoming a midwife.

Becoming a midwife is more formalized than it was when Browder began her career. In Montana, midwives must graduate from an accredited school, which entails courses offered through the National College of Midwifery in Taos, N.M. The student must then serve as an apprentice during which she observes at least 40 births and manages 25, and finally get licensed by the Board of Alternative Healthcare, a license that must be renewed yearly. Though many midwives have no medical degrees (associate midwives) and manage deliveries in the mother’s home, others are nurse/midwives, which means that they practice midwifery under the supervision of a doctor. They deliver babies in the hospital, while advocating more holistic processes along the way.

“I think some women opt for midwives over OB-GYNs because the medical training that doctors get doesn’t often allow for compassion,” Browder says. “It is the long-standing philosophy of doctors that they are managing the birth. That kind of thinking takes responsibility and power away from the woman. The midwifery model of care is based on a philosophy of collaboration. When women take more responsibility, they tend to educate themselves more, to make more healthy choices.”

As Danison sees it, the “OB culture looks at birth as a potential problem that has to be solved.” Even for women of “advanced age” (i.e., 35 or older), Danison believes that all the tests, sonograms, and hoop-hurdling that OB-GYNs opt for is unnecessary. “We wouldn’t have this population if births were so problematic.”

Though in much of rural Montana where hospitals can be long drive or emergency helicopter ride away, midwives are often the safest option for delivery. Of course, complications do arise. Women can hemorrhage, placentas can abrupt (separate from the uterus prematurely), and a Caesarian section can become the only choice for a safe delivery.

The good news, however, is that today women have a spectrum of choices. Many hospitals now have birthing centers, more friendly settings with beds that transform into birthing chairs and hot tubs in each delivery room in which the woman can more comfortably labor before giving birth. Women can have a nurse/midwife along with the safety a hospital provides. She can have a medical delivery in a hospital under a doctor’s care or she can give birth in her own bathtub with the help of a midwife. She can have the collaborative input of a midwife and an OB-GYN. The key to it all, it seems, is for the woman and her partner to educate themselves. Clichés aside, knowledge is power. As is taking responsibility for one’s body and the miracle that is blossoming within.

As Campbell put it, the mother is not the only hero. “Everyone is a hero at birth because the infant undergoes a tremendous psychological as well as physical transformation.” For both mother and baby, birth is a journey, a life change like no other, involving many dangers—and joys.

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