This article was originally published by WIN Magazine Online, Issue 37, October 2000.

            WIN Magazine is now defunct.


                           ISABELLA'S GREAT START


                     By Anita Obermeier, United States


   In 1999, my newborn daughter, Isabella, became one of a small

   statistic: She was among 9,000 American babies born in a labor pool, a

   Jacuzzi-like swimming pool which eases birth for both mother and child

   as the infant transfers from the body-temperature water of the

   amniotic sac to the pool’s body-temperature water. Even fewer of these

   births shared Isabella’s entry into the world at home with a midwife.

   My delivery, highly unconventional by American standards, was the most

   empowering female and feminist experience of my life. I have never

   been so sure of my abilities in any other situation.


   I decided to have this kind of delivery soon after becoming pregnant

   when I was catapulted into the overly medicalized, sterile, and

   assembly-line treatment in a Health Maintenance Organization (HMO)

   environment. Here, the insurer’s financial interests dictate much of

   the care. Quickly, three major attitudes became clear: One, pregnancy

   is primarily perceived as an illness or a negative circumstance; two,

   women, it is implied, neither know their bodies nor are up to the task

   of birthing a child without a barrage of high-tech interventions. Even

   much of the physician-centered language people use signals that. For

   instance, one hears "physicians deliver babies" more often than "women

   birth babies"; and three, systemic negativity surrounds pregnancy

   without much celebration of such a life-altering and wonderful event.



   Moreover, without fail, every woman I talked to shared with me aspects

   of her pregnancy and hospital birth that were negative. But then one

   weekend in January 1999, three unrelated women friends of mine spoke

   to me about their own home birthing experiences. They unanimously

   recommended a midwife-assisted home birth.


   In the US, such births are very unusual, because women have been made

   afraid of their bodies and natural functions. After I decided on this

   delivery, it was often tacitly implied that I was going to harm my

   unborn child with this choice. But I found statistics showing that

   planned home deliveries have superior outcomes for mother and child.

   The US ranks a shockingly high 23rd in infant mortality and morbidity,

   even though 95 percent of births happen in hospitals and are attended

   by obstetricians.


   Countries with much lower infant mortality numbers in this World

   Health Organization statistics have more midwife-assisted births. For

   example, in Holland, midwives attend 70 percent of all births, and 40

   percent of births are at home. In my native Germany, midwives and

   labor pools are part of the standard hospital environment. A midwife

   had attended both my own hospital birth in Germany, and my siblings'

   and more recently my nephew’s and nieces' birth, too.


   In the US, different tiers of midwives exist, with most of them

   prohibited from practicing in hospitals. Furthermore, according to the

   Midwife Alliance of North America (MANA)

   <>, direct-entry midwives, those

   with experience but only some formal training, are legally prohibited

   from practicing in nine US states. I even read about midwives getting

   arrested and prosecuted for helping women in Barbara Harper’s Gentle

   Birth Choices, (Healing Arts Press, 1994).


   But immediately the care provided by Mary Henderson, the midwife my

   husband, David, and I chose on the advice of many, was highly

   personalized and respectful, in great contrast to what we had

   experienced in the clinical settings. During our 15 prenatal HMO

   visits, the providers had greeted him at only three of those visits.

   With Mary, we felt like human beings: he as half of the equation and I

   as more than a mere belly.


   Even though it was our decision to contract with a midwife, Mary could

   have turned us down. Midwives, because of their medical status in the

   US, screen their prospective patients' health carefully and will not

   contract with women having problem pregnancies or jeopardizing

   complications. Since I had had a perfect pregnancy up to that point, I

   was a shoo-in. We much anticipated our appointments with Mary, while

   dreading the ones with our HMO providers. We kept them both, just in

   case there was a late complication and to keep the hospital as a



   The midwife clinic fostered a certain sense of self-reliance: patients

   weighed themselves and took their own urine test. During the exams,

   David was encouraged to listen to the baby's heartbeat and to feel my

   tummy for the baby's position. I received a highly individualized

   pelvic exam to determine my exact bone structure, which would help the

   midwife to position the baby during the birth. No such exam was done

   at the physician's office. I was also given advice on certain

   exercises to ensure Isabella's correct birth position and on

   supplements and herbs to prepare the cervix.


   A few weeks before my due date, we picked up the rented labor pool

   from Mary's office. A labor pool is a collapsible little swimming pool

   about 1.5 meters (4.8 feet) in diameter and 60-80 cm (24-32 inches)

   deep. David set it up in the dining room where we could easily get

   water from the kitchen and where the light had a dimmer switch. A few

   days before my due date, on the night of a full moon, my water broke

   at 2:30 a.m. But since I had no other indications that birth was

   imminent I went back to bed. One of the best things about our home

   birth was that everything was done calmly without artificial frenzy.


   The next morning, I took a walk with a friend and then began picking

   out music to be played during the delivery. I found a CD called

   "Following the Moon," which seemed fitting as the full moon had

   initiated the birthing process. I even danced before the contractions

   became too strong. David filled the labor pool, which has a heating

   element that maintains the water temperature around 40C (104F) but

   cannot heat it. Lying down made the contractions rather strong and

   patterned. A previous in-house visit by the midwife had confirmed our

   location and ensured the correct supplies. All we had needed to get

   were towels, rags, and a plastic sheet for the bed in case I did not

   like the water, and baby necessities.


   When Mary arrived, I had dilated to four centimeters and was allowed

   to get into the water. The warm water acts as an antidote to the pain,

   but the most salient feature is one's weightlessness. So when the

   contraction hits, one can quickly change position, sitting, kneeling,

   or hanging over the edge of the pool. It was much more cumbersome with

   my big belly to go through the contractions outside the water.


   After the dilation phase, which took two and a half more hours, Mary

   told David, who had been busy getting me water with orange-juice

   cubes, to get his swim trunks on and join me in the water. It was time

   to push. I was sitting in his lap, and he supported my weight. Mary

   gave me breathing instructions for each stage of labor and delivery.

   The pushing phase lasted three hours and was the toughest job I've

   ever done. Instead of a fetal monitor that hooks into the baby's

   skull, the midwives used a fetoscope on my abdomen to check for the

   baby's heartbeat, which never showed distress. A fetal monitor

   restricts the woman's movement, as the monitor's line hangs out of the

   vagina and is attached to an apparatus. Midwives are more low-tech and

   prefer the less intrusive fetoscope. They do, however, also bring an

   oxygen tank with them, along with a scale, measuring devices, and

   utensils to cut the umbilical chord.


   Throughout the entire delivery, I drank over four liters of alkaline

   ionized water, which provided me with electrolytes to keep the muscles

   functioning. In American hospitals, birthing women are not allowed to

   drink anything except for ice chips and in, some cases, a soda, rather

   a nonnutritious and dehydrating abomination. Instead, they are hooked

   up to IVs to provide fluids, further restricting their movement.

   During my labor and birthing experience, I was in all positions except

   prone, and was so always mobile and unrestricted.


   After six and half hours of labor, while I was sitting in David's lap

   in the water, by flickering candlelight and soft music -- eagerly

   awaited even by our five watchful cats -- Mary eased out our little

   Isabella Maria onto my belly. Isabella opened her blue eyes within

   seconds and calmly looked at us. No pained statement marred her face,

   no cries of discomfort or fear because of strangers and bright

   florescent lights pierced the magical moment. The first person to hold

   Isabella after the umbilical chord had been cut was David, who had

   been ordered out of the tub. After Mary had pulled out the placenta, I

   climbed out of the pool and the three of us were packed into our own

   bed. The midwives examined Isabella, cleaned up, and did the laundry.

   Our neighbor, Carrie, brought us food, which I savored while phoning

   my mother in Germany. I did not have painkillers in my system, thus

   rebounding quickly. Postnatal care was also highly individualized,

   with 24-hour cell phone access to Mary and several house calls during

   the first two weeks. We partially attribute the great disposition of

   our daughter to the gentle way in which she was born.


   Although my midwife-assisted water birth cost only a fraction of the

   hospital birth, my insurance did not cover it. Mary reduced her $1,300

   fee to $1,000 for us, as we had already done the major tests; the

   rental for the labor pool was $150. David and I agree that it was the

   best money we ever spent and that we would do it again in a heartbeat

   for our second child.


   I'm not suggesting that every woman should abandon

   obstetrician-assisted hospital births for midwife-assisted home water

   births, but it was the best choice I could have made, a choice often

   undiscussed in the United States. My experiences and research should

   also raise some concerns about health care, women's reproductive

   rights, and birthing options. The decline of midwifery in 19th-century

   America and the rise of male-dominated obstetrics harbor a systematic

   bias against women. Considering all this, I'm not so sure we've come a

   long way, baby.




   Anita Obermeier is a Senior Lecturer of Medieval Literature and

   Women's Studies Affiliate at Arizona State University who also

   extensively researches health issues.