Lincoln Journal Star

No midwives allowed

NANCY HICKS / Lincoln Journal Star | Posted: Saturday, July 8, 2006 7:00 pm

Carson Miles  Loll, 7 pounds 15 ounces ,  came into this world in the early morning hours of June 23 . . . in the basement of his parents’ house . . . in a soft plastic kiddie swimming pool, adorned with brightly colored fishes .

His dad, Michael, who caught him and clamped his umbilical cord, was the only person attending his birth — besides Carson’s mom, Karen,  who really wanted to give birth at home,  with a certified nurse midwife helping out.

But Nebraska state law does not allow certified nurse midwives to attend home deliveries.

And the state has threatened unlicensed midwives with prosecution if they  attend home deliveries, according to Heather Swanson, a nurse midwife from Wilcox.

So Karen, pregnant with her third child, was faced with two choices:   

* Deliver at the hospital with her nurse midwife, or  

* Deliver at home, with no help but her husband.

She chose home, alone. 

Two weeks later, everyone is doing well.  Little Carson lounges in a pouch sling around his mom’s neck, while brothers Hayden and Blaine  peek in to kiss him.

Karen would like to see the state law changed.

A group of consumers and nurse midwives has been working without success for more than a decade to get the law changed so  licensed nurse midwives could help with home deliveries.  The consumers would also like to see other midwives without a nursing background licensed by the state. 

 At least three times in the past decade  state senators have refused to budge on the home birth issue.

This year, supporters of home birthing took their case to a state agency review process that can recommend changes to the Legislature, pointing out the  lengths some Nebraska women will go to to have a home birth.

   Expectant women in western Nebraska have reported traveling to Wyoming to have midwife-attended births in hotel rooms. 

Others have arranged to have out-of-state midwives to attend their home birth, according to Swanson, a certified nurse midwife who has been working on the home birth issue.

Others, like Karen Loll, have relied on family members.

Karen said she doesn’t understand the reluctance to give women the choice.  Births at home are the natural order, she says.

In fact, home births are becoming more mainstream as celebrities like actress Ricki Lake and Demi Moore talk about their experiences and television shows like “House of Babies” explore midwifery and home births.

For Karen, a home birth was the best way.  

She knew she would be more relaxed at home — before and after delivery.

Karen isn’t comfortable at the hospital. 

The beds were so uncomfortable at the old birthing unit of Saint Elizabeth Regional Medical Center that she made her husband sleep on the bed and she slept on the lounge chair.

She couldn’t get a decent night’s sleep, what with the nurses coming in to check things out.

“I didn’t want to do the hospital this time. I need to focus and relax and I couldn’t do that in a hospital setting.”

She had previously had long, but easy labors.

This time her labor was fast — just four hours.  

She delivered early in the morning, when her “half-asleep husband was too tired to freak out.”

Michael was not happy with the whole idea, she said. He wholeheartedly supported a home birth — with a midwife, she said.

He was less sure about doing double duty as midwife and husband.

But Karen wasn’t worried about a potential problem. “I can see the hospital from my house,” she said.

‘“If there had been any kind of a problem I would have gone to the hospital,” she said.

Karen and Michael set up a birthing pool in their basement — an inflatable pool with soft sides and an inflated bottom that she bought at Toys R Us. 

“It was big enough for me to actually float in” and deeper than the birthing tubs at the hospital, she said.

The couple’s two other little boys were asleep in their upstairs bedrooms. 

Karen said she did months of online research before she became a “UCer” — unassisted childbirther. That’s how she discovered the best pool. That’s where she bought the umbilical cord clamp.

It was her best delivery yet.  “I gave birth at 4 a.m. and I was up at 8 a.m. making breakfast for the family.”

Six hours after giving birth, mom, dad and baby went to see the nurse midwife for a checkup.  Karen got two stitches and found out how much her third child weighed at birth.

She had the state required PKU tests at the hospital later in the week. 

A week later they went to the pediatrician for a checkup. 

A few states allow  midwives to attend births.

But many states require a physician’s agreement with the licensed nurse midwife, which is a practical limitation on the number of licensed midwives who can offer help at home births. 

Nebraska is one of just two states to prohibit certified nurse midwives from attending home births, according to Swanson.

“When it comes to births in Nebraska, women have little or no choice,” said Karen.

Reach Nancy Hicks at 473-7250 or nhicks@journalstar.com.

The arguments over home birthing

* For home births: 

Giving birth is a natural process , not a disease, and should be treated that way, said Dr. Daryl Wills, a Gering chiropractor, who participated in the review process.

Supporters point to studies showing that births attended by licensed midwives have better outcomes than physician-attended births.

The worst outcomes are at home births with no one or with unlicensed people helping.  And that is the situation in Nebraska today, points out Heather Swanson, a nurse midwife from Wilcox, who has led the recent effort to change Nebraska’s law. 

In 2003, the state recorded 68 home births, she said.

* Against home births:

Safety is the big issue for opponents.

They  point to studies that indicate giving birth at home is more dangerous than in a hospital.

Home births are inherently risky, and even with low-risk pregnancies things can quickly go wrong, according to opponents at a recent public hearing on the issue.

For the safety of both mother and baby, a hospital is the safest place to give birth, opponents say.

Encouraging home births is a step backward to the 1800s, said Dr. Les Spry, a Lincoln physician.