The Advocate (Baton Rouge)

Midwives say process should
be less invasive

LAFAYETTE -- Kathy Acree, chairman of Louisiana’s Advisory Committee on Midwifery, was the first licensed midwife in the state. After 21 years of continual practice, Acree has delivered more than 900 babies — once even delivering 11 babies within a week.

Dressed in jeans, she doesn’t fit the stereotypical image of a midwife, especially one so accomplished.

Her most recent accomplishment is the June opening of Louisiana’s first accredited birthing center, where Acree hopes to engage midwives, nurse midwives, doulas, pediatricians, and other medical professionals in a community effort to support women giving natural birth and home birth.

Gentle Choices Birthing Center, in Lafayette, reminds one of a bed and breakfast.

“It’s not a mini-hospital; it’s a maxi-birthing center,” Acree said. The center includes two birthing suites with queen-sized beds, Jacuzzis, and adjoining bathrooms. A third bathroom has a Victorian clawfoot tub.

The décor is just as cozy. Sweeping floral-patterned curtains, arched or scalloped valances, cypress paneling, strawcloth linoleum flooring, and mint-green walls create beauty, warmth, and softness. A vibrating bassinette plays a lullaby. Oil paintings adorn the walls.

The center also has a prenatal room, kitchen, library, office, and parlor.

“Midwifery is consumer-driven and growing in demand. Women read more, they’re better informed, so they’re not so quick to be forced into institutionalized childbirth,” Acree said.

Edward Barham, who is from the Monroe area and was a state senator for District 33 from 1976-1980, and owner of Flying Tiger Aviation, a pilot school, is Gentle Choices Birth Center’s sole financier.

“Even though we have the world’s most complex and advanced medical centers — and my son’s life was saved with a bone-marrow transplant, so I appreciate what high-tech medicine can do … to the rest of the world our high-tech medical system doesn’t look so good,” Barham said Friday. “In the majority of cases, it looks like intervention does more harm than good. And, clearly a midwife’s services are cheaper than what you’d pay at a hospital.

“The birth of a child is a special event in a family’s life, and that ought to be respected and supported. Births have gotten so medical, but they’re sacred events.

“This is an effort to put the option out there. Everywhere we’ve turned people have reached out to help us. We feel like we’re being carried along watching it happen around us.”

Louisiana has the lowest number of practicing midwives, in the United States, as well as the highest perinatal morbidity and mortality statistics. An independent study published in the British Medical Journal last summer found that midwives have the same perinatal statistics as hospitals but much less invasive deliveries. Midwives do carry emergency equipment such as oxygen, IVs, resuscitation equipment, anti-hemorrhage drugs, local anesthesia, and suturing material.

Of the 35 licensed midwives in Louisiana, most aren’t practicing because they cannot get hospital privileges, Acree said. When Louisiana passed a law in the 1970s requiring midwives to have physician back-up, Acree was part of a consumer group that successfully lobbied the Legislature to reverse the law in 1982.

Acree said she believes midwifery is vital to the childbirth industry because it gives women freedom of choice:

* To have any loved ones present at the birth.
* To have continual labor support and comfort measures from the midwife, assistant, and perhaps a doula (a person who provides physical, emotional, and informational support to the mother before, during and just after childbirth).
* To move around, eat and drink during labor.
* To avoid invasive procedures such as the electronic fetal monitor, forceps, IVs, C-sections.
* To give birth in a quiet, comfortable, private place.
* To hold and nurse the baby right after delivery.
* To receive more frequent and personalized care during pregnancy.

Midwife-delivered births are often more cost-effective, too, Acree said. A self-paying patient would pay an average of $4,500; an insured patient an average of $6,200 (prices include all services and materials). Most private insurance carriers will cover midwife costs.

As the number of C-sections in the United States has increased to about one-third of all births, the demand for midwives is also increasing nationwide. It’s a long time coming, Acree said, considering that most countries already use midwifery as the predominant method of childbirth and prenatal care.

“Women are capable of having babies without a cascade of invasive interventions. Their bodies instinctively know what’s best for them,” Acree said.

Or, as French obstetrician Dr. Michael Odent phrased it: “Childbirth works best when health-care providers sit on their hands.”