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Seeking an option to hospital births

Jeanine Moyer's first child was born in a Massachusetts birth center -- a homelike setting where the birth was done her way.

She labored in a Jacuzzi and eventually delivered while sitting on a birthing stool. Moyer and her husband then curled up in a queen-size bed with their newborn daughter for a two-hour nap.

"The experience was amazing; it was very relaxing and peaceful," the Hamburg native said. "I felt very supported and my midwife was in the room with us the whole time. It wasn't that rushed feeling you'd get at a medical institution."

Moyer, 29, moved back to Western New York three years ago, pregnant with her second child and searching for a similar personalized birthing experience. But she couldn't find a birth center, nor could she find a midwife certified for home births.

The only nearby delivery option was the hospital, but Moyer, a computer programmer who lives in Cheektowaga, said the hospital was not where she wanted to give birth. "One thing leads to another, and you end up with a C-section," she said. "And I didn't want that."

Because of women like her, local natural birth supporters have started a grass-roots effort to try to create a free-standing Buffalo birth center that would accommodate the needs of women who desire individualized, out-of-hospital births, attended by midwives.

These facilities, found around the country, are staffed by midwives who are trained to give prenatal, delivery and postnatal care. The midwives work with minimal technology to provide care centered on the mother and infant, all in an environment that resembles home and involves the entire family unit. Additionally, costs at birth centers tend to be at least half that of hospitals.

Fundraising for the Buffalo center, to be called the Emerald Waters Birth Center, is at the beginning stages. Tracy Horn, a birth educator and executive director of the Emerald Waters development group, said the supporters hope to raise about $1 million for the center, which would operate independently but be linked to a city hospital for emergency medical back up.

"We want to give them another option," said Horn. "Birth is your most vulnerable time, and a woman should have choices of where she wants to give birth. A birth center is a good middle ground between a hospital and giving birth at home."

Horn, 43, gave birth at home in Buffalo to two healthy babies, with a nurse midwife but without medication or a doctor. She and other supporters of a city birth center believe pregnancy and birth are natural, normal occurrences that don't need medical intervention, except in cases of high-risk conditions.

>Debating safety

Of course, at-home or birth center births are not for everyone, experts say.

Dr. Kevin Fitzpatrick, the chief of OB/GYN for Kaleida Health, said while births are natural processes, "they can still be dangerous."

A local birth center would be an assest to the community if it has a prearranged relationship with a hospital in cases of emergency, he said. Such a facility would be ideal primarily for women looking for a different birth experience, Fitzpatrick added.

"But it's definitely not safer; it's safer to have the baby in the hospital," he said.

Local and national proponents of birth centers and natural birth disagree, saying it would be a move to normalize pregnancy and birth, and could minimize problematic pregnancy outcomes, such as premature babies and deaths.

They blame the medicalization of birth, through the discipline of obstetrics, for the nation's high infant-death rate, preterm births and rapidly increasing C-section numbers. According to a report this month from the Centers for Disease Control and Prevention, the United States now ranks 29th in the world for infant mortality, the worst of any industrialized country and it lags greatly behind its counterparts in Europe and East Asia.

Eileen Stewart, a certified nurse midwife in Buffalo and board president for Emerald Waters, said there's a correlation between good pregnancy outcomes and the midwifery model care. In countries where midwives still provide primary care to pregnant women and attend their births, the infant mortality rates are lower than the United States, which spends the most per baby than any other nation.

"When birth went into the hospital, the midwife did not follow as the professional care provider for pregnancy and birth," said Stewart, who revived her home birth practice more than a year ago. "It all became the domain of the profession of medicine at that time and there was more diagnosing, more setting due dates, timing and inductions. It moved from being a family-centered event to a very medicalized, controlled event."

However, Fitzpatrick said there are other factors to consider, such as access to health care, the structure of the health care system and a universal health care system in some countries. Fitzpatrick blames the high number of C-sections on medical malpractice claims and women requesting them as an elective procedure.

Fitzpatrick and other area physicians, in private practice or at hospitals, have midwives working with them. But these midwives often have to adhere to hospital protocol, which can undermine the midwifery model care, many in the natural birth community believe.

>'Low-tech approach'

Without alternatives to the hospital, Moyer and other women have sought care 45 minutes away with Cecilia Stearns, a Batavia certified nurse midwife known for successfully bringing the midwifery model and birth center experience to United Memorial Medical Center.

"It's a low-tech approach," said Stearns. "We try to give our patients choices, we allow them to have the birth experience that they think they want. We make sure mom and baby are healthy but we try not to impede on that process and allow the family to play a role. To me it's a very important part of life. We really try to provide an atmosphere that's not so medical."

That's the delivery experience that Moyer had envisioned. But her contractions became stronger and quicker than she thought they would, and she started crowning before the Batavia exit on the Thruway.

"We flew through the toll booth," said Chris Moyer. "I told the clerk, 'she's having a baby, we are going to the hospital, we can't stop.' "

They got to Batavia in a record 21 minutes, but their son Aemon was born in the car in the hospital parking lot.

As it seeks funding, Emerald Water doesn't have a timetable for construction and opening. Moyer and her husband plan to have more children, and if the Emerald Waters isn't opened when they do, they'll head back to Batavia.


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