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Special Delivery

Midwives Continue Their Push for a Woman's Right to Give Birth at Home


VENTURA — With the lights dimmed and candles burning, midwife Karni Seymour-Brown patiently held hands with the mom-to-be and offered soft words of advice and encouragement between contractions.

Big deep breaths. You're doing great. Push down low.

And just before midnight, surrounded by friends and family, Vera Fedotowsky-Long squatted in an oversized bathtub, pushed one final time and gave birth to a 7-pound, 2-ounce boy.

"Welcome to the world, gorgeous," Brown said, lifting the whimpering and slippery baby to Long's chest.

Brown has helped deliver nearly 700 babies at parents' homes since becoming a midwife two decades ago. Yet she said every birth is distinctive. Every birth is another memory in her personal and professional photo album. And every delivery teaches her something new about the ancient calling of catching babies.

"By inviting me into their lives, my clients have been my teachers," she said. "And they are my lifelong friends. They give to me in a way you can't measure."

This summer, Brown opened Sunrise Birthing Center in downtown Ventura, where Long gave birth to her son August Vade.

As a licensed midwife, the 44-year-old Brown guides mothers through pregnancy, labor and birth, offering them emotional support and physical care. She meets with them more than a dozen times during a pregnancy, when Brown usually conducts a pelvic exam, feels for the position of the baby and gives mothers suggestions on nutrition and prenatal care. Cost for midwife services generally range from $1,500 to $3,000, with much of the cost covered by insurance.

During birth, Brown monitors the contractions, regularly checking the mother's blood pressure and pulse and the baby's heartbeat. She sits with the mom, comforting, reassuring and massaging her through labor and delivery. And she guides the baby into the world.

"I tell mothers that I don't know what potholes, valleys or mountains we'll find during labor, but we get through them together," Brown said.

And after the birth, Brown gives the newborn a physical exam, checking the baby's color, breathing and temperature, and she shows new moms how to breast-feed and dress their babies. Sometimes Brown sutures the mother if she tears during labor.

Midwifery is older than the medical profession. Yet midwives throughout California and the nation have struggled for the right to help women give birth at home. Many doctors have argued women are safer in hospitals, and that midwives are not qualified to deliver babies. They say giving birth outside a hospital brings incredible risks.

Midwives, however, say home births are just as safe as hospital births for healthy women. And, they argue, they know how to recognize complications. Midwives have long been advocates for women's right to give birth at home, without the use of drugs or medical intervention and with the help of a trained and responsible attendant.


In 1993, California legislators passed a law that legalized nonnurse midwives and allowed them to apply for state licensing under the supervision of licensed physicians. Brown played a major role in securing that legislation, and was among the first midwives to receive a license from the State Medical Board. Now, independent midwives can practice without fear of arrest.

But Brown's life as a midwife has not been without tragedy. In 1982, a baby died during a labor she attended, and Brown was convicted of a misdemeanor charge of practicing medicine without a license. She pleaded guilty and was given three years' probation, community service hours and a fine.

"The midwife struggle became very personal," she said. "It wasn't something you read about in a book. It was very real to me."

Consequently, Brown said she is much more aware about a midwife's roles and responsibilities. She added that midwives are "guardians and safe watchers of normal birth."

Brown encourages women to consider hospital births if they have significant health problems or have had trouble in previous pregnancies. And when there are complications during labor, which Brown said occurs in about 12% or 13% of the births, Brown said she calls her backup physician.

Brown never intended to be a midwife. But after delivering her own son in 1976 with the aid of a midwife, she became interested in natural birth. So she trained to teach childbirth classes. About a year later a few local midwives moved from the area and couples planning home births asked for Brown's help.

So Brown began studying to become a midwife. But because there was little formal training available, she took workshops, joined study groups, shadowed other midwives and became an extra set of hands at every birth she could. And much of her education was trial by fire, as she began working as a midwife in 1979.

"I didn't wake up and say, 'My job is to be a midwife,' " she said. "One birth just led to another birth that led to another birth. I just loved going to births."

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