VOA – CONNECT
EPISODE 45
AIR DATE 11 23 2018
((FULL TRANSCRIPT 11 19 2018))
OPEN ((VO/NAT))
((BANNER))
Home Delivery
((SOT))
A deer actually gave birth right in front of this window, and I thought, I’m having a baby in front of this window if I have it at home.
((NATS))
((SOT))
The main reason that women are choosing to have their babies at home is because they want to have some control over the process.
((OPEN TRANSITION))
((PKG)) A BIRTH AT HOME
((Banner: The following contains scenes of childbirth. Viewer discretion is advised.))
((Banner: A Birth at Home))
((Reporter/Camera: Gabrielle Weiss))
((Map: Montgomery County, Maryland))
((Banner: Leading US medical groups say hospitals are the safest settings for delivering babies. Yet, a small but growing group of women are choosing to give birth at home.))
((NATS))
((Gina, Mother))
So, I’m all ready with the baby’s room. She’s the first girl, so we’ve gotten a lot of presents and stuff even though it’s my second. Her closet is full and her drawers are full of clothes. I’m 39 weeks pregnant and I plan to have a home birth, like I plan for it to be, hopefully, peaceful. I plan to actually give birth in the tub, in my living room, with the support of my husband and midwives. Before I announced that I was pregnant, a deer actually gave birth in front of my house, right in front of this window, and I thought, I’m having a baby in front of this window if I have it at home. So, this is where it’s all happening.
((Gunnar, Son))
I want to fly.
((Justin, Father))
You want to fly like Ironman?
((Gina, Mother))
I have a 3 year old. I had him in a hospital, a conventional birth. I was induced. You know everything was so medical. I’m laying on a bed. I have monitors. I can’t walk. It’s almost like the woman has no part in it. Now that I am going through this pregnancy again, I began to realize that I really didn’t like that first experience, and that I wanted to kind of take control of my labor. You know, it’s my body, it’s my experience and that I wanted to own it.
((NATS))
((Máiri Breen Rothman, CNM, MSN. Director M.A.M.A.S., Inc.))
Well, a lot of times people ask me why I went from being a choreographer to being a midwife, and my usual answer is that the first time I saw a birth, I realized I could never make a dance that good. I think I have a short attention span and I don’t usually stay interested in things for a long time but, I’ve been a midwife for 21 years and I have never been bored.
((Máiri Breen Rothman, CNM, MSN. Director M.A.M.A.S., Inc.))
Hey, puppy. Hi puppy. Hi. It’s Feeta. Come on, Feeta. Good to see you.
((Gina, Mother))
You, too. Hi, I haven’t seen you in a while.
((Máiri Breen Rothman, CNM, MSN. Director M.A.M.A.S., Inc.))
So, how’s everything going?
((Gina, Mother))
Ok.
((Máiri Breen Rothman, CNM, MSN. Director M.A.M.A.S., Inc.))
Yeah?
((Gina, Mother))
Yeah.
(Máiri Breen Rothman, CNM, MSN. Director M.A.M.A.S., Inc.))
You feeling impatient yet?
((Gina, Mother))
Yeah. I mean I’ve been having a lot of lower back pain, Braxton Hicks. I’ll like get up and walk and after an hour it’ll go away and then I don’t call. So, it’s kind of like nerve-racking because how am I going to know?
((Máiri Breen Rothman, CNM, MSN. Director M.A.M.A.S., Inc.))
You’ll know because it won’t go away. Yeah. And you know what sometimes happens is somebody will think, ‘Oh, is this labor? I better call the midwife.’ And then they call and then it goes away and it turns out not to be labor. And so then the next night that happens again and it turns out not to be labor. So then the third night when it happens again, they’re like, ‘I’m not calling the midwife. This is not real.’ But it is. So, if you ever, if it crosses your mind to ask yourself, ‘Should I call the midwife?’ the answer is yes, you should call.
((Máiri Breen Rothman, CNM, MSN. Director M.A.M.A.S., Inc.))
Ok, so you can just sit back or lie down or….That is a really nice round shape.
((NATS))
Hello, little parts. Hey, baby.
((Gina, Mother))
That sounds like a fast heartbeat.
((Máiri Breen Rothman, CNM, MSN. Director M.A.M.A.S., Inc.))
Well, you know, when she moves, she’ll cause herself to have a heartrate acceleration which is good. That’s a good sign. Yeah.
((Máiri Breen Rothman, CNM, MSN. Director M.A.M.A.S., Inc.))
Hi.
((Gina, Mother))
Hi, buddy.
((Máiri Breen Rothman, CNM, MSN. Director M.A.M.A.S., Inc.))
How are you, Justin?
((Justin, Father)) Good. How are you guys? Baby still in there?
((Gina, Mother))
Still in there.
((Máiri Breen Rothman, CNM, MSN. Director M.A.M.A.S., Inc.))
Yeah, she’s very active.
((Máiri Breen Rothman, CNM, MSN. Director M.A.M.A.S., Inc.))
Childbirth is really the last frontier of feminism. When the feminist movement started, it really looked at, in terms of reproduction, women’s right to not have a baby and to decide whether or not they wanted to be a mom. But in the urgency and importance of that issue, they kind of forgot about women who are having babies. And we’ve just accepted that as 'this is the way that birth is.’ And then I began to see women giving birth at home and in birth centers and I was enlightened into a whole other way of seeing birth where the mom is the locus of control, where her sovereignty is held and preserved by the people taking care of her, and she is seen as the expert in what’s going on in her own body.
((NATS))
((Gina, Mother))
I think it’s very important to develop that relationship before giving birth. So, I feel very comfortable. There’s the three midwives at M.A.M.A.’s midwives. I’ve gotten to know them. They’ve all been over. They kind of get to know you, right? They know my son. They know my dog, my husband, you know?
((Máiri Breen Rothman, CNM, MSN. Director M.A.M.A.S., Inc.))
Our team is comprised of me. I’m a full-time midwife and the owner of the business. And then I have two midwives working with me, Katie Shannon and Kathy Peacock, who together make up 1.5 positions. And Leslie Hill Jenkins is the glue that holds our practice together. Stuff with insurance and birth certificates, that’s all her department. She deals with the paper. Our model of care is, we call it community care, and it’s a hybrid of individual visits at the person’s home, and group visits at our place.
((Máiri Breen Rothman, CNM, MSN. Director M.A.M.A.S., Inc.))
This is when we start talking about, like, how is this actually going to work? How is this birth going to come together at your house? When people first come to us wanting to have us attend them in their pregnancy and their birth, we do an assessment of their health history and their health status currently. And then, that’s an ongoing assessment for any risk factors that would indicate that it’s not a good idea for them to be outside of a hospital.
((Gina, Mother))
So, when I was interviewing M.A.M.A.’s midwives, I had questions about their transfer rate, what the plan of transfer would be, what hospital, you know, do they prefer to transfer to, you know, what if there’s an emergency. All of those questions are very important to me and something that I needed to know and feel comfortable with before finalizing a decision.
((Máiri Breen Rothman, CNM, MSN. Director M.A.M.A.S., Inc.))
I would say that, every good midwife when she’s on her way to every birth, is rehearsing all the motions that you go through if you have a shoulder dystocia or a hemorrhage or a baby that doesn’t come out and breathe right away. We’re just going through the motions in our head. Preparing for the worst and expecting the best and 99.9 percent of the time you get the best, but that .1 percent, you need to be ready.
((Máiri Breen Rothman, CNM, MSN. Director M.A.M.A.S., Inc.))
Hey, Gina. How are you?
((Gina, Mother))
Good to see you.
((Máiri Breen Rothman, CNM, MSN. Director M.A.M.A.S., Inc.))
You, too. You’re still here.
((Gina, Mother))
That’s how I feel, like the bathtub that we blew up two weeks ago. Deflated.
((Máiri Breen Rothman, CNM, MSN. Director M.A.M.A.S., Inc.))
I know it’s hard not to feel like, you’re, you know, failing in some way or you’re defeated in some way but, honestly, I really want you to hang on to the idea that your body is doing exactly what it’s supposed to be. It’s not doing it on a schedule that somebody else has decided on but it is doing exactly the right thing. Oh, your baby’s really low.
((Gina, Mother))
Yeah, I feel that.
((Máiri Breen Rothman, CNM, MSN. Director M.A.M.A.S., Inc.))
Please call us as soon as you feel like something’s changing because your baby is only, like, this far away from the world. You probably feel like you’re walking around with a bowling ball, right?
((Gina, Mother)) I feel very uncomfortable when I walk. ((Máiri Breen Rothman, CNM, MSN. Director M.A.M.A.S., Inc.))
Yeah, you’re ready. When the baby’s ready, then you’ll both be ready.
((Máiri Breen Rothman, CNM, MSN. Director M.A.M.A.S., Inc.))
This country has the highest infant and maternal mortality rates in the developed world, and only 1% of our births happen at home. So all of those people who are dying, babies and moms, are not dying at home. They’re dying in the hospital. And I think it’s really important to understand that.
((Máiri Breen Rothman, CNM, MSN. Director M.A.M.A.S., Inc.))
When we get to 41 weeks if you still haven’t had a baby, we should have you Sunday night, do the intercourse and evening primrose oil, and then we come and do a stretch and sweep. It’s much more likely to be effective.
((Gina, Mother))
I’ve been doing things like, walking miles and stairs and they can’t hurt.
((Máiri Breen Rothman, CNM, MSN. Director M.A.M.A.S., Inc.))
They can’t hurt except they can make you uncomfortable and crampy.
((Gina, Mother)) Right.
((Máiri Breen Rothman, CNM, MSN. Director M.A.M.A.S., Inc.))
What I always tell people at this point in their labor, is get all the ‘shoulds’ out of your mind. What is most likely to put you into labor is a feeling of being happy and calm and safe and comfortable. That means not doing the ‘shoulds’. Just ask yourself, ‘what do I feel like doing?’ And do that. And don’t do anything you don’t feel like doing. And then, after you have your baby, keep on doing that because that’s a good thing to do for your whole life. Just do what you feel like doing and don’t do things you don’t feel like doing. I mean, except like the dishes or whatever.
((Gina, Mother)) No problem there. I had a complete breakdown yesterday, so that helped me feel better today, I guess. Just like surrender, like, 'Ok, I have no control over this.' I keep saying it and thinking I believe it. But I actually don’t think I believed it until yesterday, like, for the first time. I was, like, 'Ok, it’s going to happen. There’s nothing I can do.'
((Máiri Breen Rothman, CNM, MSN. Director M.A.M.A.S., Inc.))
It’s really common for women to feel like they’re late and that somehow their body is failing them because they haven’t had their baby yet. So, it’s kind of a challenge for the midwife to help them come around to understand the fact that normal human gestation is 37 to 42 weeks and somebody who’s 40 weeks and five days pregnant is not late.
((Kathy Peacock, CNM, MSN. Staff Midwife, M.A.M.A.S., Inc.))
So your due date was Saturday. So you’re 41 weeks and two days today. Any questions or concerns apart from…
((Gina, Mother))
The obvious.
((Kathy Peacock, CNM, MSN. Staff Midwife, M.A.M.A.S., Inc.))
Yes.
((Gina, Mother)) I mean, I’m definitely concerned about stillbirth at this point, right?
((Kathy Peacock, CNM, MSN. Staff Midwife, M.A.M.A.S., Inc.))
Your fetal movement counts are the best indicator that your baby is doing just fine.
((Gina, Mother))
My fetal movement counts, I do them at night, right? So, I think, I don’t feel a lot of movement, for instance, today so far. Right, so it’s like, I feel her move at night, but I don’t feel her move the whole entire day sometimes. And then I wonder, there’s a point where, like, if it were to happen, if something were to happen that was wrong, it would happen at some point during the day.
((Kathy Peacock, CNM, MSN. Staff Midwife, M.A.M.A.S., Inc.))
Let’s listen to baby and do the auscultated acceleration test and just make sure baby is doing fine.
((Máiri Breen Rothman, CNM, MSN. Director M.A.M.A.S., Inc.))
You know, when I first was introduced to midwifery I thought, well, home birth is really beautiful, but it seemed like we were trading medicine for folk art. And that I had this impression, that I think many people have, that home-birth midwives come to your house and sprinkle you with herbs and hope for the best. When actually home-birth midwives are practicing state-of-the-art maternity care. Where they’re combining modern health care knowledge and supplies and equipment with that TLC (tender, loving care) of traditional midwifery and it’s a magical combination because it yields amazing results.
((Kathy Peacock, CNM, MSN. Staff Midwife, M.A.M.A.S., Inc.))
Perfect.
((Gina, Mother)) She’s alive. You want the baby to come out?
((Kathy Peacock, CNM, MSN. Staff Midwife, M.A.M.A.S., Inc.))
Let’s schedule…
((Gina, Mother))
A C-section?
((Kathy Peacock, CNM, MSN. Staff Midwife, M.A.M.A.S., Inc.))
No, we’re not scheduling….we don’t do those in the home. We’re monitoring you very closely but, just that you’re pregnant at 41 and 2, it’s not a problem. It’s normal if women are allowed to go naturally.
((Gina, Mother))
Yeah. I hear you. But I challenge you. Second time mom. Not Caucasian. They say Caucasian women gestate longer, so I thought I’ve got that going for me for once. Nothing.
((Kathy Peacock, CNM, MSN. Staff Midwife, M.A.M.A.S., Inc.))
It’s just that your baby’s not ready yet.
((Gina, Mother))
I know.
((Kathy Peacock, CNM, MSN. Staff Midwife, M.A.M.A.S., Inc.))
It’s not a problem.
((Gina, Mother))
I know and I’m really mad at her.
((Kathy Peacock, CNM, MSN. Staff Midwife, M.A.M.A.S., Inc.))
You can talk to her all you want when she comes out.
((Gina, Mother)) She better be cute.
((Kathy Peacock, CNM, MSN. Staff Midwife, M.A.M.A.S., Inc.))
She will be.
BREAK ONE
BUMP IN ((ANIM))
BLOCK B
((NATS))
((Máiri Breen Rothman, CNM, MSN. Director M.A.M.A.S., Inc.))
Let your breath come. Let your breath help you. Send it right down into where it hurts. Breath right down into there. That’s your last little bit of cervix going away.
((Rachel Cipryk, SM, student midwife.))
Big breath. Blow it away.
((Justin, Father)) I am trying to be super cool and calm because that’s what she asked me to do, like, 150 times. And, tonight’s the night.
((Máiri Breen Rothman, CNM, MSN. Director M.A.M.A.S., Inc.))
Baby’s ROA. I think you have to sort of, yeah, exactly.
((Kathy Peacock, CNM, MSN. Staff Midwife, M.A.M.A.S., Inc.))
Gina, this is your baby coming.
((Gina, Mother))
I can’t.
((Rachel Cipryk, SM, student midwife.))
You can. Yes, you can.
((Máiri Breen Rothman, CNM, MSN. Director M.A.M.A.S., Inc.))
You’re doing it, Gina.
((Gina, Mother)) Is it happening? Are things happening?
((Máiri Breen Rothman, CNM, MSN. Director M.A.M.A.S., Inc.))
Yes, yes. Let your legs be open so the baby can…yeah, that’s baby moving down.
((Gina, Mother))
Is she coming?
((Máiri Breen Rothman, CNM, MSN. Director M.A.M.A.S., Inc.))
We can’t see anything yet but I can hear her coming down.
((Gina, Mother)) I’m sorry.
((Máiri Breen Rothman, CNM, MSN. Director M.A.M.A.S., Inc.))
You have nothing to apologize for.
((Rachel Cipryk, SM, student midwife.))
This is exactly how she comes down.
((Máiri Breen Rothman, CNM, MSN. Director M.A.M.A.S., Inc.))
Don’t apologize for being perfect. You’re going to have a baby in your arms really soon. ((Gina, Mother))
Is anything happening?
((Máiri Breen Rothman, CNM, MSN. Director M.A.M.A.S., Inc.))
Yeah.
((Rachel Cipryk, SM, student midwife.))
Your baby’s moving right down.
((Gina, Mother)) Are you sure?
((Máiri Breen Rothman, CNM, MSN. Director M.A.M.A.S., Inc.))
It certainly seems that way.
((Gina, Mother))
I know but what if I’m just being dramatic?
((Justin, Father)) Still got jokes.
((Gina, Mother))
Shhh.
((Justin. Father)) Alright. Sorry.
((Máiri Breen Rothman, CNM, MSN. Director M.A.M.A.S., Inc.))
130’s
((Rachel Cipryk, SM, student midwife.))
Sounds good, Gina.
((Gina, Mother)) Oh my god. She’s coming. She’s coming. Catch her.
((Máiri Breen Rothman, CNM, MSN. Director M.A.M.A.S., Inc.))
Ok, you’ve got her. That’s it. Here she comes. Reach down and catch your baby.
((Kathy Peacock, CNM, MSN. Staff Midwife, M.A.M.A.S., Inc.))
Here she is. Perfect.
((Gina, Mother))
Oh my god. Oh my god.
((Rachel Cipryk, SM, student midwife.))
Turn her head so she can breathe. Good job.
((Máiri Breen Rothman, CNM, MSN. Director M.A.M.A.S., Inc.))
Come over here, Dad.
((Gina, Mother))
Hi, sweetie. Hi, my love. Oh baby. Oh baby girl. Oh sweetie. Oh my god. I can’t believe I did that.
((Rachel Cipryk, SM, student midwife.))
You did it.
((Gina, Mother))
Oh my god. I did that.
((Gina, Mother))
Oh my god. I did that. I felt like it was never going to happen. And it just popped out. She just popped out.
((Justin, Father))
You worked it.
((Máiri Breen Rothman, CNM, MSN. Director M.A.M.A.S., Inc.))
You did it.
((Rachel Cipryk, SM, student midwife.))
You did a lot of work to get there.
((Gina, Mother))
Oh my goodness. I want to see her face but I’m scared to pull the placenta.
((Máiri Breen Rothman, CNM, MSN. Director M.A.M.A.S., Inc.))
You know what? If you have the energy, if we could help you get up. Your whole job is just to hang on to the baby and we’re going to help you get up, ok?
((Gina, Mother))
Hi, you stubborn, stubborn girl.
((Kathy Peacock, CNM, MSN. Staff Midwife, M.A.M.A.S., Inc.))
Let’s get you to the couch.
((Máiri Breen Rothman, CNM, MSN. Director M.A.M.A.S., Inc.))
There’s a saying that says peace on earth begins with birth. And I really think that that’s true, that the way you come into the world is important.
((Gina, Mother))
Hi, sweetie pie. We did it. She’s nursing.
((Justin, Father))
To see the process unfold naturally was, was just amazing. You can’t do anything but just, you know, be there and support and try your best not to talk and follow the instructions you were given. But, she did, she just was so amazing and I knew she would be but when you see it happen, I don’t know, it’s something.
((Máiri Breen Rothman, CNM, MSN. Director M.A.M.A.S., Inc.))
She’s 8 even.
((Kathy Peacock, CNM, MSN. Staff Midwife, M.A.M.A.S., Inc.))
Yeah.
((Máiri Breen Rothman, CNM, MSN. Director M.A.M.A.S., Inc.))
8 exactly. Alright, 8 pounds, zero ounces. (3.6 kg)
((Gina, Mother)) Thank you so much, everyone.
((Máiri Breen Rothman, CNM, MSN. Director M.A.M.A.S., Inc.))
I’m so proud of you. You were so patient and you waited until your body was ready.
((Justin, Father)) \
Thank you so much. You were great.
((Rachel Cipryk, SM, student midwife.))
You’re very welcome.
((Máiri Breen Rothman, CNM, MSN. Director M.A.M.A.S., Inc.))
Alright, troops out.
((Gina, Mother))
I’m in shock still. But I feel great. I feel great. I did not feel like this with my hospital birth. This time, it hurt like crazy but I did it, but I did it. Like, but look at her. She’s alert. She’s nursing. Because she was born when she was ready.
((Justin, Father)) She’s ahead of the game, man. I feel like she’s going to start talking soon.
BREAK TWO
BUMP IN ((ANIM))
BLOCK C
((Banner: 6 Weeks Later))
((NATS))
((Gina, Mother))
What do you think about having a sister?
((Gunnar, Son))
I like this baby.
((Gina, Mother))
You like this baby. Ok, there we go. That was a good answer.
((Gunnar, Son))
She’s happy at you.
((Gina, Mother))
She’s happy at me. Ooh, yeah.
((Gunnar, Son)) She’s a baby.
((Gina, Mother))
Look at that smile. Yeah.
((Máiri Breen Rothman, CNM, MSN. Director M.A.M.A.S., Inc.))
Well hello, little buddy. Hi.
((Gina, Mother))
Hi. Good. How are you?
((Máiri Breen Rothman, CNM, MSN. Director M.A.M.A.S., Inc.))
You look great.
((Gina, Mother))
Thank you.
((Máiri Breen Rothman, CNM, MSN. Director M.A.M.A.S., Inc.))
Hi. How’s life with two kids?
((Justin, Father)) Twice as fun.
((Máiri Breen Rothman, CNM, MSN. Director M.A.M.A.S., Inc.))
So, thinking back on 6 weeks ago, it just feels so long ago.
((Gina,Mother)) It does seem so long ago.
((Máiri Breen Rothman, CNM, MSN. Director M.A.M.A.S., Inc.)) When you think about the birth, what are your thoughts?
((Gina, Mother)) Looking back on that moment where, you know, where I was kind of huddled in pain and then all of a sudden feeling this moment of 'I’ve got this. I’m in complete control right now' and it’s all me and I turned around on all fours and pushed and then she came. And looking back on that is just like incredibly empowering, right? Like, I did it. I did it.
((Máiri Breen Rothman, CNM, MSN. Director M.A.M.A.S., Inc.))
Oh yeah. Nobody else. I often wish I could have a few contractions for the person but, no, it’s all you.
((Gina, Mother)) No, you don’t.
((Máiri Breen Rothman, CNM, MSN. Director M.A.M.A.S., Inc.))
This is your last home visit for this pregnancy.
((Gina, Mother)) Thank you, Máiri.
((Máiri Breen Rothman, CNM, MSN. Director M.A.M.A.S., Inc.)) Thank you for choosing us to go on your journey with you.
((Gina, Mother))
She says thank you, too.
(((Máiri Breen Rothman, CNM, MSN. Director M.A.M.A.S., Inc.)) So sweet. Take care.
((NATS))
BREAK THREE
BUMP IN ((ANIM)
CLOSING ((ANIM))
SHOW ENDS
