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.))