Birth Plans

Thinking about having a baby at home the natural way? It's all about choice, and there are plenty of local options.



There a number of non hospital birth options in Hampton Roads

The Scene: A modern operating room. Various medical personnel mill about fiddling with pinging monitors and stainless steel machines. A mother-to-be is wheeled in on a gurney. She is stressed and overwhelmed. Once the doctor finishes admiring the machinery and confabbing with the other physicians, he finally addresses the mother, who’s about to give birth:

"Now don’t you worry. We’ll soon have you cured. Leave it all to us, and you’ll never know what happened.” — Monty Python sketch “Birth” from The Meaning of Life

The subject of childbirth is classic comic fodder. Lucille Ball, Lily Tomlin, Tracy Ullman and Jennifer Saunders (AbFab) have all created gloriously funny bits around the experience. But the Monty Python sketch manages to both tickle the funny bone and strike a nerve, as it portrays childbirth as a medicalized procedure—a condition to be cured, rather than the natural, transformative experience that welcoming a new life into the world should be.

The Background

Since Ina May Gaskin, known as the ‘midwife of modern midwifery,’ published her influential book Spiritual Midwifery in the 1977, interest in natural childbirth has ebbed and flowed. Now, natural childbirth and home birth options are undergoing a renaissance of sorts. More than ever, women and their partners are looking for ways to have more control over as many aspects of healthcare as possible—pregnancy and childbirth included. Add into the mix recent high-profile media coverage of alternative birth choices and parenting styles, boutique midwifery services for the well-heeled and attachment parenting, and the stage is set to begin to consider planned, natural childbirth not as a fringe or celebrity-driven trend, but as a common sense, new normal for healthy moms with low-risk pregnancies. Natural childbirth can take place in a hospital-attached birth center, a freestanding birth center or in the home. It can be a comfortable, viable option. In Virginia, it is legal to give birth at home, and in Hampton Roads there are a host of resources for women considering natural childbirth options. There are even organizations designed expressly to support the unique birth-journey needs of military families.

The Players: Midwives and Doulas

The Doula—Practitioners of the new ‘old’ profession. Doulas provide emotional, physical and sometimes spiritual support for the mother, partner and family members primarily during labor and delivery either at home, at a birth center or in a hospital setting. They can also work in conjunction with midwives. Doulas do not perform any medical tasks, do not provide as comprehensive labor-related care as midwives and do not interfere with the doctor-patient relationship. A doula’s role may include: assisting the mother with natural pain relief relieving techniques such as breathing, massage and optimal body positioning. The doula may even provide postpartum help, advising the family about breastfeeding, coordinating auxiliary services or helping to plan for routine tasks as simple as pet care or household help while the family bonds with the new arrival. The goal is to make the birth experience as satisfying as possible.

Amelia Avila, founder of Birth Madre Doula Services, provides professional doula support for mothers and their partners in the Hampton Roads area, including Williamsburg, Gloucester, Yorktown and Suffolk. “Modern, Western culture has slowly drifted away from birth as a normal physiological event to a birth culture requiring extensively trained physicians and thousands of dollars worth of equipment and hospital care,” Avila says. “In addition, with extended families less the norm, the doula fills a role that in the past would have been that of a mom, sister, aunt or cousin. A doula supports a woman throughout her labor and birth and is there to say, ‘You are strong, you can do this.’ In terms of non-medicated, natural childbirth, we’re not holding mothers to an agenda of our own; we simply help them advocate for themselves.”

The Midwife—In Virginia there are two types of midwives that can attend home births: Certified Professional Midwives (CPM), and Certified Nurse Midwives (CNM). CPM’s have no hospital privileges, do not administer medications and operate in out-of-hospital settings. CPM’s in Virginia are certified by MANA (Midwives Alliance of North America) and are qualified to provide the Midwives Model of Care. Midwives provide continuous, personalized and comprehensive care: “midwives work with women to promote a healthy pregnancy and provide education to help the mother make informed decisions. In partnership with their client’s, they provide a continuum of care, carefully monitoring the progress of the pregnancy, labor, birth and postpartum period ... the education, monitoring and decision-making processes are guided by Evidence-Based Practice and Informed Consent.”

Terri Hewitt, CPM, LM, and Jennifer Derugen, CPM, LM founded Seven Cities Midwifery Care practice. Jennifer and Terri both feel that birth is a sacred time for families as a natural rite of passage. Prospective clients can avail themselves of a no-cost interview to learn more about their unbelievably comprehensive services and follow-up visits. They embrace a holistic approach and feel that the birth experience is one of the most powerful and empowering experiences a woman will have during her lifetime. They are strong advocates of giving families the space to bond after the birth in the comfortable, low-key environment of home, and their comprehensive pre-planning sessions and group meetand- greets offer support for both mom and dad/partner. To date, Hewitt and Derugen have assisted with 1,300 births.

The Birth Centers—Birth Centers, both freestanding and hospital-attached, can offer the best of both worlds. Hospital-associated birth centers generally utilize CNM’S and are good options if the mother would appreciate the comfort of having medical support staff nearby should a medical emergency arise.

There are currently no freestanding, independent birth centers in Hampton Roads. However, the Birth and Midwifery Centers at DePaul Hospital in Norfolk (889-CARE) are great options and are designed to offer individualized birth plans, natural childbirth and ‘enhanced personal care and comfort.’

Home Birth: The Advantages

  • You give birth in low-key, quiet, familiar surroundings.
  • You get to choose who attends your birth.
  • You are actively involved in decisions about your care.
  • No admissions paperwork to disrupt the birth process.
  • Giving birth at home with no drugs or interventions can lead to greater emotional well being and decreases the likelihood of postpartum depression.
  • No stressful hospital schedules, unnatural lighting, frequent tests, unnecessary interventions or interruptions.
  • Family can bond immediately, and there is on-the-spot breastfeeding support.

Case Study

Andria Timmer: “With my first child, I was planning to give birth in a birth center but for a number of reasons was transferred to the hospital in early labor. I did not have a truly horrible hospital experience as my nurses were incredibly supportive—able to do intermittent monitoring which allowed me to move around as I wanted, and they respected my natural childbirth wishes by not offering pain meds or an epidural. Things changed, however, at the moment of birth. When I felt the urge to push, I was told to wait since the doctor wasn’t there. When he arrived, I was guided into the uncomfortable lithotomy position (feet often in stirrups, perineum positioned at the edge of an examination table) when I preferred to squat or stand. The lights were turned on, and the room filled with people. My time in the hospital was tense because all I wanted to do was be with my son, but he needed to be checked and cleaned. 

Rooming in was not allowed, so again he was taken from me. I experienced a hospital birth with no complications, but it was not an ‘ideal’ birth.

When I discovered I was pregnant again, I opted for a home birth, and I knew I had made the right choice when I met Jenny and Terri. Working with them, I learned what an intuitive process birth is. As women, we know how to give birth naturally if we take the time to listen to our bodies. My daughter was born in our bed, and we stayed in that bed for a couple days. Her transition to the outside world was peaceful and beautiful.

If I had to identify one difference between the hospital birth and home birth it would be who was in control. In the hospital, I felt like the wisdom I had as a woman and as the person who had carried this being for the past 40 weeks was ignored. I almost felt as if the hospital owned my son until our discharge.

With home birth, my instinct as a mother was paramount. The midwives were there to facilitate, not direct.”

Help for Our Men and Women in the Military Avila, Hewitt and Derugen all practice in the Hampton Roads area and are acutely aware of the special circumstances that the military families in our community often face.

Perhaps a spouse or partner cannot be present for the birth of their child, or perhaps the mother’s immediate family members are far away and cannot provide needed help and support. Worst-case—the partner has been injured or has lost his or her life in support of our country. All three professionals mentioned Operation Special Delivery as an organization
that fills in the gap. OSD’s motto is ‘A Hand to Hold Till They All Come Home.’ OSD provides trained doulas for pregnant women encountering just such situations.

Natural/Home Birth Resources in Hampton Roads

www.mothersnaturally.org

www.operationspecialdelivery.org

www.doulas.com

www.birthmadre.com

www.themilitarydoula.com

www.williamsburgmothering.com

www.fullofgracemidwifery.com

www.sevencitiesmidwifery.com