Mona’s Contractions

Late in the evening, Mona’s contractions started getting quite intense. She paced around the room while we watched. She’d sit on the toilet frequently and Dave [her husband] rubbed her back when she was on the bed . . . . We tried to encourage Dave to go take a nap but he didn’t want to leave Mona for a moment. He finally fell asleep in the bed while it was our turn to rub Mona’s back. The night moved into early morning. The clock ticked away. We walked and talked.

It’s amazing how long it takes a baby to be born. As time passes slowly, labor gives one the opportunity to reflect on the process of birth. Each contraction comes and goes, [as] the uterus gets smaller and smaller [and] the baby is massaged down further and further into the pelvis . . . . Finally, the uterus, getting more powerful as it decreases in size, pushes the baby out of its first cradle, the pelvis, through the vagina, the passageway to life, into the outside world. The mother, feeling more and more pressure, joins the uterus in its expulsive efforts. She bears down gently and involuntarily at first but then more forcefully and purposefully as the baby approaches birth . . . .

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Mona’s labor built up to the point where she started to feel the urge to bear down. Her cervix was completely dilated and I felt the baby’s head low in the vagina. She squatted while she pushed during the contractions and walked during the break between them. She found it most comfortable to lean on the banister in her hallway while she pushed . . . . Dave was still behind her, supporting her hips. I encouraged her to push while I got under her to monitor the baby’s heartbeat.

Finally, the head appeared. Dave was behind Mona, sitting on the floor, I was beneath her in the front. Together we had our hands around the baby’s head, supporting it as we coaxed her to push the baby out slowly. A beautiful little boy was born into Dave’s and my hands. I held the baby as Dave eased Mona back onto his lap. His arms were around her as they both welcomed the baby into their arms. My birth assistant covered all three of them with blankets to keep the baby warm with their body heat. We turned the light low so the baby would open his eyes. In happy exhaustion, we sat back and through tears watched this family fall in love with each other.

Van Olphen-Fehr’s story helps us see both why women choose to become home-birth midwives and why health care consumers might choose a nontradi- tional option like home birth. Since this story took place, however, unaffordable insurance premiums have forced virtually all nurse–midwives to abandon inde- pendent practice and to work instead only under direct physician supervision. This situation illustrates the problems faced by nonmedical health care workers in trying to achieve professional status in a system characterized by medical dominance.

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