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A kinder, gentler childbirth

Hypnosis, midwives, labor coaches ease process.

BY SHARI RUDAVSKY Miami Herald      May 4, 2004

http://www.miami.com/mld/miamiherald/living/health/8576797.htm?1c

Dr. Patricia Calvo has delivered hundreds of babies. But when she gave birth to her first child, Catarina, the Fort Lauderdale obstetrician chose a path she never learned in medical school.         During labor, she used HypnoBirthing® techniques, a breathing and relaxation method favored by many of her patients. ”Why not open ourselves up to these alternative techniques as long as they’re safe and were not doing anything too crazy,” said Calvo, who gave birth about two months ago. “Why not take the best of both worlds?”        

Once it was either/or for women — either a hospital birth with the medical safety net or a cozy home birth with a midwife. In the past 15 years that line has blurred as the options for healthy women have exploded. Soon-to-be moms now can give birth under water at a birthing center. Or they can create a home-like atmosphere in a hospital, with a midwife, aromatherapy and a doula, or coach, to offer on-demand massages.        

LEARNING FROM EACH OTHER        

”Both entities [midwives and physicians] have learned and incorporated some of the techniques from the other,” said Dr. Hal Lawrence, an officer with the American College of Obstetricians and Gynecologists. “It all works together to provide patients with the ultimate choice.”        

Even as the number of cesarean sections continue to rise — nearly a third of all births in Florida and a quarter of all births nationwide — many women are turning their backs on hospital birth.        

Two weeks ago, Lorena Belloso crouched in a birthing tub at the Miami Maternity Center, with midwives coaching her and warm water easing Sophia Lorena Francis into the world.        

”For me, hands down this was a beautiful experience as a woman,” said Belloso of Miami Lakes. “They help you, they’re coaxing you through the whole time.”        

Nearly 30 years ago Miami Maternity Center founder Shari Daniels opened the nation’s first midwife-run birth center in El Paso, Texas. Today about 160 birth centers, including those run by doctors, handle about 20,000 births each year, the National Association of Childbearing Centers estimate.         In a hospital the promise of an epidural lurks around the corner of every contraction. In the Maternity Center, the staff emphasize natural childbirth. Said Daniels: ‘You get to the next contraction and we say, `oh, this is a good one,’ and you say, ‘Yeah, I can do this.’ ”        

Even women like Calvo, who had an epidural during the second half of her labor, can incorporate alternative techniques into the process. Many birthing centers and hospitals offer instruction in HypnoBirthing®, which helps mothers-to-be grapple with contractions.        

”The advantage of HypnoBirthing® is that it eliminates the fear and tension of the pain syndrome,” said Rina Lichtinger, whose Fort Lauderdale Healing Light center offers a 10-hour course on the technique. “Its mind over body.”        

Hospitals, too, have jumped in. Some, like South Miami, have relaxed their once-stringent rules, allowing the baby to remain with the mother as opposed to in the nursery. Where once visitors had to arrive within a small window of time and were not allowed to hold babies — that privilege was reserved for the parents — visiting hours now last all day.         

”Things have definitely lightened up,” said Janine Balkin, a parent educator at South Miami.        

South Miami, through its Birth-Day School program, offers an array of classes to prospective parents: Lamaze, childbirth, infant CPR, breast-feeding.        

Joana E. and Marcelo Weiss of Doral took many of the courses to prepare for the birth of their daughter, Daniella, now 3 months old.        

The class on epidurals helped ease the 27-year-old first-time mothers fears about the pain-easing medication. And the information she gleaned from the childbirth class proved invaluable in February when her water broke.        

”I knew what to look for,” Joana said.        

INTRODUCING THE DOULA        

Hospitals have opened their doors to a new brand of childbirth professional, the doula. Added to the American Heritage and Websters Collegiate Dictionaries last year, the word ”doula” refers to a woman who provides labor or postpartum support.        

The concept grew out of a 1980s study of birth practices in Guatemala in which assistants ”observed” labors. But one assistant did more than observe; she held the women’s hands, rubbed their backs and — it turned out — skewed the results. Her presence in the room, the researchers learned, reduced the number of cesareans and amount of pain drugs used. And so the doula, taken from a Greek word for ”wise woman,” entered the delivery room.        

Today Doulas of North America, founded in 1992 to train and certify doulas, has 4,800 members, said Ann Grauer, president. Florida has about 130 certified doulas.        

”The role of the doula is that of educator and that of emotional and physical support. She’s a bridge that brings everyone together,” said Marlo Robinson, owner of Mothers Care Doula Services of South Florida, which provides services to Memorial Regional and West and Palmetto General hospitals and Mount Sinai Medical Center.        

Although his wife, Leigh Ann, was not sure she needed a doula, Ed Federkeil was sold, after learning about it through a childbirth class.        

The Cooper City couple contacted Mothers Care and met with Dawn Deardorff, one of 10 labor doulas at the Pembroke Pines company. Deardorff regularly called to check on Leigh Ann, encouraging both Federkeils to ask questions.        

When Leigh Anns water broke one night at the end of March, she was baffled. She called her doula, who encouraged her to go to Memorial West, where she soon met the Federkeils. When Deardorff arrived, it was like a friend showed up, Ed recalled thinking.         

As Leigh Ann, 42, labored through the night, the nurses came and went. Dawn stayed by her side throughout, massaging her back and playing soothing music.        

By the time the doctor delivered Erin Leigh at 5:59 a.m. on March 29, Ed Federkeil felt he had shared a life-defining experience with the doula.        

”We feel like Dawn’s a part of our family now,” he said. “I couldn’t imagine having a child without a doula.”

Contact Linda Alexander – linda.alexander@talktalk.net 0141 632 1440 or 07875 493 358

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