When Kathey Merten decided to have her baby at home with a midwife, she knew there would need to be a lot of trust involved. The chances of anything going wrong were slim, but if an emergency did happen, Merten would have to go to Barton Memorial Hospital and that transportation time could be deadly.
"I had to trust. It's a whole process of being empowered with the pregnancy and it involves deep, deep trust. It seemed like an opportunity to embrace pregnancy and birth instead of being treated like a number," Merten said.
Merten, a prenatal yoga instructor based in Meyers, said she ultimately chose a planned home birth because she tended to avoid doctors and hers was a low-risk pregnancy.
She also had a lot of faith in her midwife, Lenny Sue Tinseth.
Tinseth started delivering babies in the South Shore in 1986, and in that time she's caught about 600 infants. Her practice, Alpine Midwifery, continues to grow, and in the past year alone she's seen a 20 percent increase in business.
Tinseth attributes that growth to an increased awareness regarding midwifery. Many mothers and physicians consider home births more dangerous than hospital births, but Tinseth disagrees and said that more women are starting to see the merits of having their child at home.
"Women are finding out that they can safely have a birth outside of the hospital. I hope that low-risk pregnant women will seek midwifery care. It's been shown that you can reduce the mortality and the morbidity rates for women and children with home births, and that's phenomenal," Tinseth said.
A 2005 research article published in the BMJ, an open-access, peer-reviewed medical journal, found that planned home births for low-risk pregnancies for women who used certified professional midwives had a lower rate of medical intervention than hospital births.
"Despite a wealth of evidence supporting planned home birth as a safe option for women with low-risk pregnancies, the setting remains controversial in most high-resource countries. Views are particularly polarized in the United States, with interventions and costs of hospital births escalating and midwives involved with home births being denied the ability to be lead professionals in hospital," the study read.
The American College of Obstetricians and Gynecologists opposes home births, maintaining that hospitals and birthing centers are the safest settings for pregnant women. And a 2010 metaanalysis published in the American Journal of Obstetricians and Gynecologists compared home births to hospital births and found that neonatal mortality rate tripled during home births.
Tinseth is familiar with the 2010 study, and said it doesn't take into account whether or not a professional midwife attended the birth. Tinseth apprenticed for six years before she sat for the Medical Board of California exam to receive her midwifery license and she's certified in neonatal resuscitation, anesthetic and suture, and she carries the medications for hemorrhage.
What Tinseth can't do is a C-section or a blood transfusion if there's an emergency. For most low-risk pregnant women, births go smoothly. But when something does go wrong, the woman has to be transported to the nearest hospital, and it's that transit time that has some mothers like Stacey Hamburg worried.
"No, I would not consider a midwife. I would describe myself as being pro-science, pro-medicine, pro-doctor.
"One claimed benefit of midwives is that they provide a 'natural' birth. When something does go wrong, who does the midwife call? They call the expert doctor. It seems best to just start with the expert in the first place," Hamburg wrote in an email.
As health care reform continues to shake the foundations of the medical structure and hospital births become more expensive - Merten said she would have had to pay about $11,000 for a hospital birth compared to the $4,000 she payed for Tinseth - more women are looking toward midwifery. According to the U.S. Centers for Disease Control and Prevention, births taking place outside a hospital increased by 30 percent between 2004 and 2009.
"It's the future. If the woman is low-risk, I would advise her to have a home birth with a trained physician. The only risk is transport time, the unexpected. I like for women to have options. I wouldn't want hospitals to go away. I want us to work together," Tinseth said.