Special Delivery
With the lights dimmed and candles burning, midwife Karni Seymour-Brown patiently held hands with the mom-to-be and offered soft words of advice and encouragement between contractions.
Big deep breaths. You’re doing great. Push down low.
And just before midnight, surrounded by friends and family, Vera Fedotowsky-Long squatted in an oversized bathtub, pushed one final time and gave birth to a 7-pound, 2-ounce boy.
“Welcome to the world, gorgeous,” Brown said, lifting the whimpering and slippery baby to Long’s chest.
Brown has helped deliver nearly 700 babies at parents’ homes since becoming a midwife two decades ago. Yet she said every birth is distinctive. Every birth is another memory in her personal and professional photo album. And every delivery teaches her something new about the ancient calling of catching babies.
“By inviting me into their lives, my clients have been my teachers,” she said. “And they are my lifelong friends. They give to me in a way you can’t measure.”
This summer, Brown opened Sunrise Birthing Center in downtown Ventura, where Long gave birth to her son August Vade.
As a licensed midwife, the 44-year-old Brown guides mothers through pregnancy, labor and birth, offering them emotional support and physical care. She meets with them more than a dozen times during a pregnancy, when Brown usually conducts a pelvic exam, feels for the position of the baby and gives mothers suggestions on nutrition and prenatal care. Cost for midwife services generally range from $1,500 to $3,000, with much of the cost covered by insurance.
During birth, Brown monitors the contractions, regularly checking the mother’s blood pressure and pulse and the baby’s heartbeat. She sits with the mom, comforting, reassuring and massaging her through labor and delivery. And she guides the baby into the world.
“I tell mothers that I don’t know what potholes, valleys or mountains we’ll find during labor, but we get through them together,” Brown said.
And after the birth, Brown gives the newborn a physical exam, checking the baby’s color, breathing and temperature, and she shows new moms how to breast-feed and dress their babies. Sometimes Brown sutures the mother if she tears during labor.
Midwifery is older than the medical profession. Yet midwives throughout California and the nation have struggled for the right to help women give birth at home. Many doctors have argued women are safer in hospitals, and that midwives are not qualified to deliver babies. They say giving birth outside a hospital brings incredible risks.
Midwives, however, say home births are just as safe as hospital births for healthy women. And, they argue, they know how to recognize complications. Midwives have long been advocates for women’s right to give birth at home, without the use of drugs or medical intervention and with the help of a trained and responsible attendant.
*
In 1993, California legislators passed a law that legalized nonnurse midwives and allowed them to apply for state licensing under the supervision of licensed physicians. Brown played a major role in securing that legislation, and was among the first midwives to receive a license from the State Medical Board. Now, independent midwives can practice without fear of arrest.
But Brown’s life as a midwife has not been without tragedy. In 1982, a baby died during a labor she attended, and Brown was convicted of a misdemeanor charge of practicing medicine without a license. She pleaded guilty and was given three years’ probation, community service hours and a fine.
“The midwife struggle became very personal,” she said. “It wasn’t something you read about in a book. It was very real to me.”
Consequently, Brown said she is much more aware about a midwife’s roles and responsibilities. She added that midwives are “guardians and safe watchers of normal birth.”
Brown encourages women to consider hospital births if they have significant health problems or have had trouble in previous pregnancies. And when there are complications during labor, which Brown said occurs in about 12% or 13% of the births, Brown said she calls her backup physician.
Brown never intended to be a midwife. But after delivering her own son in 1976 with the aid of a midwife, she became interested in natural birth. So she trained to teach childbirth classes. About a year later a few local midwives moved from the area and couples planning home births asked for Brown’s help.
So Brown began studying to become a midwife. But because there was little formal training available, she took workshops, joined study groups, shadowed other midwives and became an extra set of hands at every birth she could. And much of her education was trial by fire, as she began working as a midwife in 1979.
“I didn’t wake up and say, ‘My job is to be a midwife,’ ” she said. “One birth just led to another birth that led to another birth. I just loved going to births.”
Now, Brown also teaches midwifery skills workshops, trains apprentice midwives and attends conferences and seminars. She said she hopes to start offering classes in birthing, parenting, yoga, infant massage and CPR at the new birthing center.
Last year 3,000 of the state’s 600,000 babies were delivered by midwives, according to the California Medical Assn. Women decide to give birth at home with a midwife for various reasons.
Some want the comfort of a bedroom, rather than a hospital room, and don’t want to worry about their doctor going off duty during the birth. Others want more control over their deliveries, and the freedom to have their friends and family participate. Still others say they want a chance to really get to know the person who will help them deliver the baby.
Carrie Scarpino, 24, said she wanted to give birth at home because she didn’t want people running around and bright lights shining on her. So with Brown’s help, Scarpino gave birth to her son Joshua in her childhood bedroom. Her labor was 15 hours, and the baby weighed 10 pounds, 8 ounces.
“Even though it was painful, it was perfect,” Scarpino said. “It was everything I wanted it to be.”
On average, Brown has a caseload of between eight and 20 women, and helps deliver between two and four babies a month. Being a midwife requires tremendous sacrifice, Brown said. She is on call 24 hours a day, doesn’t take weekends off and rarely takes a vacation. She is married and has two sons, ages 4 and 24.
“My clients come first above my family,” she said. “That’s the way our life is. It’s a lifestyle, it’s not a job.”
Brown said many of her clients have become her extended family. After the babies are months or even years old, Brown continues to receive frantic phone calls from moms with questions on teething, chicken pox, the flu.
Less than a week before Long’s due date, she came in for a prenatal checkup. She was confident, but full of nervous energy. When Brown put the ultrasound on her belly, Long said, the heartbeat sounded like a trumpet.
When Brown asked Long how the baby felt inside her, Long said it felt like he was wiggling his toes against her side.
Then on Aug. 14--her due date--Long began having contractions, and called for her midwife at about 1:30 a.m. Brown arrived at the center at 3:30 a.m. to set up for the birth, and Long and her fiance, Vade Long, drove from La Conchita to Ventura four hours later.
*
In the home-like center on Main Street, photographs of moms and babies decorate the walls. A box of toys occupies a corner of the living room, next to bookshelves filled with birthing literature and photo albums. In the bedroom, flowered sheets and fluffy pillows cover the bed.
For much of the day, Long lounged in a rocking chair in the bedroom, breathing, and moaning through her contractions and being comforted by her fiance, her mother and her midwife.
Caroline Fedotowsky said she was thrilled her daughter decided to have a natural delivery at a birthing center rather than in a hospital. “There’s such a world of difference,” she said. “I would have loved to have given birth with a midwife. But back then, it wasn’t that common.”
Her daughter’s labor was long and tiresome. Finally, at 9:40 p.m., Long stepped into the bathtub, and started pushing at about 10. Brown guided her, and continued to check the mom’s cervix and the baby’s heartbeat until he sounded his first cry at about 11:30 p.m. Then, as young August Vade Long rested on his mother, Brown carefully cut the umbilical cord. The new mother wrapped her arms around her baby and kissed her lightly on the forehead.
Shortly after the birth, Long said she couldn’t imagine having a better experience delivering her first child.
“Karni was pretty awesome,” she said. “I don’t think there is any other way to do it.”
*
About This Series. “On the Job” is an occasional series about working people in Ventura County and how their lives have been shaped, challenged and enriched by what they do. This installment focuses on the work experiences of Ventura midwife Karni Seymour-Brown.
