Only six hours after the birth of her second son, Kira Smith is transported to a nearby hospital.
Following delivery, this would be her second severe postpartum hemorrhage out of her two pregnancies. Kira’s firstborn was delivered in a hospital, which is the somewhat traditional approach to birth. Without pain medication, the delivery and experience was “decent,” according to Kira.
Four years later, her second child is being delivered at home, and this time, Kira is assisted by a midwife. Specifically, the midwife who trained her. According to Kira, her experience with a mainly at-home birth and the use of a midwife was “phenomenal.”
Now a Certified Professional Midwife (CPM) at The Natural BirthHouse, Kira Smith averages between 2-4 patients monthly. Her facility, located in Broussard, Louisiana, is one of the very few freestanding birth centers in the state and provides midwife and doula services.
A midwife is a healthcare provider trained to assist women before, during and after their pregnancy, including prenatal care and delivery. Although a midwife can deliver in-hospital, many are still licensed for at-home delivery, either meeting the client at their home or providing a facility. A doula, which is certified labor support, does not provide medical assistance.
The rise of midwifery and doula care, in and out of hospitals, may seem to be attributed to the growing interest in natural health and birth techniques. This type of personalized care, compared to hospitals, may also provide the opportunity for a more enjoyable birth experience.
Brenda Broussard, Women’s Health Nurse Practitioner (WHNP) and Certified Nurse Midwife (CNM), refers to this demand for natural birth as the “home-birth movement.”
“The theory is that birth is normal and we treat it like a disease, so by putting it in the hospital, it’s within that medical disease model,” Broussard said. “The fewer the interventions, the better, and that’s why women tend to want to be at home.”
Studies have shown that home birth is safe, according to Broussard, and that collaborative practice between hospitals and midwives are becoming more common.
Another obstacle for midwifery practice and home birth is the somewhat normalized dependency on hospitals.
Broussard also said that in Louisiana specifically, however, the rise in midwifery practice tends to be more closed due to location which affects demand. Nurse-midwifery, the more common form of practice in Louisiana, provides mainly in-hospital midwifery care, which may be a more comforting option to those still questioning. According to Broussard, however, hospitals can tend to look down on natural birth-care like midwives and doulas, affecting the availability of such services.
“We have patients that are coming to us because we are midwives, sometimes driving two or three hours because there is no midwifery care in their communities,” Broussard said.
Aside from its similarities to most certified women’s health specialists, midwives may provide unique qualities for a more positive birth experience compared to traditional hospital birth.
However, the amount of OB-GYN practices, especially in Lafayette, may compete with midwife practices, according to Broussard.
“The pie can only be cut into so many pieces, and it really comes down to economics,” Broussard said.
Although there are obstacles such as cost and availability, however, the rise of midwives for births in the United States are steadily rising. According to the American Midwifery Certification Board, around 11,475 as of August 2016, were certified nurse midwives in the U.S.
According to Smith, her website search history shows the high curiosity rate of at-home birth. Her YouTube channel, where she is known as “CajunStork,” also provides informational content that ranges from client experiences to answering commonly asked questions. Getting someone to make further decisions, however, is where the challenge lays, which Smith said she believes is due to misinformation.
“I think women want this option, and now it’s a matter of educating them that it’s a safe option,” Smith said.