Alabama Midwives Wait To Come Out Of The Shadows

May 25, 2017

It looks like the 2017 legislative session ended with big news for expectant mothers in Alabama. After thirteen years of lobbying, lawmakers voted to let midwives can come out of the shadows and practice legally in the state. APR’s Pat Duggins has more as midwives wait for Governor Kay Ivey’s signature to make it all official…

We're heading into a collection of shops in downtown Cullman. While business as usual takes place downstairs, something else is going on upstairs. A midwife is at work. Karen Brock uses a hand held heart monitor on today’s clients. James Parker Nelson and his wife Holly are expecting their fourth child. And, Holly says before you ask, yes, they’re repeat customers and so is their extended family…

“Well, this midwife delivered my husband’s…two of his siblings. So, we had already heard about her, and she knew his family. And, I guess people who know midwives…I think she comes highly recommended. We all love her!”

And, Brock says her resume comes with a specific skill set, when things go routinely, and when they don’t… “I can resuscitate a baby, I’m certified in infant and neonatal resuscitation. Thankfully, I very seldom need it. Healthy moms…healthy babies are meant to live. And you don’t often need those emergency techniques or skills.”

But, up to now, state law says it’s a misdemeanor for a midwife to attend a birth in Alabama. Today’s exam includes things like things like nutrition. Husband James says that’s where he comes in. “You remember what she ate over the past couple of weeks, or so. So I help fill in the gaps there. Make sure everything…make sure everything…remembering those different areas of life, all those things we’re gonna be doing, so those decisions we’ll make all jibe together.”

There was more than a little talk about politics during today’s exam along with the pro’s and cons of sweet potatoes. Our visit came in the final hours of the legislative session where lawmakers debated a bill legalizing midwifery, yes, that’s the term. I asked Brock if even today’s coaching session was legal. She just shrugged her shoulders.

After Holly and James wrap up and head out, James’ brother Phillip and his wife Macauley come in for their exam. It’s their first visit with baby number two on the way—but Brock handled baby number one. Macauley says after having a midwife, she’s never choose a hospital experience…

“Lay on the bed, put your legs up…with every woman being different with how they labor. And, so the freedom of just laboring however your body is telling you to is really comforting…with a midwife specifically.”

But, Phillip and Macauley know from firsthand experience how dicey using a midwife in Alabama can be. Since their first delivery happened during the state’s ban on midwives, they had to drive to Tennessee where it was legal. The process means going to what’s called a birthing house where their midwife oversees the process. Macauley says that took two hours…

“It seems like four hours when you’re in labor…like, we’re never gonna there.”

And, they almost didn’t for baby number one. Phillip says he and Macauley headed north when she went into labor. Brock followed in a separate car… “They left and then a wreck happened. And they were stuck and that wreck took seven hours for people to get through.”

That meant Macauley faced the possibility of going through the big event, without the midwife she was used to. Phillip says it got tense in the car…and he means tense for him…

“I just hoping she’d get there, because I didn’t want to deliver the baby, I didn’t know what I was doing!”

“My mom was there with us as well," said Macauley. "And she kept saying ‘we’re going to have to deliver this baby,’ she jumps to the whole…she wants to be active in the situation. But, she jumps to the extreme.”

Brock detoured around the accident and arrived in time. It’s a story with a happy ending now, but Brock says it points to more serious issue in Alabama. Namely, the state’s infant mortality rate which leads the nation.. “We go neck and neck with Mississippi, and it’s not because of midwives. Midwives could help the situation.”

Phillip says he and Macauley are choosing the natural child birth route. But, if they had to go to a hospital, they say it would be worse… “To the hospital in Birmingham, it would take an hour and a forty minute, I believe. It would longer than going to Tennessee for us, because I have to travel a lot longer distance to get there.”

The Parkers live in Lawrence County, and getting obstetrical care is a growing problem in rural areas. Only twenty nine of Alabama’s sixty seven counties have hospitals that can handle a birth, and rural families routinely face a drive of fifty miles or more to get help. More and more hospitals in Alabama are closing their birthing units as a cost cutting measure.

For Karen Brock, the notion of finally coming out of the shadows as a midwife means carrying on a family tradition. Her grandmother was one… “I remember her doing one birth that I could actually remember. So, mostly for me being one of the younger granddaughters, Alabama had stopped midwifes at that time.” But, legality could also mean losing sleep. “The part that would be a lot easier for me is helping these moms because they call in the middle of the night, and ‘is this labor?’ If I could just run to their house, and say ‘oh, yes, this is labor’ or no it’s not, or whatever. That would be very beneficial. I’d have happier moms.”

And not just the moms and dads… “And grandparents I may say," says Brock. "Because I’m doing a whole lot of second generation families. And those grandparents are very angry that they’re watching their daughters or sons have load up and drive off to Tennessee, and they’re not happy at all with it. It would be a happier, less stressful situation for everybody.”

And, with a stroke of the pen by Governor Kay Ivey, these grandma’s and grandpa’s can be there to hand out cigars with births closer to home with midwives in charge.