Sioux Center Community Hospital building

Written by Earl Horlyk and Published in Siouxland Life (July 2009)

Midwives keep mom in charge of her pregnancy

Julie Hamann used to think giving birth with a certified nurse midwife was "too new-agey or too hippy-dippy" for her to consider.

That is, until Hamann, a former newspaper reporter, researched the topic of midwifery while pregnant with her now 15-month-old daughter Gabbi.

"I thought having a midwife meant having the baby at home," she said, laughing. "Or it meant having a natural childbirth without drugs. I knew when I was nine months pregnant, I was gonna need drugs and I was gonna need plenty of 'em!"

Once Hamann contacted Belinda Lassen, a certified nurse midwife affiliated with the Sioux Center Medical Clinic, her initial concerns were put to rest.

"Belinda took time to get to know me," Hamann, a Correctionville, Iowa, resident, said. "She walked me through the physical and emotional changes I'd be going through during my pregnancy, taught me how to maintain good health habits and made me feel like I was an active participant in the birth of my child."

Hamann added: "I never felt like just another number with Belinda."

"People often have misconceptions about midwives," Lassen, the sole certified nurse-midwife in western Iowa, said. "They think of it as being what frontier women from 'Little House on the Prairie' used to do when they were pregnant."

At the beginning of the 20th century, 50 percent of all U.S. babies were born with the assistance of midwives. This tradition waned in the 1910s when babies increasingly were born in hospitals. This was seen as a way to combat infant mortality rate. Hospitals had the latest medical equipment and the support personel needed in case a problem arose during problem pregnancies.

But, according to the American College of Nurse Midwives, the number of certified nurse midwives and certified midwives-assisted births has risen nearly every year since 1989. In 2006, the most recent year for which statistics are available from the National Center for Health Statistics, certified nurse-midwives and certified midwives attended 317,168 births, a record number. This represents 7.4 percent of all U.S. births or 10.8 percent of all vaginal births.

In 2006, 98 percent of certified nurse-midwives and certified midwives, attended births occured in hospitals. The other 2 percent occurred in either freestanding birth centers or in homes.

The reason women choose midwifery, according to Lassen, is because they want to be in charge of their birth process.

"A first-time mother is bound to really bone up on birthing options," she explained. "They want to know everything there is to know about the process and a certified nurse-midwife can offer a more individualized approach. Also, a woman who's already been through childbirth might opt for a midwife because she want a greater say."

The relationship between a family and a midwife can span the entire 40 weeks of a normal pregnancy since certified nurse-midwives can provide all aspects of prenatal care, labor and delivery and postpartum care independent from on obstetrician. But if a complication does occur, a referral to a doctor can be made.

"Certified nurse-midwives are experts when it comes to normal births," Lassen said. "But when a problem arises, there are other options."

Previously a registered nurse, Lassen would spend time in a delivery room with expectant mothers until the doctor came in.

"I'd develop this wonderful rhythm with mothers and, then, the doctors would come in at the last minute," she recalled. "Women would ask me all the time: 'Why can't you do this?' and that kind of planted a seed for me to get proper training to earn certified nurse-midwife status."

Affiliated with the Sioux Center, Iowa, hospital as a certified nurse-midwife for more than 19 years, Lassen has overseen nearly 2,000 births.

"Childbirth is the most natural thing for a woman to do," she said. "My main role is to facilitate the natural process of labor so a mother can deliver her baby as naturally and with as few interventions as possible."

"Motherly," Jody Haverhals, a Hawarden, Iowa woman, said from her hospital room. "That's the best way to describe Belinda in the delivery room."

Lassen has helped to facilitate the birth of all four of Haverhals' children, including Ethan, born April 29.

For Melanie Kaufman, Lassen wasn't just motherly. She proved to be inspirational.

A former registed nurse at Mercy Medical Center - Sioux City and St. Luke's Regional Medical Center, Kaufman decided to become a certified nurse-midwife after Lassen facilitated the birth of Kaufman's now 3-year-old daughter Raven.

"Most doctors are in the delivery room to catch the baby and are out while the mother's still in stirrups," she said. "I didn't want that."

Nor did Kaufman want a Caesarian section.

"First births take a long time," she explained. "I figured if my labor lasted 12 hours, I'd be a rock star. Instead, my labor lasted 18 hours. Had I gone a more traditional route, there is no way an obstetrician would allow that. Belinda helped me to make choices that were best for me and not best for the hospital's schedule."