As Melissa Morrison stood in her shower, her husband Todd remained by her side.
“You can do this,” he repeated to her over and over again.
Melissa Morrison was giving birth at home – for the second time.
The Morrisons live with their six children on a 17-acre farm in Hillsboro, Todd Morrison directs a youth orchestra in Purcellville, and Melissa Morrison stays home to take care of the kids, raise poultry and bake her own bread.
The Morrisons have not always taken the organic path, however; until four years ago, they lived in Sterling and had their children at Bethesda Naval Hospital.
“I had never been all that happy being in a hospital,” Melissa Morrison said. “They just assume that there's going to be complications.”
After moving to Hillsboro, she found Certified Professional Midwife Liz O'Shea and decided to give birth with as little medical intervention as possible – meaning, no sonograms or ultrasounds and not much medical monitoring.
While the labor was long and hard both times, Selah (in 2011) and James (in 2012) were born without complications.
“We call these last two our organic babies,” the mother said.
Loudoun County is one of the biggest baby producers in the nation, with a birth rate in the top 50 counties, according to the Centers for Disease Control and Prevention. New maternity wards, natural birth centers and midwife services have correspondingly flourished across the county.
Because of this, mothers-to-be are increasingly able to choose their own way to give birth. The hospital, while still popular, is no longer the only option.
The Birthing Inn
|Photo Courtesy/Morrison family|
Melissa Morrison holds her son James Robert on Feb. 15, 2012, the day of his birth.
Cindy Andrejasich, a nurse and birthing navigator at the Loudoun Ladies Board Birthing Inn in Leesburg, greets everyone with a warm handshake and a loving smile. If you know her well enough, she will probably give you a hug.
Andrejasich has been an obstetrical nurse for 30 years, including stints in southern Florida and Switzerland. However, she loves The Birthing Inn the best – she has worked there since it opened in 2003.
“It's just such an amazing privilege to be able to help women and to be involved with women during this most important time in their lives,” she said.
The Birthing Inn is a revolutionary maternity ward in that it tries to unite advanced medical aids with a relatively homelike setting. New mothers can give birth and recover in the privacy of nine labor rooms and 24 postpartum rooms, each with its own bathroom and seats for guests.
The hospital offers wireless monitoring and soaking tubs for natural births, while two cesarean section operating rooms and epidurals are available for medicated births.
As a birth navigator, Andrejasich meets couples before the birth so she can answer their questions and help them fulfill their wishes.
She decided to make birth navigation a more formalized service after watching many couples who were confused or frightened by giving birth in a hospital setting.
“It really can appear a lot more overwhelming than it is,” Andrejasich said.
She is always on call to answer couples' questions – she even sleeps with her cellphone. However, Andrejasich has noticed that mothers increasingly know what they want for their baby.
“Women are much more knowledgeable, much more empowered and very articulate,” she said. “They're much more savvy, and their partners, too.”
Midwives at the Inn
|Times-Mirror File Photo/Beverly Denny|
A delivery room at the Birthing Inn of Inova Loudoun Hospital in December 2010.
Margie Brandquist loves it when women know what they want in a birth experience.
As the co-owner of Loudoun Community Midwives and the author of the pregnancy guide "Birth Happy," she believes women should feel empowered no matter what kind of birth experience they have.
“I'm a firm believer that there's no perfect way to have a baby,” Brandquist said.
Brandquist is a Certified Nurse Midwife, or a midwife who has received nurse training in addition to midwife training. Loudoun Community Midwives only delivers babies at The Birthing Inn, providing consistent coaching and non-interventive care with medical aids at hand if necessary.
“Midwife means, 'to be with woman,'” Brandquist said. “It's kind of like having your best friend with you.”
Loudoun Community Midwives has delivered more than 4,000 newborns since Brandquist opened it in September 2003 with fellow midwife Wendy Dotson.
The midwife service is covered by most insurance companies and costs the same as a normal obstetrician.
First-time mother Betsy Paine had Brandquist as her midwife for her birth seven weeks ago.
She attended prenatal meetings with her best friend, Kate. When she had to have an epidural for her 9 ½ pound child, Brandquist supported her decision.
"They really treat you as an individual, a whole person," Paine said. "They just want what's best for you and the baby."
Call the doula
Instead of, or in addition to a midwife, some women choose to have a doula at their child's birth. Doulas do not have medical training, but they can be certified as a kind of "birth coach" that aids a woman during labor.
Leesburg-based doula Mari Stutzman Smith began her business Celebrated Birth after a doula helped her give birth to her first child.
"I really wanted to help people the way my doula helped me," Smith said.
Smith meets with women before, during, and after labor for $1,200, a fee that is sometimes covered by insurance.
"I'm sort of like the team leader," she said.
Smith will help women have a natural birth wherever she is needed – while she often helps women give birth in hospitals, she also enjoys attending home births and births in natural birth centers run by midwives.
Kate Davinroy hired Smith last year when she had her son Joey at NOVA Natural Birth Center in Chantilly.
"We aren't anti-hospital per se," Davinroy said. "We wanted to keep things as private as we could."
While she had a hard labor, Smith helped her walk around the birthing center bedroom, which looked like a hotel room with a queen bed, soaking tub and decorative palm trees.
Davinroy believes that she could never have had Joey naturally without Smith's help.
"It was the hardest work I've ever done. Every muscle hurt. Every hair on my head hurt," Davinroy said. "We knew we needed a little extra support to be really successful."
Letting nature take its course
As a young nurse in the 1970s, Peggy Franklin was disturbed by the then-current hospital practice of sedating mothers during labor.
She decided to leave the hospital system in 1997, when she earned her certified professional midwife degree. In 2011 she opened NOVA Natural Birth Center, the only birth center in Loudoun County to be run independently by CPMs.
CPMs are not legal in all states because many officials are suspicious of their small amount of medical schooling. Virginia only began to regulate them in 2005.
"We're still fighting it out nationally," Franklin said.
CPMs make up for a lack of formalized training with practical experience: they must attend more than 100 births to be certified with the North American Registry of Midwives.
Franklin has heard many challenges to home birth, including claims that it is less safe for both mother and baby.
In some cases, she agrees: like most midwifery practices, NOVA will not accept women who cannot safely have a natural birth.
However, she believes that for most women, even driving to the hospital interrupts labor and leads to medical intervention: "It affects mom's thoughts."
She referred to a 2005 British Medical Journal study of CPM-assisted births in North America, which found that infant mortality was comparable to low-risk hospital birth.
"Birthing's kind of like life in general. There are no guarantees," Franklin said.
NOVA Natural Birth Center offers the comforts and natural setting of a home birth without the clean-up afterward. Four private birthing chambers offer soaking tubs for water births. There are no fetal monitors or epidurals, so women can walk around and eat while in labor.
"You just kind of let nature take its course," Franklin said.
Costs for a CPM like Franklin begin at around $4,000, not including a facility service fee for using a birthing center. Insurance may or may not cover the fee, although the Patient Protection and Affordable Care Act will make insurance companies cover many licensed maternity professionals beginning in 2014.
Becoming more aware
Melissa Morrison remembers how exhausted she was after her first home birth with her daughter, Selah, in 2011.
"She came out and they put her right on my belly," Morrison said. She was so exhilarated – yet so tired – that she did not even check the baby's gender.
"Giving birth is so much about trust," she said. "Women are just becoming more aware. There is another option."
Doula Mari Stutzman Smith agrees: "Virginia's a great state for options, and Loudoun as well. … The biggest thing for me is having trust in my providers."
See also: The business of changing minds