A guide to nontraditional birthing options in Southeast Missouri

Having a baby can be a joyful, beautiful and stressful time in a woman's life. With the limitless amounts of information on the internet and an abundance of advice from family and friends, it could be difficult for any woman to determine which birthing plan is the best for her.

Although natural childbirth with a physician is the most common practice throughout the country, alternative options like having a water birth and working with a midwife are becoming more available locally.

Tracy Carr, a certified nurse midwife at Saint Francis Medical Center, says alternative birthing options are available to women in Southeast Missouri, but a number of women simply aren't aware of them.

"Midwives are very popular in other areas, just Southeast Missouri has no idea that we exist, so we're trying to get the word out," she says.

In terms of available obstetric options at Saint Francis, Carr, who was trained as a nurse first, then went on to get her master's degree in nursing and added the midwifery specialty, is available to care for low-risk women (those without high blood pressure, diabetes, previous cesarean sections or other pre-existing conditions) from the beginning of the pregnancy through delivery and postpartum.

She also can help women with annual exams, birth control and management of menopause.

"I can do just about anything outside of surgeries," she says.

As a midwife, Carr says she is able to, in some cases, provide a closer relationship with her patients throughout their pregnancies.

"We tend to be a little bit closer than some of the physicians; it's just a different way of managing," she says. "We're taught to be nurses first ... 'midwife' actually means 'with women,' so we tend to be there labor coaching a little bit more when we can."

Kelly Donze, a certified nurse midwife at Ste. Genevieve County Memorial Hospital in Ste. Genevieve, Missouri, agrees, saying she likes to sit down with her patients and discuss their expectations and the plan they desire for their birth.

Mother and baby

"One of the things we pride ourselves on is we do really think women should have a choice, and we encourage women to bring a birth plan in," she says.

Both Carr and Donze say properly educating patients and ensuring they know and understand all of their options is a vital component of choosing a birth plan.

"We do try to do a little bit more education, a little more teaching, that's just that nursing part of us," Carr says. "Doctors do teach as well; it's just sometimes a slightly different angle at it."

Ste. Genevieve also has a group health care model called CenteringPregnancy, which focuses on health, education and support for women to experience as a group during their pregnancies.

"I think the information and education that our providers and nurses give women is very empowering for women," says Lisa Bird, a registered nurse and director of the Women's Health and Childbirth Center at Ste. Genevieve. "We feel like our patients are really engaged."

Donze says she enjoys offering women an array of options during their pregnancy to decide on the best plan for them.

"Research does show that those women have better perceptions of their delivery, better outcomes, less postpartum depression; so that's all very important," she says.

Both hospitals offer water births as an option.

In Ste. Genevieve, women can labor and deliver in a permanent water birth tub that maintains water temperature and helps sanitize the water.

At Saint Francis, women can labor in jetted tubs, but must bring their own birthing tub and supplies if they wish to deliver under water.

"Water is extremely comforting in labor, without a doubt, even if you just labor in the water," Carr says. "It is much more comforting than laboring out in the air because ... it's a sense of flotation, the pressure is less intense. It's not that the contractions are any lighter, they just feel better in the water because when their whole belly is submerged, it's much more relaxing, it's much easier to relax."

Along with natural birthing with a midwife, several techniques are available to help avoid using an epidural or medication while in labor.

Carr says the Bradley Method is a series of classes, more advanced and intense than Lamaze, that teaches breathing and visualization techniques, along with ways to position the body to manage pain throughout labor.

Hypnobirthing also is an option, Donze says, that incorporates hypnosis techniques to fight the fear and pain that come with natural childbirth. In addition, Donze says a nurse at Ste. Genevieve recently was trained in the rebozo method, which employs a long shawl to help relax the mother, support her weight and shift the baby if need be.

Carr says "lay-midwives," or women who act as midwives but are not clinically certified, can assist in home births, but may not be able to recognize significant birthing problems. She recommends working with a midwife on staff at a hospital, rather than an uncertified midwife in-home, to ensure there is backup available if any problems with the baby or mother arise.

"I have doctors behind me at all points in time so all I have to do is, if it even looks like something I haven't seen, all I have to do is walk down a hall or pick up a phone," she says.

Overall, Carr says women should know what options they have available and the different routes they can take throughout their pregnancies and deliveries.

"They should know that there are alternative options, and it's not for everybody, it's your own personal choice," she says. "But you should know that the option does exist, especially in this area; whereas it exists all over the United States, it should be an option to Southeast Missouri as well."