When Jamie Winn prepared to deliver, she didn't pack a bag or head to the hospital. She and husband Justin invited a midwife into their Temple Terrace home.
"My entire life, I had always assumed that when I did decide to have children, I would have a hospital birth. I never considered any alternative," she said.
It's been three years since the Winns transformed their master bedroom into a delivery room and welcomed their son River to the world. That experience - one Winn shares with about 3,000 Florida women each year - counts for less than two percent of total births in the state and nation, new data from the National Center for Health Statistics show.
A century ago, nearly every baby in the United States was born outside a hospital. Today, the opposite holds true. But more families are choosing delivery options at birthing centers and at home, with the help of licensed midwives. Each year, roughly 54,000 babies in the United States are born in a non-hospital setting.
Midwife Kim Verbarg said the low numbers didn't stop the Winns from wanting to recreate the quiet, low-stress setting for baby number two late last month.
"Well, it was a really beautiful evening. It had been raining that day. When I got here, they had the candles lit. And the windows were open a little so you could hear the rain falling,” said Verbarg, a licensed midwife and owner of Sweet Child O’Mine midwifery center in Brandon. “The energy in here was just really good. They had a variety of different kinds of music, really relaxing."
Florida is one of 28 states where midwives are legally allowed to assist in an at-home birth. Women who want to give birth at home must have low-risk pregnancies, state rules say.
Verbarg says these deliveries are designed to put mom in charge.
In Winn's case, she could move around the house during labor and deliver in a birth pool set up in the family's living room. Winn says that helped as she labored to deliver baby Russell, now a cooing one-month-old.
“I ended up laying on the floor for most of it, like on my side, like even dozing in between contractions, listening to the music, psyching myself out you know. And it worked until I got to about 8, 8-and- a-half centimeters, and then all hell broke loose basically,” she said. “And I did get in the tub, maybe two, three hours before Russell actually came."
A week before Russell's birth, the American College of Obstetricians and Gynecologists took an official stance against water births. The group previously issued similar concerns about home births.
The review's chairman, Boston obstetrician Jeffrey Ecker, says laboring in water can help with a mom's pain, but newborns face some rare, serious risks. That includes exposure to infection and trouble regulating a baby's temperature in the water.
"There are lots of ways patients and doctors can talk and meet and come up with a plan for birth that addresses needs and concerns for the family, short of engendering fear,” he said. “But also, following a course and path of interventions that are safe and appropriate. I don’t think, our group does not think that delivery under water is a safe and appropriate choice for folks.”
Verbarg, who has practiced as a midwife for 20 years, said doctors who deliver in hospitals are unfamiliar and uncomfortable with water births. Licensed midwives have stringent guidelines outlined in state rules. They say how midwives can and can’t practice, who is low-risk and eligible for care, and when midwives have to consult with or transfer care to an obstetrician, she said.
"I disagree. You know, I've done hundreds of water births and I haven't had any issues with respiratory distress or cord issues we couldn't take care of right away," she said.
Jamie Winn understands that not all moms would be comfortable delivering their baby in water, or at home.
“I felt like the water was a great asset to me this time. I appreciated it. And they are likely scaring off a lot of women who may have otherwise considered using water to aid them in their labor,” she said.
She says stepping back and deciding how and where to deliver is a tough, personal decision that each family must make on its own.
"You have to make sure you are not afraid to do it. I wasn't afraid to give birth at home,” Winn said. “I felt like it was something that I could do. I was even looking forward to the experience."
For this mother and her family, the best decision was to just stay home.
--Health News Florida is part of WUSF Public Media. Contact reporter Mary Shedden at (813) 974-8636, on Twitter @MaryShedden, or email at shedden@wusf.org. For more health news, visit HealthNewsFlorida.org.
