Island Babies

Published 1:00 pm Saturday, August 13, 2005

Five-year-old Jacob Bachman picks up a stethoscope and listens to the baby’s heart beating inside his mommy.

It’s not unusual for Jacob and his two siblings to attend mom’s checkups here at the Greenbank Women’s Clinic and Birth Center.

Having a baby is always a family affair in the Bachman family. The newest addition is due Aug. 25, and like the baby’s siblings, will be born at the family home in Oak Harbor.

Karey Smisek Bachman strongly believes in natural childbirth.

“The idea of giving birth in a hospital has never appealed to me,” she said.

Midwife Cynthia Jaffe will attend the birth, as will Jason bachman, the baby’s father, and any Bachman’ children awake at whatever hour the baby arrives.

Regardless of the hour, attending births is all in a day’s work for Jaffe. Since earning her Midwifery License from the state in 1991, she has attended more than 900 births.

Jaffe said she delivers about 30 percent of the babies born on Whidbey Island.

While a staunch advocate for natural childbirth, Jaffe says it just isn’t an option for some women. Either they want access to heavy-duty pain relief or suffer from physical conditions that require medical intervention or support.

Her first step is reviewing a patient’s condition and ability to undergo natural childbirth.

“We believe everyone should make an educated choice,” Jaffe said.

Baby docs reduced

But the choices are shrinking. The number of pre-natal and baby delivery options are shrinking on Whidbey Island.

The cost of malpractice insurance is rising like a thermometer exposed to fever. The ability of docs to deliver babies is endangered by insurance costs too steep to pass on to patients or their insurance providers.

Insurance costs have driven out all but one doctor. Dr. Lucie Riederer, an obstetrician and gynecologist, continues to deliver babies. And Whidbey Naval Hospital employs physicians to deliver babies for military families.

About 800 babies are typically born each year on Whidbey. About half are delivered at the naval hospital. About 200 are born at Whidbey General.

The commissioners of Whidbey General Hospital are exploring options to give support to Riederer, who after all can’t be on call 24 hours a day, and also broaden the choices for expectant mothers.

The commissioners are considering hiring a doctor to assist with gynecological surgeries and two part-time nurse-midwives.

Kate Sutherland knows all about bringing babies into the world. She works as a labor and delivery nurse at the hospital. She is an Advanced Registered Nurse Practitioner and also is a board certified nurse-midwife.

She is not employed as a midwife by Whidbey General. But before she came to Whidbey three years ago, she headed the midwifery program at Virginia Mason Hospital until the hospital got out of the baby business. Midwives used to deliver 50 percent of the 400 babies born each year at the Seattle hospital, Sutherland said.

The difference between Jaffe and Sutherland is the scope of services they can provide to patients.

Jaffe is licensed by the state to handle the normal childbearing cycle with healthy mothers who don’t have any health risks. She can administer some pain relief. She delivers babies in the home or in her birth center, which is set amid peaceful gardens at Greenbank.

Jaffe said some women prefer birthing at home, but others may lack the type of setting for a safe and comfortable delivery. The birth center is homey, with instruments and equipment tucked away out of sight. In addition, there’s a jetted tub to ease childbirth pangs.

Sutherland can care for maternity patients coping with moderate health risks. She also can order and give pain medications and assist a physician with Caesarean sections.

All midwives licensed to practice in Washington are trained to examine and test their patients to spot abnormalities in pregnancy and birth. They must consult a physician when a problem is suspected.

Sutherland has chosen to only do deliveries in hospital settings, but like Jaffe believes in providing all the options so women’s birthing needs are met.

Midwives deliver

Laura Rookstool is a physician’s wife who has experienced seven home births. Her first two babies were born in hospitals, with no complications.

Rookstool said she was attracted to natural birth — the more she heard about it from friends and from her own reading.

She told her husband that she wanted their third baby delivered at home, with the assistance of a midwife. She said Dr. Bob Rookstool was skeptical. After all, he had delivered babies himself, and was tuned into the hospital model of labor and delivery.

The Rookstools were based in Japan at the time. Laura hired a midwife and Bob was present, but in the role of a father and not the doctor.

The experience was so positive that the couple chose home delivery for the six children who would later arrive. Their nine children range in age from 24 years to 10 months.

Rookstool works as an ER doctor these days, but was always present when a new baby arrived. In fact, baby number 6, Abigail, was hanging on her father’s back when he caught the entry of her sibling into the world at their Coupeville home, Laura said.

Jaffe attended several of the Rookstool births, her calm competent manner appreciated.

“Cynthia (Jaffe) is such a wonderful presence.” Laura Rookstool said.

Combine the midwife training with gender, who can better understand the birthing process, she said.

“It seems right to have a woman there,” she said.

Rookstool said, “Midwives have tricks of the trade, so to speak, to help a woman with delivery.”

One of those techniques is finding just the right position for giving birth, which differs among women.

Jaffe said, “The most unfortunate way to give birth is lying down.”

Sutherland said midwives take time to work with women through the labor process, calming fears that can impede the process.

Midwife Janette Gyesky joined Jaffe’s practice a couple of months ago. Like Jaffe, she met the educational requirements to obtain a license from the state. In addition, she had to attend 100 births and was in charge of 30 of them before she could start working professionally.

Gyesky said if women are fearful, often due to lack of knowledge, the tension and pain may escalate.

“We want a safe, gentle birth,” she said.

Jaffe said both Whidbey General and Island Hospital have been supportive of both patients and midwifery.

No matter where a birth transpires, “Midwives want it made a wonderful event that’s worth remembering,” Jaffe said.

The wonder and conscious experience of birth is what Karey Smisek Bachman plans with her fourth home delivery. She does lots of visualizations, walks through early contractions, takes a dip in the tub, and relies on her family and Jaffe for encouragement during the most natural of human processes.

“I have to remember to have faith in my body,” she said.