By Kenton L. Sizemore, M.D.

I read with interest the recent news articles and opinion pieces regarding obstetrical care here on Whidbey Island. It has been particularly interesting to see how these articles and letters have provided the midwives on the island advertising, while contributing little to the solution of the problem. I hope that even those who are most actively cheerleading for the midwives will be interested in another opinion on the issue.

As I read the August 13 article in the Whidbey News-Times, I found myself agreeing with most of what was said. I do not believe there is any argument about the long and proud history of midwifery, nor the usual “naturalness” of the labor and delivery process or the desire to make it a pleasant, memorable and rewarding experience for those involved. However, one point that was not emphasized enough was, “What happens when this natural process takes an unnatural turn?”

When there is a problem, either pre-delivery or during the labor and delivery process, a midwife sends/takes her patient/client to see an obstetrician at a hospital. Without a competent obstetrician and a quality hospital to provide backup when there is a problem or emergency there can be no safe midwifery, unless we wish to return to the high maternal and infant mortality of the 1800s. Whidbey General Hospital would continue to provide quality, compassionate obstetrical care without a single midwife on the island, but is the opposite true? Even among those who might choose home delivery with a midwife, would anyone feel comfortable entering the labor process without a quality hospital and physician providing back-up, just in case?

In addition there are those women who choose not to deliver, or find that the pain of labor in their situation precludes delivery without modern pain relief techniques, such as epidural anesthesia. For those who wish to deliver without pain medication or epidural anesthesia, that option is available in the hospital as readily as with a midwife. To my knowledge, no woman has ever been forced to accept pain medication at Whidbey General Hospital.

To imply that the only way to have a so-called “natural” birth (is there such a thing as natural appendectomy or tonsillectomy done without anesthesia?) is with a midwife is nonsense. At every hospital at which I have performed deliveries, including Whidbey General, a woman’s wishes for pain relief, or lack thereof, have been honored. However, those who choose to deliver with a midwife on Whidbey Island have their pain relief options limited to “little or nothing.” For some women little or nothing is sufficient, but is it fair to not have something better to offer for those who need or want it? On a regular basis when a patient/client is brought to Whidbey General by a midwife, in labor, among the first words out of her mouth are, “May I please have an epidural, now?!”

Lastly, midwives do not have a monopoly on compassion, concern, support, kindness or other human qualities. Once again, to so imply is unfair and a gross misrepresentation of the truth. Whidbey General Hospital has a wonderful labor and delivery unit, now called “Whidbey Family Birth Place.” There are well-trained compassionate nurses to provide support during the labor process. In addition, there are birthing balls, a Jacuzzi and private rooms that are tastefully decorated where families can have as natural of a birthing experience as they wish. The days of bright, cold delivery rooms are gone forever. Of course, Whidbey General Hospital also has 24/7 availability of epidural anesthesia, a lab with a blood bank and an operating room with the ability to perform emergency cesarean section if needed. Basically, the best of both worlds.

We have read in the pages of this newspaper a great deal about midwifery on Whidbey Island. On the other hand, I know there are hundreds of women who have delivered at Whidbey General Hospital who had an overwhelmingly positive experience, and would not choose, if there was a choice, to deliver any other place. It would be interesting to hear from some of those women in the pages of this paper. Do the citizens of Whidbey Island want midwifery to be the only childbirth option on the island? I sincerely hope not.

Kenton L. Sizemore, M.D., practices in Coupeville, although he is leaving the island shortly for an opportunity elsewhere.