Birthing center celebrates decade of special deliveries

Mothers-to-be at the Cambridge Birth Center can consume the customary ice chips during delivery, but have also been known to try candied apples, yogurt, even granola.

Not everyone who comes here, however, conforms to your typical "crunchy" Cambridge stereotype. Rather, they represent a spectrum of backgrounds that encapsulates the diversity of Cambridge itself, but are united by the desire for a natural childbirth free of surgery or medication.

"There's the middle-class white feminists who are looking for alternative birthing practices, but there are also the Guatemalan moms who are thinking, 'Hospital? Who would give birth in a hospital?' because they've always known home as being the normal place for birth," said Carol Densmore, director of the center's doula, or birth assistant, program.

A Cambridge Health Alliance facility, the center is based in a Victorian next to Cambridge Hospital, and seeks to create a "homelike birthing experience" in a setting that replaces fetal monitors and IV drips with a kitchen, an outdoor garden, and three bedrooms equipped with Jacuzzis and queen-size beds draped with handmade quilts. Last year, the center's 10 nurse-midwives coached about 120 women through drug-free births, followed by recovery times that typically saw the women return home within 12 hours of the birth.

But even as the center celebrated its 10th anniversary this month and nears the birth of its 1,000th baby, it is staring down a series of challenges.

"This is a milestone for us," center director Christley Harris said. "But across the country, birth centers do fail," due to financial pressures. In Massachusetts, she added, "there were three centers, and now there are only two."

Birth centers, which are registered as ambulatory rather than in-patient sites, struggle to obtain reimbursement from insurance companies, and women considering giving birth at the center often encounter "external pressures from families, from their spouse, who don't understand the concept of the birth center," Harris said. "As midwives, we always hear families saying to women, 'Why do you want to have your baby in a birth center and not in a hospital, where there's a doctor?' "

Samilla Quiroa harbored similar doubts before the birth of her first child at the center on May 22.

"I'm from Brazil, where the C-section rates are just so high," said Quiroa, 25. "I had in my mind that I would have a C-section because everyone over there has one. Of all my friends, no one really tried to have normal deliveries."

She toured the birth center out of curiosity and found herself won over by the prospect of being able to give birth immersed in water and being surrounded by friends and family in the birthing room.

"I had a party during my labor because I had my brother videotaping and I had another three or four friends with me and my parents were here," she said.

Erin Tracy, an obstetrician and gynecologist at Massachusetts General Hospital, said birth centers are a safe option for women with low-risk pregnancies, so long as the center can make "quick and timely transfers of patients for emergency Caesarean section, if necessary." She also noted that some pregnancies believed to be low-risk end up having complications during delivery.

The presence of Cambridge Hospital - visible from some of the birthing-room windows - is reassuring to many families who choose to deliver at the center, which has worked hard to obtain the support of the hospital's administrative staff, Harris said. Last year, about one-third of birth center patients were transferred to the hospital for medical or obstetrical reasons, she said.

Jamaica Plain resident Ashley Graves Lanfer, 33, was a birth center patient who began childbirth at the hospital because of health concerns. But when that issue was resolved, she moved to the center to complete the delivery.

"I was in a traditional practice, a medicalized practice, and I got very competent but very clinical care," said Lanfer, who transferred her prenatal care to the center in her last trimester. "Sometimes the looming specter of the legal liability was present in the room with us in almost a palpable way. I felt like a patient who was ill, instead of this incredibly life-affirming thing that I was getting to participate in."

Her son was born at the center in September 2006, and Lanfer plans to have her second child there in August.

A recent tour of the center found several women sitting in the living room and waiting area, surrounded by ceramic sculptures and wood carvings on the fireplace mantel and a bookshelf filled with titles such as "Women's Bodies, Women's Wisdom."

The women come from all over the world and from a world of different backgrounds: a patient in a pink embroidered salwar kameez (traditional South Asian garb) smiled across the room at another patient wearing a stylish little black dress.

Kanae Kurok moved to Cambridge from Tokyo 18 months ago when her husband took up a research position at MIT. She found out about the birth center through a blog by a Japanese woman who had delivered there last year.

Through an interpreter, Kurok spoke gamely as she began to experience the contractions of early labor. In Japan, she said, partners are not permitted in the delivery room. "At the birth center, everybody is there working together, so it makes me feel very happy," she added, pausing on occasion to massage her lower back.

"I decided I wanted to rely on my own strength and not on medication. I wanted to have birth the way people have had it for thousands of years."