Midwives offer women special deliveries

FAIRFIELD, Conn. --It all started because Pam Luise is afraid of needles.

So when the 33-year-old Fairfield mom became pregnant with her first child more than eight years ago, it wasn't the pain of labor that most intimidated her.

It was the possibility she might be hooked up to machines, or receive an injection of anesthesia.

"I knew that, when I went into the hospital, they were going to stick me with a needle," Luise said.

Hoping to avoid needles, Luise delivered using a nurse-midwife. Nurse-midwives are advanced practice nurses with additional training in childbirth and prenatal and postpartum care. They tend to focus on how pregnancy affects each woman physically and emotionally.

Luise opted for a nurse-midwife because she thought it would be a more "natural" delivery. Though doctors sometimes assist in midwife births, Luise decided to use a midwife. After some searching, she found Katy Despot, a certified nurse-midwife practicing in Trumbull.

Despot worked with her during her pregnancy and birth. She kept Luise calm through the delivery of her child without the use of medication or needles.

"It was very easy and very successful," Luise said. "Katy is so calm and so reassuring, she relaxes you just by talking to you."

Luise now has three children and is almost five months pregnant with her fourth child. She's never had a physician for any of the births -- only Despot -- and plans to continue with her approaching birth.

According to the National Center for Health Statistics, 305,606 births in the United States were attended by certified nurse midwives in 2001, the most recent year for which statistics were available.

In Connecticut, nurse midwives attended about 5,000 births in 2000, according to the state chapter of the American College of Nurse Midwives. The college also reports that, though nurse-midwives deliver babies in hospitals and in homes, most births attended by certified nurse midwives occur in hospitals.

Nurse-midwives may perform births alone if no complications ensue and some women, like Luise, prefer the option. That's likely because nurse-midwives provide more personalized care than a regular physician, said Mary Ellen Rousseau, director of Yale University's School of Nursing's midwifery specialty, the state's only such graduate program.

"The biggest part is building a relationship with the women," Rousseau said. "The doctors are high-tech. We're low-tech, high-touch."

Certified nurse-midwife Debbie Cibelli is the former chairwoman of the Connecticut chapter of the American College of Midwives, and co-owner of Women's Health Associates, a nurse-midwifery practice with offices in New Haven and North Branford. She said nurse-midwives generally spend more time with women during office visits than physicians.

"Most prenatal visits with patients are 15 to 20 minutes," Cibelli said. "Physician visits tend to be about five minutes."

Nurse-midwives also spend a lot of time educating patients about the birth process. By the time the baby comes, the midwife and patient know each other well and are comfortable with one another.

There are about 150 certified nurse midwives in Connecticut, including Despot. She works at Women's Health care LLC and is in practice with two obstetrician-gynecologists, and patients have the option of seeing Despot, one of the doctors, or a combination.

"They are looking for more reassurance and care at their bed side," Cibelli said.

Rhonda Simner, 28, of Trumbull used Despot to help deliver her first child in March because she wanted a natural birth.

She said she liked the way midwives "look at the whole person," and always try to make the process as noninvasive as possible. For instance, Simner's son was delivered 11 days past her due date, and she's not sure she would have been able to deliver naturally if Despot weren't present.

"I think you get amazing one-to-one contact with a midwife," Simner said. "She was with me the whole time, from when the contractions started to be regular to the delivery."