“There’s no better feeling than seeing a woman give birth to her baby, on her own terms, then look at you and say, ‘I did it,’” says Jennifer Crook Moore, a Birmingham midwife. Women, Moore believes, should not be forced to depend solely on hospitals and doctors for birthing, something women have been forced to do in modern times.
Moore has relied on natural childbirth herself, the first time when she gave birth to her oldest child, Gabriel. She experienced the same thrill she has seen on the faces of mothers she has attended. “He was big, and it took me a long time to get him here,” she says. “I pushed for two and a half hours. I will never have that feeling again, the biggest feeling of accomplishment in my life. I’m holding this little creature in my arms that I have successfully delivered from my body, with no drugs, nothing but good friends there to encourage me.”
Moore would like to give more Alabama women the chance to use midwives and experience natural childbirth, but there’s a problem — midwifery is, for all practical purposes, illegal in this state. Moore is licensed as a Certified Professional Midwife (CPM) in Tennessee and must drive there in order to serve as the primary caregiver for a pregnant woman or attend at-home births. “It’s not illegal to birth at home in Alabama,” Moore says. “But it is illegal for a midwife to attend that birth.” The state recognizes Certified Nurse Midwives (CNMs), but they can only work in a hospital under an obstetrician’s supervision, and it’s difficult for midwives to find doctors who wish to enter into that relationship. This limits the number of midwives available to Alabama women.
In recent years, Moore and others have attempted unsuccessfully to get the Alabama legislature to legalize CPMs, allowing them to attend at-home births. Moore is the legislative co-chair of the Alabama Birth Coalition (ABC) and serves on the educational committee of the Alabama Midwives Alliance.
Among the barriers to passing the bill, according to Moore, is the intense lobbying against natural childbirth by professional organizations of doctors and nurses, who raise safety issues. “I can provide you with a stack of studies that say it’s safe,” she says. Moore cites a study in the British Medical Journal that concluded that planned home births posed no greater health risks to healthy moms than hospital births.
According to Moore, natural childbirth is safe, despite the fact that midwifes try to avoid the technological interventions often employed by hospitals. “We want to be as hands-off as we can be,” she says. “You don’t have a higher rate of infant mortality if you birth at home. If you need lots of technology, chances are you need to birth in the hospital. But most healthy women don’t need that.”
The Midwives Model of Care (MMOC), an explanation of the practice of midwifery, is available atwww.cfmidwifery.org. According to the MMOC, the midwife should be aware of the expectant mother’s psychological as well as physical well-being, and provide her with prenatal care, assistance during labor and delivery and postpartum support, as well as individualized counseling in such areas as nutrition.
“It’s seeing a woman as a whole person, and not a vessel for a baby, which, unfortunately, happens a lot,” Moore says. “And getting to know one another. It benefits you in the labor because you’ve got a mom who feels comfortable with you. In labor, when a mom calls, she knows who she’s getting from the beginning, whereas in the hospital, you get the physician who’s on-call.”
According to Moore, one important goal of the MMOC is to identify women who need to birth using more conventional methods. These women might have some pre-existing health condition that could make an at-home birth less safe. In fact, Moore would like to not only practice in Alabama but also be able to refer women to doctors when necessary. “I want to be able to call up an obstetrician and say, ‘I have this woman who is presenting these symptoms and I think would benefit from a visit with you,’” she says. “That’s how women get the best care. That’s one of my main drives to getting legislation passed.”
The ABC, according to Moore, is not attempting to put a bill through the legislature this year. However, Laura Hall, a state representative from Huntsville, has submitted a resolution to establish a joint House and Senate committee to study the midwifery issue in more depth over the summer and fall, between legislative sessions. “We’ve really turned our focus toward public education,” Moore says. “I’ve yet to meet a person who hasn’t been appalled when I’ve told them I’m a midwife and it’s illegal for me to practice in this state, even if they may not make that choice for themselves. One thing that will really help us advance legislation is an army of constituents willing to go to bat for it.”
In the meantime, Moore will continue to drive to Tennessee in order to help mothers give birth the natural way. “It’s a job that you have to have true passion for,” she says. “It’s hard.”
One of the most difficult aspects is being on call while working with a pregnant woman. “You get a call the morning of your kid’s fifth birthday party, your first responsibility is to that mother, not to your family,” Moore says. “And it’s exhausting. You can leave for a birth and have the baby within two hours, or it may be for 48.”
Despite the drawbacks, Moore is hooked. “I can’t imagine a more rewarding life,” she says. “It’s a privilege to be invited into this sacred moment for this family. To be able to help in some way is overwhelming and beautiful.”
She also extols the beauty and power of natural birth and the sense of accomplishment it gives to women. “ I don’t mean to demean women who choose not to do it that way,” she says. “They can still have that feeling of accomplishment. But when you labor naturally, there are physiological things involved you don’t have with a medicated birth. You’ve got endorphins coursing through your body that dull the pain, and it’s like being high as a kite. You’re in a different universe. It’s a whole different experience, one of the greatest feelings ever.”
Moore received her midwife’s license in Tennessee in 2005. She has a B.A. in religion from the University of the South at Sewanee, an M.A. in women’s studies from the University of Alabama and a master’s degree in public health in maternal and child health from UAB. She and her husband John, an assistant professor of Spanish at UAB, have three children — Gabriel, now 8 years old; Lucas, 6, and Cleo, 3.