Womencare Midwives works with 2nd generation

BONNERS FERRY – When midwife Barbara Rawlings moved from Boise to North Idaho in 1978, she knew some changes would come along with the relocation.

But along with small town charm, friendly neighbors and stunning scenery, she encountered something completely unexpected – a large, regional network of women who served the community as midwives.“I wrote to a doctor friend of mine after we moved and said, ‘I think I’ve died and gone to midwife heaven,’” Rawlings recalled.

The number of area midwives has seen its share of ebb and flow over the 35 years since she came north. Recently, though, Rawlings has noticed rapid growth in the ranks of women who assist in out-of-hospital births.“I see a resurgence,” she said. “There are more student midwives who have many more educational options than we had back then.”

Another change has been the advent of licensing and accreditation for midwives. Despite the learning curve involved, Rawlings believes the improvements in accountability and public safety that come with licensing have been good for the profession.With a total of about nine midwives in the two northern counties – three of them serving Boundary County – the word continues to spread about this choice when it comes to giving birth. Some midwives – Rawlings among them – have realized even more growth due to the addition of a “birth room” to their practices.

In her case, it’s a cozy space in an equally cozy former home on Ash Street, where mothers can have their babies in a middle ground between staying home and going to the hospital. That said, the majority of her work still takes her to where her clients live when duty calls.“This is a great convenience for people who live far out in the country or when the roads are bad,” Rawlings said as she sat at the foot of a quilt-draped bed in the birth room. “But my heart is still in people staying at home.”

Since she first began assisting in births, awareness has leapfrogged across generations to the point where the only cultural reference to midwives is no longer the vague memory of a scene from “Gone With the Wind.” Today – at least around Bonners Ferry – most people not only know what a midwife does, they are likely to have had some direct experience with the practice.“It used to be that people asked, ‘Midwife? What’s a midwife?’” said Rawlings. “That simply is not the case any more. Talk to anybody, anywhere, and they have at least a passing connection with someone who chose to have their baby outside the hospital.

“I’m doing many second-generation births now,” she added, “and catching babies for babies I caught.”Rawlings’ business, Womencare Midwives, teams her up with Kendra Scarlett, who first apprenticed with her nearly 30 years ago before going into partnership. Between them, they now assist in an average of 20-30 births a year.

“We don’t even have to talk any more,” said Rawlings. “After being together for 28 years, we know the dance.”Unlike the early days of her career, licensing now allows midwives to administer life-saving medications, IVs and oxygen in their birth centers.

“All of which we rarely ever have to use,” Rawlings said. “Birth is a pretty darn good design.”Reaching to a nearby shelf, the midwife hands over a quote she likes to share:

“Birth is safe,” it reads. “Women’s bodies can be trusted. This is the message midwives breathe.”In the U.S., midwifery had fallen out of favor by the 1950s – a time when women were sequestered while they gave birth. Forceps and sedatives often sped the process along, virtually replacing the earlier school of thought that the baby would arrive when it was good and ready to. By the 1970s, some states, such as California, had gone so far as to make the practice illegal.

In the course of two decades, a centuries-old profession was shunted aside and society began to think of hospitals as the “traditional” place to give birth.“I object to people using the term ‘traditional birth’ when they’re referring to the hospital,” Rawlings said. “Traditional birth has always happened outside the hospital.”

Still, this midwife appreciates the local medical community and the skills it brings to bear when extra care is needed. In her case, the relationship with those professionals has been not only cooperative, but also complementary.“I’m really grateful for what we have up here and I’m eminently grateful to our medical community, because it’s not that way in a lot of communities,” she said. “That’s how the system is supposed to work – everybody has their eyes open and knows what their part is. The whole idea is seamless care for our clients.”

Licensing has done much to improve the level of cooperation between Idaho midwives and medical professionals, though Rawlings herself opposed the licensing direction for more than 25 years. When there were rumblings that the state legislature was considering making the practice illegal, however, she joined other veteran midwives who went from being in the vanguard of fighting accreditation to the front lines of making it happen.“It was a perfect storm,” she said. “There were newer midwives coming onto the scene who were more in favor of having a legal status, and there was the changing tide, nationally, of it coming whether we wanted it or not.”

Now one of what she calls “the seasoned midwives,” who have been at this work for 35 years and longer, Rawlings takes pride in being one of the women who helped lay the groundwork for new generations.“We really did pave the way,” she said. “But I’ve never thought of myself or my colleagues as pioneers – we were just doing what we did and learning from each other as we went along.”

There’s something about Bonners Ferry, she noted, that has made the practice of midwifery especially welcome. It could be the rural nature of the community, or the fact that it has a large percentage of people who think and act independently. Whatever the reason, that welcome has made it far easier for Rawlings and other midwives to do their jobs.

“Midwifery, home birth and out-of-hospital birth are not part of the mainstream,” said Rawlings. “Even in the best of circumstances, midwives are swimming upstream. In Bonners Ferry, there’s a real sense of cooperation and being embraced. That’s not always true in other parts of Idaho and other parts of the country.“But we have come a long way in our communities and nationally,” she continued. “Midwifery has gone from being seen as ‘backwoods’ to moving back into the mainstream.”

Even after attending hundreds of births, Barbara Rawlings hasn’t lost her sense of wonder when a new baby is born. Each birth is like watching a fresh, new wave wash to shore. Every time, it’s like being witness to a miracle.“To be a part, at the very beginning of that, is a blessing,” the midwife said.