Family Matters: Return of the Midwife
A growing number of practitioners are choosing to help others give birth using a combination of ancient spiritual connections and New Age techniques.
Lonnie Morris likes to say she comes from a long line of midwives. The ancestors she claims are the biblical Shifra and Puah, who tried to save the male babies of the Israelite women in Egypt, including Moses, against Pharoah’s orders.
At Passover, which celebrates the birth of the Jewish people, Morris always recalls the midwives’ critical role. “I always ask my kids at the Seder table, ‘If it weren’t for whom…?’ They answer: ‘If it weren’t for the midwives we wouldn’t be here now.’”
The midwives’ names themselves breathe life. According to www.ritual well.org, which provides resources for creating innovative, contemporary Jewish rituals, “Puah” symbolizes life, birth or breath; “Shifra” symbolizes life or hope. Some midrashimidentify them with Yocheved and Miriam, Moses’ mother and sister. Their faith in God and heroic defiance laid the foundations for the Exodus and redemption.
Today’s midwives keep that faith, and what may truly be the world’s oldest profession is making a comeback. Just as Shifra and Puah rebelled against authority, modern midwives challenge many conventional birth practices. “God made women to have babies,” says Morris, who was raised Orthodox and now attends a Reform synagogue. “Using monitors and machines…is not what God intended.”
The American College of Nurse-Midwives (ACNM), which certifies both midwives and nurse-midwives, began with 124 members 50 years ago. It counts 7,000 today, only a small percent Jewish, according to Morris. Ten percent of births in the United States were attended by nurse-midwives in 2002, a figure that has doubled since 1990.
Morris has delivered about 4,000 babies in 29 years. “My grandma used to say that God gave me golden hands,” says Morris, 58, who has a doctorate in nursing. “Any time I touched someone I made them feel better.” Her father, who owned a clothing factory, taught her to sew but deterred her from pursuing a career outside the home. She enrolled in Columbia University’s midwifery program six weeks after the birth of her first child. “I sew garments, quilts…and perineums,” she says. Because of high malpractice insurance, she sold her practice, the Childbirth and Women’s Wellness Center in Englewood, New Jersey, to Pascack Valley Hospital Women’s Health Center. She is now its director of midwifery.
The relationship of trust between midwife and mother-to-be is critical, says Risa Klein, a midwife in New York. It is a process that begins long before the birth itself. Klein finds out what makes the women laugh and cry; what they fear; how they met their husbands; when they knew they were in love; what their mothers told them about birth. At the delivery, “they can melt in my arms when they are in pain…. I hold their hands, look them in the eye and tell them women have done this for thousands of years. I tell them, ‘You are part of this legacy. You are not alone.’”
Midwifery is primarily intended for healthy women, providing pregnancy, childbirth, postpartum, newborn, gynecological, contraceptive and well-woman care.
Today, almost 40 universities nationwide offer midwifery programs. However, midwives can have varying levels of licensing and training, because each state has its own licensing regulations, no one model exists. And yes, there are male midwives (about 70 across the country).
Midwives work for doctors, hospitals and health clinics, or they can run independent practices in which they collaborate with physicians. Most typically, midwives consult, collaborate with or refer to physicians in case of emergency or when there are complications beyond the scope of their practices. Several studies indicate the success and cost-effectiveness of nurse-midwife care: It is comparable to physician care; midwives are more adept at providing services that depend on communication, meeting both medical and emotional needs; mothers in collaborative midwifery care (midwives working together with physicians) spend less time in birth facilities, experience fewer Caesarian sections or assisted vaginal births and fewer episiotomies; and nurse-midwives have been able to reduce infant and maternal mortality, premature births and low birth-weight rates. (For more information and to learn how to choose a midwife, visit ACNM’s Web site: www.midwife.org.)
Those who turn to midwives cut across the spectrum of ethnicity and observance, says Morris. Whether they are Orthodox Jews, Christians, Muslims or Buddhists, religious groups tend to be midwife-friendly because they trust God and nature, notes Donna Tabas, 45, a nurse from New City, New York, who recently received her midwifery certification. These women fear birth far less than nonreligious women, she says. Others seek out midwives “to avoid unnecessary technology, tubes and wires. We rely on alternative methods to help labor go forward—eating and drinking, rocking, walking, birthing chair, tub, squatting. We ‘catch’ the baby, but the power comes from the woman.”
Like many women who have become midwives, Tabas was motivated by her own birth experience 20 years ago—a long, difficult and premature birth that ended in a Caesarian section. When she became pregnant again she “delved into the world of natural birth” and succeeded in delivering vaginally. “It was a personal turning point,” she says. She changed the focus of her nursing, began working with Morris and later enrolled in Columbia’s midwifery program.
Whatever their personal religious observance, midwives are powered by a profound spirituality and a sense of the sacred. “I’m a partner with God in helping these babies come,” relates Tabas, who is Reform. “There’s got to be a holy connection.” Tabas says it literally hurts her to see women waiting to give birth “watching Jerry Springer on TV,” devoid of any spiritual connection. Many midwives feel that spontaneity, adaptability, respect and sensitivity are important hallmarks of their care.
Tabas assisted Nancy Wechsler-Azen, interim rabbi at Temple Beth Torah in Upper Nyack, New York, and her husband, David, also a rabbi, at the birth of their second child, Eliza, five years ago (their first, Max, was a Caesarian section).
“David, Donna, the doula [trained labor companion] and I droned and hummed as the contractions took their course,” remembers Wechsler-Azen. “There was no feeling that we had to hurry, or the midwife had something else to do or somewhere else to go. Everyone was there for the duration, no apologies. I don’t think I had ever felt that kind of full acceptance in my life.”
Wechsler-Azen was sure that the baby would be a boy; her husband, who has two sons by a previous marriage, “makes boy babies,” she says. When the baby turned out to be a girl they were stunned. “The Sheheheyanu came to my lips and I continued to offer this blessing like an endlessly flowing waterfall,” Wechsler-Azen remembers.
“It was the most heartfelt prayer moment I’ve ever seen,” Tabas recalls. “I was brought completely to tears.” The Wechsler-Azens now share the pulpit of Congregation Beth Shalom in Carmichael, California.
At another birth, Morris and Tabas were assisting an Orthodox woman who was in difficult labor. Morris decided she and Tabas should sing the “Shema” to the baby. “As we were chanting the baby came right down and out,” Tabas recalls. “Coincidence? Maybe. Awesome? Definitely.”
While the midwives’ primary focus is on women, they also recognize the importance of including fathers. Dads-to-be who want to participate in the birth might help with positioning, massage, cutting the umbilical cord or even assisting in “catching” the baby, says Tabas.
Many Orthodox couples are careful in observing the laws of nidda, which restrict physical contact between the woman and her husband during active labor. “In such cases,” relates Tabas, “midwives recognize the value and contribution of the father’s spiritual support…which may include [praying] nearby or keeping connected with a keen ear from an adjacent room.”
One mystical belief shared by many Orthodox families is that when a woman is fully dilated, the gates of fertility are truly open. It’s a custom at that moment to read a list of names of friends and family trying to conceive. In the midst of one “heavy-duty birth,” Tabas recalls, the mother-to-be shouted to her husband, “‘Shmuel, get the list!’
“He rummaged through their bags and read, ‘Rachel Goldman, Sarah Waxman….’ It’s amazing that they could think of other people at the height of that intensity.”
For her book Expecting Miracles: Finding Meaning and Spirituality in Pregnancy Through Judaism (Urim) author Chana Weisberg interviewed 24 religious Jewish mothers in the Jerusalem area to find out about their experiences in pregnancy and childbirth. Weisberg includes an interview with Sarah Landau, a Brooklyn-born mother of eight, who decided at age 40 to go back to school to become a nurse and then a midwife.
For both religious and nonreligious Jewish women in labor, Landau suggests verses to recite, including one about Shifra and Puah. She also tells them about segulot, customs believed to promote Divine blessing for a woman in pregnancy and childbirth. “I’ll tell her the Shekhina stands above her head and that she should daven for different people,” Landau says. “All this sort of gets them out of that pain thing….”
Because the women feel God’s presence, some think about bringing about the redemption of the Jewish people when they push the baby out; some meditate on God’s name; others hold pictures of the Lubavitch Rebbe and ask him to tell Hashem to give them strength.
“With the births it was the closest I ever felt to Hashem,” says Bracha, a 25-year-old mother of three who was interviewed in the book. “I was yelling to God, ‘help me!’ It was really an intense religious experience. I had no control over my body, it was contracting whether I wanted it to or not, and I just couldn’t fight it. I just had to give over myself and my body to God and go with the flow.”
The Jewish Pregnancy Book (Jewish Lights) by Dr. Sandy Falk and Rabbi Daniel Judson suggests both traditional and contemporary prayers. Women in labor can use Psalm 126 (“Those who sow in tears will reap in joy”) or a prayer from the Reconstructionist Rabbinical Association Rabbis’ Manual: “My hand reaches for the Divine midwife whose tender care will help me through my sore distress….”
For Betsy Jelisavcic of New York, though “affiliated and connected” Jewishly, it was hard to think about praying during her three home births (her children are 7, 4 and 2).
“I was just trying to live minute to minute,” says Jelisavcic, 36. But her Jewish values did inspire her. “To treat other creatures with goodness and kindness—including my own baby—is a mitzva,” she explains. “The best thing I could give my babies was a kind birth where they were not subject to any rough procedures” in the hopes that “the gentlest start in life would help them to be kind to others as well.”
Klein, the midwife at the birth of Jelisavcic’s youngest son, Elijah, born on the first day of Passover, urges synagogues to run workshops educating women on the power and beauty of birth and the role of midwives. She suggests several connections between birth and Passover: “On Pesah we clear our house of hametz. So we clear our body in birth…. As we hope for ‘next year in Jerusalem,’ so birth brings hope for family and future.”
Klein was a television news producer until the birth of her daughter, Dariana, now 15. “I switched from broadcast production to birth production,” she says. “I was my own midwife. My doctor was in the Hamptons on vacation and I did not know the backup doctor. He didn’t ask me what kind of birth I wanted. [I] showed up at the hospital 10 centimeters dilated.” Klein decided later to train to be a labor educator, then a labor assistant, added prenatal birth counseling and hypnosis and finally became a nurse-midwife.
Wechsler-Azen, who labored at Morris’s childbirth center, shares the wisdom that continues to influence her: “Lonnie told me that a woman labors like she lives her life. That has to do with sacred intensity, the willingness to accept support and the courage to be in the moment.
“I now strive to live my life the way I labored.”