Stephanie’s Story of Birth on Two Continents

Stephanie's exercising

Exercising while pregnant in Europe


Stephanie shares her unique story of motherhood. Stephanie is not only an advanced maternal age mother of two, but also a reverend and a doula in Austin, Texas. Founder Sharon had the pleasure of meeting her in person.  

I gave birth to my children at age 36 and 38, and it wasn’t until halfway through my second pregnancy that I experienced a health professional treating me differently because of my “advanced maternal age.”  This is because I did not go the traditional OB route of care.  I chose to birth my babies at home, under the care of a midwife.

 

My first pregnancy and birth happened while I was living in the Netherlands, where my husband and I were pursuing master’s degrees.  The Dutch generally have a very different view of birth than Americans.  They see birth as a normal event.  Painful? Yes.  Inherently dangerous? No.  In the Netherlands, student OBs must first train with midwives to learn about normal birth before they go on to study its possible complications.  Midwives attend most births there (since most births are uncomplicated), and the parents-to-be have the choice of giving birth in the hospital or at home (about 20% of Dutch births are home births).

midwife at home

Stephanie’s dutch midwife weighing her baby

I was all set to give birth in a Dutch hospital, until I realized, at about month 8 of my pregnancy, that I would be a lot more comfortable at home.  I knew I didn’t want to use drugs for pain relief, and, after getting loads of encouragement both from my midwives and from my prenatal yoga class, I had become more and more confident in my body’s ability to give birth.  I continued to walk and ride my bicycle right up until I went into labor. 

In short, I had adopted the Dutch view of pregnancy and birth as normal.  

However, I was sensible enough to realize that I my family back in the States had not been on the same journey that my husband and I had, so we chose not to tell them about our change of plans.  My dear mother arrived about a week before my due date, and we had every intention of sitting down over dinner the evening of her arrival and talking her through our homebirth plan.  Only…my water broke on our walk back from the grocery store.  I had no contractions at first, so we calmly informed my mother of our intention of staying put and called the midwife.  My mother was totally supportive, as I knew she would be.  The midwife came by and advised me to go to bed and get some sleep—contractions would likely start in the night, and there would be plenty of time for activity tomorrow.  She did not do a vaginal exam, because she did not want to risk infection.
In fact, during my entire pregnancy, I had not had any vaginal exams.  Nor did I ever pee in a cup.  I had never set foot on a scale, either.   At every appointment, the midwives had checked my blood pressure, palpated my belly, and checked the baby’s heart using a hand-held doppler.  

Twice they pricked my finger, to check for gestational diabetes, and something else I can’t remember.  That was it.[/pullquote]

So, after the midwife left, we all settled in to bed.  I was having a few mild contractions, similar to menstrual cramps.  My husband was reading aloud to me, when all of a sudden it was like someone hit a switch.  I jumped up out of bed with contractions that were very intense and maybe a minute apart.  After about 20 minutes of this, I insisted that my husband call the midwife and insist that she come over right away.  She came, checked my cervix and found that I was 9cm dilated!  I’ve never seen anyone move so fast!  From the start of those crazy contractions to finish, my labor was 3 hours.
People will sometimes say that I am lucky to have had such a fast labor, but I’m not so sure.  I have almost no memory of it, only sensory impressions.  I somehow managed not to panic.
I credit that to the very high level of confidence I had in the birth process, as well as the calm and capable people—my husband and mother, my midwife and her assistant—who surrounded me and supported me.   After my daughter was born, the midwife and her assistant cleaned up, tucked us all in bed, and left.  To me, this is one of the best parts of home birth: sleeping in your own bed afterward.  The next day (and for a week afterward), a postpartum doula came to care for us.  The midwives came and checked on me a couple of times, as well.  
None of this cost me a dime.  My insurance (which ran me about 50 bucks a month) covered everything, including the postpartum doula.

Shortly after we returned to the U.S., I became pregnant again.  I knew that after enjoying such supportive, nurturing and hands-off care, I would not be able to use an OB and give birth in a hospital here.  I found a wonderful midwife (whom my insurance actually covered!) and prepared for my son’s peaceful birth at home.  I was surprised at the number of interventions my midwife here used prenatally, including urine tests at every visit, glucose screening, and at least one vaginal exam, but I went along.  She also sent me for a 20-week ultrasound at another office.

This was where I encountered my one and only experience of being treated differently as AMA. 

Because I was over 35, they told me at the front desk that I would need to undergo genetic counseling for all the things that could possibly be wrong with my baby before they even did the ultrasound exam.  I found this completely ludicrous.  How could they have any idea about my baby’s health without even looking?  I asked whether I could decline this, and the clerk grudgingly handed me a waiver to sign. Everything was, in fact, normal, and 21 weeks later I gave birth to my 9lb 4oz baby boy, at home, after another superfast birth—which I was at least prepared for this time!  
Baby Dory

Baby Dory

 

Maternity Leave in the U.S., Part 1

pregnant at workTheir are many nuances involved whenever navigating  motherhood and the workforce. One of these nuances is the current legal standard in the U.S regarding pregnancy and the workplace. At the Federal level, there is only one federal law that addresses the issue of maternity leave and family leave.

Starting in 1993, the Family Medical Leave Act (FMLA) established the parameters for an employee’s eligibility to take job-protected leave for family or medical issues. The law also establishes the minimum requirements that all employers must abide by with regard to granting its employees  a work leave of absence. At the most basic level, the FMLA insures that employers must grant up to 12 unpaid weeks of leave to workers seeking leave for a Varity of health and family reasons, these include caring for a newborn child within a year of its birth, caring or preparing for the adoption of a child, caring for a spouse, child, or parent with a serious illness, or a if the employee has a serious health condition or physical ailment that affects their ability to do their job.

The law begins to get more complicated when considering the requirements that employees must meet to become eligible for the FMLA.

  •  To be considered an eligible worker, a person must have been an employee of their current business for over a year,.
  • They must have worked more than 1250 hours within that year, and
  • Employees must work at a business that maintains over 50 employees.

If an employee does not meet these standards, their job is not protected regardless of their current family or heath situations. The eligibility requirements set at the federal level do not cover a large portion of working women. Small business under the 50 employee threshold have no legal obligation to grant leave for family or health issues.  In addition, the specificity of the hour requirement creates a situation where essentially only full-time or very busy employees are afforded job-protected leave.

It is important to note that the FMLA is only the minimum requirement determined at the national level, states and individual business’s and corporations can make their own policies regarding work leave as long as they abide by the basic guidelines of the FMLA. That being said, the proportion of large scale employers or states who actually expand upon the family and medical leave policies within the FMLA, is somewhat small.

How do these laws actually effect mothers or potential mothers within the workforce? For starters, even in cases where mothers are eligible to take maternity leave, the majority of working mothers usually either take a very small portion of the federally protected 12 weeks or they don’t take the leave at all. One of the biggest reasons for this trend is the fact that employers are only required to offer un-paid  maternity leave. This particular stipulation effects lower-class working women to a greater extent due to the finical strain caused by taking unpaid leave. On the other side of this issue, middle class or upper class working mothers typically have better-paying and higher-ranking jobs, which are more likely to offer paid-maternity leave. These women are also much more likely to be able to afford taking extended leave in cases where their employer does not offer paid leave.  In recent Census data collected in 2008, women with college degrees made up the majority of mothers who where able to take either paid maternity leave or extended maternity leave.

All of these issues involved with the FMLA play a role in determining the both mother’s choices within the workplace as well as their choices regarding their family and financial planning.

For many women, the financial risk of having a child is too great, especially for those who are in the early stages of their career.

The structure of the law itself and its lack of finical support for working mothers helps to create conflicting scenarios  of having children or sustaining a career pathway with finical stability. This type of conflict could be potentially eased if a more financially supportive federal law was in place regarding maternity and family leave.