Midwife opens new birthing center

A week ago, licensed midwife Elizabeth Emmert delivered the first baby in her new, European-style birthing center in Kalispell.

Her patient rested in a bed with a quilt and pillows. Candles added to the cozy atmosphere.

She kept her medical tools out of sight along with the oxygen tank with its frightening pint-sized mask.

"That really helps women relax," Emmert said.

The expectant mom became Emmert's friend during months of prenatal visits and monitoring. She knew what to expect when she arrived at the birthing center.

No one broke her water or shouted "push" to speed up the process. Even when the cervix dilated to 10 centimeters, Emmert and practical nurse Tiffany Rietema waited four more hours until the mother decided to push.

"Her water broke when she pushed for one minute," Emmert said.

Located next to Kalispell Regional Medical Center's emergency room, Kalispell Maternity and Birthing Center caters to healthy women who prefer a homelike atmosphere with medical help nearby.

Emmert said she positioned her facility as close to the hospital as possible.

"I have a healthy respect for what can go wrong during a birth," she said. "I have the highest respect for doctors - thank God they're there."

She said her birthing center follows the European concept.

In Sweden, for example, Emmert said midwives deliver 99 percent of the babies at birth centers. She said that frees physicians' time for high-risk, complicated births.

Although critics may question the safety of births without physicians, Emmert points to infant mortality rates. Sweden ranks third-lowest in the world, while the United States comes in at 50th.

After two years of practicing in a small office in Kalispell, Emmert opened her birthing center when the perfect location became available in the Northwest Professional Center.

It culminates a dream that began at an early age.

"I always wanted to deliver babies," she said.

After graduating from Columbia Falls High School in 1993, Emmert spent four years taking pre-med and pre-pharmacy courses at the University of Montana.

Emmert and her husband decided the intensity of those careers was too much for their growing family. So she changed her goal to becoming a licensed midwife.

She spent three years studying for her midwife license through the National College of Midwifery in Taos, N.M., as well as a year of clinical work.

Emmert hopes to put to rest the stereotype that a midwife is less than bright or poorly trained.

"That's what I'm trying to smash into the dirt," she said.

Montana licenses midwives, and a board that includes four obstetricians oversees their practices.

Recently retired local physician Dr. Van Kirke Nelson serves on the board.

Emmert estimates that she has delivered 35 to 40 babies on her own. She has witnessed more than 100 births.

As a mother of three boys, she has experienced three different birth environments as a patient.

Her first birth at age 18 was in a hospital.

"I didn't know midwifery was an option," she said.

She gave birth to her second child in Helena with a certified nurse midwife. Emmert explained that the midwives are licensed to deliver babies in hospitals.

During her last pregnancy, Emmert experienced her training from the patient's perspective. She was assisted during a home birth by a licensed midwife.

"It was wonderful - nobody broke my water," she said.

Emmert said she enjoyed the freedom to get up and move. She also appreciated getting into the birth position that felt most comfortable.

Emmert finds most women choose kneeling: leaning over a support, such as a couch.

"It takes all the pressure off your back, and there's very little cord compression," she said.

Without the pressure to deliver quickly, Emmert said she was able to listen to her body for the right time to push. Because of that, the baby's head came out slowly.

Emmert said a birthing center differs from a hospital in two significant ways.

"We don't offer chemical pain relief, and we can't offer a C-section," she said.

Her license allows her to use Lidocaine for numbing if a new mom requires vaginal stitches.

She also administers a vitamin K shot to the baby and a medication to the mom that helps the vagina stop bleeding.

Births in such centers also differ from hospitals in cost.

Emmert's $2,900 fee compares with a hospital expense of about $7,000, she said.

Because most insurance companies don't cover midwife services, Emmert negotiates monthly payments for those who need time to pay her fee.

The midwife said the $2,900 fee includes prenatal and postnatal visits as well as unlimited telephone calls. Along with physical monitoring, Emmert discusses nutrition and body mechanics with women and keeps tabs on their stress.

"We do a lot of social support," she said.

State law provides guidelines about whom midwives may accept as patients.

"We only take healthy, low-risk women," she said.

Ineligible women include those with heart disease, kidney problems, alcohol or drug abuse problems, cancer and many other conditions.

If problems arise during prenatal visits, Emmert consults with physicians or refers the patient to a physician for medical treatment.

She considers her role a huge responsibility but that doesn't take away from the thrill of placing the baby, wrapped in a warm towel, in a new mother's arms.

"I still cry," Emmert said.

Women interested in more information about Kalispell Maternity and Birthing Center may reach Emmert at 253-5346 or 857-2004.

Reporter Candace Chase may be reached at 758-4436 or by e-mail at cchase@dailyinterlake.com.