Midwife/27″/dt1st/mark2nd

By ANN DONAHUE

Staff Reporter

When 8-pound, 4-ounce Presley Walker Gerber was born last month, it was in his parents’ Brentwood home, attended by a midwife.

His mother, supermodel Cindy Crawford, wouldn’t have it any other way.

Neither would Pamela Anderson Lee or singer Erykah Badu. These celebrities have joined the hundreds of pregnant Los Angeles women who have turned to midwives recently to help them give birth at home.

“It’s an old profession going through a renewal,” said Shelly Girard, the midwife who attended to Crawford.

But it’s still pretty rare 6 percent of American women who gave birth in 1995 used midwives, up from 3 percent in 1989, according to the Centers for Disease Control and Prevention. No more recent figures are available.

For these women, using a midwife provides a sense of comfort and control over the birthing process that some believe is lost in the rushed pace of modern hospitals.

“If you’re healthy enough and obviously take all the precautions, it seems like an ideal way to give birth instead of a sterile hospital room,” said Crawford’s spokeswoman, Annett Wolf. “It truly was for the comfort of the baby to be born at home, instead of in a room full of strangers.”

There are about half a dozen midwives in Los Angeles County who tend to women wanting to give birth at home. Each can have caseloads of up to 90 patients and many find their services are in demand from a broad spectrum of the population.

“It’s something that appeals to old hippies and yuppies and fundamentalist Christians and far-out spiritualists,” said Lani Rose Jeansdottir, a midwife in Canoga Park. “It really cuts across all lines. I have doctors to warehouse workers to secretaries to artists.”

The one constant is an interest in keeping the experience as natural as possible no painkillers, no machines, no sterile environment.

“They realize birth is not an illness,” said Fran Torgerson, a midwife in San Pedro. “That doesn’t necessarily mean they’re all vegetarians, just that they are very in tune with their body.”

Tawnya Nason, 30, of San Pedro, gave birth at home last month to her third son, Duncan. Torgerson was the midwife for the birth, which took place underwater in a special tub.

“My first baby I had in a hospital and the second in a birthing center,” Nason said. “This time I decided to have a good, relaxing, peaceful atmosphere for the baby. It turned out better than I had hoped.”

Nason said she wanted the privacy of the home birth, which was attended by her husband, her mother and her sister, who took the pictures. “There wasn’t the stress of strangers running in and out of the room and people poking at you,” she said.

Torgerson also assisted Libby Bastach, 40, of Rancho Palos Verdes, in the birth of five of her six children.

“I think hospitals are great, but they’re for sick people,” Bastach said. “People should be able to choose the birth they want. If I want to stick my leg up on a wall and doing that makes the contractions feel better, then if I’m at home I can do it. In a hospital, they would be freaking out.”

Torgerson has been in nursing since 1958. Trained to handle high-risk obstetrics cases, she believes delivering at home is actually safer for a healthy woman than going to a hospital.

Indeed, a CDC study notes that the risk of infant death was 19 percent lower for births attended by certified nurse midwives than for those attended by physicians.

“If we leave the body alone, it will work through the problem,” Torgerson said. “In a hospital, you’re on a time clock because you have somebody waiting for that bed and you have to get done in the next six or eight hours. If you’re not ready by then, doctors can induce labor.”

The cost for the services of a midwife ranges from $2,500 to $3,500, which covers prenatal care and regular visits for several months after the child is born. Also included is the equipment needed for delivery, such as oxygen tanks, tubs for women who want to give birth underwater and gynecological equipment.

(The average cost for a vaginal birth in a hospital is $4,030, according to the Office of Statewide Health Planning and Development.)

Torgerson worries that poor women may decide against home birth because no health maintenance organizations cover the procedure. Medi-Cal does not cover midwife services either.

“For a young couple, $3,000 is a lot of money, especially if they want to buy stuff for the new baby,” she said. “Since HMOs are the insurance of this century, many women go to hospitals because (the HMO will) pay for it.”

A recent report released by the Pew Health Professions Commission and the University of California San Francisco’s Center for Health Professions encourages HMOs, hospitals and research organizations to take midwives more seriously.

“The midwifery model of care is an essential element of comprehensive health care for women and their families that should be embraced by and incorporated into the health care system and made available to all women,” the report said.

Two kinds of midwives are licensed by the state. Certified curse midwives have a nursing degree and receive specific training in midwifery. Direct entry midwives don’t have a formal medical background; they receive their knowledge of midwifery through apprenticeships and accredited training programs. All midwives must pass a board examination to practice.

The vast majority practice in hospitals or birthing centers, offering comfort to expectant mothers as they go through labor. Less than 1 percent attend home births, according to the American College of Nurse-Midwives.

The handful that do must cope with a very rigorous workload. “I was just telling a friend the other day that I put my pager on before my underwear,” Torgerson said.