Feb. 01, 2009
The bone-crushing agony. The spine-chilling terror. The blood-curdling screams.
Valerie Melotti can't believe how much I'm overreacting as she delivers her baby in front of me. (Every now and then, I check my pants for deliveries of my own.)
"It's about me over here," Melotti says in the 150-gallon birthing pool erected in her Henderson living room.
Tonight, I'm stepping in for Corinne Flatt, 42. A midwife for 10 years, she delivered Melotti's first child, Isabella, the same way two years ago. Flatt is seated behind me -- along with her assistant, Ranni Gonzalez -- should anything go wrong.
Midwives have assisted expectant mothers through pregnancy, childbirth and the postpartum stage since Roman times. (Flatt calls it the "second-oldest" profession.) Although traditionally female-dominated, 2 percent of today's midwives are male, according to the American College of Nurse-Midwives.
Flatt is a home-birth midwife. She is apprentice-trained, one of many paths possible to the job in Nevada, which doesn't license the profession. She sees an average of three clients per month, charging between $2,000 and $5,000 for her services.
"Babies don't have to be born in a hospital," Flatt says. "Half of the babies born in the world today are born in social settings as opposed to medical ones."
The real miracle of birth is that it happens by itself, according to Flatt, no need even to boil water. ("That's just to give other people a job to do so they stop bothering you.")
In addition to monitoring fetal heartbeat with a Doppler device, my main task is comforting Melotti.
"Be soft, warm and open with her," Flatt says.
Before the instructions leave her lips, Flatt realizes how ridiculously unable I am to fulfill them. I'm freaking out, flashing back to what my friend Roy told me after witnessing the birth of his first child last July: "Dude, I was shocked. I had blood all over me. The room looked like a murder scene."
I couldn't even watch the screen when that baby's head crowned in "Knocked Up."
Someone fetches "The Pocket Midwife" by Susan Fekety, a book of things to say to a woman in labor. I flip to random pages and read sentences about her body being open and whole. Funky jazz wafts in from the living room, imparting coffeehouse flavor to my spoken word.
"That's me," says Joey, Melotti's husband, who plays keyboards in Barry Manilow's band and wants me to mention his solo album. "I did all the programming and vocals."
A 2000 study of 5,400 midwife-assisted home births, by Canada's Center for Chronic Disease Prevention and Control and International Federation of Gynecology and Obstetrics, found them no more dangerous for low-risk mothers than hospital deliveries.
"Give me drugs!" Melotti yells between shallow breaths.
"Just kidding," she clarifies.
There is a problem, though, and it's no joking matter. The baby's heartbeat has slowed from a normal 140 beats per minute to 80. Flatt and Gonzalez haven't said anything, but it's obvious. They step behind a bar at the back of the room to prepare a canister of oxygen.
Flatt has handled breeched babies and cord-wrapped necks before. She says she drives fewer than 5 percent of her clients to the hospital last minute -- a "good number" of those only because they choose to.
However, Flatt admits that placenta previa, transverse births and low or sporadic fetal heartbeat are out of her league.
The trip to St. Rose Dominican Hospital is about 10 minutes, which illustrates the main problem doctors have with home birth: distressed newborns can suffocate, and their mothers can bleed to death, en route.
The baby's heartbeat has returned to normal. Flatt explains that it frequently slows as the head gets compressed by the mother's pelvis.
"Nobody's allowed to be worried," Flatt says, "until I look worried."
A stay-at-home mom who moved to Las Vegas from Utah with her husband in 1986, Flatt entered midwifery after the first of her seven kids arrived via a Caesarean section she calls unnecessary.
"I didn't dig it, and I never went back," she says.
The friendship she developed with her own midwife developed into an apprenticeship when they began attending births together.
That scream wasn't mine this time. It came from the bathroom. Even with my level of midwifery experience, I knew that allowing Melotti a last-minute potty trip spelled trouble. She is now fully dilated, to 10 centimeters, with broken water.
Flatt rushes to the toilet while delivering an off-color joke she has heard many times: "Maybe she'll call it John."
This is not the type of water birth Melotti dreamed of, so Joey and I help her back to the pool. She vomits into a bowl. Five hours after beginning labor, it's birthday time.
Flatt hands me latex gloves. Since they're individually wrapped, there's only time for the left one.
"Feel your baby dropping down," she tells Melotti. "Your baby is so heavy."
Melotti isn't the only one pushing now. Joey pushes, too -- me out of the way so he can catch his baby. Flatt noses in there, too, leaving me to watch from a distance.
First comes the head, then louder screams.
Underwater, like the slowest torpedo ever, a mound of pinkish-gray flesh shoots out horizontally. Vincenzo or Olivia (the Melottis didn't want to know beforehand) is coated not in blood but a substance resembling cottage cheese.
The process is considerably more wondrous than gross. (My friend Roy's wife had her baby in a hospital, I neglected to mention, and an episiotomy and forceps were involved.)
Melotti and her husband sneak a peek, then welcome Vincenzo. Thirty seconds later, their bundle of joy cries, no backslapping. (That's another myth, Flatt explains.)
"I know," Melotti tells her hysterical boy. "I feel the same way."
I may have spoken too soon about this not being gross. The idyllic scene of a mother nuzzling her newborn son is intruded upon by a color change in the water. Within two minutes, it resembles the ocean around the swallowed girl in the opening of "Jaws."
"Where are you going?" Flatt asks as I gather my things and dry heave. "Delivering the afterbirth is part of a midwife's job, too."
Fear and Loafing runs on the first Sunday of every month in the Living section. Levitan's previous adventures can be found at www.fearandloafing.com.