“Would you like to help us listen to the baby?” Melissa Cheyney asks 8-year-old Isaiah. “OK, push that button!”
As Isaiah carefully holds an ultrasound device against the pregnant belly of his mother, Amanda Wise, ocean-like sounds fill the bright, freshly painted living room. The eyes of Isaiah and his younger sisters and brother widen, as their father Jesse and Amanda exchange smiles.
“Lots of moving in there, huh?” laughs Cheyney, a certified midwife. “It won’t be long before you get to see your baby!”
The Wise family is among the 1 to 2 percent of Americans who make the choice to give birth at home. This would be the 367th homebirth that Cheyney has attended and one with significance for maternal health policy in Oregon and beyond. It is part of a statewide study led by Cheyney to document the impact of midwives in a health-care system that overwhelmingly favors giving birth in hospitals.
“Among the most wealthy countries, the United States now ranks 31st in infant mortality. The vast majority of our nation’s births are in hospitals, and about one-third of those are by Caesarean section. The World Health Organization recommends no more than 10 to 15 percent, so our rate is two to three times higher than what is considered safe. And yet, society maintains the myth that births at home are risky,” says Cheyney
As an Oregon State University anthropologist, Cheyney takes a participatory approach to her work. “My active practice is an immersion. Every client interview, every birth I attend, I am conducting primary research: witnessing, listening. It continues to add to my understanding of the enormous range of normal in human birth.”
Cheyney accepts 10 to 20 clients a year in her midwifery practice. At each prenatal visit, she conducts examinations and provides information about birthing options, offering guidance as families make their own choices. She is certified in neonatal resuscitation and is able to administer anti-hemorrhagics and other medications that help to make childbirth safer.
Her goal is to inform medical educators and to support consumer protection and choice. She and her co-researchers in the Oregon Midwives Study will identify how midwifery education and licensure may be modified to optimize safe, affordable and high-quality services.
“The Oregon Midwives Study is part of a larger, nationwide prospective study, and we are already compiling an enormous database of sound scientific data,” she says. “We are looking at over 100 variables for each birth and will have a sample size of close to 20,000 deliveries by the end of this data collection cycle.”
Cheyney has consulted with policymakers in Indiana, Idaho and Oregon as they deliberate on issues of legalization and licensure for midwives. In Oregon she has testified at hearings held by the Oregon Health Licensing Agency on changing licensure from voluntary to mandatory.
As the political process winds on, the pregnancies at the heart of Cheyney’s work come to term at their own pace. On May 29, Amanda Wise gave birth to Evan Judah (9 lbs., 10 oz.) without complications in a waterbirth tub, a specially designed warm-water pool. He was the first of the five Wise children born at home.