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Why is N.C. afraid of midwives? 

Charlotte resident Salina Beasley was sewing black-and-white bedding for her daughter's room when her first contraction hit. It was 10 a.m. on Wednesday, Aug. 4. She was home with her 1-year-old son, Salem, and her mother, who'd traveled from Orlando to help manage once the new baby arrived. Her husband, Clark, was due back in a few hours from out of town.

Salina continued sewing. She mentioned to her mother that her granddaughter may be on the way. The expectant mom then called her husband and next her midwife — it was an action that, in Charlotte, has often been done in hushed tones. Salina, however, had no worries.

The Beasley family had relocated to the area from Atlanta a couple of months earlier. And because the stay-at-home mom and singer was already more than 30 weeks pregnant at the time of the move, finding medical care quickly was imperative. She'd delivered Salem naturally in a hospital without the use of drugs, and she wanted to do the same with her daughter; however, she learned upon arriving in Charlotte that to utilize her insurance for labor and delivery, she'd have to travel back to Atlanta.

That was not acceptable. She began exploring other options.

"I knew I didn't have the nerve to have a home birth, but I also knew I didn't want to go through the assembly-line-strapped-to-the-bed experience at the hospital," says Salina. "I wanted the comfort of knowing that medical interventions were close if I needed them, but otherwise, I wanted to be in a place where I felt my birth was being celebrated as a natural process and not treated like an illness."

By the time Salina finished up her sewing, Clark was home. It was time to head out for her checkup. The couple jumped into their gold Honda Odyssey and trekked down I-77 South to Exit 88 — which is located in Fort Mill just a couple of miles inside the South Carolina state line. Within a few minutes, they pulled into the parking lot of the Carolina Community Maternity Center.

The heat outside was sweltering. Salina's contractions were getting stronger. But inside the maternity center, Salina felt like she'd walked into a bed and breakfast. Subtle and inviting, the mahogany-colored furniture, giant birth tubs, decorated birth seats, soothing pastel-hued walls and hardwood floors made her feel at home. Leigh Fransen, her midwife, greeted them warmly. The two women had met only eight weeks earlier, but they were as familiar as old friends.

"I ended up having a very difficult last trimester with a lot of rare pregnancy things popping up," recalled Salina. "Leigh and I spoke almost every day. She was available by cell, Facebook and e-mail. It was totally different from having to call a 1-800 number and getting the automated.

"I don't even remember the name of the doctor who delivered my son," she continued. "They got me in and out. But with Leigh, I was never with her for less than 45 minutes. She took time to get to know me."

As Fransen was checking the baby's heartbeat, Salina had a contraction.

"That was pretty strong," Fransen commented.

"Yeah, and they're getting to be pretty regular. Like eight minutes apart," said Salina.

"OK. Well, you'll know when it's time to come in," said Fransen. "Call me when you get to the point that you can't talk through them."

Back out in the car, Salina and Clark decided that it was time to help nature along. The couple hopped over to Carolina Place Mall to walk. After spending a couple of hours there, they headed home. The contractions were getting stronger, but they were bearable. Her main concern was not to wait as long as she had with Salem to head to the hospital. When delivering him, she'd had to ride in the back seat of their vehicle on her knees because the contractions were too strong to allow her to sit down.

For her daughter's birth, however, she was looking forward to laboring because that type of stress was eliminated and because the maternity center facilities are so nice. So, between contractions she sat and watched Ricki Lake's documentary, The Business of Being Born, which uncovers truths about the maternity care system in America. It boosted her confidence for the hours that lay ahead.

Once it was over, she and Clark tried to get some sleep. At 2:30 a.m., she called Fransen. The midwife answered the phone and told her to meet her at the maternity center in 20 minutes.

Since opening its doors for business last year, the midwives at the Carolina Community Maternity Center have delivered nearly 90 babies: 44 percent of the newborns were to first-time moms; 75 percent of their mothers traveled from North Carolina; and 48 percent of those moms came from Charlotte.

Fransen went to Windsor Park Elementary School and Eastway Junior Senior High in Charlotte before her Air Force family moved away. She attended the International School of Midwifery in Miami. It was while she was training at the Miami Maternity Center that the idea for the maternity center was planted.

"Many of the moms I worked with in Miami were just ordinary women who would've never had a natural birth if the birth center wasn't there," Fransen said. "They weren't moms who would've had a home birth, and they weren't really moms who would've thought they could have a great residential birth in the hospital. It was not a fringe group of women who were going to fight to have a natural birth experience."

But the experience is one that Fransen believes is worth fighting for. She set out to replicate the Miami model in an area that didn't have a birth center as an option. After scouting the country, she decided that Charlotte, or just outside of Charlotte to be exact, was the perfect spot.

"I recognized that this was a very unique situation," explained Fransen. "Midwifery [without supervision of a physician] is illegal in North Carolina. In South Carolina, however, it's legal, licensed and regulated, and North Carolina's largest metropolitan area is sitting on the border."

After identifying the need, she started making calls. She said the first call she made was to the organization Midwives of South Carolina. She asked why there wasn't a birth center in Fort Mill. She also asked if anyone was working on building one and if there was a reason not to. When she got the replies back that it was a good idea but nobody was doing it, she knew what she had to do. She and her family moved from Miami in late 2008, and she began networking with other local midwives.

One of the first midwives she connected with was Damaris Pittman. A midwife with 17 years of experience, Pittman was open to the idea of a birth center, but initially had no intention of stopping her practice as a home-based midwife.

"When Leigh approached me with the idea, my plan was to help her make some of the connections she would need to get started," said Pittman. "But one day in March of 2009, three of us were brainstorming at my kitchen table and the idea of making it a nonprofit came up. That's when we all got excited. We realized that was the way we could make it work. "

At the table that day with Fransen and Pittman was Christine Strothers. In the days following, they invited midwife Lisa Johnson to join them, and the four women began taking steps to make the Carolina Community Maternity Center a reality. Over the next few months, they established a board, found a location, did fundraising and began doing prenatal visits with expectant moms at Johnson's house in Fort Mill.

On Oct. 22, the Department of Health and Environmental Control did the final inspection of their facility and handed them their license to do business. The four midwives took themselves to lunch to celebrate their accomplishment. They'd been shooting to open on Labor Day, which would've been six months since the kitchen-table conversation, but a month beyond that was fine with them. On the way to the restaurant, Pittman called one of her moms who was a few days beyond her due date to tell her the news. The mom called her back 10 minutes later saying her water had just broken. Later that night, the Carolina Community Maternity Center welcomed its first bundle of joy.

It was just before 3 a.m. on Aug. 5 when Salina and Clark pulled back into the maternity center. By this time, the contractions were coming hard and fast. It took Salina five minutes to get to the door because she doubled over twice.

Inside the center, Fransen and her apprentice were quietly filling the bathtub and setting out their essentials. The back birthing suite decorated with different shades of green was dimly lit and ready. Salina moved to the oversized tub and slipped off her gray nursing gown before sliding into the warm water.

By 7 a.m., she was exhausted and getting frustrated. The contractions kept coming, but nothing else was happening. She told Clark to take the clock off the wall; it was in her direct line of vision, and she was getting discouraged. Fransen suggested a change in strategy. They helped Salina climb out.

At one of Salina's prenatal visits, Fransen had offered her fresh figs from a tree in her yard. Salina loved them. She'd requested that Fransen bring in some for her birth. Once out the tub and walking around, Salina began munching on figs and Powerbars to keep up her energy. At this point, she was dilated 10 centimeters, but had no urge to push.

"I know that if I had been in a hospital, things would've gone very, very differently intervention-wise," said Salina.

Founding midwife Strothers, who is a former labor and delivery registered nurse, agreed: "In a hospital, there's really not support for having a drug-free birth. It's kinda laughed at. It's like, 'Oh that person's a hippy. She's not gonna do it and wait until she starts having real labor.'

"I heard that all the time, and a lot of times the nurses didn't know how to handle it," she continued. "I can remember being asked to stay and work overtime because the nurses that were coming on had never worked with someone who hadn't had an epidural, even though they had worked in the hospital for years."

In Salina's case, intervention did go differently but in a natural way. The actively laboring mother walked, squatted, leaned against the wall and put one foot on a stool. She and her husband moved around the birth room quite a bit in an effort to encourage their daughter to drop into the birth canal. Salina says she kept eyeing Fransen to see if she was in danger, but she recalls that the midwife was not at all alarmed. That gave her comfort, and she and her husband kept up their breathing exercises and movement. Labor continued.

Just after 11:30 a.m., more than 25 hours into labor, Fransen suggested a reprieve.

"Salina, why don't you just lay down and try to get some sleep, if you can. Your body is completely exhausted."

Salina looked at the midwife quizzically but obeyed. She walked over to the bed and climbed in with her husband. By now, she was contracting every three to four minutes. But, within minutes of lying down, her water broke. Fifteen minutes later, standing in the birthing tub, Salina caught 9-pound, 4-ounce baby Amelia as she said hello for the very first time to the world.

"It was the greatest feeling of relief and reward," said Salina. "Just that moment made it worth it."

To learn more about the Carolina Community Maternity Center visit www.carolinabirth.org. And to connect with Salina, check out her blog that celebrates marriage, motherhood and the arts at www.ladylullabuy.wordpress.com.

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