Cuts You Up

As the number of cesarean section deliveries in South Florida soars, some women use midwives to learn to trust their bodies and give birth naturally

After 14 hours, Wasserman was informed that her labor was "failing to progress" and that she required surgery. "They said they were concerned about the baby," she remembers. "They were concerned about me." The operation went well. "The surgeon had a lot of experience," Wasserman observes wryly. (Six years ago, Mount Sinai's cesarean rate, now 38.8 percent, had already topped 30 percent.) Yet she remembers feeling "devastated." She was depressed about the delivery and says she did not fully recover physically for a year afterward; she is still numb where her nerves were cut to make the incision.

So when Wasserman discovered she was pregnant again two years later, she sought out Devorah Stein, a friend who had graduated midwifery school with Fitch. The two Orthodox women live within a mile of each other on North Miami Beach; their families worship together at the Young Israel of Greater Miami synagogue. Wasserman paid attention whenever Stein, who had survived her own unpleasant C-section, talked about alternatives to hospital birth. "I did not want to repeat what had happened to me," Wasserman explains. "I was going to do the exact opposite of what I did with [my first son] with [my second]."

Wary of depending exclusively on a midwife to deliver her second child, Wasserman hired Stein as a doula, an advocate for a woman during labor. She found a doctor, Wayne Di Giacomo, willing to give her a VBAC. Though one of the few doctors willing to perform such deliveries in South Florida, DiGiacomo is no renegade. He blames doctors' fears of malpractice suits for the rising cesarean rate. Following ACOG guidelines, Di Giacomo advised Wasserman on a Thursday, as she approached 41 weeks of pregnancy, that if she didn't go into labor by the weekend, he would induce her. "I was afraid the whole thing was being set up again," Wasserman remembers. So she took extract of blue cohosh, an herb midwives believe naturally induces labor, and drank a root beer float laced with castor oil, another homeopathic remedy. On Friday afternoon, she turned to her husband, a professional acupuncturist with an office in Aventura, for treatment. Two hours later, she began the early stages of labor.

A daughter is born to Cher Durham at her home in Kendall this past February.
Jonathan Postal
A daughter is born to Cher Durham at her home in Kendall this past February.
Cher Durham reacts to the pain of a contraction during her at-home birthing experience.
Cher Durham reacts to the pain of a contraction during her at-home birthing experience.

On Saturday afternoon, Wasserman went to Stein's North Miami Beach birthing center, where she labored for 25 hours, going to Aventura Hospital only when she was on the verge of pushing out her son. Because she labored so long, she remembers Di Giacomo telling her over the phone -- again following ACOG guidelines -- that if she did not deliver by 10 p.m., "I'm going to cut you." Wasserman delivered her son Efrem at 9:59 p.m. When the baby weighed in at seven pounds and 15 ounces, Wasserman recalls that the doctor observed, "If he had been any bigger, I would have had to cut you."

Three years later, Di Giacomo, who delivers 20 or more babies a month, no longer remembers Janessa Wasserman or anything he might have said or done during her delivery. Yet he has had enough clients like her, who do not like the level of medical intervention typical of hospital births, that he opened A Birth Center last summer near Memorial Regional Hospital in Hollywood. If more women demand more control over their care, Di Giacomo says, obstetricians will have to accommodate them. "Consumer demand drives the market," the doctor observes.

After delivering her son without surgery, Wasserman remembers feeling as if she didn't need a wheelchair to carry her to the recovery room. "I wanted to run a marathon," she says. "I had so much energy." To this day, Wasserman considers natural delivery "the single most empowering moment of my life."

On May 16, 2003, not long after Cher and Johnnie Durham returned from their honeymoon, the newlyweds realized that the night would bring a lunar eclipse. An avid student of nature, Cher has a moon tattooed on her right shoulder and a sun on the left. Although they had not planned on starting a family quite so soon after the wedding, Cher felt that the universe was giving them a sign. At that moment, as the sun, moon, and Earth aligned, she says, the couple conceived.

The Durhams had an inkling that they might like to try natural childbirth, but once the pregnancy was confirmed, Cher sought out Obstetrics and Gynecology Associates of Kendall, the practice that successfully delivered Johnnie's sister's twins at Baptist Hospital. The Durhams signed up for a five-week session on Wednesday evenings at a Baptist Hospital outreach center near their home. Durham sat with her husband, taking in every word uttered by Judy Resuzenko, a licensed nurse and certified doula. The teacher went around the room, asking everyone to share with the class his or her greatest fear about childbirth. Johnnie joked that he was afraid of "the hospital bill." Cher was serious: "I was more afraid of the epidural than the birthing process." She was terrified of having a needle filled with painkiller jabbed into her spine.

What resounded most with the Durhams, though, was when Resuzenko told the class, "Your body is naturally capable of giving birth." The message appealed to biology majors Cher and Johnnie. Cher felt a spiritual connection to the natural process. Johnnie felt a Darwinian security, inspired in part by the many mornings he arrived at work to find primate babies born in the night without any medical assistance.

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