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

The next afternoon, Cher wandered out to where her husband was cleaning the tamarin cage. As the tiny golden monkeys clambered up onto their keeper's shoulders, Cher shared her doubts about going through with a hospital birth. "What if we did something alternative?" she asked her husband. "Whatever you feel comfortable with," Johnnie reassured her. Looking for a midwife in the yellow pages, the couple didn't go too far into the alphabet before an ad caught their eye: "Birthright, free consultation, Corina Fitch."

By the time Janessa Wasserman found herself pregnant with her third child in the spring of 2003, her friend Devorah Stein was also pregnant, with her sixth, and no longer practicing midwifery. Determined to deliver her third child naturally, Wasserman hired Stein's friend Fitch and sought out another doctor who would perform a VBAC. She called a number of practices before finding William Shure, head of obstetrics at Memorial Regional Hospital in Hollywood. Wasserman used her lawyer's skills to do a thorough background check on Shure: Trained in New York, he has been in practice since 1979 and has no outstanding malpractice suits. Here was a physician she could trust.

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.

By the time she was 30 weeks pregnant, though, Wasserman got the feeling that her doctor was developing amnesia. "I couldn't fault him, because he sees so many women," Wasserman grants. Yet she could not help feeling distressed every time Shure would glance at her chart and say, "Cesarean, right?" She would answer, "No, VBAC." They would go through the same routine every visit until two weeks before her due date. "This is really upsetting me," she says she told the doctor. "We met with you specifically to see that there's no problem doing a VBAC."

The distressed mother claims the doctor hedged: "Well, Memorial has only had one VBAC in the last month." As she sat on the examining table, it dawned on Wasserman that the doctor had no intention of doing a VBAC. Still she could hardly believe what she heard next.

"I believe all babies should be born by cesarean," she recalls him saying.

"Do you mean all VBACs or all babies?" she asked, incredulous.

"All babies should be born by cesarean," the doctor clarified. "Better for Mom. Better for Baby."

Shure, who delivers ten to 12 babies each month, tells New Times over the phone that he does not remember a patient named Janessa Wasserman. In any case, Shure insists that he never made any of the statements Wasserman attributes to him. "I do VBACs all the time," he maintains before asking himself aloud: "I wonder why a VBAC would be a problem in this case."

Whatever transpired in Shure's examining room, Wasserman found herself looking for another doctor two weeks before her due date. Fitch recommended Mark Spence, an obstetrician based in North Miami. Born in Jamaica and raised in New York City, Spence did his residency at Bronx-Lebanon Hospital Center, where he says the staff kept cesarean sections down to 12 percent of all births.

Like Di Giacomo, Spence believes the rising cesarean rate is driven by perceived liability rather than real health benefits and risks. "A lot of info we're using now is more protective to the physician," he points out. "Everybody is so worried about being sued, we're not paying attention to the experience."

Wasserman says she felt comfortable and safe in Fitch's hands. "It was so peaceful and calm at home," she remembers. Yet after 11 hours of labor, her lingering fears prompted her to go to the hospital as planned: "I still had in the back of my head: 'You have a scar. Something could go wrong. You have to go to the hospital. '"

Although his practice delivers 25 to 30 babies a month, Spence remembers Wasserman well. "Since her [previous] doctor said 'I'm going to cut you,' that took away a lot of her confidence," Spence surmises. He remembers the fear he read in her face: "Was my doctor right? Is this person going to treat me the same way? Is he going to see a blip on the monitor and cut me?"

Wasserman was so panicked about potential intervention that she locked herself in the hospital room's tiny bathroom rather than allow herself to be hooked to the fetal monitor. The exasperated nurses noted Wasserman's lack of cooperation on a chart, then left to attend to other patients. Fitch waited patiently outside. She did not call the nurses or the doctor back into the room until the baby's head had crowned.

By that point, Wasserman had placed herself on her hands and knees on the floor, a stance Fitch recognized as the Gaskin position, helpful in dislodging babies whose shoulders get stuck in the birth canal. Not schooled in midwifery, Spence told Wasserman that for a VBAC, according to hospital protocol, she would have to get on a bed, where she could be better-monitored. "They're the deep pockets," the doctor deferred to hospital administrators. Shortly afterward, Wasserman pushed out the head and -- despite a short delay because, sure enough, the shoulders were stuck -- she pushed out her daughter's body. At eight pounds, four ounces, Talia was her biggest baby.

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