ARDMORE, Tenn.— Midwifery is not a job but a calling for Karen Brock. Her passion is assisting in the delivery of natural home births. She said women sometimes overlook or just don’t realize this option is available because, in the United States, it is just assumed that one gives birth in a hospital.

“Ninety-six percent of the world’s population are born at home,” said Brock. “I think it’s empowering to women.”

Brock has four children. Though she experienced natural childbirth, with no drugs, with all the births, the first child was born in a hospital and three at home.

After the hospital experience, Brock thought about her grandmother. Brock was raised near her grandmother, who was a midwife in Alabama, and grew up knowing natural childbirth was just the way it was done.

That’s when inspiration took hold for her to be a midwife.

After training on The Farm in Summertown, Tenn., among other places, Brock became a certified professional midwife in 1997 and was then licensed by the state of Tennessee in 2002.

She then established a service called Alternative Birth Choices to give mothers more options. She lives in Cullman and owns a house in Ardmore, Tenn., where she invites mothers to come to deliver their babies naturally.

Nature’s way

Brock said her idea for the birthing house came from her first personal experience with childbirth in a hospital. She wanted to give birth naturally without medications and without being confined to a bed with monitors constantly strapped to her.

“I had to fight to have a baby naturally,” Brock said. “It’s hard to have birth naturally in the hospital with all their protocols.”

Several birthing options are available. A birthing pool at the house appeals to a lot of mothers. The spa-like pool is comforting for labor pains and the mother can give birth underwater, as well, said Brock. A birth stool, an inflatable ball and, of course, a bed are also available at the house.

Most women ask about the pain of child labor without an epidural, or other medications, Brock said.

“It’s a working pain,” she said. “Your body is doing something. It’s a positive pain. The pain is not so bad if you can move around.”

Mothers choose the kind of experience they want at the birthing house. Those in labor commonly stroll in the back yard, watch movies, walk in a nearby park, visit the Dog Day Flea Market and even eat at a Mexican restaurant close by.

“That’s what most women are looking for, to be treated as if it’s normal instead of a sickness,” she said.

Brock said she and her assistants are only involved as much as the mothers need them to be.

Mothers are given a key to the house as their due dates near. When contractions start, a mother will call the midwife to let them know she is arriving at the house. Then she calls again when she feels she would like them to arrive to assist with birth.

“Most women just enjoy being there with their husbands. We come when they want us,” said Brock. “Some want to stay home for as long as possible.”

When Brock gets to the house, she checks the baby’s heartbeat, the dilation of the mother, and helps make the mother comfortable. Then, she waits.

“We wait until she has the urge to push,” she said.

Typically the father will catch the baby as it is born and occasionally moms will catch their own babies, Brock said.

“We are really just monitors, letting the mom and dad focus on the baby,” she said. “The baby never leaves the mom’s side. We give them a complete checkup when they’re about an hour old.”

Across the line

The birthing house is especially inviting to Alabama residents who want at-home births, so they drive across the state line to Ardmore, Tenn.

“I’m so busy with women from Alabama that I’ve never even advertised in Tennessee,” said Brock.

It is illegal in Alabama for a certified nurse midwife to deliver a child without supervision of a doctor. In 1976, laws changed in Alabama stating that midwives could not assist in homebirths unless they were registered as a CNM, and then must be assisted by a doctor.

Brock said she practiced without physician supervision in Alabama for years before she realized that it was illegal, and that CPMs were not recognized as birthing professionals.

In Tennessee, where the Ardmore house is located, CPMs are licensed and autonomous. Lab work is still preformed by CPMs and they also collaborate with doctors for advice.

Brock said when she was assisting with births at people’s homes in Alabama, the health department would send low-income families to her door for pre-natal care, and offices in Montgomery would also call her about birth certificates for babies she had delivered.

No one ever told her she was practicing illegally, she said.

Brock and her apprentices always take safety precautions, such as asking the mothers to choose a hospital to be transported to in case of an emergency or if the mother decides the pain is too much.

A mother from Shelby County lost a full-term baby under Brock’s care in 2002. The mother’s uterus ruptured at home. Brock said doctors attributed the woman’s survival to Brock controlling the mother’s bleeding and rushing her to the emergency room.

However, she was later charged with practicing certified nurse midwifery without a license, a misdemeanor, and she plead guilty, paid a $500 fine and was put on probation for 18 months. This is how she found out that an at home assisted births with a midwife without a doctor’s supervision was illegal in Alabama.

“We don’t see many complications; however, the majority of my training is for complications,” she said. “Our biggest transports (to the hospital) are first-time mothers that get tired in labor and want pain control.”

Brock is not licensed to perform surgery but she is certified to use oxygen, intravenous fluids and Pitocin to slow bleeding. She uses several different herbs to aid mothers as well. She will not use Pitocin as hospitals do to speed labor.

“A nurse’s training is geared towards training with all this equipment. Our training is more toward what’s normal,” said Brock.

She said she always wants to do things by the law and do the best thing for the mother and baby. The right thing, she said, is for everyone to work together, and for midwives to stay with moms regardless of the situation.

Brock and representatives from Madison County will propose a bill in state legislation in the spring to recognize CPM as a profession in Alabama.

“I’ll never work in a way where I can’t be with the mom,” said Brock. “ When the hospitals, doctors and midwives work together, that’s when you’ll have the safest environment for the baby to be born in.”