The Lucinia Birth Center, Cottage Grove.
PART II (Read Part 1 here)
In talking with Gail Hoelzle at the Bookmine, the subject of natural childbirth came up and why am I not surprised to learn that little ol’ Cottage Grove has claims to being on the cutting edge, with innovations in childbirth that happened here first or very early in that movement. What got Hoelzle started was her very positive experience with the birthing of her own children here and the fact that couples were coming from all directions to have their babies in Cottage Grove from the late 1970’s until 1998.
Barbara Kaye (later Bonillas) worked as a Certified Nurse Midwife in what could be called the “Golden Age” of Natural Childbirth in Cottage Grove. A number of factors came into play connecting the right people at the right time. The whole child and pediatric care developed through connecting public health people with midwives, social workers, and medical professionals.
Bonillas came to Cottage Grove to observe and get some practice after completing her masters in Midwifery in June of 1977. While checking out the Lucinia Birth Center, Bonillas was surprised to be offered a job and helped preside over the four patient rooms there. When the Birth Center closed she found herself in a fix, “I had moved here, bought a house and had started a life.”
In April of 1978 she appealed to the local Cottage Grove hospital. She was surprised to find them very receptive and ended up as a hospital employee. She helped to set up two birth rooms at the hospital and was a member of the Birth Center team. “We tried to make it feel as much as possible like the old Birth Center. Being a midwife who was employed by a hospital to provide prenatal care and work there in the OB department probably was a first in the State of Oregon,” Bonillas said.
There were some changes in practicing in the hospital. For example state rules prevented children being present at the delivery, something that had been allowed at the old birth center (with some training beforehand). Since CG hospital was a single floor, an accommodation could be arranged and the future siblings, along with some family members, witnessed the birth while assembled outside looking in through the windows.
Sometimes the exuberance of wanting to be a part of the birth by relatives was intimidating to the mother-to-be. Bonillas would always ask the mother to tell her just what she wanted. “We will be the bad guys,” so that prospective mother really got the birth setting she really wanted but was afraid to ask for from their over-eager relatives. “It was fun and a feeling of rightness to make the birth as natural as possible in the hospital,” Bonillas said.
The “Small Wonder” Birth Center earned WHO’s baby-friendly designation.
Being in the hospital with an operating room available allowed them to accept more cases that were risked out of a home birth or birth center setting, such as breech and twins.
When Christine “Chris” Heritage selected Barbara Kaye Bonillas to assist her with the birth of her first child in 1982, she was working as a school librarian in Sutherland. Besides the wonderful event of welcoming a son into her life, the birth experience guided by midwife Bonillas was a profound, life-changing moment. “It was pretty immediate, I suddenly knew that this is what I wanted to do, I got the call to become a midwife. I never went back to the library, instead I started my nurse’s training. After becoming an RN, I worked as a labor and delivery nurse, getting experience in medical side of birthing. Then I enrolled in the graduate program in Nurse-Midwifery at Oregon Science & Health University (OSHU) in Portland.”
Altogether this educational path lasted thirteen years. When Heritage had completed her midwife training she emerged from the program at an uncertain time. Jobs in midwifery were scarce, but in an amazing twist of timing Barbara Kaye was looking to expand her services in Cottage Grove so Chris was able to come full circle. “It felt just perfect, like it was meant to be, to be working with the person who had inspired me to become a midwife,” Heritage said.
“The birth program at Cottage Grove Hospital was really guided by the midwifery model. Rather than looking at something that needs to be managed from a medical point of view, we looked at birth as a normal physiological process that women can do on their own naturally,” Heritage related.
This approach is really a before, during, and after process. Midwives work with pregnant women to educate, prepare, and build confidence during the prenatal stage. They are there during labor and delivery in a hands-on supportive role, and to follow up during the postpartum period in a continuing support for the new mother.
“We really had the best of everything at the CG Hospital. There was medical assistance if needed, we had lactation support, pediatric care and well baby checks extending six weeks after the birth. It was really a very special time and place and our patients were very happy with their experience,” Heritage said.
Desiree (Nelson) Larson joined CG Hospital in 1981 after completing her nursing training. It was her first job in maternity care and she landed on the night shift, paying her dues as the newbie. During her education she had independently studied labor and delivery and knew that was the area she wished to specialize in. She became aware of the attempt by formula companies to commercialize women and their babies like no other part of medicine. “They were using doctors and hospitals as marketing tools, buying us lunch, all with an eye for business,” Larson said.
This coincided with a huge rise in interest by prospective mothers in avoiding the medicalization of births, such as the increasing frequency of C-sections. “We really tried to listen to what women’s goals were for their births and help them have the birth they wanted safely. This approach led to very high patient satisfaction as evidenced by glowing survey results about their hospital experience from the new mothers. Not only did they return for their next birth but they also told their friends. We had many women transferring their deliveries to CG Hospital because they felt that as a woman they weren’t taken seriously and that their wishes hadn’t been listened to and their delivery plans were sabotaged. We had a reputation here for just the opposite,” Larson said.
In America the practice of breastfeeding babies has a spotty and bizarre history. As early as the 1890’s doctors began to involve themselves in what should be a natural process and formula was developed with the pretext to help save babies’ lives. Add to this that more women were in the workforce and unable to be able to nurse their children and the country moved toward a bottle-fed nation.
It seems simple to just breastfeed. But without the generational experience or examples in the family, young mothers were hesitant and unprepared to do so. Despite the many benefits for both the mother and baby, breastfeeding had fallen out of favor. Desiree took on the task of preparing herself to help educate and guide new mothers into breastfeeding by going through the rigorous process to become an International Board Certified Lactation Consultant.
Together with Barbara Kaye, and the maternity nursing staff they championed breastfeeding for infants as a foundation of good health. Together they also worked very hard to implement practices and protocols at the “Small Wonder” Birth Center in order to meet the World Health Organization’s Baby Friendly designation. These criteria center on “the global effort to implement practices that protect, promote, and support breastfeeding and the care of pregnant women.”
In 1997 all of that effort was rewarded by having Cottage Grove’s Birth Center being named one of the first few Baby Friendly Hospitals in the nation. Another Cottage Grove first in Oregon.
Nearly all of those in Labor and Delivery were not from Cottage Grove and although they were very idealistic and hardworking there was a lot to learn about the community and its residents. “We met women and families where they were and tried to help them as best we could. Working together we tried to empower women when we discovered they were dealing with domestic violence, low education levels, poverty, and child abuse. We started working as a team to help case manage,” Desiree Larson said.
Next week’s story will look at a unique coming together of public health officials, medical workers, midwives, social workers, school personnel, and community members to find a way forward for improving the life of women and their children in the area.
Contact Dana at [email protected]