By MARK ANDERSEN / Lincoln Journal Star | Posted: Tuesday, February 23, 2010 12:30 am |
PAWNEE CITY -- Five women and two men swap tales of nurse midwives, mostly explaining a preference by the Amish for home deliveries over hospital births.
Anna Schwartz, wife of Pawnee City-area Amish Bishop Jake Schwartz, gave birth to seven of eight kids at home with midwives.
On the other hand, Ellen Stutzman had doctors and hospitals for all six of her children, including five by Caesarean section.
There's broad support among the Amish for legislative proposals making it easier to employ nurse midwives for home deliveries. Three bills empowering midwives are stuck in legislative committees again this year.
Although known for their religious beliefs, the Amish support midwives and home births mostly out of earthly concerns.
"We get scared if somebody goes to the hospital," Jake Schwartz says. "It's the price."
Religion gets scant mention in this conversation.
Members of this growing Amish community began moving here a couple of years ago, coming mostly from Iowa and Wisconsin. Nebraska law does not permit nurse midwives to attend home births. Midwives receive less training than physicians.
While there's broad support among the Amish for allowing midwives at home births, there's a diversity of opinion on the ability of midwives to address complications like breach babies or bleeding.
It's a free-ranging conversation. As bishop, Jake Schwartz explains, his role is more like an elder.
"I don't have all the say so."
The Amish discuss things, usually in German, until there's general agreement, he says. But today they've come to the stove-heated house of EliJay and Elizabeth Gingerich to make the case to the English -- their name for car-driving, Internet-addicted Americans. It's the "us" as opposed to "them."
There is a difference.
Old Order Amish don't use electric appliances, don't drive motorized vehicles and won't be photographed. Even the youngest boys in the house wear suspenders, and all of the girls cover their heads and wear traditional dresses.
And yet the Amish hire cars and drivers to travel distances. And it's OK to seek modern medical technology to save lives.
EliJay Gingerich praises Omaha surgeons for fixing an infant son's bowel malformation.
The nuances of Amish beliefs and customs aren't easily conveyed.
"(For an English person) to try to get down to the way we live is about impossible," Jake Schwartz says. "The only way would be to come out and live with us for a week and do without what you're used to."
It's just an hour's drive from here to the state Capitol, but the journey bridges the 19th and 21st centuries.
Many, if not most of the 80 Amish souls in this Pawnee City community of 13 families, were born at home using midwives.
Among the women gathered, only Stutzman, with her history of complicated births, says she feels more comfortable delivering children in hospitals.
"When I get into a hospital, I relax," she says. "I know there's (Amish) people that can't."
Stutzman says a midwife told her after her fourth C-section that she (the midwife) wouldn't be scared to attempt a ******l delivery.
"I was the one scared," Stutzman says.
And had she gone forward, Stutzman says she later learned, it would have led to placenta acredia, which means an abnormal attachment of the placenta to the uterine wall.
"And she wouldn't have known it," Stutzman says.
The others in the room view midwives with far more confidence.
If it's been a normal pregnancy with monthly checkups, if the mother and midwife feel comfortable, they say, there's minimal risk.
"If they (midwives) have a concern," Anna Schwartz says, "they recommend you go to the doctor."
EliJay Gingerich says a midwife knows what to do if there's an emergency, but many times, they don't have to do anything.
In established Amish communities in Iowa, women from within the group attend home births. Families pay them what they can afford.
Anna Schwartz says she's been present for several births but feels she doesn't have enough experience should something go wrong.
In Wisconsin, the Amish hired professional nurse midwives for about $1,200 per birth, including prenatal care. In Nebraska, Elizabeth Gingerich says, they were quoted a price near $20,000 for a normal delivery at a Lincoln hospital.
"That's more than I make in about a year," says EliJay Gingerich.
The Amish don't carry health insurance, Jake Schwartz says. And unlike insurance companies, they don't have the ability to negotiate cheaper prices, so they get stuck with inflated bills.
The distance to a hospital is another problem.
"When I start going into labor," Elizabeth Gingerich asks, "what transportation would I have?"
She moved to Nebraska while pregnant and felt frustrated by the state's laws. She ended up having her child at home anyway.
Lastly, there's the issue of comfort and control.
Jake Schwartz relates an incident in which he felt hospital officials usurped power.
He had taken a son to a Wisconsin hospital around 11 p.m. with symptoms of a respiratory virus, he says. He'd done the same thing with another boy a year earlier, and his doctor had placed that child in a humidifying tent.
But this time, his doctor wasn't there. Six nurses descended on the crying child, trying to get blood, he says. Jake Schwartz went into the lobby, thinking, "This isn't going to work."
A woman in charge at the hospital told him a helicopter was on the way and she needed his signature to send the child to a hospital in Madison, Wis.
It's not necessary, Jake Schwartz says he told her, but she kept on him. Eventually, he signed.
"It's the same as lying," he says. "I'm not for it."
A nurse drove his wife to Madison, he says. There, she was told to take the child home.
The helicopter ride cost $15,000. The hospital bills totaled $9,500. The child's regular doctor later admitted, Jake Schwartz says, the boy should not have been taken to Madison.
Everyone makes mistakes, Jake Schwartz says. But in a situation like that, he gets nervous.
"They do as they please. You're just stunned."
Elizabeth Gingerich says, "I just depended on the midwife and believed God would help."
That's more the Amish way, Jake Schwartz says.
"We put a lot of our trust in a higher hand