Vicky Wells is a midwife always on call, ready to help pregnant women have what she calls "an all-natural birth."
About two-thirds of her clients give birth in the Labor of Love Birth Center that Ms. Wells owns and operates, while she assists about a third to have a traditional home delivery.
A few times, she has helped clients give birth in the back of their car on the side of the interstate when the baby came before the mother could reach the birth center.
In those cases the dad might have called, saying the baby was pushing, so Ms. Wells rushed in her car to meet the parents.
Laughing, she said she has even run outside with her gear and delivered a baby a couple of times in a car at the curb in front of the birth center at 421 S. Bonner Ave. in Tyler when the mother couldn't make it inside.
The birth center is a comfortable-looking, attractively furnished two-story house with birth rooms, including one with a birthing tub, and a checkup room upstairs. It is near hospitals if the need arises for medical care.
"We are considered a 24-hour care facility," Ms. Wells said.
Unlike nurse midwives licensed by the state medical board who work under a doctor and have more medications at their disposal, Ms. Wells is a trained, independent certified professional midwife. Both she and Labor of Love Birth Center are licensed by the Texas Department of Health.
Certified professional midwifes cannot induce labor and must assist with an "all-natural progression" of birth, Ms. Wells said.
Talking about why she got into the midwifery practice, Ms. Wells said, "It's hard to put in words when a woman is called to help other women. It's just a God-calling."
Ms. Wells said she was drawn by the opportunity to give hands-on care and have a personal relationship with women. She added, "I always knew I wanted to be in births."
Originally a stay-at-home mom, Ms. Wells planned to go to school and become a labor and delivery nurse. Before starting any schooling, she met her sister-in-law's midwife, Sylyna Kennedy, who was then the owner of Labor of Love Birth Center.
"I found out about the (midwife) program and how it all worked. I thought this is the kind of care I want to give … hands-on, beginning to end kind of care," Ms. Wells said.
Within a month, in 2003, she began the academic and training program for midwives conducted by the Association of Texas Midwives, which the Texas Department of Health has approved.
"We train through an apprenticeship program under a midwife while we do academic work through the education program," Ms. Wells said. The academics and training take about two years, she added, and cover all parts of maternity care, labor and delivery, how to handle complications and even post-partum care for mama and baby.
Ms. Wells started as an apprentice for Ms. Kennedy at Labor of Love Birth Center.
Upon graduating from the midwife-training program, Ms. Wells passed the North American Registry of Midwives exam Texas uses for licensure of certified professional midwives.
Ms. Wells was licensed in 2006, and in 2008, she bought the Labor of Love Birth Center practice, which has been in operation about 25 years in various locations.
"We run around 45 to 50 pregnant clients; I average about five to six births a month," Ms. Wells said.
Typically, clients are eight to 12 weeks along in their pregnancy when they come to the Labor of Love Birth Center.
"They find me through word of mouth and the Internet," Ms. Wells said. "We do all their lab work. We see them every month until they're 28 weeks. Then we see them every two weeks and then the last month, we see them every week until they deliver."
After delivery, mama and baby come to Labor of Love Birth Center for checkups in two days, two weeks and six weeks. She said she follows them after birth to make sure the baby is healthy and growing.
"Follow-up care is always necessary, especially with the baby. You want to be sure the baby is eating right and gaining the proper weight and is healthy and be sure the mom is recovering well," Ms. Wells said. "We take care of low-risk pregnancies. Any time that they move out of the low-risk category, then we transfer (clients) to medical care."
Expectant moms receive a lot of one-on-one time with the midwife and have 24-hour access as needed. Dads and some other family often come with expectant moms to see the midwife.
During a regular prenatal visit, the birth center staff does lab work, checks blood pressure and urine, checks for swelling, measure; staff members make sure the baby is growing well, listen to the baby's heart beat, answer questions and address any problems.
For those planning a home birth, Ms. Wells makes one home visit at 37 weeks to be sure she knows where to go when delivery time come. Depending on how the birth went, she may do a two-day checkup at the home after delivery.
Ms. Wells has handled home births as far away as south of Houston and Beaumont and as far north as Texarkana and as far west as Blue Ridge. But most of her clients are from the Tyler-Nacogdoches-Henderson area.
Pregnant clients planning to give birth at the birth center call Ms. Wells when they think it is time.
"We talk about what's going on. If I decide it's active labor, then we meet here and we stay with them the whole time," Ms. Wells said, noting that labor usually lasts six or seven hours.
"Sometimes, we are here a long time; it just depends," she said. "We try to have two midwives here to help with the delivery in case of an emergency. It's an all natural birth."
JUST IN CASE
About 10 percent of the time, a mother may have to be taken to a hospital, she estimated, perhaps for failure to progress, the baby not coming down or the mother just needing extra help at the hospital.
The primary reason people opt for a natural childbirth with the aid of a midwife is that they "do not want the interventions that hospitals push on them," Ms. Wells said.
"They can eat and drink while they are in labor here. They are not on an IV. They are not on constant monitoring of the baby. They can be up and moving around if they want."
Economics is also a factor in the decision, Ms. Wells said.
"It's cheaper (than a hospital). The normal price is $4,000, but if they pay by the 36th week, they get 25 percent off," Ms. Wells said, with the average price for cash-paying clients around $3,600, while the cost of giving birth in a hospital may run from $6,000 to $10,000.
A MOTHER'S STORY
Shauni Sams is pregnant with her third child, all of them through Labor of Love Birth Center, and drives a little over an hour from Kemp for appointments.
"My mother used them, too, and they've done a very good job every time. They have a lot of experience; they are very professional," she said. "During my births, any kind of problem that's come up, I've always liked the way they've dealt with it. I feel like I'm in good hands."
Having a baby naturally allows the mother to be more a part of the birthing experience and she can deal with the pain a lot easier, Ms. Sams said.
"Anytime you interfere with natural, you have maybe more complications. I'm really happy to do it this way," she added.
Olivia Coulston and her husband Ryan drive from Shreveport, Louisiana, to use Labor of Love Birth Center.
She had her first baby in a hospital and wanted "to experience something different" with her second baby.
"I felt like I was missing something (in the hospital), so I just wanted a natural birth," Ms. Coulston said.
Ryan Coulston said, "We feel that pregnancy and child birth have become too much of a procedure and not a natural thing. It doesn't have to be intervened with a ton of medical intervention. We just feel it's more the way that's comfortable for us."
Coulston said they chose Labor of Love Birth Center over other birth centers they considered because of "the comfortable feeling, the elegance of the house. It's a lot more laid back. The ladies here have been great for us. They are responsive to us."
Ms. Wells has information handouts that she gives clients on a variety of topics, such as diet, iron if they get anemic, herbs, breast-feeding and morning sickness.
"My favorite part of the job is watching first-time dads watch their baby being born," Ms. Wells said. "It's something they've never seen before and they are overwhelmed. Some get very, very emotional. That's the fun part of the job."
Ms. Wells expressed satisfaction from knowing she is helping these women have their birth dreams come true.
"Fortunately in Texas, women are still able to have a choice of where and how they want to give birth as long as the baby is safe and everybody is healthy," she said.
Studies have shown that for a low-risk healthy woman, a natural birth with the aid of a midwife is "at least as safe if not safer than being in the hospital," Ms. Wells said.
"In many countries, the midwife is the first line of maternity care," she said.
Midwifery dates to ancient times and is mentioned in the Bible, Ms. Wells said.
Ms. Wells is president of the East Texas Midwives Association. She is also an associate member, regional representative and preceptor for the Association of Texas Midwives.