NORTHAMPTON — Certified nurse-midwives Kirsten Kowalski-Lane and Ginny Miller have attended a lot of births. Between the two of them, more than 5,000.
“I stopped counting at 3,000,” Miller said of her personal attendance record.
That number is only going to increase in 2020. This summer, the two women plan to open Seven Sisters Midwifery and Community Birth Center at 74 Maple St. in Florence. A birth center is a home-like, freestanding facility where licensed providers offer care to healthy pregnant women who have a low-risk pregnancy, according to the American Association of Birth Centers.
“We will be the first midwife-owned, freestanding birth center in the state, in a nutshell,” Miller said on a recent morning over tea at the Freckled Fox cafe. Seven Sisters would be one of three birth centers operating in the state — and the only one open in western Massachusetts. The other two centers are in Cambridge and Beverly, according to the Massachusetts Department of Public Health (DPH).
Kowalski-Lane, an Amherst resident, currently works as a certified nurse-midwife at a hospital in Berkshire County, and she previously worked at a birth center in Connecticut. She is also a women’s health nurse practitioner. Miller, who lives in Florence, is now in private practice after decades of working at Cooley Dickinson Hospital and Holyoke Medical Center.
When it comes to giving birth, hospitals can be a necessary option — for people with complicated pregnancies or pre-existing conditions, for instance, or for those who need services that a birth center can’t provide, like a cesarean section, said Kowalski-Lane.
But she and Miller say that birth centers can be the right place for many people with low-risk pregnancies and can be another option between giving birth at home or in a hospital.
A major benefit of going to a birth center, they said, is personalization.
“Unfortunately, the current state of women’s health care and maternity care is really cookie-cutter,” said Kowalski-Lane. “It’s like you show up, you have your little 15-minute appointment, and off you go on your way. So much is driven by huge overheads that practices have to have in order to function.”
At a birth center, “The setting is a lot more intimate, and that’s important,” said Kowalski-Lane. “We can really personalize individual care because it’s our time, and we control that a lot more. We don’t have, like, 18,000 middle managers who are basically telling us what to do … Hospital systems, they’re just giant.
“Of course,” she continued, “health and safety is number one, always, but what we’ve seen working in hospital systems is that a lot of times, decisions stop being made about just health and safety and it’s made because of institutional policy. Really, you can’t put the same policy on every single person — people are unique.”
The duo also aim to develop deeper relationships with clients by spending more time with people. “If you have more of a relationship, you can identify things that are changing, or possible warning signs,” Miller said.
Receiving care at a birth center typically costs less than an uncomplicated birth in a hospital — it can be up to half the price, according to the American Association of Birth Centers. Seven Sisters will take all major insurance providers, including MassHealth.
The birth center will be a short stay facility where people receive care for about six to 12 hours after giving birth. “But it’s not like we just leave you out there on your own,” Kowalski-Lane said. “That very next day, we’re coming to you in your home. If you live within an hour radius of the birth center, we will come to you.” Subsequently, there will be followup appointments at the center.
After giving birth in a hospital and leaving the facility, “You might come back in two weeks or you might come back in six. But there’s a big void there,” said Miller. In that time period, issues such as postpartum depression and problems with breastfeeding can arise, said Kowalski-Lane. “It’s a really critical time period.”
The birth center is required to have a working agreement with a hospital to transfer both obstetric and pediatric patients to if necessary. Cooley Dickinson, which is about a mile away, agreed to be its transferring hospital.
“I want to give them props — it is such a big deal,” Kowalski-Lane said of the hospital and its affiliates. “It would sink us, basically, without them.”
Certified nurse-midwives had to work under the supervision of a doctor until the state law changed in 2012. Now, they need a relationship with an obstetrician-gynecologist. Seven Sisters has a “consulting physician,” who works in obstetrics and gynecology at Cooley Dickinson Health Care, Kowalski-Lane and Miller said. She helps the nurse-midwives develop policies and advises them, they said, but she does not supervise them.
The birth center’s construction plans received DPH approval, and Seven Sisters can apply for a license to operate when the building is closer to completion or done, according to the DPH.
Kowalski-Lane and Miller also have raised money to open the center and taken out a loan from Greenfield Savings Bank — money that they said they feel lucky to have.
“When you show up at a bank as two nurse-midwives who are looking for a pretty big loan to start a business, it’s a little terrifying,” said Kowalski-Lane.
The birth center-to-be is already raising awareness around what nurse-midwives actually do, a job that Miller said some people don’t completely understand. “People think that we just attend births, that we just catch babies,” she said, “and we do the whole scope.”
“We’re more than baby catchers,” Kowalski-Lane added.
In addition to birthing babies, the nurse-midwives plan to offer prenatal, pre-menopausal and menopausal care, as well as artificial insemination and support around basic infertility. They will also provide care for adolescents and the LGBTQ community.
“We can take care of teenage girls when they’re first making their sort of sexual debut and deciding to go on birth control or whatever they need, all the way into some of the post-menopausal and everything in between,” said Kowalski-Lane.
Some people turn to reproductive medicine specialists, but Kowalski-Lane said, “Most lesbians, trans couples, things like that, they are fully capable — their organs work, they don’t need that kind of assistance — but they go to reproductive medicine because they think it’s the only thing they can do.”
But there are other less complicated options, they said. The solution can be as simple as answering the question: “How does conception work when you don’t have sperm in your bedroom?”
“The reality is,” said Kowalski-Lane, “that someone like Ginny approaches it from a completely different, a completely human and holistic standpoint … You might need to get some sperm from somewhere, but we can make this work, and we can do this in your home, in our office, we can involve your family, we can have an acupuncturist to make it work out better.”
Seven Sisters is currently offering gynecological care, and in the new year, it will start providing limited maternity care for clients whose due dates are after Aug. 15, 2020. While the new facility is under construction, Seven Sisters will provide care in its office at Thornes Marketplace.
Greta Jochem can be reached at gjochem@gazettenet.com.