Eau Claire nurse brings new approach to giving birth

By Ashley Dziuk
dziukaf@uwec.edu

The highlight of her job is a very small amount of time, Tara Sabin said.  She spends the majority of her day in the clinic doing paperwork and conducting clinical visits. But a few times a month, she gets to see that 10-minute window of new life.
           
“There’s something cool about being the first person to hold a life in your hands,” Sabin said.

Sabin has delivered close to 500 babies in her nursing career and is on number 98 as a certified nurse midwife. Without a nurse’s uniform or a doctor’s lab coat, Sabin said, she looks at her work as an alternative kind of health care.
           
“I have a more holistic sense of health,” she said. “Beyond my physical body – looking into the food I eat, the way that food is treated, the way we treat our environment – that leads me to a more of what I call a natural style of living.”
           
She uses this philosophy in taking care of women, Sabin said. If someone comes in and is depressed, Sabin doesn’t go right to Prozac. She looks at the problem, how medication is going to help and whether it’s going to get to the root of the problem or just cover up the symptoms.
           
“I think that kind of guides my philosophy of practice,” she said. “To me, true midwifery is an alternative style of care. ... My outlook on life helps me keep midwifery true to what I believe midwifery should be.”
           
She received her bachelor’s degree and her master’s in nursing with a major in midwifery. Sabin has worked at Luther Midelfort Hospital since 1999 as a labor and delivery nurse and since 2004 as a certified nurse midwife. According to the American College of Nurse-Midwives, 1,158 students were enrolled in midwifery education programs in 2004.
           
Jennifer Estenson, who gave birth at Luther Midelfort Hospital in May, said midwives have a better reputation than before she got married.
           
“I think it has changed a lot,” she said. “They believe whatever you believe in –
help you with anything.”
           
The key difference between physicians and midwives is that people get more time with midwives and more education about birth, Sabin said.
           
“We have long visits, and we sit and educate women about normal changes that occur in pregnancy,” she said. “We see it as a real normal event, and the most important thing is to teach women about that and prepare them so that they can kind of guide themselves through and empower themselves by learning about their bodies.”
           
According to ACNM, there were 307,527 certified nurse midwife-attended births in the United States in 2002 – more than 10 percent of vaginal births that year.
           
The births of her first two children were not as personal as she would have liked, Estenson said. She chose a midwife for her third child after looking midwives up on the Internet.
           
She chose not one, but four midwives at the hospital, including Sabin. When Estenson began labor, Sabin was there when she got in the door and stayed throughout the evening, Estenson said. Sabin stayed an extra hour after her shift ended to make sure the baby was healthy.
           
“It was a great experience,” Estenson said. “I have told a lot of people to go that way.” 
           
The midwives were like family, she said. They helped her have a healthy daughter and answered all her questions.
           
“I felt like I wasn’t really a patient – I was family, friends,” she said, adding of the comfortable atmosphere, “It wasn’t like sterile or anything like that. It was wonderful.”
           
Sabin said when she got pregnant, she knew she wanted a homebirth.
           
“I wasn’t sure if I would be able to do that, be able to afford it,” she said. “But I looked into it and found a few midwives in the area that did homebirths.”
           
Her midwife met with her once a month, Sabin said. She had a fast labor. Her water broke and about an hour later she was ready to push. Her midwife got there 20 minutes before her son was born, she said. Being single, it was just Sabin and her friend, who was also a nurse, waiting for the midwife.

When her midwife got there, Sabin said, she was excited because she had wanted to push for a long time. It was wonderful, and she said she felt comfortable doing a homebirth.
           
“With that short of a labor, I would have spent all my time transitioning between home and hospital and doing the paperwork,” she said, “so for me it was good.”  
           
Sometimes the work is stressful, Sabin said. Women and babies depend on her for their care and well-being. She has to feel confident in the decisions she makes.
           
“Sometimes I’ll go home at the end of the day, and my head is just swimming with these things, and that can affect my personal life – my friends, my son,” she said. “It’s a heavy job with a lot of responsibility.”
           
Balancing being a single mom and working full-time can be tough. Luckily for her, Sabin said, she’s lived in Eau Claire for most of her life, so she has a good support network of friends and family. When she has 24-hour call shifts, she and her son stay with her parents. 
           
Now that her son is in school, she has more free time to herself. But it can be a downfall too, Sabin said, because she’s working, and he’s at home with her parents.
           
“I actually feel like I can’t move sometimes because I need my parents to help raise my child,” she said.
           
A typical call-in clinic day begins at 6:30 a.m. when Sabin calls into the voicemail system where the midwives leave messages for each other, she said. She checks whether she needs to see anybody or follow up with women who have already given birth. Then, she gets herself ready, gets her son up and ready for school, drops him off by 8:30 a.m. and goes into the clinic.
           
After catching up on her messages, she starts her rounds in the hospital, checking on women who had their babies and making sure they are OK, she said. If someone is in labor, she changes into scrubs. She said she helps the woman in labor with anything she needs from getting ice to giving massages to getting into a different position in the bed.  
           
“If they have an epidural and they are just kind of snoozing, I don’t just hang out,” Sabin said. “If she doesn’t have an epidural, then I pretty much just hang out with her in the room.”
           
When they get down to pushing their baby out, she said she doesn’t really leave.
           
“We catch their baby, and pretty much our job is done,” Sabin said.
           
Midwives help the woman start breastfeeding, make sure the bleeding is good and then the nurses take care of them after that, she said.
           
Sometimes there are days where there aren’t women in labor and she can catch up on other things left over from the busier days, Sabin said.
           
“I’d rather have ebbs and flows in my days than have steady Monday-through-Friday nine-to-five same pace every day,” she said. “I don’t do well with that. I want to be busy, and then I want some down time.”
           
It’s how she deals with the stress of parenting and her job, Sabin said. Just like life, she has busy periods and slow periods.
           
Empowering women with the knowledge that their bodies are made to give birth has lifelong repercussions on women’s abilities to mother, Sabin said.
           
“I think we are bringing back women’s innate ability to have knowledge about their bodies,” she said.
           
The most rewarding experience of a midwife is seeing someone come in with little knowledge about birth, she said. Then they discover what natural birth provides for women and start to get excited about it. Although she doesn’t judge women who choose pain medication, Sabin said she believes there is more joy involved with giving birth without medication.
           
“I think the endorphins are just cruising through your body,” Sabin said. “It’s just always really exciting to me to see the women. How proud of themselves they are, how proud their partners are of the women to see them go through that process. Even if they have had medication, to finally just see them take their babies up after they are born and hold them.”
           
The baby actually coming out is a short time, but the momentum is building all along, she said. The excitement is built through education along the way.
           
“The excitement naturally builds,” she said. “At first you see them once in awhile, but then you see them more, and then more and it’s like you’re gearing up for the big day and then – boom, it happens.”
           
It can be difficult to do just the clinic stuff or have a birth that isn’t very satisfying, Sabin said. When the woman’s just not enjoying it whatsoever or she’s not seeing any value in it, the birth can drain Sabin. But then she gets births that are good.
           
“Yeah, she’s in pain, and it hurts, but she’s so excited to be giving birth, and then the baby comes out, and the woman is just ecstatic and happy with that baby,” she said. “That is when it’s like ‘Wow – that is something to watch.’ ”
           
That can happen once or twice a month and it gets her through the rest of the time, because she knows it can be so good, Sabin said.
           
At the moment of birth, she said she feels special. Sometimes she feels bad saying it, but if she’s helping this woman push and she sees the baby’s hair, she knows no one’s ever seen that baby before. Sabin said she feels lucky to be doing this job. 
           
Sometimes fathers like to get in there and help. They want to be the first to touch the baby’s head, she said. It’s something really meaningful and special. There are very few people in the world who can say they held a life first, Sabin said.
           

Links:

The official Web site for Luther Midelfort Hospital, where Sabin has worked since 1999.The site contains information about health issues in the Chippewa Valley.

A Marshfield Clinic selected study contains an article on the rising number of midwives operating in modern medicine.