Kerin Asher-Galloway

It’s not every day that you go drinking with your healthcare practitioner. This is what I’m thinking as I meet midwife Kerin Asher-Galloway at Wood & Vine in Hollywood. We had met before at the Eisner Pediatric and Family Medical Center, where she works when not delivering babies at California Hospital or as part of her own homebirth practice, Haven at Home. The night we meet is ostensibly her day off, though when you have two sons, ages five and nine months, and patients who could go into labor at any time, a “day off” can be an academic concept.

We order some wine and decide to share an order of scallops and a beet salad. Wood & Vine, located inside the historic Taft Building and co-owned by three friends who wanted to bring a venue to Hollywood that wasn’t so “sceney,” is one of few spots on the Boulevard that seem more inviting to residents than tourists. The menu varies daily depending on what looks good at the farmers market. With a fire always going and homey décor like the copy of Ulysses on the mantle, it seems just the place to discuss that threshold drama, birth.

Kerin is one of the few midwives a woman on Medi-Cal can see. With the vast majority of publicly funded births in Los Angeles attended by doctors, one in three pregnant women will deliver by Cesarean section, and most will experience some if not several interventions, like inductions or narcotics. Patients of midwives have fewer interventions and, therefore, fewer complications. I ask Kerin why she believes that midwives have better success rates than doctors. She attributes it to our litigious culture. Doctors, oddly, have come to consider it safest to perform surgery rather than to risk any problems that might arise from labor. But Kerin points out that a C-section is major abdominal surgery and shouldn’t be such a nonchalant undertaking. She is frustrated by what she considers a trend towards punishing, rather than respecting, women.

Kerin’s first encounter with this medical recklessness came after she graduated from UCLA and found herself working for an obstetrician. This particular doctor induced, as a matter of routine, when women were 37 weeks pregnant. (For first-time mothers, birth often begins naturally as late as 42 weeks.) The women would come to their regular appointments “like lambs to the slaughter” and end up in the operating room. Driving down Ventura Boulevard one day, Kerin had a moment of clarity, and decided to become a midwife. On September 10, 2001, she boarded a plane for L.A. to begin her new career after completing her nurse-midwife degree at Columbia University. She has since delivered 790 babies. She logs the mothers’ names in a book and plans to continue keeping track, at least until she reaches a thousand.

Kerin and her partner deliver on average two babies per month through their homebirth practice. Many of these families pay out of pocket, since insurance rarely covers homebirth midwifery care, despite the pleas of birth activists who point to healthier outcomes for mothers and babies. Birthing tubs, which utilize water to alleviate pain, are available in only a few Los Angeles hospitals (including California Hospital), but are standard in homebirths and part of the appeal. “Homebirth is a luxury ticket item,” Kerin says. While it makes sense to avoid any extraneous interference in the case of a low-risk pregnancy–even driving in a car to the hospital–homebirth is not for everyone.

A visit with a homebirth client can take as long as two hours. At the Eisner Center, on the other hand, Kerin sees between 18-25 patients each day for an average of 15 minutes each. “It’s my least favorite part of the job,” she admits. She might deliver three or four babies in a shift at California Hospital. She compensates for this conveyor-belt pace by running discussion and support groups at Eisner for women due around the same date. In these communal prenatal appointments, Kerin can take time to answer questions, offer pain management advice, and discuss baby names. She has even been known to show videos of her own children’s births in these groups. And then there are times when scheduling pressures need to be set aside: at a postpartum appointment recently, Kerin stayed with a woman who had experienced an intrauterine fetal death for as long as she needed to talk, without regard to the clock or the powers behind it.

Pregnancy and birth call to mind, for some, issues of feminism, environmentalism, inadequate healthcare, and economics. But Kerin, who has no interest in performing abortions–as some midwives do–is her own breed of activist. To her, midwifery is above all a caring profession. Pregnancy and birth are simply about one mother’s experience bringing a child into the world.

We bolster ourselves with another round of wine and some fries before I delve into the hard topic of teen pregnancy. Kerin cares for both more established homebirth patients and predominantly low-income teenagers. One in 10 babies in the U.S. is born to a teen. “I feel blessed to be part of their lives,” Kerin says. She loves educating them. “They birth well,” she shares, as if to find something positive to say about teen pregnancy, “and their breasts are perky so the babies latch right on.”

Kerin acknowledges that many of her patients are conflicted about their pregnancies: “Unplanned pregnancy is devastating.” She has seen women get pregnant at least twice from the allegedly impenetrable IUD. Her work involves a fair amount of contraceptive counseling, and she often finds herself asking difficult questions of women who are on the fence between birth and abortion.

Kerin’s husband, home with their two boys, calls at this point in the conversation, reminding me that this woman is always on call. Once back, she brings up the pleasure she gains from teaching. She would like the residents, student midwives, doulas, and nurses she comes in contact with to rely less on machines. “You don’t have to look like a fumigator,” she adds, with respect to the apparatus women generally find themselves attached to during a hospital birth.

What Kerin terms our “vending machine society” denigrates natural childbirth. We distrust, and fear, nature. Too many midwives become “medwives,” advocating shortcuts to understandably anxious mothers.

Having delivered babies for hundreds of families and given prenatal care to many others, Kerin oozes professional fulfillment, despite countless nights of interrupted sleep.

Our waitress drops our check, and it strikes me that our evening has lasted far longer than most prenatal appointments. I am honored to report that neither Kerin nor I were watching the clock.

Marissa Engel is a freelance writer and creative writing teacher living in Los Angeles.

*Photo by Marissa Engel.