A Labor Without End

Bill Lubic didn't faint. He held his wife's hand and coached her through her breathing during a natural labor that took more than 24 hours. "It was a very long-lasting memory to see Doug's head come out in stages," says Bill, who describes it as "a close emotional experience between the three of us."

A nurse gave the baby to Ruth right away to breastfeed. The doctor and nurses left the new family alone for an entire hour, a rarity then. "It was the most important thing that has ever happened to me in my life," Ruth says, her eyes starting to water at the memory.

Later, she told her doctor that Douglas's birth had moved her to consider working in maternity care. He suggested she become a nurse-midwife.

"What's that?" she asked. Nobody in nursing school had ever mentioned the term.

In 1961, Ruth enrolled in the country's first midwifery school, run by the Maternity Center Association, a New York-based nonprofit that championed care for mothers and infants. Her class had just six students. The only hospital willing to give them clinical training was King's County, an overcrowded facility that served poorer families.

At a hospital meeting, Ruth remembers the head of the maternity unit praising the student midwives. He believed their attention to patients encouraged them to return for follow-up visits and helped reduce infant mortality rates.

But one doctor responded: "And what are you saving? You're saving material for the welfare rolls." Ruth was horrified. "How [that doctor] had the nerve to stand up and talk that way about human beings, I don't know," Ruth says.

Another time, a young doctor obliged a woman who wanted to deliver her baby vaginally, rather than by C-section. Ruth says she overheard an older doctor say to him, "Well, you just did me out of $150." Vaginal births were not as lucrative -- or often as dangerous -- as C-sections.

When Ruth received her certificate in midwifery in 1962, no one would hire her. Midwives, who have attended births since ancient times, were considered by doctors to be unqualified. Some worked as nurses in maternity wards and didn't tell people they were midwives. Half of the students in Ruth's class went overseas as missionaries, where their training was more appreciated. "You don't know how enormously frustrating it was," says Ruth, who left the field to get a graduate degree in anthropology. "There just weren't any jobs."

Ruth finally got the chance to change that in the mid-1970s. By then, she was the director of the Maternity Center Association, which wanted to open the country's first state-licensed birth center in an Upper East Side townhouse. It would be staffed by nurse-midwives and allow women to give birth in a family-oriented, homelike environment.

A furor ensued. Ten of the 18 doctors on Maternity Center's advisory board resigned to protest the birth center, and others threatened to follow. Ruth spoke before a state health committee and faced a barrage of hostile questions. Didn't she know that her plan was dangerous? Women would certainly bleed to death giving birth in a non-hospital setting. How could she risk that? Any birth outside of a hospital was unsafe. She didn't know what she was doing.

When the Childbearing Center opened in 1975, doctors lobbied health officials to shut it down. Some of the staff of the hospital that provided emergency backup to the center balked at working with midwives. Ruth held her ground. Denied Medicaid reimbursements, the birth center sued and won. Meanwhile, scores of women who were fed up with doctor-dominated childbirth were finding their way to the Childbearing Center and safely delivering babies.