Karen Carr is a midwife who pleaded guilty in connection with the death of a Virginia baby she delivered in September. (Toni L. Sandys/The Washington Post)

The explosive case of Karen Carr, the well-known midwife who has accepted a plea agreement in connection with the death of a baby she was trying to deliver, has created a polarized atmosphere in the world of midwifery. If you don’t believe me, check the dozens of comments on my last post on the subject.

One side says Carr is a martyr to a hospital culture, the other says the baby who died was sacrificed to an ignorant, selfish subculture.

Neither is true. There are reasonable people with good intentions on both sides and — this is the part no one’s talking about — in between.

Take Washington Hospital Center. Roebuck is one of six certified nurse midwives on the recently expanded midwifery team. They work with about one hundred patients, she said, offering many of them a natural, un-medicated experience that is nothing like the stirrup-and-epidural hospital stereotype.

“When you come in, you can walk for a couple hours, you can drink water, have light snacks. You have freedom of movement. I’ve caught babies on the toilet, standing up, I go wherever she goes.”

The middle ground part comes in that this natural birth is actually in a hospital. So if, as Roebuck said, “I’ve pulled out all my tricks and it’s not working, the mother is sick or the baby’s in distress” there are medical options and surgical teams close at hand.

There are gaps in this model, especially in this region where natural childbirth is not as embraced as it is in some other cities. Right now, the WHC midwives work on regular business hours. If a patient goes into labor after hours or on the weekend, they still might get a natural experience but they wont have a midwife to assist them.

The team also works with only no-risk and low-risk pregnant women. The women in Carr’s case was high-risk and had been turned away from other midwives.

Natural hospital births will always seem like an oxymoron to some. Hospitals will never be able to offer the atmosphere of a birthing centers or home for labor and delivery.

But Roebuck expects rising demand for some middle ground will lead to larger midwifery staffs, longer hours and more options. Already some of the hospitals in the region, like George Washington University Hospital, Providence and University of Maryland Medical Center have, or are expanding, their midwife options.

“I feel like DC is having an awakening,” Roebuck said, “The women [who want natural childbirth] are here and more are coming.”

Carr thinks the process of birth is too medicalized. What would have been or would be your ideal birth situation?