Caretakers of Homebirth: Doctors Who Come to You

By Wendy Correa 
Issue 112 May/June 2002

On a bright May morning, 17-year-old Matthew Smith and his 15-year-old sister Emily watched their mother, Elaine, give birth to their baby sister Katherine. Until the early 20th century, this would have been a very common family event in rural America. But this was 1993, in Chicago, and the setting was not a hospital but the Smiths' own home. 

Matthew and Emily themselves were born in hospitals. Both births had been induced with pitocin; for Emily's birth, Elaine was flat on her back, feet in stirrups, attached to a myriad of catheters, IVs, and monitors. Because Matthew's pediatrician recommended artificial baby milk supplementation within three months of his birth, presumably due to slow weight gain, Elaine sought the advice of La Leche League, which recommended that she simply breastfeed more often. Matthew thrived, Elaine's interest was piqued, and she became a La Leche League leader.

Elaine's co-leader was a nursing student with Homefirst Health Services, a family practice group that also attends homebirths. Fifteen years after her last baby was born, with numerous miscarriages in between, Elaine gratefully learned that she was pregnant. Armed with the knowledge of Homefirst's success and reputation, Elaine and her husband, Donald, decided that their baby would be born at home. "I knew that a homebirth would be better than what I had experienced with both of my hospital births," Elaine explains. "I'm much more comfortable at home, and I did not want my baby taken away from me."

To prepare Matthew and Emily for the birth, the Smith family went to an informational evening at Homefirst, at which the homebirth process was explained by doctors and nurses with videos and testimonials. Matthew remembers that he felt queasy while watching footage of a birth and feared that he would have the same reaction at his sister's birth. But by the time Katherine arrived, he says, his experience was more about the joy, excitement, and wonder of watching a new life coming into the world.

That day Matthew was responsible for answering the door to let in the nurse, Jude Wrezesinski, and the doctor, Mayer Eisenstein, getting his mother cold washcloths and drinks, and helping his father hold his mother's legs as she pushed her daughter into the world. Finally, Matthew got to cut Katherine's umbilical cord. Two years later, Matthew and Emily attended their sister Rachel's homebirth. This time, Matthew photographed the birth, and Emily got to cut Rachel's umbilical cord.

Mayer Eisenstein is the medical director of Homefirst, now the largest physician- and midwife-attended homebirth practice in the nation. Eisenstein maintains that homebirth is many times safer than hospital birth for over 90 percent of low-risk women, especially if you can take the hospital to them. Since 1973 he and his practice have delivered 15,000 babies at home, including five of his six children and all six of his grandchildren; they are now delivering second-generation babies for women who themselves were born at home with Homefirst.

With six medical centers in the greater Chicago metropolitan area, Homefirst has ten doctors, four certified nurse-midwives, and 45 registered nurses and certified nurse assistants. They provide preconception counseling, prenatal and postpartum care, delivery, and breastfeeding instruction and support. Homefirst also offers a full range of pediatric services as well as women and men's health care.

Eisenstein's unusual career began while he was still in medical school at the University of Illinois. The birth of his own first child was a less than satisfactory hospital experience, so, for their second birth, he and his wife sought the help of Gregory White, a physician who had quietly been doing homebirths for a number of years. Eisenstein was so awed by the birth of his second child that he began attending homebirths with White. He saw that the pregnant women were walking around until it was time for the actual birth, that they were empowered by the presence of family and friends, and that there were no episiotomies, forceps, or drugs. "The birth was a joyful, spiritual experience for the mother, rather than the climax of many fearful and helpless hours spent on her back at the mercy of medical staff. Dr. White was the most patient person in the world and could make everyone feel comfortable. The simplicity of his techniques amazed me. He would watch and watch at a birth, just really watch what was happening, and soon the baby would come out," Eisenstein recalls.

At the same time, Eisenstein began working at Chicago's Cook County Hospital to learn all he could about forceps delivery, episiotomies, and other intervention techniques because, White assured him, "You won't learn about these things at homebirths; they just aren't necessary." At the hospital, he soon began to "accidentally" drop the episiotomy scissors on the floor so that they could not be used. Consequently, he was the doctor called whenever a laboring woman did not want drugs or an episiotomy.