CHARLESTON, W.Va. -- When Trebor Sutler delivered Mason, the first of her and husband Rob's four children, her doctor recommended inducing labor at 37 weeks because her amniotic fluid had dropped. After a pitosin-induced labor, the baby showed signs of distress and was delivered via Caesarean section.

"I was scared to death. The baby wasn't ready to be delivered," the Charleston woman said. "Basically, I think they induced me to get it done and that's just too common. West Virginia has the fifth-highest rate of C-section deliveries in the nation."

"I think there's a misconception out there that C-sections are easier for the mothers. I think they're easier on the doctors who often perform them out of convenience," Trebor said. "If the mother's body and the baby aren't ready, it's harder on both of them."

Although the Sutlers were grateful for their healthy baby boy, his delivery left Trebor dissatisfied. When she became pregnant with her second child, she requested a vaginal delivery, which is not routinely recommended after a Caesarean. Her doctors advised her of an increased risk of uterine rupture and other possible complications.

She delivered baby Mallory via Caesarean, and later learned that repeat Caesareans carry their own set of risks, including infection, scar tissue on the bladder and complications that prohibit future children. Her doctor scraped away scar tissue that had formed on her bladder from her previous surgery.

"I was made to feel bad about wanting to have my baby naturally," she said. "I was given horror stories about what could happen if I tried."

Although the Sutlers planned to have a large family, they reconsidered after Mallory's 2001 birth. Trebor thoroughly researched vaginal births after Caesareans and was encouraged by success stories she read and heard. Teresa Stire, a Morgantown woman who had children naturally after three C-sections, was especially inspiring.

Four years after Mallory's birth, Trebor was ready to try again. A pregnancy ended in miscarriage at eight weeks. In 2006, she became pregnant again. Armed with her research and the support of friends, Trebor was determined to deliver this child naturally. She contacted a midwife at a birth center, but their policy was not to accept patients who had more than two Caesareans.

Trebor convinced the doctor who delivered her first two children that she understood the risks, but wanted him to help her deliver vaginally and that she would like to have a doula, or labor support person, with her at the delivery. He agreed. Both she and her doctor signed a consent form saying she would deliver vaginally unless a Caesarean was medically necessary. "He wasn't happy, but he signed," she said.

Trebor told her doctor that she planned to labor at home for as long as possible with the support of a Scott Depot nurse midwife Angy Nixon. He strongly advised her to labor at the hospital.

"I wanted her to help me labor at home. I knew at the hospital they would put me in a stressful position and that I would lie there like a watched pot," she said.

Nixon agreed to act as doula for Trebor at home and at the hospital. As Trebor labored at home, starting on a Saturday, Nixon checked her and the baby's progress and vital signs. When Nixon thought she was ready, they went to the hospital where Trebor received an epidural because she was so sleep-deprived.

Baby Cameron was born on Monday, eight hours after his mother was admitted.

"It felt great to have a vaginal birth," she said. "I'm grateful to my doctor." Nixon commended her doctor for supporting her decision.

CHARLESTON, W.Va. -- When Trebor Sutler delivered Mason, the first of her and husband Rob's four children, her doctor recommended inducing labor at 37 weeks because her amniotic fluid had dropped. After a pitosin-induced labor, the baby showed signs of distress and was delivered via Caesarean section.

"I was scared to death. The baby wasn't ready to be delivered," the Charleston woman said. "Basically, I think they induced me to get it done and that's just too common. West Virginia has the fifth-highest rate of C-section deliveries in the nation."

"I think there's a misconception out there that C-sections are easier for the mothers. I think they're easier on the doctors who often perform them out of convenience," Trebor said. "If the mother's body and the baby aren't ready, it's harder on both of them."

Although the Sutlers were grateful for their healthy baby boy, his delivery left Trebor dissatisfied. When she became pregnant with her second child, she requested a vaginal delivery, which is not routinely recommended after a Caesarean. Her doctors advised her of an increased risk of uterine rupture and other possible complications.

She delivered baby Mallory via Caesarean, and later learned that repeat Caesareans carry their own set of risks, including infection, scar tissue on the bladder and complications that prohibit future children. Her doctor scraped away scar tissue that had formed on her bladder from her previous surgery.

"I was made to feel bad about wanting to have my baby naturally," she said. "I was given horror stories about what could happen if I tried."

Although the Sutlers planned to have a large family, they reconsidered after Mallory's 2001 birth. Trebor thoroughly researched vaginal births after Caesareans and was encouraged by success stories she read and heard. Teresa Stire, a Morgantown woman who had children naturally after three C-sections, was especially inspiring.

Four years after Mallory's birth, Trebor was ready to try again. A pregnancy ended in miscarriage at eight weeks. In 2006, she became pregnant again. Armed with her research and the support of friends, Trebor was determined to deliver this child naturally. She contacted a midwife at a birth center, but their policy was not to accept patients who had more than two Caesareans.

Trebor convinced the doctor who delivered her first two children that she understood the risks, but wanted him to help her deliver vaginally and that she would like to have a doula, or labor support person, with her at the delivery. He agreed. Both she and her doctor signed a consent form saying she would deliver vaginally unless a Caesarean was medically necessary. "He wasn't happy, but he signed," she said.

Trebor told her doctor that she planned to labor at home for as long as possible with the support of a Scott Depot nurse midwife Angy Nixon. He strongly advised her to labor at the hospital.

"I wanted her to help me labor at home. I knew at the hospital they would put me in a stressful position and that I would lie there like a watched pot," she said.

Nixon agreed to act as doula for Trebor at home and at the hospital. As Trebor labored at home, starting on a Saturday, Nixon checked her and the baby's progress and vital signs. When Nixon thought she was ready, they went to the hospital where Trebor received an epidural because she was so sleep-deprived.

Baby Cameron was born on Monday, eight hours after his mother was admitted.

"It felt great to have a vaginal birth," she said. "I'm grateful to my doctor." Nixon commended her doctor for supporting her decision.

Last spring, Trebor learned she was pregnant again. This time, she was determined to have her baby at home with the support of her midwife. Nixon, who has delivered more than 600 babies, agreed to deliver. She saw her through her prenatal visits. Trebor's ultrasounds were normal.

In 1905, 90 percent of American babies were born at home, Trebor said. By 1950, only 10 percent of births were performed at home. Worldwide, 70 percent to 80 percent of mothers deliver at home.

As she researched home births, Trebor was enamored with the concept of gentle water births, in which mothers labor in a sanitized tub of warm water and deliver the baby in the tub. "You're going to do this at home?" Rob said, when she first told him about the water birth. Nixon had delivered 20 babies in water births.

Trebor purchased all the items on a homebirth list. Nixon brings oxygen, IVs and other medical supplies. The Sutlers' insurance covered 60 percent of the delivery costs.

"You're not flat on your back in a bed. The water is warm and relaxing," she said. "The moisture promotes oxygen for the mother and the baby."

As her delivery date approached, Trebor's confidence in her decision to have a home birth grew, despite some family members' concerns. She knew Nixon could call upon several doctors if needed. Rob, a firefighter, knew their West Side home was minutes from the hospital, where he knows many emergency-room professionals.

The day of Stephen's delivery differed markedly from her other deliveries. During her initial contractions, she shopped and enjoyed a pedicure. Her contractions were 5 to 7 minutes all night long, but her labor didn't progress sharply until the following afternoon.

She was in and out of the birth tub Rob set up in their bedroom. She listened to a CD of soothing music and meditated. "I tried not to tense up against the pain," she said. "The goal was to try to relax and let it happen."

Her daughter was in the room with Trebor as she labored. Rob shooed her out as the contractions grew stronger. Without any pain medications, Trebor felt pain, but said she was too exhilarated to be troubled by them.

"I felt the baby move down through me. It was indescribable," she said. "Water birth babies are a lot quieter. The transition from water to water is not such a big shock to them."

Stephen was born on Christmas afternoon, more alert than any of her previous babies, because his birth was medication-free.

"His birth taught me, changed me and empowered me forever," she said. "This is how we were created. This is how it was meant to be."

Reach Julie Robinson at jul...@wvgazette.com or 304-348-1230.