"I graduated in '98 and was looking nationwide for positions as a midwife. West Virginia was the best offer. I wanted to work in and out of hospital settings, so I moved here to work at Family Care. I was there the first five years before starting my own practice in 2003.
"I've been involved in more than 600 births, more than 400 at Family Care and now in my private practice, I've had 213 as of two weeks ago.
"In 2010, I had my first midwife partner come to West Virginia. In 2011, I planned to take a sabbatical. I spent a lot of 2011 in Africa. I went for a conference. I was serving on the National Board of Midwifery, so I was interested in seeing what midwifery was like internationally.
"I traveled in three countries and studied the maternity care system and talked to midwives. What we have here is an overabundance and overuse of technology and interventions. What they have is an underavailablility and underuse of interventions and technology.
"Here, I feel like being a home birth midwife is a thing of pride. I minimized it in Africa because home birth is not the same. Women there need to have better access to hospital and medical services. We still have women dying of infections, but worldwide, those things are much more prevalent.
"My first partner stayed a few years. In June 2013, I brought in somebody else. I have my home office in Scott Depot. My partner, Kathryn Haines, is in Charleston.
"Home birth is not for everyone, but it's an important thing to make available to women who want this type of experience. They have to be committed to having an unmedicated birth, which most American women don't want. That knocks out a lot of people right there.
"I know my women pretty well by the time we're in birth together, so I pick up subtleties that might otherwise be difficult to spot. You don't get a lot of surprises.
"I learn something new practically every birth I attend. Childbirth never gets old. Normally, I can keep it together. But if the dad cries, that makes me cry.
"There are physiologic advantages both to mother and baby with natural childbirth. It preserves birth in its natural habitat. People perform all other bodily functions in the convenience of their homes. We don't rush to the hospital to digest food or to breathe. We accomplish those things without a lot of interventions.
"Occasionally things do go wrong, but we are good at sifting out the people who are likely to have a problem. We always work in collaboration with physicians.
"Our caesarean rate is 7 1/2 percent. This state has one of the highest caesarean rates in the country, usually between 35 and 40 percent. I think there is a lack of awareness of physiologic processes. Most of the physicians are trained in intervention and recognizing human pathology, and sometimes they see it when there isn't pathology. So there is a rush to intervention.
"Most caesareans happen about 5 in the afternoon and 10 at night, and that seems a little suspicious. I attribute it to a shortage of health-care professionals trained in physiologic birth and those who are unwilling to have the kind of schedule where they are up all night.
"I can save somebody between two-thirds and three-quarters of what they would spend in a hospital. I think of myself as a sort of pioneer. Ninety-six percent of nurse midwives practice in hospitals, so it's very unusual for a nurse midwife to be doing out-of-hospital births. There are only two of us in this state.
"Until now, we have been doing births totally in the home. The physician I've been working with for the last 10 years works at Pleasant Valley Hospital, and he wants to start a midwifery service. His grandmother was a midwife and he attended home births when he was a teenager.
"My long range goal is to have a program in the hospital. I have temporary privileges there. I may focus on building a hospital-based practice. We have two primary midwives and a student close to finishing. So I will have a couple of midwives who can focus on home births. The hospital has been very open about embracing the concepts of midwifery.
"I've never ever been pregnant. I don't have very good street credit at all. But being childless makes me valuable as a midwife because it makes my life more straightforward and unbalanced. You become a workaholic.
"Winning the Champion for Choice Award was very special for me because I knew the woman the award was named for, Helaine Rotgin. She was an amazing champion for women' issues.
"I would like to have a different word for choice because that is polarizing for a lot of people. My approach is really one of compassion for women in any situation that involves pregnancy. I like to not participate in the decision-making but just to be there for them.
"I would love it if I could expand the services I provide to more women on Medicaid. Financially, that's a loser for me. Mostly it's charity work, 19 cents on the dollar.
"And I'd like to see more midwives licensed so it's more professional. A lot of people misuse the term lay midwife. You have to be trained before you can ever consider yourself a midwife. I don't know of anyone untrained who is practicing midwifery.
"I'm really drawn to international midwifery and the academic experience I've had. I've had a couple of articles published in the last couple of years. That's fun. To be published."Reach Sandy Wells at san...@wvgazette.com or 304-348-5173.