Just six hours after giving birth, Karen Federici [a University of Ilinois medical student] holds her new son, Alex, with the proud father, Barry Federici, and big sister, Kayla, in the family’s Tinley Park home. Dr. Benjamin Lo (below), who assisted in Alex’s birth at home, records information from another patient at his office in Rolling Meadows. (Robert Milkowski/Daily Southtown)

A small group of doctors help their patients deliver babies at home Sunday, April 16, 2000

By Meghan Deerin
Staff Writer

"Mommy's having a baby," said 3-year-old Kayla Rose
and went back to playing with her dollhouse.

Karen Federici was indeed having a baby just down the
hall. Sometime during the next hour, the 32-year-old
medical student would join the 1 percent of American
women who give birth outside a hospital.

But unlike the vast majority of babies born at home,
Federici's would be delivered by a physician, not a
midwife.

"I think this is equally safe to having a baby in a
hospital," Karen Federici said, several weeks before
going into labor.

Her husband, Barry, lay at her side on the queen-sized
water bed. He whispered encouragement, rubbed her
back when she asked and stopped when she swatted
his hand away as she did now, gripped by another
contraction.

Nurse Karen Bachman sat cross-legged at the Tinley
Park woman's feet, checking the baby's heartbeat with
a portable Doppler monitor.

"That's a nice strong heartbeat," said Bachman, who
had been coaching the expecting mother since 5 a.m.
that March morning.

At 6 a.m., she had helped her to the shower. At 7:05
a.m., Karen, who had been in labor since 9 the night
before, began pushing in earnest. Now, nearly a half
hour and seven pushes later, the baby was on the verge
of crowning and the mother was in tears.

The doctor — one of the few in the United States still
willing to deliver a baby at home — was on his way.

At 7:35 a.m. a certified nurse midwife and another
nurse arrived, crowding the tiny bedroom with bags of
equipment.

"In the bags is everything you'd have in the hospital —
oxygen, resuscitating equipment, IV's, etc.," said nurse
Ginger Wisniewski, who has given birth to six of her
seven babies at home. "We hardly ever use any of it,
but it's a comfort to the patient.

At 7:45 a.m., the doctor walked in.

"How's it feel when you push, Karen?" asked Dr.
Benjamin Lo, a quiet young M.D., who has been
delivering babies at home since 1996.

That was the year the Ivy League-educated doctor
joined Homefirst Health Services, an unusual
Chicago-area practice whose specialty is delivering
babies at home.

"Some doctors would be very uncomfortable in the
home — they don't have the ease of resources and
there's a little more creativity and adaptability required,"
Lo said.

Still, Lo sees a distinct advantage to birth at home.

"In their own homes, women feel empowered to do
what feels right," said Lo, such as trying different
positions that make it easier for the baby to come out.
"You can be on your hands and knees and not feel like
a specimen."

Homefirst's founder, Dr. Mayer Eisenstein, estimates
that there are only about 50 home-birth physician
practices left in the United States. Of those, his is the
largest, he says.
"I definitely didn't think I was in control," said the
University of Illinois medical student, who can
appreciate the irony of the fact that the hospital was the
last place she wanted to deliver her second child. "They
had control of the birth and control of me."

In the hospital, Karen said, she was given Pitocin to
induce labor and an epidural to block the pain.

After the birth, she remembered nurses telling her
when it was time to eat, time go to the bathroom and
time to nurse the baby.

"I don't think birth should be a medical procedure and I
definitely think it's over-medicalized in the hospital,"
Karen said several weeks before giving birth at home.
"I think (medical personnel) are really ready to
intervene in the hospital, whether they need to or not."

She was searching for a pediatrician for Kayla Rose
when a contact at La Leche League, a breastfeeding
support group, referred her to Homefirst in a family
practice in Oak Forest.

After learning she could give birth at home attended by
one of Homefirst's physician, Karen decided there was
a safe way to avoid another hospital birth.

"I didn't really think that was an option other than with a
midwife," she said.

So, on a cold Friday in March, there she was at home
giving birth, surrounded by family. Her husband lay next
to her. Her mother, Jeri Biggs, popped in and out of the
bedroom, fetching whatever was needed — fresh
towels, boiled water, even a video camera.

Her grandmother, Eleanor Biggs — born at home 84
years ago — was in the kitchen making breakfast for
Kayla Rose, who wandered in every so often to check
on her mother's progress and whisper, "I love you."

This time, Kayla's daddy motioned for her to stay. The
baby was almost here. Kayla — who had watched the
video of her own birth and had been told that there
would be blood and screaming, but that Mommy would
be OK — wanted to see the birth.
"Here comes the baby's head," midwife Cynthia Neal
said excitedly. "Little pushes now, little pushes — Oh!
It's a baby boy."

Karen reached down and hugged her baby to her. She
was laughing now.

Barry Federici kissed Kayla Rose and patted Neal on
the back.

Lo stood back and smiled. He'd exercised what he says
his job often calls for — "the wisdom not to interfere
when things are going well."

"Look at that baby boy!" Jeri Biggs beamed, capturing
her daughter's joy on videotape before calling out to her
mother-in-law. "Gram, you were right — it's a boy!"

Minutes later, Karen basked on the bed, eating a
cheese omelet her mother prepared for her, as Lo and
Neal examined the baby on the bed next to her.

Under Kayla Rose's curious stare, they checked
Alexander James' vital signs and weighed him,
pronouncing the boy a healthy 7 pounds, 6 ounces.

Like nearly all of the births Homefirst doctors deliver at
home, Karen Federici's was uncomplicated, said
Eisenstein, who founded the practice in 1973.

Since then, Eisenstein's practice has delivered about
14,000 babies at home, including five of his six children
and all five of his grandchildren.

"It's an experience that's unimaginable in this country,"
he said. "It has been taken away and been replaced by
sterile rooms."

Over the years, he has become something of a
one-man crusade for home birth, hosting a local
twice-weekly radio show and appearing on national
television programs, such as "Oprah" and "The Phil
Donahue Show" to wave the home-birth banner. Just
last month, Eisenstein published a book, "The Home
Birth Advantage."

In Chicago, his practice has developed a
following among a growing cadre of women.
Most are college-educated professionals, Eisenstein
said. About 15 percent are registered nurses. Nearly 10
percent are teachers.

"It just keeps growing over the years," said Eisenstein,
who has offices in Chicago, Libertyville, Naperville,
Rolling Meadows and Villa Park. "The first year, we
delivered 30 to 40 babies at home."

This year, he predicts, the practice will attend 500 home
births.

Although he believes that home birth is the safest
choice, there are times when the hospital is the best
place to give birth, Eisenstein said.

Women who exhibit risk factors during pregnancy —
as roughly 10 percent of the practice's expecting
mothers do — should give birth in the hospital, said
Eisenstein, who is on staff at Weiss Memorial Hospital
and St. Mary's of Nazareth, both in Chicago.

It is rare, however, that an emergency requiring
hospitalization crops up at a home birth, he said.

"Only 1 to 2 percent of the time do we transfer
someone from home," Eisenstein said.

So far, when it has been necessary, his home birth
patients have gotten to the hospital in time for
emergency C-sections.
The four certified nurse midwives and 10 doctors who
work in his practice are trained to notice the problems
early.

The fact is, he delivers babies at home because
Eisenstein is convinced that home births are far safer
than hospital deliveries.

It's safer at home, he said, because there, labor is
allowed to progress naturally, citing statistics from
comparison studies of hospital and home births
conducted in Scandinavian countries, where home birth
is the norm rather than the exception.

As for his own practice's safety record, Eisenstein
boasts that it is exemplary.

"As far as babies go, clearly we have a lower mortality
rate than the hospital," Eisenstein said. "It's a
tremendously small number — about one per year.

In Illinois, there were 8.2 infant deaths per 1,000 live
births in 1998, the most recent year for which statistics
are available, according to statistics from the Illinois
Department of Public Health.

"I can't remember the last time a baby died at home,"
Eisenstein said, acknowledging that it had happened.
"It's not where babies die. They die when they have
problems early in pregnancy, or early in labor and they
are transferred to the hospital."

Home births are safer, he explained, because women
avoid the complications resulting from Caesarean
sections and drugs commonly used in the hospital.

"You're not exposed to the germs that are in a hospital
or the Caesarean section rate," said Eisenstein.

Homefirst's C-section rate is 4.1 percent, Eisenstein
said.

The national C-section rate was 20.8 percent in 1997,
the most recent year for which statistics are available,
according to the National Center for Health Statistics.

"The percentage of women having epidurals today is
staggering," said Eisenstein, adding that epidurals can
cause some mothers to run fevers after birth.

In fact, the percentage of women getting regional
anesthesia during childbirth has tripled since 1981 at the
nation's busiest hospitals and quadrupled at small and
mid-size hostels, according to a 1999 study by the
University of Colorado School of Medicine.

About 66 percent of women who delivered in 1997 at
hospitals with at least 1,500 deliveries a year received
epidurals and spinal analgesia, compared with just 22
percent in 1981.
"The hospital environment is a drug-oriented
environment that puts women into the awkward position
of taking things they would never take," he said.

Likewise, introducing forceps or narcotics can put the
baby at risk, Eisenstein added.

These are convictions that pit Eisenstein against the
vast majority of his colleagues.

"It was so much better just being here," Karen Federici
said, nestled in the living room easy chair, nursing her
baby boy an hour after giving birth.

Her husband, busy blowing up surgical gloves into
balloons for Kayla to play with, nodded.

"This is home," he said, "and home is where the heart
is."

The Associated Press contributed to this report .