University of Delaware
Office of Public Relations
The Messenger
Vol. 5, No. 4/1996
Welcoming  New Life

     Dorinda Dove, Delaware '84, records her career highlights in
what looks like a guest book. "Here is the first birth I
attended," the certified nurse midwife says, pointing to a
handwritten record in a large, white book. The book includes 103
births, the last chronicled as carefully as the first. "I keep
this for myself," Dove explains, "with any details that made a
birth memorable for me."
     Given her intimate "guest" record, it's only fitting that
Dove's workplace, the Birth Center of Delaware, resembles a
private home. The center welcomes about 150 new babies each year
at a small, brick house in Wilmington, Del., where it has
operated since its founding 14 years ago. All the modern medical
equipment required for prenatal care and births is available.
But, the center also has marks of a home: Three cozy bedrooms, a
living room, kitchen and shelves of children's and parenting
books. This home-like setting is key to a midwife's unique role.
     "We view birth as a natural life event, not an illness,"
Dove explains, "so, our focus is on wellness, prevention and
wholeness. That perspective affects how we make decisions and
approach each client." Dove shares this perspective and her work
with Edie Wonnell, certified nurse midwife, founder and director
of the Birth Center. Two registered nurses complete the staff. As
Delaware's only independent birth center, the center provides
families with an alternative to hospital delivery and with the
advantages of a midwife's care during pregnancy.
     It was while serving as a Peace Corps volunteer in Malawi,
Africa, that Dove first encountered midwifery. "I gained a lot
from working with the midwife there," she recalls. "She was a
powerful presence to the women she supported in labor, and she
made a strong impression on me." At the time, Dove was a new UD
graduate, with a B.S. degree in nursing.
     "Delaware prepared me well for an expanded practice role,"
says Dove, who followed her Peace Corps service by working as a
hospital labor and delivery nurse. With that experience, she
entered a 14-month, midwife certification program at Baylor
College of Medicine in Houston. When she became certified in
1992, she joined the ranks of some 4,000 nurse midwives
nationwide in a profession that has gained popularity and
acceptance in recent years, as more people have come to
appreciate the midwife's special emphasis on a woman's
responsibility for her own pregnancy.
     "A big part of our work is empowering our clients," Dove
says. "We trust a woman to participate in her care. She is free
to have input, and we respect her choices." This approach
requires a low-volume practice and personalized care, with many
hours devoted to client counseling. The Birth Center offers a
range of courses for expectant families, including such topics as
prepared childbirth, sibling preparation and infant assessment.
"We educate people to help them make their own decisions. It
takes time, but it's a priority," says Dove.
     Another difference: "We see the routine use of technology as
interfering with the birth process," Dove explains. "Technology
is essential when necessary, but not always best if it's not
really needed." As an example, Dove cites the fetal heart rate
monitors used in hospitals, which can slow labor by restricting a
woman's mobility. The Birth Center's intimate setting also can
help a labor progress more easily. There, a woman knows the
midwife and registered nurse who attend a birth; in a hospital,
she would probably deal with strangers. "People birth best when
they feel safe and familiar," Dove says.
     Most Birth Center clients return home after a postpartum
stay of only about six hours. "Generally, women want to get home,
where they can rest better. And, because we put so much into
educating our new mothers, they are ready," Dove says. "We follow
up closely-the mom needs to call us daily, and, on the third day,
a registered nurse makes a home visit. People can't fall between
the cracks here, as they might in a bigger system."
     Growing acceptance of midwifery practices has influenced
hospital labor and delivery rooms. Dove explains that hospitals
now are much less likely to whisk a newborn away from its mother
and may be slower to introduce the use of technology during
labor. "It's gratifying to see the changes since I first worked
in hospitals," says Dove. "They are working to become much more
in tune with people, and many hospitals now have midwives on
staff."
     Non-hospital births also have become more accepted, as, over
time, statistics have shown superlative safety records for birth
centers. In fact, many people maintain that, for low-risk
pregnancies, birth centers are safer than hospitals because their
caesarean rates are much lower. According to Dove, Birth Center
clients are carefully screened. High-risk pregnancies (cases
involving twins, breech positions or high blood pressure, for
example) are referred to the center's back-up physicians.
"Emergencies rarely come out of nowhere," says Dove. "We always
look for signs and symptoms of a problem, and we have the
necessary training if one arises."
     Dove's greatest challenge, she finds, is balancing her work
with her family commitments. "Of course, babies always come in
the middle of the night," she says. "It's great to have a
supportive husband who jumps right in." Dove and her husband, Ron
Ozer, Delaware '84, have two young children. Dove limits her work
schedule to only one 24-hour shift per week and one long weekend
a month when she is on call. But, her work is necessarily
unpredictable. "When I walk out the door [to deliver a baby], I
don't know when I'll be back."
     The exhilaration of her work keeps Dove energized. "It's
very satisfying to welcome new life into the world," she says.
"Being present at a birth is a real high." She also enjoys
getting to know her clients. "I form a relationship throughout
the pregnancy and am part of the process. I consider it a
privilege."
                                        -Mary B. Hopkins