Extended care; Nurse midwife's service goes beyond childbirth

Sitting beside Baxter on the floor was Deborah Riddell, who had delivered Baxter's first two children and had provided medical care throughout Baxter's pregnancy.

On this night, Riddell's soothing voice was helping guide the 27-year-old through her first water delivery.

But Riddell is not a nurse.

She's not a doctor, either.

"I'm a certified nurse midwife," Riddell said, "but my patients call me Deb."

A COUNTY PIONEER Since 1982, Riddell has delivered more than 1,000 babies.

"I stopped counting a long time ago," she said.

The Batavia resident's career began at Provena Mercy Center in Aurora, where, in 1987, she became the first midwife in Kane County.

"It was lonely," Riddell said.

Although county numbers have grown since 1987, the care provided through midwives still remains a mystery for many.

The role that a nurse midwife plays in a woman's life is one that goes beyond that of delivering babies.

"That's only half of what we do," Riddell said.

"There's a lot of misconceptions about midwifery."

Conducting gynecological care, offering pre-conception counseling and following a woman through her pregnancy, delivery and postpartum care is all part of Riddell's job.

Midwives conduct Pap smears and provide breast and pelvic examinations, breast self-exam education, referrals for mammography and laboratory studies, and general wellness counseling, according to the American College of Nurse-Midwives.

If specific treatment is needed, they will refer a patient to a doctor or gynecologist.

For example, if a woman were to have a Caesarean section, a doctor would perform the surgery, but Riddell said the midwife would be present.

"I don't manage her surgery or postoperative care, but I stay with the family and am involved," Riddell said.

"I assist a woman on all aspects of her care."

Some people still perceive a midwife as someone attending a home birth, complete with a bucket of boiling water and towels.

But it's a stereotype that has no basis in reality today, Riddell said.

Only 4 percent of midwives practice home deliveries, she said.

Most midwives are part of a local health care system, working at hospitals and birth centers.

There are more than 5,000 certified nurse midwives in practice in the United States, according to the American College of Nurse-Midwives.

Geneva's Delnor-Community Hospital staffs three midwives, Provena Mercy in Aurora has six and Rush-Copley Medical Center has two, Riddell said.

Like all certified nurse midwives, Riddell was trained in midwifery and nursing at a graduate and master's level.

She is nationally board certified.

CHANGE IN COURSE As a young girl, Riddell never imagined herself as a midwife.

Her interests drove her toward a life in music and drama.

The summer before she went away to St. Olaf College in Northfield, Minn., Riddell worked as a nurse's aide in the maternity unit of a hospital.

"All summer, I worked with mothers and babies," Riddell said.

"I was full of questions."

Her experiences at the hospital were at a time when mothers were not allowed to see their babies for 24 hours after delivery.

"Now we look back from our vantage point and we say, `Where does that baby belong? In your arms,'" Riddell said.

After completing a summer of work at the hospital, Riddell approached her freshman year with enthusiasm, though her thoughts traced back to her experiences at the hospital.

"I decided that I needed to change my major," Riddell said.

The following year, Riddell transferred to Northern Illinois University and studied nursing.

After hearing a professor describe in class her own experiences as a certified nurse midwife, Riddell knew where she was headed.

"That day in class, she crystallized what I wanted to do," Riddell said.

After earning a master's degree from the University of Illinois, Riddell began her newfound career into midwifery in 1982 in Hinsdale.

Five years later, Riddell became the first to practice midwifery at Provena Mercy Center in Aurora.

"It was unheard of out here," Riddell said.

Today, she is among several midwives in Kane County.

Her office in Aurora was established in 1997. The "Women First" sign on the door of Riddell's clinic reminds her patients that this 49-year-old mother places women at the top of her list.

"We are caring for the woman first and foremost and putting her first in how we deliver the care and respect that she deserves," Riddell said.

"When you go through something as life-altering as birth, the intensity is a very powerful thing -- spiritually and emotionally."

During office visits, it's obvious that Riddell's relationships with her patients go beyond that of a casual conversation and a routine checkup.

Take Baxter's relationship with Riddell.

Through her experiences at Provena Mercy, Riddell met Baxter, who was attending nursing school in 1995. Baxter, a nurse at Provena Mercy Hospital, is a mother of two daughters and -- since 12:48 a.m. March 13 -- a newborn son.

Riddell has been there for each of Baxter's deliveries.

"I totally trust her," Baxter said.

"I feel like she is not there to be in charge of my birth but to work with me."

Jean Flynn, Riddell's office manager of 18 years, is a grandmother of four -- all of who have been delivered by Riddell.

"She doesn't arrive just to catch the baby," Flynn said.

"There's a great friendship between Deb (Riddell) and her patients."

Riddell's receptionist, Pauline Haverkate, has worked with Riddell for nearly a decade.

Haverkate said that what makes Riddell stand out from others is her compassion, kindness and honesty.

"She's very truthful with her patients," Haverkate said.

"She's always receptive to what the patient is saying."

Listening to her patients is something Riddell values, and it's also something Baxter wanted in a midwife.

Baxter wanted to have a water delivery this time around, something most doctors would frown upon, she said.

"Most doctors would flip at the thought of a tub birth," Baxter said.

Midwives such as Riddell practice delivery alternatives, including different delivery positions and water births, but safety is their first concern.

Riddell said a water birth allows the mother to have a more comfortable delivery.

"The depth and volume of the water really allows (mothers) to turn," she said.

"Mothers can change their positions beautifully."

`IT'S SHOWTIME' After spending weeks meeting with Baxter during routine office visits and outlining her progress, around 10:30 p.m. March 12 Riddell got a call from Baxter, who had examined herself and told Riddell she was partially dilated.

"It's showtime," Riddell said before heading to Provena Mercy Center.

Baxter and family were ready when Riddell arrived.

Baxter was lying in bed, and across from her sat her family, waiting for Baxter's contractions to take a more intense course.

Lined up across from the expectant mother was her mother-in-law, Sue Baxter; her mother, Sheila White; her sister, Trichia Wilkins; her sister-in-law, Beth Dahl; and her husband, Brian.

"Oh, this is so boring!" Baxter yelled out as she closed her yes, breathing in and out.

Riddell kept an eye on the fetal monitor, periodically asking Baxter how she felt.

"Your baby is right against the cervix," Riddell said.

By 11:40 p.m., Baxter was feeling contractions every five to six minutes.

Riddell suggested she walk around and "stir the baby up a little bit."

Each time Baxter's uterus contracted, Riddell stood by her patient, massaging her back and giving her emotional support.

All Baxter could do was wince with pain and close her eyes, breathing deeply.

Just after midnight, Baxter's patience was beginning to go.

"God, if I could just have some contractions I could have the kid," she exclaimed.

Riddell has grown to accept the unpredictability of births.

"There are some times I rush and find out I'll be there eight hours," she said.

"There are other times I call home and say I'll be a while and I go back in the room and deliver a baby.

Every birth is different.

It's really energizing."

By 12:30 a.m., Baxter had submerged herself in the warm water while Riddell took her place on the floor.

Huddled in the background, Baxter's family waited.

A few minutes after she was nestled in the tub, Baxter's contractions began growing in intensity.

"That's it.

That's the way," Riddell whispered to Baxter as she clutched the tub's handlebars and closed her eyes.

"Oh God!" Baxter screamed.

Putting on a glove, Riddell reached into the water, feeling Baxter to determine the baby's position.

"Your baby is really low," she said.

"Let the baby come right into my arms."

"I feel like I'm gonna rip, Debbie," came Baxter's plea.

Her mascara running down her face, Baxter tensed her face for one more push.

"There's nice dark hair coming in, nice dark hair," Riddell whispered to Baxter.

"It's oh so perfect.

You're so powerful."

Riddell's next words meant the most to Baxter.

"It's a boy."

Grabbing him out of the water, Riddell quickly handed Joseph Christopher Baxter to his mother as Baxter screamed in delight.

"Oh God, he doesn't look like the girls!" she yelled out.

A few seconds later, Baxter stepped out of the tub and delivered her placenta.

"I hate that," she said to Riddell, turning away from the blood.

With the help of Riddell and her sister, Trichia, Baxter walked to her bed, leaving a trace of few red footprints on the floor.

Wiping down Baxter's legs, Riddell delicately cleaned her patient and placed fresh sheets over her.

"Oh, I'm so excited," Baxter exclaimed as she wiggled her legs.

Leaving the Baxters, Riddell wrote her report.

The fact that it was 1 a.m. and that another one of her patients was down the hall didn't faze her.

"Sleep becomes a precious commodity in this trade," she said.

Even though her night was shaping up to be a long one -- and her next day was to begin with 9 a.m. office visits -- Riddell took the time to check on the Baxters one last time.

Her eyes showed signs of exhaust, but Riddell's soothing voice remained calm, her spirits still high.

Although this was one birth out of more than a thousand in her career, Riddell never takes for granted what it is she does.

"Being able to participate with the family like this and being able to welcome the baby," Riddell said, "you just get a sense of what a celebration life is."

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BY THE NUMBERS 8 Babies delivered each month, on average, by certified nurse midwife Deborah Riddell.