Kim Jacob of Conway said having a baby at home never occurred to her until her sister-in-law did it.
Not only did Jacob have a home birth, she is a licensed and nationally certified midwife.
“We have gained so much more respect and built our profession,” Jacob said.
Jacob has more than 20 “active” clients and will attend their home births with an assistant.
She and her husband, Nathan, moved from Colorado to Cabot when she was pregnant with their first child, Antigone, 14.
Jacob had a doula, a labor coach, in the hospital. She said the woman, also a midwife, now works in labor and delivery at Conway Regional Medical Center.
“I felt so cared for by her, as a doula, and I was so inspired by her,” Jacob said.
Because Jacob had no risk factors and was healthy, she decided to have a home birth and a midwife with her second child, Simon, 12.
“I thought, ‘You know, that’s a lifestyle,’” Jacob said.
“I said to Nathan, ‘Hmm, I feel like maybe I want to be a midwife.’ I got this really floaty feeling, like I was floating up off the couch. Nathan looked at me like, ‘Yeah, OK,’” Jacob said, laughing.
Jacob said she is certified as a doula, too, but her main role is as a midwife.
She’s also the chairwoman of the Arkansas Department of Health Midwives Advisory Board.
“Home birth is only for low-risk people,” she said.
“All our clients see another practitioner twice in their pregnancy.
Someone else has seen the blood work. If they become high risk for any reason, we’re transferring. We’re experts for normal births.”
The state provides free risk assessments for home-birth clients, she said, and most of the women go to a county health department.
Jacob said all her clients get ultrasounds early in their pregnancies.
A midwife is on the same schedule with the woman as an obstetrician, Jacob said.
“At our prenatals, we’re measuring, feeling positions, checking urine and blood pressure,” she said.
She said checkups are given once a month until the woman is 28 weeks pregnant; then every two weeks until 36 weeks. When the woman is 36 weeks pregnant, Jacob and the other midwives and doula, if there is one, visit the patient in her home. After that visit, the midwife sees the woman once a week until the birth.
Couples order a birth kit with disposable items, and Jacob brings other equipment that she sterilizes, she said.
“We spend more time [than an obstetrician]. We stay at least two or three hours after the birth,” Jacob said. “I go back at least three times postpartum.”
Jacob said most Arkansas midwives charge $3,000, which is at the low end of the nationwide range, which can be as much as $7,000, she said.
She said statistics show that planned home births “are as safe or safer than hospital birth. That’s the reality.”
“My personal statistics are about 7 percent of when we need medical support; statewide, it’s 7 to 12 percent,” Jacob said. “The majority of that is not emergency.”
She said sometimes a woman will be exhausted, or the baby “is not in a great position.”
“Usually when we go to the hospital, I’ll call and say, ‘Hey, this is Kim Jacob. I’m here with a client, and she’s kind of running out of batteries. She might need Pitocin, an epidural and some sleep.’”
She said midwives have neonatal resuscitation and CPR training.
“It’s very rare that we have an actual emergency that we have to rush to the hospital. … Of course, we’re trained to handle that,” she said.
“These people are super healthy; they don’t have risk factors. We’re not meddling. They’re not getting epidurals; we’re not strapping them to the bed. We see that physiologic birth works better. It just works better; it’s faster,” Jacob said.
“Because I would say the majority of our clients are college-educated, some of them overly educated people, they’re really just looking and questioning and hearing stories and seeing statistics,” Jacob said.
She said most of her clients have water births, and a birth pool is used.
“It’s a nice transition for that baby to come out in that warm water — from a warm body, into warm water. Those babies seem to be a lot more calm. They’re still getting oxygenated by the cord,” she said.
She said women who use midwives have a 99 percent or better breast-feeding success rate past six weeks, too.
Anna Bowden and her husband, Kraig, of Conway hired Jacob to be the midwife for the birth of their daughter, Bell Ivy, seven weeks ago.
“Kim was wonderful,” Anna said. “Kim is just so calming. [She’d say] ‘It’s going to be OK; we’re going to do this,’” Anna said.
“Kraig got to catch; she was born underwater, which was so relaxing.
“I couldn’t have asked for anything better; that’s what I tell everybody,” Anna said.
More information on midwifery can be found at www.healthy.arkansas.gov or kjacob
Senior writer Tammy Keith can be reached at (501) 327-0370 or firstname.lastname@example.org.