by Barbara Sellars

It sounds like a joke: Why was I running down the street pushing a wheelchair at 12:20 a.m. on a frigid January night? The answer: Trying to beat the stork.

After 30 years as a midwife, I knew Ayanna Wayner's baby was going to be born very quickly. Her husband, Richard, and I were in almost constant contact by cell phone as her parents drove them from Brooklyn to Roosevelt Hospital in Manhattan. I was waiting in the emergency room, the only hospital entrance open at that hour when Richard called to say they were coming up 10th Avenue. I knew a right off 10th toward the ER would put them going the wrong way on a one-way street. So I grabbed the wheelchair and sprinted to the corner just as their car pulled up.

Many people are unfamiliar with what modern midwives do. Some ask: "I thought midwives were extinct?" and "Aren't they only in the Bible?"

Before joining the field, I got my master's degree in nursing at Yale University's Midwifery Program, studying prenatal care, baby delivery, postpartum care and well-woman gynecology. My New York State license qualifies me to prescribe medications relevant to my work and to order tests.

I do all births in the hospital (only 1 percent of births attended by midwives in the U.S. are done at home) and I'm by my client's side throughout the process. If the birth is normal — not requiring a C-section or another procedure — I deliver the baby. My partner at CBS Midwifery, Elizabeth A. Boyce, and I also do follow-up care.

Being by the client's side means rolling with the unexpected. Ayanna's first labor had been hard, and after many hours, her doctor gave her an epidural anesthetic. The baby's heartbeat dropped, and Ayanna had a C-section. While her daughter, Arielle, is healthy and intelligent, Ayanna and Richard were disappointed they couldn't experience the joys of a natural birth.

After starting her prenatal care for her second pregnancy with different doctors, Ayanna became disillusioned at their attitude about her desire for a vaginal birth. While they didn't say "No," they emphasized how dangerous it might be. In about 0.7 percent of attempted vaginal births after C-sections, the uterus ruptures.

I can't say the involvement of a midwife lowers the chances of a uterus rupturing — which, if it's going to happen, typically occurs during labor — but midwives usually spend most of their time in the patient's room, watching the fetal heart rate and closely observing the client. When a previous client's C-section scar began to separate during labor, I alerted a doctor so a repeat C-section could be done before a full rupture occurred.

Before Ayanna got to the hospital, Richard told me by phone she was coping well with contractions in her bathtub at home. I asked them to call me when the contractions were closer together. Richard called two hours later to tell me Ayanna's water had broken and she felt like pushing.

At the hospital, the baby's head was almost out by the time I pushed Ayanna to the only available labor room, and everyone could see the urgency of the situation. Someone threw a sheet over the hospital bed and two minutes later, Ayanna's big healthy baby boy was born. Alfie arrived without any of the hospital interventions that Ayanna and Richard had wanted to avoid. A few more gray hairs for the midwife, but what a triumph!

Barbara Sellars, a certified nurse-midwife who is A-rated on the List, co-owns and operates CBS Midwifery Inc. in New York City. She's the mother of two grown daughters, Amy and Jennifer, and delivered all three of her grandchildren, Kendall, Kieran and Clementine Rose.