Cover Story: The Mother of All Miracles

Jackie Gruer lives a midwife's dream

 
Lisa Bialac


Jackie Gruer made a home-like environment at Northside's Midwives Care.



At the very source of female power is the power of birth. Like goddess/protectors of an ancient rite, modern midwives represent female power incarnate.

With strong hands, silver hair and a throaty chuckle, Jackie Gruer is one such icon of the postmodern birthing experience. Further, she lives a midwife's dream — she's self-employed and working with the support, but not under the control, of physicians.

Yet ask Gruer about power, and she doesn't talk about herself.

"My definition of power is the ability to have goals and carry them through," Gruer says. "And that's what I see with women giving birth and it changing their lives. They may not consciously have chosen to get pregnant. Most pregnancies aren't planned. But (it's) the woman's ability to adapt and accept the responsibility for another life and let it change her and move into that role."

Gruer's role as a midwife isn't what we've been socialized to believe. After completing her master's degree in certified nurse-midwifery at the University of Kentucky, she moved to Cincinnati in 1983. Along with two others, she's a co-founder of Midwives Care (www.midwivescare.com).

The women attended home and hospital births, and during its first decade Midwives Care shuffled its attention between clinics and consulting doctors. Meanwhile, Gruer dreamed of a birth center.

Her dream found a home when she saw a "for sale" sign in the yard of an old house in her Northside neighborhood.

Opening its doors in 1997, The Birth Center, 4244 Hamilton Ave., offers a unique alternative in maternity and well-woman care. It's the only licensed and nationally accredited, midwife-owned and -operated birth center in Ohio.

Employing three certified nurse-midwives and three birth attendants, Midwives Care annually assists 200 hospital, 20 birth center and 20 home births as well as services ranging from exams to sibling education classes.

The beautiful century-old house has an air of timelessness, ornamented by the delicate femininity of Victorian trimmings. The idea is to make clients feel at home. And it works.

Downstairs are exam and office rooms, a cupboard-turned-filing-closet, a homey kitchen and a parlor-like waiting room. There are two birth rooms upstairs, each with private bathrooms complete with whirlpool bathtubs.

Throughout, The Birth Center is touched with home. There are Amish quilts adorning the walls, "payment" from women who traded them in a barter system in exchange for their births.

Gruer's grandfather's rocking chair is here, and there's the collage of baby pictures on the fridge. This "office" breathes life.

Gruer became a midwife because she wanted such an environment in which to provide continuity of care.

"There are people whose babies I've delivered and now we're working through menopause together or we're just doing pap smears and it's a blast," she says. "They bring in pictures of the kids, and we spend half an hour talking and laughing or talking and crying 'cause I see women go through relationships. They're with a guy when they're pregnant and having babies and then I see them come out of those relationships and struggle to be a single mom and move on with their lives."

Gruer's eyes sparkle when she talks about her dream of one day being a "granny midwife" — a midwife who's attended the birth of a baby and the birth of that baby's baby. She might get her wish.

The Birth Center attracts women from all walks of life.

"We have Cliftonites with piercings and tattoos and we have middle-class women," she says. "We have doctors and their wives, and we have Medicaid women. Racial diversity, as much as we have (it) in Cincinnati, and people bring their kids, so usually the waiting room is a pretty lively place. As a whole, we get patients who are interested in the quality of their birth experience."

There's room for traditional, medically based and midwifery based care.

"(Doctors) have a different focus in pregnancy and birth," she says. "I think they essentially consider it a potentially pathological condition. Midwives look at labor and birth as facilitating what's a normal process and being tuned into the development of any problems that (require) a physician. So we're starting out from two different places. Generally speaking, you're not normal one second and pathological the next. It's a process."

Midwifery is that rare vocation falling somewhere between a profession and a calling, but with lots of passion. And like most midwives who attend home births, Gruer often finds herself in the role of activist. She struggles to educate doctors, insurers, lawmakers and women that midwives can and should play a substantial role as caregivers in a medically uncomplicated birth.

Midwifery isn't only about babies wrapped in the empowering embrace of women's issues. The Birth Center's biggest battles are insurance-related.

Although it was recently approved for Medicaid reimbursement, some major insurers still don't cover its services. Gruer also anticipates the center's liability coverage to double this year.

But after a decade, Gruer is finally beginning to trust her tenacity.

"We want to be here because we think just the fact that we exist shows women that birth can be a powerful event," she says.

Speaking of powerful events, how would the world be different if women, or midwives, were in charge?

"I think there would be a whole lot less war," Gruer says. "I don't think you birth babies to put guns in their hands. I think that women and breastfeeding could change the world — will change the world. And not that women can't be assertive or aggressive or war-like, but I think that women are a lot more attached to the humanity of people."

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