MERCED — Stefanie Vega-Strong was lying down on a couch in her living room Tuesday afternoon with her shirt pulled partway up as her midwife used her hands to gently search and feel the baby.
A few seconds later, Detrah Hele took out a set of fetal scopes from her bag to hear the baby's heartbeat. She then passed the fetal scopes to Vega-Strong so she could hear as well.
"Sshh ... she's trying to hear the baby's heartbeat," Brian Strong, 33, told their 3-year-old daughter, Isabel, who was trying to get her mother's attention.
Vega-Strong, 32, is 28 weeks pregnant with her third child. She and her husband have decided to have another home birth after having had a positive experience with Isabel's home birth almost four years ago.
"I really liked the comfort of having your child at your house," Vega-Strong said. "It feels nonintrusive."
Some women in the Central Valley, such as Vega-Strong, are seeking alternatives to the traditional hospital birth experience by using midwives and doulas. Many traditional medical professionals still oppose home births, but Vega-Strong hopes women will consider all their birthing options.
Vega-Strong had a natural birth at a hospital with her first child, Lilia, 10. For Isabel, she used a midwife to give birth at home. With her third child, she is using a midwife and a doula to give birth at home.
The midwife does the prenatal care and delivers the baby, and the doula provides support and encouragement for the couple as well as assists in their decision-making process.
Vega-Strong has her prenatal appointments at her house, and they usually last about 30 minutes.
Not all couples have the same comfort level when it comes to having their baby at home, her husband said. "But I think it's important that moms know it's an option."
In larger cities, the use of midwives and doulas is fairly common, but that's not the case in places such as Merced.
Vega-Strong said when she tells people about her home birth, many are shocked while others seem interested in the alternative approach. Vega-Strong believes there's slowly starting be more awareness of it in Merced.
But the issue isn't without controversy.
Rebecca Cates, director of the Family Birth Center at Mercy Medical Center, said the hospital is in agreement with the American College of Obstetrics and Gynecology that hospitals and birthing centers are the safest settings for births.
However, Cates said, it's ultimately up to the woman to make the decision.
"We respect the right of a woman to make a medically informed decision about their delivery," she said. "Women inquiring about planned home birth should be informed of its risks and benefits."
A planned home birth is associated with a twofold to threefold increased risk of neonatal death compared with a planned hospital birth, according to the American College of Obstetrics and Gynecology.
Women can have the option to use a doula while giving birth in a hospital if they don't feel comfortable giving birth at home but want additional support.
Cates said she doesn't see doulas at Mercy frequently.
"I don't see the rate of that increasing," she said. "We certainly encourage our moms to go through childbirth and breast-feeding classes about how they want to manage their labor and manage their delivery."
In this country, home births make up less than 1 percent of all births outside a hospital, Hele said. She's been a midwife for about eight years, serving women from Merced to Tulare.
Every year, she's seen an increase in women seeking her services. She has had about 40 clients in the past year.
Midwives only take low-risk pregnancies, Hele said. However, if any complications emerge during labor, midwives are trained to respond to emergencies and transfer a mother to a hospital, she said.
Melanie Pool, Vega-Strong's doula, said she believes doulas make a significant difference for the baby and mother. For example, she said doulas help cut down on C-sections and help increase breast-feeding rates.
Education is key during a woman's pregnancy, Vega-Strong said, so she can make decisions that are best for her. "They really should make it the experience they want it to be," she said.
Reporter Yesenia Amaro can be reached at (209) 385-2482 or firstname.lastname@example.org.