Susan Terwilliger, midwife and owner of Alaska Birthing, discusses the option of homebirth and describes the process from pre-natal to well baby care. STAR PHOTO BY SALLY FOO

In Terwilliger's cozy one-room office and examination room above Sleepy Dog Coffee Co., she explained what she offers an expectant mother, in addition to a homebirth.

It starts with full-service prenatal care and follows through with well baby care for the newborn's first six weeks of life.

She explained that her clients are “women that are low risk that take care of themselves that want to have a healthy, non-medicated birth.”

“People that are higher risk or want more of the medical options including drugs, they would not come to me,” she said.

Women choosing a more conventional delivery would seek out an obstetrician and opt for a hospital birth.

“If nothing is wrong, my clients would never see a doctor,” she said. But if they want a sonogram or a particular test, she can refer them to a doctor. When she is concerned something is “out of the range of normal,” she can refer them to a doctor in Anchorage who sees her clients when necessary.

Terwilliger and her husband moved here from Austin, Texas. They had lived there for 25 years, and she had a midwifery practice for 17 years before deciding to move to Eagle River two years ago.

“We had a full life in Austin,” said Terwilliger, but she said something clicked when she and her husband visited Alaska.

With a degree in English and a minor in elementary education, she taught for a time and worked as a land surveyor in Texas, but it wasn't until a friend asked her to look into a midwifery program in Austin that midwifery even crossed her radar.

Her friend chose to enter a program in Houston, but Terwilliger had done a lot of research, and her interest was piqued.

She decided to follow the path of a certified direct entry midwife rather than a certified nurse midwife, which would have meant nursing school and advanced schooling to become a midwife, she said. It took her about five years, which included several years of apprenticeship, to become a midwife and earn her certification. In addition to her CDM, she is also a certified professional midwife.

“It became a passion and a calling because it included my issues of alternative health and options for women,” she said.

Terwilliger has found the midwifery community in Alaska very welcoming. Statewide, she estimates there are about 24 practicing midwives.

She has found a higher percentage of women opting for midwifery in Alaska than in Texas because the care is covered by insurance. Her clients in Austin, she said, were all self-pay.

In the event of an emergency, she said midwives are trained for the unexpected.

“Nobody wants trouble at home,” she said.

Kelly Forestal, 32, of Eagle River had an unexpected complication with her first planned homebirth when she lived in Juneau.

During that pregnancy, all of her prenatal care was given by midwives, but her son, Caleb, was delivered in a hospital because Forestal became ill during labor and had an escalating fever.

Forestal later moved to Eagle River, and she contacted Terwilliger after seeing a write up about her new practice in the newspaper. The item ran the same week Forestal found out she was pregnant with her second child.

That first birth experience was far from ideal, not the natural birth she had anticipated. Forestal said she explained this to Terwilliger and throughout her pregnancy, she received a lot of emotional support from her.

“I had a lot of fears because my first birth went so badly. I was very nervous about what my labor and delivery would be like with this one, so she really worked with me on that,” said Forestal.

Forestal's daughter, Cassandra, was born at home with no complications.

“I'm just really grateful that Eagle River has a midwife like Susie, because I think it's just great that pregnant women have another option,” she said.

In Forestal's estimation, “midwifery care is just the greatest.”

Describing a homebirth in soothing tones, Terwilliger said “the lighting is low, the sound hushed and the woman gets to be herself.”

“I always think of it as entering into birthland. The rest of my life stops,” she said.

Once the baby is born, she checks it over “from head to toe.”

While the state recommends new parents take the baby to a pediatrician at one week, Terwilliger can perform all of the newborn testing required by the state, including putting in eye drops and administering Vitamin K.

“I'm there for the whole thing,” she said. “And for three or four hours afterward. And then I go back 24 hours later, and then three days later. It's the whole continuum, continuity of care.”

In her years as a midwife, she has delivered about 540 babies.

For more information, call Alaska Birthing at 694-1123 or e-mail AlaskaBirthing@aol.com.

Reach the reporter at sally.foo@alaskastar.com.

This article published in The Alaska Star on Thursday, May 10, 2007.