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Extreme Birth

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A prenatal visit at the office of her client Nicole Tucker.  

When my wife, Robin, found out she was pregnant, she insisted I queue BOBB on Netflix. I’d never even heard of it, but Robin had read about it in Vogue, and all our pregnant friends had seen it. My friend Michael from Park Slope said it’s always popping up in that what-your-neighbors-are-watching feature on Netflix.

Robin and I happened to be in the midst of a maddening search for the perfect doctor. Several years ago she’d been diagnosed with lupus, a disease that makes it more difficult to carry babies to term. She was, in obstetrical terms, “high risk,” a label that automatically excludes women from most offices, except the enormous and impersonal hospital practices that can afford the monstrously expensive high-risk malpractice insurance. So we found ourselves, unhappily, in a large high-risk practice at NYU. The waits were excruciating, the offices sterile, and it became obvious at each visit that without our chart the doctor wouldn’t have known whether we were there to have a baby or take her lunch order.

Muhlhahn was different. One hot day last August, we went to her home office on 11th Street between Avenues B and C. A female assistant brought us into a waiting room decorated like a Moroccan souk. I was touched by her interest and impressed by the amount of time she was willing to devote to our case. But I was concerned by her lack of experience with lupus, and mystified by her reaction when Robin brought up the idea of delivering with a highly recommended midwife who delivers the babies of high-risk patients at St. Vincent’s. Muhlhahn rolled her eyes. “You might as well go with an obstetrician,” she scoffed.

I could tell that Robin was lapping up the home-birth pitch: no drugs to cloud baby’s or mother’s mind, no separation from baby, no cutting, and the promise of an unparalleled sense of accomplishment and an indescribable hormonal rush. Like many women, Robin recognized her opportunity to experience—to feel—one of the few truly primal experiences life still offers. “You will go into an altered state of consciousness,” says medical anthropologist Robbie Davis-Floyd in BOBB. “And you cannot have the bliss without the pain.”

The goal is, in Muhlhahn’s words, to render the experience “more poetic than clinical.” To that end, Lake and Epstein will soon put out a book, Your Best Birth, that approaches birth the way a wedding guide might, with chapters like “The Guest List” and “Loving Your Labor.” During the birth of her first son, Lake was crestfallen to be transferred from the birthing center at St. Luke’s-Roosevelt to the labor and delivery ward after her labor stalled. “I wanted it a certain way,” Lake tells me. “I’m like a type A, a Virgo, and I had mapped out this birth plan and I wanted a certain song playing and the whole thing.” Epstein, upon seeing a room at the Roosevelt birthing center, said it reminded her of a “cheesy hot-tub suite in a slightly run-down Las Vegas hotel.” Why settle for this when you can have prosecco in bed followed by a delicious homemade pasta Bolognese, as the writer Daphne Beal chronicled in a piece about her idyllic home birth in Vogue?

But even more essential than promised nirvana or perfect aesthetics is the implication that messing with the birthing process can affect the bonding between mother and child. In BOBB, French obstetrician and natural-birth pioneer Michel Odent contends that a “complex cocktail of love hormones … create a state of dependency, addiction” between mother and child. Interrupting that natural flow with drugs or a Cesarean, he posits, invites dire consequences. “It’s simple,” he says. “If monkeys give birth by Cesarean section, the mother is not interested in her baby … So you wonder, what about … the future of humanity?”

When you ask Muhlhahn’s many happy customers to recount their birth stories, they struggle a bit; you suspect they feel the way an astronaut might attempting to describe space travel to someone who’s never flown in a plane. “When you get through that transition, and you experience the birth of your child, you get the endorphins, the best bonding experience, I mean, I can’t even explain how meaningful and important and life-changing an event it was,” says Jeannie Gaffigan, who delivered her second child with Muhlhahn. (Her husband, comedian Jim Gaffigan, recounted their experience onstage: “[Home birth] means you take the hundreds of years of medical knowledge and just throw that away. And you wing it! Hey, I can’t program a VCR. I’m here to help. Where would you like me to stand terrified?”) Joking aside, women turn to Muhlhahn because she inspires confidence in them—confidence in her clinical skills and knowledge of the birth process but also confidence that their bodies are fully capable of the arduous task. Her admirers say that she’s gifted at intuiting when a laboring mother needs cheerleading and hand-holding and when she needs her to step back and leave her to labor in peace. “You really do develop a relationship and a friendship with her,” says Leigh Pennebaker, a sculptor who delivered with Muhlhahn in 2007. “You don’t feel like a number, or a random patient, and you never feel that clock ticking. What she offers is just so remarkable.”


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