A TRADITIONAL BIRTH: No birthplace like home

FAYETTEVILLE — Brannan Sirratt stepped into Birthroot Midwifery's prenatal meeting room with husband Jacob and toddler son Nate in tow.

Escaping a chilly February day, the family got warm hugs from Maria Chowdhury and Jennifer Creel, the midwives who helped with Nate's birth in September 2006.

The group settled into a brown couch, plush blue chair and wooden rocking chair arranged around a coffee table, eager to catch up with one another.

Brannan said she was about 12-14 weeks pregnant. Sipping a chlorophyll health drink from a red plastic cup, she described feelings of sleepiness and nausea.

The midwives explained her headaches could be from dehydration, and Brannan admitted her fluid intake wasn't consistent. They suggested she fill an empty milk jug with water each morning to monitor how much she drank.

They asked Brannan about her nutrition. In addition to prenatal vitamins, she rattled off Grape Nuts, peanut butter sandwiches, cheese, pita bread and hummus, but laughed at the mention of vegetables. She couldn't handle the smell of broccoli and had to grate carrots to hide them in foods.

Chowdhury suggested baby carrots and ranch dressing. "You can eat anything with ranch on it," she said.

As for exercise, Chowdhury recommended regular stretching and aerobics to stimulate circulation - yoga, squats, lunges, walking.

"Do what you can do; trust your body," Chowdhury said.

Chowdhury stroked Nate's blond hair as he played with a colorful toy from the kids' area.

They talked about what might be different this time.

For this birth, Brannan said she wanted to have the baby in a small pool of warm water to ease the process.

Mariah White, 29, a midwife apprentice, watched as her mentors asked the expectant mom if she wanted an ultrasound of the baby. Brannan said she preferred the least intervention possible during the pregnancy. The pair reminded her she'd have to get two risk assessments with an obstetrician or other physician because the midwives only deal with low-risk pregnancies.

A lot had happened in the last three years. Brannan had graduated from high school, married, had her first child and was pregnant again.

The Sirratts are big believers in midwifery and natural childbirth because of the control it affords over the birth experience.

Once inside the exam room with its lavender walls, the midwives checked Brannan's blood pressure and heart rate, and Nate crawled up on the table. With a finger to her lips, his mother asked him to be quiet while the midwives listened to the baby's heartbeat and measured Brannan's belly.

Chowdhury's hands were warm as she pressed on the mother's abdomen, feeling the size and position of her uterus. With a thin measuring tape, she measured the fundal height - from the top of the pubic bone to the top of the uterus. Exactly 12 centimeters.

With her long, brown hair in a loose bun, Creel leaned over and pushed the stem of the fetoscope against Brannan's belly, listening for the "whoosh" of the fetal heart rate.

"Sounds like a snowstorm," she said.

JOINED BY GOD

Brannan Fitzgerald met Jacob Sirratt through a home-school group in Fort Smith. She joined the debate club that Jacob's mom coached.

They agree that God brought them together.

"There's no other way that that could have worked," Brannan said.

"She couldn't stand me, and I had no idea who she was," Jacob said.

Now 21, Brannan is laid back, witty and patient. Her husband uses humor and sarcasm to connect with people.

From the start, Jacob, now 25, bonded with Brannan's father, Kevin Fitzgerald. The first time Jacob visited her house, he and her dad stayed up until 3 a.m. talking.

The couple started dating the spring after Brannan turned 15. During Brannan's senior year of high school, Jacob put 53,000 miles on his used Hyundai commuting from Fort Smith to work in Fayetteville and to visit her at her home in Wilberton, Okla.

The couple married Oct. 9, 2005, seven weeks after Brannan turned 18. Her father, a Southern Baptist preacher, conducted the ceremony outdoors at Ruinstone State Park in Heavner, Okla.

Brannan designed the white dress for their vintage-style wedding, combining details like the drop-waist and box pleats from several patterns. The guys wore zoot suits, and the couple rode away in a dark-red 1937 Packard limousine.

At the end of the ceremony, her father misspoke, saying Brannan could kiss her bride, but Jacob didn't hesitate long. For each of them, it was their first kiss.

Brannan didn't pursue college or a career because she always wanted to be a stay-at-home mom.

Two months after the wedding, she was pregnant, and she worked at a daycare center during her first trimester. She then took a part-time job at Ozark Natural Foods, where she often took home "write-offs" and discounted items.

She's the saver, while he's the spender. So, she's learned to be frugal. She's constantly pulling out her calculator to budget. The summer she was pregnant with Nate, they spent about $150 a month on groceries.

Since before they married, Jacob has worked at DFI Technologies, where he's now manager of warehouse operations. He got a promotion around the time Nate was born, and their monthly food budget increased to $200.

She saves by cutting out meat, except for some beef for the iron, especially when pregnant. She buys beans in bulk, then cooks and freezes them to use in various dishes. She makes her own bread and tortillas and has learned to knead dough while nursing.

They took out a loan to pay the midwives' $3,000 fee for Nate's birth but didn't need one for the current pregnancy because of Brannan's freelance editing skills.

"We've been able to pay off debt and everything else and get everything that we need for the baby and just not have to worry about it," she said. "But I'm still a tightwad."

After paying off their car loan, they're now debt-free and in the process of buying their first home.

CHOICES ABOUT BIRTH

When Brannan wants to make a decision, she reads, researches and talks to others. She's cerebral and analytical and likes to be informed.

She read Ina May's Guide to Childbirth by Ina May Gaskin, a noted midwife and founding member of the Midwives Alliance of North America. Jacob's family was familiar with home births, as two of his three siblings and eight of his aunt's 10 children were born at home.

The couple considered a hospital birth with Nate, but Brannan wanted a natural birth and a midwife.

They started with an obstetrician at Washington Regional Medical Center in Fayetteville, which has a midwife on staff. Brannan had heard about many good experiences there. But she wasn't comfortable with the process after touring the facility.

They toured labor and delivery, and the stirrups made her nervous. She'd read about waiting to cut the umbilical cord until it stopped pulsating and the newborn began nursing. She was told on the tour that the cord wasn't long enough to allow for that.

"I was really nervous about home birth because I didn't know about it," she said. "When you're programmed, as our society is, to think you go to the hospital - that's the safe place to have a baby - I was kind of nervous about it."

Brannan knew that if they stayed at the hospital, they'd be bickering with the staff during labor. And she wouldn't be able to speak for herself.

"And I can't just let somebody else fight those battles," she said.

She couldn't imagine being stuck on her back, hooked to cords, with ultrasound and other medical interventions at a hospital birth.

"It's all about following those onesize-fits-all standards," she said.

Brannan found Birthroot Midwifery in the phone book. After the initial consultation, Chowdhury and the apprentice hugged her. Brannan told her husband, "They're a little eccentric, but they're really sweet."

The hour-long prenatal visits are filled with direct, gentle conversation. The midwives ask about diet and exercise and how the woman and family are coping with the pregnancy. They ask about life stresses, talk about midwifery news, and share recipes and parenting tips. Then, blood pressure, heart rate, weight and fundal height are taken in a small exam room. "The medical checks are kind of secondary," Brannan said.

FIRST-TIME PARENTS

During her first trimester with Nate, Brannan was the picture of a "perfect pregnancy" - eating protein-rich foods along with vegetables and salads. "Then the nausea subsided and the cravings hit," she recalled.

In the middle of the night, she wanted bologna-and-cheese sandwiches on white bread. She didn't want another salad.

At 42 weeks, she woke up with contractions in her back every five minutes. She walked with her husband before dawn and she figured she'd have the baby by dinner.

Chowdhury said Brannan was in the preliminary stage of labor, but she, Creel and an apprentice came to the couple's tiny apartment. By 7 p.m., they told her she needed to sleep or get to work.

Contractions kept her from sleeping, so she went for a walk and found a cove of trees. A football game was being played at nearby Greenland High School. "Something would go on at the football game and everybody would cheer," Brannan said, explaining that she imagined the cheers were for her. By morning, she wanted to be done. Growling - it was her coping mechanism during the labor pains - "took my mind off of it," she said. Brannan delivered the baby on a birthing stool set between Jacob's legs as he sat on their black couch. Her water broke when she was pushing and felt like a water balloon coming out, she said. The midwives saw meconium in the water bag as Nate's head came out. They suctioned out his mouth while Brannan breathed through a contraction.

Once she delivered Nate, she nursed him, selling herself on the idea of home birth. The Sirratts eagerly returned to the midwives upon learning of the second pregnancy.

Early in the pregnancy, she read about a water birth in the midwives' newsletter. She didn't trust the old floors of their small rental house to support a birthing pool, and she'd always thought an outdoor birth would be nice.

When the midwives suggested she have her baby outside in the water, she was thrilled. Jacob supported her in whatever she chose. She was the one having the baby, he said. If she wanted to be on the porch in a pool, fine.

Instead of collecting beads at an event to bless the birth, Brannan asked for pieces of fabric she could sew into curtain panels to enclose the porch. Her dad would build the frame to support everything, including a black tarp that he insisted on in case of rain.

She had confidence in her birth plan. And she'd pictured the perfect nighttime birth.

But, with her Aug. 30 due date, she couldn't imagine how the cool breeze she wanted could happen.

MONDAY: Brannan Sirratt gives birth at home with the assistance of midwives Maria Chowdhury and Jennifer Creel and apprentice Mariah White.