She did it her way

Doctor-wary Folsom woman chooses to give birth all by herself

Janice DaSilva with son Dylan.

Janice DaSilva with son Dylan.

In an age of modern conveniences and technology, many people view unassisted home births as a thing of the past—something our foremothers did, dropping babies on the dusty floors of frontier cabins. Today, it’s considered a risky undertaking to be avoided at all costs. But for Janice DaSilva, it seemed like her only viable option.

In May 1999, DaSilva had her first child, Tyler, by an unwanted Caesarean section. Like most first-time parents, she and her husband, Danny, were excited and nervous. They wanted what was best for their baby.

DaSilva had researched unassisted childbirth as an option. She believed in her body’s natural ability to give birth without the use of drugs or invasive procedures, or even another person. Yet she knew it was rare and frowned upon by doctors, and she wrestled with what she’d always been taught, which was to trust doctors implicitly.

“My mom always taught us how important it was to listen to doctors. They knew everything. But it’s not true. They don’t know everything. No one knows everything,” she said. “I could not communicate with my doctors, as I didn’t trust them. … They wouldn’t listen to anything I had to say about my prenatal care or desired birth.”

She’d written up a birth plan that drew laughter from the medical staff. She said she was told that because she was eight or nine days past her due date, labor would have to be induced. But DaSilva wanted to let the contractions start on their own. She said she was told that she was putting her baby’s life at risk by not following their instructions. She felt intimidated into doing things their way. Even her husband was concerned that she was not being a good patient and out of fear for her life and their child’s, he didn’t support her wishes.

“They induced me and it caused stress on the baby. … They didn’t want anything to progress naturally,” DaSilva said. Her doctors ulitmately performed a C-section on her.

Tyler’s birth left DaSilva feeling depressed and unable to bond with her son. The Folsom couple wondered if they would have any more children. Danny knew his wife couldn’t go through another traumatic birth experience.

So when DaSilva, who is in her early 30s, became pregnant with their second son, Dylan, she knew she had to rid herself of her fears about childbirth and ignore the objections of concerned friends and family. She didn’t want to have to defend her beliefs and resorted to hiding the truth about how she would give birth, even from physicians. But this time, Danny was on board, though still apprehensive.

“I was still scared with Dylan’s birth, but I gave her the support she needed,” he said. “But if anything were to go wrong, I wanted the chance to be able to do something.”

Unable to find a Folsom doctor who respected her views, she sought the help of two Citrus Heights midwives. She said initially they were supportive, agreeing to provide her with prenatal care and as much or as little assistance as she wanted during her labor and delivery. DaSilva said she made it clear she did not want them to help her deliver her baby. They accepted a $300 non-refundable deposit for her first prenatal visit. But at the second meeting DaSilva was told they would not work with her.

“They decided I was a risk to them because if I had my way with them as my midwives and anything were to happen, and they were shown that they were providing prenatal care, then they could get in trouble. It was a thing to protect the one midwife’s license,” DaSilva said.

DaSilva emphatically explained that she would not have blamed the midwives for any negative outcomes at the birth. She understood the risks, and was comfortable with the cycles of life and death. “I’m not afraid of death,” she said.

“We had no back-up or emergency procedures. I told my husband that if anything happened to me, I would rather die giving birth at home than have the doctor’s touch me,” said DaSilva. “That’s how much I don’t trust doctors.”

Kimberly Ferguson, a licensed midwife for 20 years not connected to the DaSilva’s situation, said she understands a woman’s desire to give birth at home, and the difficulty she may have in getting the help or support she needs. But according to Ferguson, a practitioner can be liable, regardless of what a parent or couple says.

California’s Midwifery Licensing Act of 1993 requires midwives to immediately report complications to a physician. Although midwives are trained to handle common complications that can occur with any birth, including a baby who can’t breath or a woman who starts to hemorrhage, they are not trained or authorized to perform surgical procedures such as C-sections to deliver babies. They can only help stabilize a woman for transport to a local heath facility.

“There’s no way, legally speaking, that I could go to a birth and not be liable. And to be honest, why is that midwife there? She’s not there for the times that everything is completely normal. She’s providing coaching and support, and encouragement and direction, but really you’re hiring the midwife for common types of things that can happen that a midwife can take care of very easily. That’s why the midwife is there—to guard the normal and to treat the abnormal,” said Ferguson.

And while home births, like hospital births, can carry risks, information gathered from the nonprofit grassroots organization Citizens For Midwifery (CFM) and Senate Bill 1479, a 1997 revision of the Midwifery Licensing Act, supports Ferguson’s claim that births attended by midwives generally have good outcomes. But she also said it is up to the individual practitioner to decide what risk factors they are willing to deal with.

According to CFM, discrepancies arise when raw data, such as birth certificates, give an inaccurate picture of the risks of home birth because they include a large proportion of unplanned home births and births without a trained attendant—both situations that carry extremely high risk. Consistent with the circumstances surrounding the birth of DaSilva’s first son, CFM claims that it is possible that the overuse of interventions in hospital births introduces risks, while the home environment often promotes problem-free labors.

Ferguson hasn’t noticed a trend toward homebirths, just an increased awareness, because midwives have been licensed to practice in California since 1997. She believes this has resulted in more families, like the DaSilvas, opting to seek out alternative birth methods. But she explained that nationally, over the last 20 years, homebirths in the United States have remained around 1 percent, a figure confirmed by a 1990 report from the Centers for Disease Control.

DaSilva was a little depressed when the midwives let her go, but she gathered her thoughts and let her pregnancy progress. Then on June 3 at about 5 a.m., her first labor pangs began. DaSilva labored alone in the couple’s dimly lit bedroom and bathroom, with only the sound of her breathing and rustling leaves on the trees in their backyard to keep her company. In the other room, Danny read about the stages of labor, while their son Tyler and DaSilva’s good friend Ronda slept on the couch.

She was able to eat and drink to keep up her strength. And using deep breathing and visualization techniques to work through the labor, DaSilva visualized herself as a flower in a field opening her petals to the warm sun. By the time she was done, she said the pain of each contraction was gone. Although it took some time for Dylan to be born, DaSilva said she never pushed. Her body did all of the work.

“I couldn’t do anything to help it or prevent it. It’s very powerful what the body does all on its own. I was never screaming or out of control or worried,” she said. “I had my mind on other things. I really think it’s a mind over matter thing.” DaSilva laughed as she spoke. “My husband didn’t ever think I’d ever be able to do this because I’m so dramatic about everything.”

In the early morning hours of June 4, DaSilva gave birth on her knees. With only the moonlight spilling into the room, she leaned against a pillow on the bed, and seven-pound Dylan DaSilva slipped quietly into the world. DaSilva described it as “a happy ending and a beautiful beginning, all at the same time.” The first hands he felt were his mother’s. The first voices he heard, and the first faces he saw, were of his loving parents.

Watching DaSilva smile as she holds little Dylan in her arms makes it easy to understand why she believes she made the right choice. He’s now a happy, alert and healthy 3-month-old, who smiles effortlessly and seems to be drinking in the world around him.

“I think we take it for granted that we have our own power within us to do what we want,” said DaSilva. “I’ve taken back the power of being a woman and being given this body that can do things by itself without anybody’s intervention.”

In a written account of Dylan’s birth, DaSilva wrote: “It was an amazing event yet ordinary all at the same time. I don’t feel particularly courageous or strong for doing it. I think determination and faith were a couple of the key elements to giving birth in the manner I chose. Fear and doubt were the biggest obstacles I had to overcome.”

And overcome them she did.