Earlier in her career, Pinger used to wear a pin that read “Just Say No” and depicted a doctor standing over a supine woman in labor. It was her protest against the increasing technologization of birth. If that history makes her an unlikely choice for a chain-owned hospital, embracing her typical patients is a no-brainer.
In addition to promising to adhere to a set of diet and exercise guidelines that would please the most traditionalist doctor, the women in Pinger’s practice must be in excellent health and agree to hire a doula, a birth assistant whose services can run from $800 to $1,200 dollars in the Washington area.
It’s no surprise, then, that the group is largely composed of the highly educated and the professionally employed. Pinger says she sees lawyers, doctors, and even OB-GYNs. They are athletic women who have pushed their bodies before and will apply the same strength and endurance to preparing for labor.
To the women drawn to Wisdom, power is important. “They know what they want and know what their body can do,” Pinger says. “They want to be empowered, to be powerful.”
Tracey Mills, communications manager for George Washington Hospital, offers an identical characterization. “They know what they want and know how to find it,” she says. “They seem to want to embrace the whole experience.”
Cameron Rupprecht, a holistic health coach, is delivering with Wisdom in March. A dedicated CrossFit athlete, she liked Pinger’s emphasis on exercising during pregnancy. She also liked the idea of letting her body do what it was designed to do. “We’ve done this forever. We can do it. Why not try?” Rupprecht says. She says some people don’t understand why she’d want to experience pain. “I want to be present for the birth, fully feeling,” she says.
But for all the emphasis on natural, Rupprecht says she knew home birth wasn’t for her after seeing the Jennifer Lopez movie The Back Up Plan, which included a scene mocking home-birthers with a water tub and someone playing bongos in the background. Rupprecht also liked the idea of being at a hospital. “I can do the natural thing, but if something goes wrong, you’re right there,” she says.
Scholars who study birth say it’s hard to tell if more women are going the natural route. The overwhelming majority of births happen in hospitals, where epidurals and interventions are the norm. But Eugene Declercq, the assistant dean of doctoral education of Boston University’s School of Public Health, says anecdotal evidence indicates pockets of women interested in low-intervention births.
One pocket appears to be in the D.C. area. Pinger’s patients, who are typically over 30, represent the fact that educated women typically bear children later. This population, she says, has given more thought to the kind of birth experience they want.
Dr. John Larsen Jr., chairman of the obstetrics and gynecology department at GW, brought Pinger into his hospital. He says her hiring was partially a response to a demand he’d seen in the market. “Many women in Washington, D.C. are very interested in having a completely normal birth without medication, and vaginal delivery,” Larsen says.
Susanna Montezemolo, a vice president of legislative affairs for a non-profit organization, says she became interested in natural childbirth several years ago via prenatal yoga training (she’s also a yoga teacher). As a 36-year-old first time mother, she wanted the access to immediate medical backup that a home birth would not provide. Montezemolo did her homework. “Wisdom gave the best probability of having a natural childbirth,” she says. The day she found out she was pregnant, she emailed Pinger. “I got the positive test at 6 a.m.. At 6:20, I emailed her to get a spot.”
Montezemolo’s labor this fall was not an easy affair. She arrived at the hospital almost ready to deliver her baby, and describes it the most painful thing she had experienced. But, she has no regrets. “It was really such an amazing, empowering experience.”
Our definitions of “amazing” and “empowering,” of course, change with the times. And from diets to drugs, ours is a moment of a certain suspicion of the expert in the white coat. In the maternity industry, that means a backlash against practices that aren’t medically necessary and don’t benefit both mom and baby. The number of home births, while still tiny, has been rising. That’s true especially among educated white women, according to a 2011 Centers for Disease Control report. Talk show host Ricki Lake has become a front person for this trend with her documentary The Business of Being Born and her new book Your Best Birth. A glance at the latter’s cover is telling: Rather than depicting the kind of shaggy 1970s types whose images adorned prior natural-birth guides, the tome is illustrated with a cover shot of stylish, beautiful, and expensively made-up expectant mothers. In August, a prominent doctor published an editorial in the Obstetrics and Gynecology medical journal about how to stop the “relentless rise” in cesarean deliveries.