In years, the number is just 30.

But when you start counting healthy newborns, the figures get a whole lot bigger.

Nearly 10,000 babies have been born at or with the assistance of Tucson's Birth & Women's Health Center, which celebrates 30 years next Sunday.

In recent years, the center's average monthly deliveries have gone up from 30 to as many as 50 each month, reflecting a national trend as more pregnant women seek out midwives and birth centers.

Certified nurse-midwives and certified midwives attended 313,516 births nationwide in 2009, says the National Center for Health Statistics. That's an all-time high, accounting for more than 11 percent of all vaginal births in the country.

The majority of these births occurred in hospitals, with about 2 percent of the babies born in free-standing birth centers, like the one in Tucson, and 1.8 percent in homes.

The Arizona Department of Health Services registered 12,169 Pima County births in 2010 with 500, or 4.1 percent, attended by a Birth Center midwife.

Tucson's Birth Center mothers choose whether to deliver at Tucson Medical Center or the nearby center on East Grant Road. If complications arise, they are transferred to TMC.

It's a perfect fit for someone like Jami Hepworth, who is about 30 weeks pregnant and plans to have her daughter at the Birth Center. Hepworth, 24, feels passionate about natural childbirth and had her son, now 18 months, with the help of a midwife in Utah.

Hepworth and her family moved here last year so her husband can attend medical school at the University of Arizona. Hepworth began researching midwifery in Tucson and was excited to hear the options.

"I heard about the Birth Center and it really appealed to me," she said. "I did choose a hospital for my firstborn because I didn't know what to expect, but now that I've had my first, I feel more confident. I want to try for a water birth this time."


The Birth & Women's Health Center opened in 1982 as the first free-standing birth center in Arizona. Two certified nurse midwives operated out of now-defunct Thomas Davis Medical Center.

The center became private and moved to the campus of Tucson Medical Center before opening at its current location in 2011.

More than a decade after Tucson's facility opened, another free-standing Arizona clinic was started, this time in Centennial Park, a polygamist community on the Utah border.

In the last few years - and reflecting the national trend - three more have opened in Arizona including Bisbee, Mesa and Phoenix.

There are now 240 free-standing birth centers nationwide, an increase of 30 percent in the last five years, said Kate Bauer, executive director of the American Association of Birth Centers.

In Tucson, the birth center made it through some challenging times before becoming part of El Rio Community Health Center in 2007.

"El Rio saved our lives," said Judith Treistman, a retired nurse midwife and El Rio board member who practiced midwifery on Long Island and in Kentucky before continuing her work in Arizona.

"Five years ago, we were about to die because malpractice insurance was going to go up over $1 million and we just couldn't do it."

The partnership eliminated the birth center's malpractice insurance costs since El Rio is a federally funded center that covers its affiliates for free through the Federal Tort Claims Protection Act.

The center's new home provides four birthing rooms, each outfitted with birthing tubs, as well as seven exam rooms.

Sharmin Pool-Bak, owner of Complete Dimensions Interior Design, helped with the interior design of the new birth center and said the best way to describe her approach is as a "maxi home," not a mini-hospital.

The rooms are decorated with fixtures and finishes one would expect at home, she said. The exam rooms are painted the vibrant colors of the seven chakras, the energy centers in the body, while warm, neutral colors were used in the birthing areas.

The public rooms and exam rooms were deliberately separated from the private family and birth rooms, Pool-Bak said.


Midwifery came to the United States from England in the early 1930s as way to help reduce infant mortality in southeastern Kentucky, Treistman said.

Once considered the childbirth option for the impoverished, midwifery was embraced by more women and families in the natural childbirth movement of the late 1960s and 1970s, she said.

"I think public acceptance of midwifery has really grown, particularly in the last five to eight years and particularly when you see celebrities using midwives," she said. "The media and actual experience has made society much more accepting of midwifery."

About 35 years ago, there were about 2,500 midwives in the United States and today there are more than 11,000, says the American College of Nurse Midwives.

Not surprisingly, non-medical births are much cheaper than hospital births.

In Arizona in 2010, a birth center vaginal birth averaged $2,450 while a hospital vaginal birth without complications averaged $10,197, says a national nonprofit, Childbirth Connection. A cesarean birth, in comparison, runs between $17,909 with no complications and $25,433 if there are complications.

The birth center serves women with or without health insurance, as well as those on AHCCCS, the state health plan for low-income families.

Olga Ryan, clinic manager at the Birth & Women's Health Center, said ideally midwives try not to assist in more than 10 births per month, and the ideal number is eight.

Women and families have been turned away in the past, but Ryan said that's not happening now that the center partners with El Rio and can refer women to El Rio's midwives as well.

Suzanne Hammerquist recently had her twin girls at TMC with a Birth Center midwife and an El Rio doctor in attendance.

"We were very excited to have twins. It runs in my family. The only drawback was we couldn't do the birth center," she said.

The doctor and the hospital setting were necessary in case anything went wrong, Hammerquist said, but intervention wasn't needed. Hammerquist, 31, had a natural birth and the babies were delivered by her midwife.

"It's very empowering to have a baby naturally, to have it the way you want it," she said. "And to have a midwife deliver your twins is pretty much unheard of."

If you go

• What: The Birth & Women's Health Center's 30th birthday celebration

• When: 4 to 6 p.m. Sept. 30

• Where: 5979 E. Grant Road

• Cost: Free

Contact reporter Patty Machelor at 806-7754 or