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Labor of Love

Certified nurse midwife and long-time Albany natural birth pioneer Betsy Mercogliano delivers progressive childbirth care

by Tania de Rosier on August 17, 2011

Photo by Joe Putrock

During a thunderstorm this past spring, Betsy Mercogliano was awoken by a phone call in the middle of the night. Her client was in labor and the contractions were getting stronger. The baby was ready to come. Mercogliano quickly dressed in the darkness, fetched her supplies and set off in the pounding rain, driving an hour and a half to her client’s home in Columbia County. For the next two days she held her client’s hand, encouraging and supporting her through the long, difficult labor.

It was Memorial Day weekend and while others were kicking off summer with poolside barbeques, Mercogliano was helping usher a new life into a safe and nurturing environment.

Such moments drove Mercogliano to return to school, enabling her to make official a calling she has devoted a lifetime to already. After providing birth support and education to Capital Region families for 35 years, the 57-year-old mother of two completed the coursework last spring to become a certified nurse midwife. The license fulfilled New York State’s requirement for legal homebirths and solidified her role as a leader and pioneer in the region’s natural childbirth community.

“Betsy is a local treasure,” says Tisha Graham, a Saratoga Springs doula, midwife and Mercogliano’s professional partner in midwifery care. “She has an incredible knowledge of birth and a deep dedication to women in this area.”

Mercogliano’s belief that everyone should have access to legal home births motivated her return to school, and was the subject of her thesis research. Until two years ago, there were no legal homebirth midwives in the Capital Region, according to Mercogliano. Mothers who gave birth at home with a midwife paid about $3,000 or more in out of pocket expenses that were neither recognized nor reimbursed by insurance companies. Mercogliano’s mission is to change that.

“Finances should not determine where a woman has her baby,” says Mercogliano, who can now be recognized as a primary care provider and accept health insurance. “Anyone who wants a homebirth should be able to have one.”

The interest and need for homebirths and home-like birth settings continues to grow, according to Mercogliano. As part of her thesis research, Mercogliano surveyed 450 Capital Region women asking if they would support a birth center. The results, she says, were overwhelmingly positive and are being used as the basis for a proposed independent birth center in the Capital Region. It would be the region’s first and only center of its kind.

Though Mercogliano conducted the initial research, her colleague Lily Alayne Owen of Guilderland is spearheading the project. Owen is writing a business plan and collecting feedback from the natural childbirth community of educators, doulas and midwives.

“We want the center to reflect the needs and values of the local birth professionals of our community, so it’s important that it be organic in its evolution,” she says.

The center, whether it’s privately owned or not-for-profit, will follow the midwifery model of care, which emphasizes a woman-centered, hands-on approach to childbirth, she says. With the center, Mercogliano is serving as consultant to a project she has dreamed about for many years. For now, her primary role is that of catching babies and providing birth support and education. And that too is growing.

As one of only five certified homebirth midwives in the Capital Region, Mercogliano’s services are in demand more than ever before. As a result, she is expanding the Family Life Center, a childbirth and parenting education center she helped found in 1976, into new locations in Albany and Saratoga Springs. And she is partnering with The Trinity Alliance, a social services not-for-profit, to bring childbirth and breastfeeding classes to Albany’s impoverished South End neighborhood. Harris Oberlander, Trinity’s CEO, described the collaboration with Mercogliano as a vital component in the effort of bringing higher education classes to the community.

“We want to help people who don’t have access to information about birth and who are struggling with childrearing issues,” he says. “Betsy brings access to that information in an organized fashion and that’s what we’re after.”

Mercogliano, who is married to Albany author and educator Chris Mercogliano, says she has always been drawn to teaching and helping others. As a teenager in Chevy Chase, Maryland, Mercogliano volunteered at local public elementary schools and spent summers working at Camp Shriver with developmentally disabled children. There she eventually met her husband, who was a fellow volunteer.

After high school Mercogliano went off to Trinity College in Hartford, Conn., only to find herself distracted and restless in a traditional educational setting. It was the early 1970s, the height of the alternative free school movement, and she and Chris, who was attending Washington Lee University in Lexington, Va., were itching to plug into this educational revolution.

The pair dropped out of college after their freshman year and moved to Mercogliano’s family vacation home in the Adirondacks, where they spent the summer of 1973 writing to every free school in the country offering to volunteer as intern teachers.

Only one person responded: Mary Leue, director of The Albany Free School. Leue invited the couple to teach at the growing urban alternative school she had founded five years earlier. The 19-year-olds moved to Albany that fall and began volunteering at a school they eventually come to co-direct almost 10 years later.

It was as a young teacher that Mercogliano discovered her passion for childbirth. A colleague from the Free School asked Mercogliano, an avid hobby photographer, to document the birth of her first child. The event left a profound impression on the young Mercogliano who was deeply moved by the experience.

“When I was at her birth I witnessed a miracle and I felt deeply called to this work,” she says. After that moment, the 22-year-old Mercogliano began pursuing a life-long journey in childbirth education, support and midwifery. With no homebirth midwives in the area willing to take on an apprentice, Mercogliano looked abroad to the experts and pioneers of the natural childbirth movement. She attended childbirth workshops in London, where she trained with renowned educator and founder of the Active Birth Movement, Janet Balaskas, whom she invited back to Albany to conduct workshops. Mercogliano read and studied independently and eventually graduated from Sage College as a nurse.

Mercogliano’s first job as a new RN was on the delivery floor of Albany Medical Center, where the outspoken Mercogliano quickly began to butt heads with other nurses and doctors by challenging their professional judgment. Despite being written up for insubordination, she continued working and looking for ways to educate both women and the medical industry about natural childbirth.

So Mercogliano and Albany Free School-founder Leue decided to create a space as an alternative to hospitals where mothers could share stories, receive childbirth education and build community. Together, they opened the Family Life Center and began inviting mothers to talk about their birth experience. Then they went a step further and invited residents from Albany Med to attend these meetings where women discussed birth plans and the radical idea of a non-medicalized natural birth.

“It was a time of women’s consciousness raising and birth was a territory for women to reclaim themselves as powerful people,” she says.

Then Mercogliano became pregnant with her first child, but she miscarried in late pregnancy. When she became pregnant a second time, she left her nursing post and returned to the Free School to co-direct with her husband while continuing her work at the Family Life Center. But again, she was devastated by another late-term miscarriage.

I was deeply discouraged and depressed,” she says. “I thought, how can I help others have babies if I can’t have my own? But going through that process made me realize that I’m still a whole woman, and I can still have an impact and help other mothers.”

Despite her own reservations, Mercogliano decided to see a Boston obstetrician on a friend’s urging. It was there she discovered she had an abnormally shaped uterus that was causing her miscarriages. With the encouragement of her new doctor she decided to try having another baby. The high-risk pregnancy required a lot of bed rest and frequent ultrasounds, a device that was relatively new in the early 1980s, but she was able to give birth to two healthy girls, two years apart. Though the medicalized hospital births were nothing like the natural homebirths she had attended and studied so much about, to Mercogliano, the experience renewed her focus and commitment to the birth movement.

“My births informed me that having more information about birth, how the medical system works and how our bodies work was huge,” she says. “I felt more confident about helping other women.”

For the past three decades Mercogliano has done just that, and built a strong reputation as a teacher and a leader in the community along the way. Locally, the midwife is known for her vast knowledge of pregnancy and birth, as well as her gentle touch and holistic approach. She is known to travel as far as the Adirondacks or the Catskills to attend a birth and will stay with a family, often spending several nights with them, until the baby finally arrives.

When Sophia Sherman became pregnant with her first child she knew exactly who she wanted attending her birth. Sherman had witnessed Mercogliano’s skills when her sister gave birth and was deeply moved. Naturally, Mercogliano was their first choice.

“Betsy was wonderful at my birth,” she says, adding that Mercogliano and her midwife partner Graham arrived in the middle of the night after traveling more than an hour to her home in Harlemville, Columbia County. The women settled in, brewed a pot of tea and made sure Sherman felt safe and comfortable. “I felt so well taken care of. She was so loving and compassionate; it felt like having family with you.”

When Sherman needed stitches after her baby’s birth, Mercogliano made all the arrangements with the hospital and accompanied her through the procedure. And she has continued checking in on her client with post-partum visits for the past two months, often bringing her family a home-cooked meal. While Sherman’s homebirth experience is in keeping with the universally recognized midwife model of care, Mercogliano’s skillful approach made the care she received unique, says Sherman. So much so, that the couple was willing to pay out of pocket to secure Mercogliano’s services before learning that their health insurance would cover the homebirth.

“She recognizes the individuality of each pregnancy and birth and helps every woman feel confident and comfortable with her birth,” she says.

Even before the Greek word doula, meaning woman’s servant, became part of the childbirth lexicon, Mercogliano was attending births and offering hands-on support, often for free. Buoyed by the strong interest in birth advocacy, she and Heidi Ricks, another local midwife, began teaching annual four-day doula training programs that continue to draw women regionally and from neighboring states. In all, Mercogliano estimates she has trained about 100 women over the past 10 years.

Today her doula practice with Albany partner Erin McKinney, a doula and licensed massage therapist, is a large part of her business.

“Betsy is so dedicated to her job,” says McKinney who trained under Mercogliano and spent four months shadowing her as a doula apprentice in 2007. “She lives to help families, to empower families.”

Besides witnessing a family’s satisfaction in experiencing a powerful birth, Mercogliano also considers role in the delivery room vital to the natural birth movement. Her work informs doctors, nurses and hospitals of the normal process of a doula-supported natural birth with no medical intervention. Ultimately, that’s how change occurs, she says.

At least one doctor agrees.

“She has a lot of conviction,” says Albany obstetrician Jeffrey Altman, who has known Mercogliano for more than 10 years. “She’s willing to go as far as she needs to go to support her client.” Altman admits to having had some lively discussions with her about client care, but adds that she is also very open to suggestions and isn’t afraid to seek advice from doctors when necessary.

“She’s a strong advocate for letting a labor continue and for doctors not to be so quick to intervene, in order to give the woman the best chance for a vaginal delivery,” he says. “This goes against the medical establishment.”

While her convictions may not win her many allies in the delivery room, her devotion to childbirth causes has won her the admiration of those she has worked with.

Earlier this summer Mercogliano’s colleagues threw her a surprise party at the Family Life Center to mark her new achievement as a certified nurse midwife. About 80 people attended the event, all of who had somehow been affected by Mercogliano’s work. At the end of the night her friends strung a Buddhist prayer flag across her office wall with hand-written wishes and accolades.

“May your awesome presence at births and life continue to help peace and love in the world,” wrote one friend. “Betsy is a birth midwife goddess,” wrote another.

The Family Life Center, among the historic row houses of Albany’s Mansion Neighborhood is Mercogliano’s home base. Here she conducts pre-natal and post-natal meetings sits to collect her thoughts before the next appointment in her busy schedule. It’s also where she draws inspiration, gazing upon an entire wall of photographs of families and babies she has worked with over the years.

Sitting in front of the cluttered shelves sagging with three decades worth of books on childbirth and post-natal care, Mercogliano reflects on her journey so far.

“I always thought I’d do this work until I die,” she says, sweeping her long salt and pepper braid to her back. “As long as people are still having babies, I hope to continue working.”