Some seventy-five to eighty years ago, Braxton County expectant mothers often depended upon Belle Singleton, popularly known as “Mom Belle,” when time for delivery came. A midwife for most of her life, Singleton lived near Frametown but traveled far and wide to offer her services. Today, in Stuarts Draft, Virginia, Singleton’s great-granddaughter, Janna Reynolds Grapperhaus is following in her ancestor’s footsteps—although obviously in much different surroundings.The road to Grapperhaus’ career took several years; she received her license to practice midwifery in 2010—sixteen years after she first became interested in the profession. The daughter of Max and Sharon Singleton and a graduate of Braxton County High School, at eighteen, she left the area to attend college in Virginia. After one year in college, however, she married, as she tells it, “because she wanted a family.” Two years later, she had her first child, and she had begun her interest in midwifery.
“During my first pregnancy, I started prenatal care with a physician, but I switched to a midwife after a few weeks,” she said, “and things worked out really well.” Continuing, Grapperhaus explained, “The midwife’s care was entirely different. For one thing, a midwife can, and does, allow much more time with a prenatal visit. I would be with a doctor for fifteen to twenty minutes, but, if I needed her to, my midwife would sit and talk to me for two or even three hours.”
Her training actually began when her first child was “a few months old,” as she “started working with the midwife who had delivered [her] daughter.” That was back in 1996. The training at that time “entailed joining the midwife in prenatal visits and attending births.” Grapperhaus went on to explain that Virginia’s midwifery training “typically takes four to six years because the trainee must have attended at least 100 prenatal visits and fifty births.” She actually “had attended over 250 births over a period of twelve to fifteen years as an assistant” before she received her license from the North American Registry of Midwives, which sets up training requirements.
Asked why gaining her license took almost twice as long as is typical, Grapperhaus responded, “I was having babies.” She elaborated, “The training is not only rigorous but also demanding in that the trainee must be available 24/7, and there were times during that period that I couldn’t do that. I had some six-month long stoppages of training late in my pregnancies and following the births of my other three children.”
In the state of Virginia, once a trainee completes the requirements, then she must pass two rigorous parts of an exam. The first lasts eight hours and consists of the clinical exam, during which the student “is fit with a proctor who reviews all of the candidate’s skills.” The second, also an eight-hour session, is the written test administered by the North American Registry of Midwives. Grapperhaus mentioned that she actually “had the second highest score in the United States on the written exam.” Once a student passes both exams, the Virginia Board of Medicine issues the license to practice.
All four of her children were born at home, and, as a midwife, Grapperhaus tries to provide the same level of care which she received during her pregnancies and the births of her children.”The shortest prenatal checkup I do is one hour,” she said. “I perform all of the same procedures that the physician would—lab tests such as blood and urinalysis, blood-pressure checks, measuring the baby’s growth and checking the baby’s position,” she added.
To illustrate what she considers a major difference between what she does and what a physician would do, she said, “The rest of the visit centers around educating the mother in a close-knit one-on-one situation. I answer questions, not just about physical conditions of the mother and the baby she’s carrying, but also about things like how to help a toddler accept a new baby.”
Grappherhaus point-ed out numerous other differences between the traditional hospital delivery and delivery at a birthing center. To begin, she emphasized, “By the time a woman delivers, the midwife and she “are family because they have spent so much time together over the period of the pregnancy that they are on a first-name basis, the midwife knows the client’s family situation, and often knows her other children.” Grapperhaus said that some of her clients’ children refer to her as “Auntie Janna.”
Another major difference which she mentioned is that the midwives at the birthing center “don’t ask women to wait until they’re in hard labor to come to the center.” She said, “They come when they want us; all they have to do is call and let us know they’re coming. Then, once they’re there, we don’t leave their side the whole time they are delivering.” Not only that, but Grapperhaus commented that they “encourage those in labor to eat and drink and to get up and walk around.” She emphasized, “We don’t strap them to beds so they are much more comfortable, and that comfort allows them to have easier deliveries. They aren’t stressed. As a matter of fact, they don’t even ask for pain medication. I’ve never had a woman ask for pain meds during delivery.”
A birth at the center often entails the midwife’s presence for 24 hours or longer, Grapperhaus noted. “If I, or the midwife on duty, leave the room—never for more than a short nap of an hour or so—we always have an assistant with the client. We never leave her alone,” she commented.
Asked about any “real scares” she may have had during deliveries, she responded “only once or twice,” adding, “Once, during my training, I was present during a delivery which involved a prolapsed umbilical cord. The delivery was taking place in the home, and this happened in the middle of a blizzard in 2009.” Fortunately, the situation didn’t result in any tragedy. “The delivery was far enough along,” she said, “that the baby emerged. I gave her one breath, and she turned pink and let out a loud cry.” They do have, at the birthing clinic, equipment to take care of emergencies, and they also attempt to prevent the possibility of emergencies through careful prenatal care along with screening of their clients. “We restrict clients to low-risk individuals,” Grapperhaus said. “We take no one with chronic health conditions, and we don’t deliver breach babies or twins,” she added.
A “typical week” for this midwife, who owns The Birthing Place, located one-half hour out of Charlottesville, VA, includes two or three days of prenatal visits, and she has “typically four to six women” due a month. “We never take more than six clients at a time,” she said, “because we want to give them the best care possible.” She and one other midwife do all the deliveries, and they have four volunteers who help with the center. “Our volunteers are all student midwives, who use this time to obtain clinical experience,” Grapperhaus said.
To state that Janna Grapperhaus believes in what she does would definitely be an understatement. The passion that she feels for midwifery and its advantages resounds through her descriptions of the birthing center—Here she emphasizes it’s a “center,” not a “clinic,” because “a clinic is for sick people”—and her picture of the relationship between the midwife and her client. It’s truly easy to believe her as she declares, “What I do is a calling.” For her, just as it may have been for her great-grandmother Belle Singleton, it is indeed a “calling.”