Island Born

If you’re not an Islander, that doesn’t mean your child can’t be one. The number of Vineyard births is increasing, along with the maternity resources at the new hospital and among private providers across Martha’s Vineyard.

“There’s something about being surrounded by water. The baby is surrounded by water floating in mom’s belly; we are all floating here together on this Island...encircled in this watery world,” says Elissa Lash of Island Birth and Family Services. Giving birth on Martha’s Vineyard, she says, is “a beautiful way to bring a baby onto this planet.”

Despite the potential problems that could arise, like being flown to Boston on a moment’s notice because of medical complications, many Vineyard parents hope that their child’s birth certificate will say “Oak Bluffs, Massachusetts.” These days, about 165 babies each year can lay claim to being Island-born.

My one-and-a-half-year-old son, Owen, is a thirteenth-generation Islander. He came home from Martha’s Vineyard Hospital to live in the house where his grandfather was born. One of his first words was “boat.” He cannot feed a horse, board the ferry, or roam a beach without waving to a second cousin or great aunt. Beyond growing the Silva-Cottle-Gale family, I have experienced how the whole Island becomes a family, as we birth and raise children in this rural community.

Part of the club

In many ways, the Vineyard resembles small-town America from long ago, akin to Bedford Falls in It’s a Wonderful Life: a place where small businesses are passed down through generations and there’s a strong tradition of community support. Our surrounding seascapes, farm fields and woodlands, strong school system, and safe neighborhoods offset the lack of discount stores and city culture.

Despite the benefits of this way of life, new moms can sometimes feel cut off. The Island has “a New England ethic of stoicism and toughness,” says Elissa, who is a young mother, a prenatal yoga instructor, and a doula (a trained professional who assists a mother through labor, childbirth, and afterward). “We can get very isolated, especially in the craziness of summer, or the dreary damp winter days.”

Raising a Vineyard baby does involve making sacrifices. Families settle for fewer choices and pay more for necessities such as diapers and clothing, or plan exhausting off-Island shopping days. Specialized programs, such as hypno-birthing courses, baby sign-language classes, and parents-of-multiples support groups are not available here. Parents have few choices in doctors and just one hospital. Access to pediatric specialists usually requires traveling, sometimes white-knuckled, to Children’s Hospital Boston. Child-care options and activities are also limited. Even small things, like the absence of a twenty-four-hour pharmacy, can cause extra stress when a baby spikes a fever at 9 p.m.

Yet many Islanders who leave come back to start a family, maintaining a bottle-is-half-full perspective about being born here. Jeremiah McCarthy of Vineyard Haven enjoyed a nomadic lifestyle before moving back home to have his son, Everin, who is now two. “One of the things I can identify myself with,” Jeremiah says, “is that I am an Islander. [I] belong to this club....I wanted my son to have that on some level....It’s his home that he can always come back to.” Now Jeremiah’s childhood nanny takes care of Everin.

Sandy Ciciora, a maternity nurse at the hospital, appreciates working at a small hospital and living in a small community. “We bond with patients and really get to know them and sometimes deliver their second babies too. We watch the babies grow up and see them around town. If I took care of them, I still call them ‘my baby.’ I’ve been here since the eighties, so now I am seeing some of my babies’ babies too.”

Ruth Cronig Stiller was born in 1922 in Vineyard Haven. “I was born in the house I live in now,” she says. “You didn’t go to the hospital in those days if you had already had a few children. ...Most of my friends were born at home.”

After living in New York City for two years, she and her husband returned to the Island in the 1940s to have their four children: Gayle, Pamela, Miriam (known as “Goodie”), and Neal. “I wanted to be with my friends and my huge family,” she says.

West Tisbury’s Ann Bassett and her six siblings were raised on the Island in the 1940s and ’50s. Their experience was so positive that even though they left the Island to be educated, travel, and live abroad, Ann explains, “We all came back here to raise our families. We see my mother at least once week.”

Like Ruth, Ann’s mother lives in the house she was born in, which has been in her family for more than a hundred and fifty years. “From her, we all have this sense of place. I know what the community looked like when my mother was a little girl and my grandfather was a boy. I have a sense of how the Island has evolved since the first settlers. People who grow up here have a sense of history.”

The slower pace in this family-oriented community makes it easier for new parents to trim out distractions and focus on parenting. Sherry Sidoti of Vineyard Haven, a yoga teacher, moved to the Island from Los Angeles with her husband and baby boy eight years ago. She found the Island lifestyle to be “very conducive to that period of time in life where you want to nestle down and be with your baby. [In Los Angeles] I felt a pull of what I could no longer do as a new mom and all the things I was missing out on.”

The Island’s family-friendly vibe put her at ease. “I feel very comfortable with my son in tow pretty much anywhere on the Island, which is not how I feel when I travel with him.”

The way it used to be

For much of the twentieth century, the culture surrounding childbirth in this country differed from today. On Martha’s Vineyard during that time, if babies arrived in the hospital setting, family doctors, such as Dr. Russell Hoxie and Dr. Robert Nevin, presided over the birth. There were no obstetricians, labor coaches, or even family members attending.

“You couldn’t get a husband into the labor room to save your life,” Vineyard Haven’s Peg Goodale remembers.

Ann Bassett recalls, “They left you alone in the bed [during labor], strapped down, offering drugs every few minutes. There were no childbirth classes: It was not talked about....Clothing was designed to hide pregnancy.”

Nurses cared for newborns and bottle-feeding was encouraged, as mothers rarely saw their babies during week-long recuperative hospital stays. Although this was the case at the “old” (second) hospital, built in 1929, this distant approach to birthing continued in the Island’s third hospital, which was erected in 1972. Around that time, Dr. Susan McCoy became the hospital’s first obstetrician-gynecologist (OB/GYN), relieving family doctors of some of their birth load. (Her tenure was short however, followed by a revolving door of doctors filling in. In the early eighties Dr. Jason Lew became the hospital’s resident OB/GYN, a post he held for nearly two decades before going into private practice.)

The 1970s ushered in a national resurgence of belief in childbirth as a natural process, not a medical problem. For years many Island women had been reading about drug-free delivery in books like Grantly Dick-Read’s ground-breaking Childbirth Without Fear, but in the seventies they started to receive the support they needed to pursue it. A group of women began teaching classes for pregnant women and their partners. “We changed the hospital in a great many ways,” explains Lee Fierro of Vineyard Haven about the childbirth education work she did with Peg Goodale, and Elizabeth Gilmore and Bronwyn Hill, who have since moved off-Island. Women seeking a more conscious birth could ask one of them to be a volunteer coach at a hospital birth or plan to deliver at home with a midwife such as Pamela Putney of West Tisbury or Arba Wildanger, now living off-Island.

In 1980 the hospital began offering childbirth classes taught by maternity nurses such as Cathy Chase and Marney Toole. Cathy was in tune with the community’s desire to have a certified nurse-midwife and a more personal, home-like environment (akin to a birthing center) at the hospital, so she attended midwifery school with approval from the hospital’s administration. A midwife specializes in attending to low-risk pregnancy and childbirth, and can also provide primary care related to women’s health. Cathy was drawn to midwifery’s emphasis on personalized care and natural childbirth.

“I like what nursing represents: the chance to be connected with a patient and provide ongoing compassionate, sensitive care,” Cathy explains. “I like the medical side of looking at focused problems or issues with a personal touch.”

Nancy Hugger, a labor and delivery nurse, says when Cathy became a certified nurse-midwife in 1997, “the hospital moved from a medical model to more of a midwifery model. That was a huge shift in focus.”

At the new hospital

In the past decade, the number of OB/GYN medical staff at the hospital has doubled in order to address more women’s health concerns and to serve a growth in population. Certified nurse-midwife Nancy LePort became a working partner with Cathy Chase in 2003, and together they serve roughly 95 percent of healthy pregnant women on-Island, Cathy says. In 2008, Dr. Linda Stewart was hired to partner with the hospital’s former OB/GYN, who left the Island shortly thereafter. This past fall Dr. Daniel Pesch joined the team. The doctors focus on higher-risk pregnancies, while also performing surgeries and providing pre- and post-care for off-Island surgeries.

Excitement permeates Dr. Pesch’s voice and smile as he discusses his new life and work on the Island. Returning here feels like “coming home, as I summered in Chilmark as a child.” Since leaving Advocate Lutheran General Hospital, one of the largest hospitals in the Chicago area, Dr. Pesch has enjoyed the advantages of working in a smaller hospital. One such perk includes the ease of making improvements based upon current research. “You can’t do that in a big hospital. You have to get a hundred and fifty nurses on the same page,” he explains. At a smaller hospital, “no strangers come in [to see patients] when a doctor is away....We have a uniform care team.”

At his former job, Dr. Pesch was the chairman of obstetrics and gynecology and the director of the hospital’s OB/GYN residency teaching program. Here he appreciates his new focus on “taking care of patients.” He is eager to expand women’s health care on the Vineyard to allow women in need of more complicated surgery to stay on-Island for their procedures. Already he and Dr. Stewart have improved collaboration with off-Island hospitals to support patients who receive treatment elsewhere.

Recent years have seen dramatic changes at the hospital. The new facility opened last year just as an anticipated July baby boom was getting underway. Maternity unit supervisor Joyce Capobianco recalls, “The last week in June, we delivered twelve of the July babies. That was the week we moved into the new hospital.”

The maternity team is thrilled with the new hospital. They have three private rooms with amenities like flat-screen televisions, access to two hydrotherapy labor tubs, and medical equipment for newborns, such as warmers, so mother and baby can stay together. Partners can attend childbirth education classes and are encouraged not only to assist in labor, but also to stay for the duration of the mother’s hospital visit, which is typically two days. On the last day, parents enjoy a special three-course steak dinner and sometimes even a delivery of afternoon tea and scones. In the visiting room, friends and family can admire both a new baby and a water view.

It’s not always smooth sailing though, and some families have voiced complaints: A small facility can result in limitations (perhaps a long wait for a prenatal appointment), and different people will have their own expectations and experiences (one laboring woman was disappointed the hydrotherapy tub water was cold).

For a healthy, uncomplicated pregnancy, many agree the Island is an ideal place to deliver and not just because of the state-of-the-art facility. The low number of births, about three a week, has its benefits. New mother Chelsea Pennebaker of West Tisbury comments, “The care I received from the nurses was amazing – supportive, nurturing, and personable.”

Outside the hospital

Though most expectant couples choose Martha’s Vineyard Hospital, it isn’t for everyone. Since the hospital isn’t large enough to offer a neonatal intensive care unit, a mother experiencing complications, like pre-term labor, is usually transported via helicopter to deliver in Boston. And some women plan an off-Island delivery for medical or personal reasons. One common reason is to have a vaginal birth after a cesarean section, since the hospital here currently prohibits it; these women can receive prenatal and postnatal care at the hospital, but they are advised to leave the Island four weeks before a due date.

Each year, a few families choose to have a home birth, usually for philosophical reasons. “Birth is a very natural thing,” says Dardanella “Dardy” Slavin, who recently gave birth to her son at her Chilmark home. “The medical model has become very intervention oriented and fear based.”

Certified professional midwife Sybille Andersen of Nantucket flies or takes a boat to the Vineyard, and families usually cover all of the costs themselves. Delivering a handful of Islanders each year, she teams with Lila Fischer of West Tisbury, who is newly certified as a professional midwife, and doula Meeghan Athearn of Chilmark.

Pam Putney is a longtime health-care advocate and midwife, and she has delivered babies (on and off the Island) for more than thirty years in both hospital and home settings. She says, “The choice to have a baby at home, as long as you don’t have a known medical complication, is a very reasonable...[and] intelligent choice. The statistics bear that out.”

After a new baby has arrived, the Island has a diverse network of support. The Vineyard Nursing Association offers mom and baby a free, one-time, in-home checkup. The free Breastfeeding Network, run by trained volunteers, visits families as often as needed to help new mothers begin breast-feeding in the comfort of their homes. The Martha’s Vineyard Community Services (MVCS) Family Center in Oak Bluffs welcomes new families in a free support group called Baby’s First Year and offers education and support to parents of children up to age six. And in this tightly knit community, many families benefit from the support of friends, family, and neighbors, be it in the form of prepared meals, help at home, or baby-sitting offers.

Beth Butler of Oak Bluffs, who moved here as a single parent from Ohio with her five-year-old son in 1990, says, “I missed, I think, a unique opportunity in not having Craig here. It seems that you are instantly enveloped in friendship and open to some incredible mentoring when you’re part of that group.”

Dardy Slavin, in addition to being a mother of two, is a chiropractor and co-founder of Integrated Health in Vineyard Haven, which supports mothers dealing with prenatal and postpartum concerns and infants struggling with colic or ear infections. “A big part of why we are so interested in treating this population is because, since we opened in 2006, there have been seven babies and one grandbaby born [to staff]. It is clearly where we are in our lives and we hope to impart some of our wisdom to the families that we treat,” she explains.

It’s an island that raises a Vineyard child – native or wash-ashore. Day in, day out, we raise money to send children on their school trips and run each other’s errands because we’re headed to Conroy Apothecary anyway. If word spreads that an Island baby needs medical attention, friends are quick to organize a fundraising dinner or party to support the family. Nurse Nancy Hugger says, “Although there’s something lovely and embracing about being born here, it’s more important if you are raised here.” Lizzy Bradley of Edgartown concurs: “I never once thought that my kids were less of the Island just because they were actually birthed on the ‘continent.’”

It seems that the safe, idyllic childhood that Ann Bassett remembers when “mothers shooed children out of the house to play and did not see them until supper...where the community knew who the kids were and where to find parents if something happened” is still alive today.

Born on Martha’s Vineyard or not, all children can be become part of the Island family. Morningstar Tarter of West Tisbury, who was born here in the eighties, explains what’s most important is to live as part of the Island community. “Being born here wasn’t necessarily the most critical part. It’s about having a childhood filled with the Vineyard experiences...a radically different one from growing up in just about any other place on earth.”