At Cape Cod Hospital, Janice DiGioia and Jodi Belson are among eight skilled and certified nurse-midwives who help deliver hundreds of babies every year. “I can’t really explain how delivering a baby makes you feel,” says DiGioia. “It’s just such a spiritual time.”By Lisa Cavanaugh | Photography by Julia Cumes
On a snowy, overcast morning in early April, three-day-old Leland Forgeron is snuggling with his mother, Chelsea, and father, Kyle, in a room at Cape Cod Hospital’s Family Birthplace. Baby Leland is just one of around 800 infants who will be born here this year, and like more than half of them, he was brought into the world with the help of a midwife.
Midwifery (pronounced midwhiffery) has been practiced holistically as part of reproductive healthcare for as long as women have been giving birth. “It’s a calling,” says Janice DiGioia, who has been a midwife for more than 30 years and has delivered thousands of babies. “And I do think the mothers love what we represent.”
While the term midwife, which literally means “with woman,” may connote ideas of home births, the reality at Cape Cod Hospital is vastly different. Expectant mothers have the option to choose midwifery care before, during and after giving birth, provided by eight skilled and certified nurse-midwives (CNMs), including DiGioia, who are employed by the hospital and work in collaboration with other medical staff.
“We provide family-based maternity care as a team,” says Jodi Belson, another nurse-midwife with the Cape Cod Hospital program. “Every woman has a midwife, a nurse, a physician, anesthesia if that’s appropriate, a pediatrician, social worker and lactation support. We really have such an amazing relationship with our doctors.”
Dr. Tara Chute, an ob/gyn who works on the labor floor, agrees. “Everything here is a team effort and that’s why I think we have such good patient outcomes. The patients are thrilled with their midwifery care.”
When Belson began working part time in the program’s office, she was a new mother herself. “What interested me originally was reproductive rights and healthcare,” she says. “When I went to school, I thought that was all I was going to do, but then I unexpectedly fell in love with delivering babies.” Belson sees patients starting in their adolescent years, providing gynecological and reproductive healthcare throughout their lives. “If they choose to have families, we support that and empower them to make the choices they want. I really love the whole circle of care.”
Belson had previously worked with DiGioia when they were both at South Shore Hospital, after DiGioia had effectively brought midwifery to Cape Cod in the 1980s. “In 1985, I was the initial midwife who came here to Cape Cod Hospital,” says DiGioia. “I stayed for six years, but after all those years of working solo, I wanted to be part of a group of midwives, so I went to South Shore.”
Originally from Rochester, New York, DiGioia attended nursing school at Alfred University and fell in love with maternity care. “I spent a year as a practicing nurse on a Navajo reservation in Arizona,” says DiGioia, “and then I applied to midwifery school. For me, the goal was always providing care for women who needed it.”
After DiGioia received her masters at the University of Kentucky, she began researching midwife jobs. “One of those opportunities was with Dr. Bill Connolly on Cape Cod,” she says. “I came up here to interview and he took me out for lobsters and Bloody Marys, and I said, ‘Oh, I think I like it here!’” she says, with a laugh. “It was a perfect balance, bringing midwifery to the population on Cape Cod just as the advanced nurse practitioner concept was growing.”
In 2009, when DiGioia, Belson and one other midwife eventually launched the current program at Cape Cod Hospital, the community welcomed the idea of midwives delivering babies in concert with physicians. “We are a hospital-based practice,” says Belson. “We have midwife coverage here 24/7 and stay in constant communication about what is happening with our patients. It’s our job to know what they need and make sure they get it.”
“The midwives are doing 75 percent of the vaginal births,” says Dian Birch, director of nursing at Cape Cod Hospital. She explains that if there is an abnormal presentation, midwives will call in doctors. But their skilled care often lessens the need for medical interventions.
Birch also shares that Cape Cod Hospitals’ Family Birthplace is well on its way to being certified as a World Health Organization/UNICEF “Baby Friendly Hospital.” This global initiative’s specifications, such as placing newborn babies in skin-to-skin contact with their mothers immediately after birth, all are intended to promote and support breastfeeding.
“We have evidence-based data that if the baby is in skin-to-skin contact with their mother for at least an hour, you have a much healthier baby,” says DiGioia. “Midwives have been doing that for centuries,” adds Belson, “but now we can have benchmark measures for outcomes for mom and baby.”
These impacts are especially critical for vulnerable populations. Cape Cod Hospital can collaboratively handle higher-risk maternity patients with diabetes, high blood pressure, psycho/social issues or multiple births.
Clearly, every baby born here is special to the midwifery team. “You do feel connected,” says Belson. “My kids are in classes with babies I’ve delivered. In fact, I delivered one of my neighbors’ babies, and every year on his birthday she puts flowers on my doorstep.”
DiGioa has had patients whose mothers remind her that she delivered the expectant moms decades earlier. “That always gives me a happy little chill.” She pauses and reflects on her years of midwifery. “I can’t really explain how delivering a baby makes you feel. It’s just such a spiritual time.”
DiGioa and Belson check in on the Forgerons to ensure that everything is going well with Chelsea and her newborn son. Also in the family room is sister-in-law Lyndsi Forgeron, herself pregnant due this past July. Leland seems very content as he gets tenderly held by each visitor. When it’s her turn to hold the infant, DiGioa smiles at his sleepy face. “How lucky are we to do this every day?”