Brazen Woman 2002: Paula Tipton-Healy
   Like most midwives, Paula Tipton Healy has a wonderful story of how she began her training, thirty years ago. When she was eighteen years old she was attending college in San Diego to become a dietician. She had an assignment to interview a group of people about their dietary habits. She chose pregnant women, but she found that pregnant women were difficult to come by. Paula called all over town to find a physician who would allow her to interview his pregnant patients. Most didn’t believe that nutrition had anything to do with pregnancy, and wouldn’t give her the time of day.

   Finally, she contacted a doctor named Dr. Repaire, and he called her back immediately. He welcomed her to visit during one of his prenatal days. One of the interviews was particularly meaningful for her. The woman was a third time mom and they connected with each other right away. They continued talking after the interview was over, and the woman asked her, “Why are you interested in patients having homebirths?” Until then, Paula had no idea that Dr. Repaire was practicing homebirth. This mama finished their meeting by inviting Paula to her birth.

   Paula remembers showing up at her house around midnight a few weeks later. She sat on the couch with the woman’s two sons and watched her and her husband as she gave birth to their third. It was an incredible, life changing moment. She realized that this was what she wanted to do with her life. She began attending births with Dr. Repaire.

   Paula moved from San Diego to Aspen, Colorado, where she later worked with an RN doing homebirths and then began assisting a Chiropractor doing homebirths in exchange for teaching her Homeopathy. She later returned to San Diego and partnered with another General Practitioner. By the time she was 24 years old, she was doing births on her own.

   Paula has been to over 2000 births; including those she attended during a two-year stay in Mexico, teaching homeopathy and training midwives. She has four daughters of her own, all born at home. Her first daughter was delivered by Dr. Repaire, the other three attended by midwives.

   Paula first became involved in midwifery politics in 1978. She hosted a meeting about midwifery legalization with the handful of other midwives practicing in San Diego at the time. Soon afterwards, she heard that midwives in Northern California were trying to put together a state organization and the San Diego midwives joined in.

   The greatest contributions Paula provided for CAM were in fundraising and education. For many years, region 10 consistently had the largest contributions to CAM in the entire state. Paula created large benefit events that made significant money, including concerts with well-known bands that she had been connected to through birth. For example, she did a birth for two of the members of Big Mountain, a Reggae band that then threw a benefit concert in return. Paula also caught babies for a famous author and a number of fashion designers, all of whom she inspired to raise money for CAM. She once held a benefit fashion show that included a maternity of line clothing and children’s bathing suits.

   Paula also developed a very strong apprenticeship program, and then shared this model with midwives across the state. Paula has apprenticed so many midwives in her practice that the majority of senior practicing in San Diego have trained with her. She realized long ago that midwives had come to learn their trade in such eclectic ways, that few people had a set way to train apprentices. Although this has changed somewhat since licensing, at that time she recognized there was a lack in clear, systematic programs for midwifery training.

   The apprenticeship model that Paula designed required a 3 year commitment, consisting of 6 months or about 10 births as an observer, 6 months as an assistant to the apprentice, 1 year as an apprentice/assistant & the 3 rd year as an intern with a senior practicing Midwife assisting and overseeing her. She gave classes throughout the state and at conferences for years; teaching midwives how to utilize this model. She also taught homeopathy to midwives throughout the state.

   Yet Paula believes that her single most important contribution to California midwives was her recent battle with the medical board. The medical board became involved with her just as she was retiring and she could have easily just said that she was retired and given up her license. But instead she kept her license current to complete the process, because she believed the outcome could have positive consequences for existing midwives and the future of midwifery.

   The issue was over a VBAC transport. At that point, Paula had been practicing for 30 years without a single complaint against her. This mama had a great labor at home, but transported after three hours of pushing without any progress. Though Paula had a strong working relationship with a hospital in the city, mom did not want to travel any further than the nearest hospital. The nurses there were lovely, but the Doctor who received them was terrible. He refused to shake her hand, instead demanded to know who her backup Doctor was. When Paula responded that the parents had a backup doctor in another hospital, he said, “I didn’t ask that, I asked who your backup was.” He ended the interaction with “Well young lady, I’m going to have your license!” although he was himself quite a bit younger than Paula.

   The outraged father stepped in. He was the head of the nursing department at a local college, and he tersely informed the Doctor that he and his wife were educated people, who chose their midwife after careful consideration of her training and reputation, and that unless they were being turned away form the hospital, he had better start treating them appropriately.

   In the end, a healthy 9 pound girl was delivered by cesarean surgery after a diagnosis of CPD. Mom had pain at her suture site for two full years. The Doctor did indeed turn Paula in for attempting to do a VBAC at home. Dad still goes to medical board meetings to tell their story and advocate for midwifery.

   When the medical board began investigating Paula, she was tempted to turn in her license and end the ordeal. It was terrifying to face them – she came of age as a midwife back when it was common to hear of midwives going to jail. The thought of the medical board questioning her was horrifying. But she refused to be ruled by fear.

   At the interview, she was faced with a retired Ob who spent 4 hours reviewing her charts line by line. He concluded that she was meticulous in both her care and her charting. He said that she had followed the midwifery standard of care and had done nothing wrong. He suggested that she follow up by contacting every hospital in her area and asking them for privileges, then keeping their refusal letters on file for her own protection.

   The investigator concluded that he could dismiss the case immediately, but he would prefer to have it go on to review to set precedent for the fact that VBAC is not unsafe at home. Although she desperately wanted the whole thing to be over, Paula agreed to this. The case went to review one year ago, and it has caused a great shift. The medical board is now more open to VBACs.

   Paula has been retired for about a year and a half. She says that aside from raising her own daughters, midwifery has been the most wonderful blessing of her life.

   Paula says that the coolest thing about midwives is that they are such a diverse group of women. In a lot of ways, this is also the hardest thing. Differences can work for us or against us – we must learn to be cohesive despite them. We cannot have power without unity.

   She reminds us that midwives live with a legacy of fear. It is time to move past that now. Paula says that she herself was ruled by fear for a couple of years. Then she realized that she would never let that happen to her again. She knows that she practices from a higher calling. She knows she has to do what she believes is right and practice midwifery the way it is supposed to be practiced: safely and gently, regardless of what the government says. She reminds us that when we practice from a place of fear, it is too easy to make mistakes. We become detrimental to ourselves, our clients, and midwifery as a whole because we are letting fear cloud out intuition and get in the way of our good judgment. She says that her own life changed dramatically once she was able to let go of fear.

   Paula says that she has felt it such an honor not only be a small part of the miracle of birth, but also to be counted among such wonderful, bright, brave and Brazen women that are Midwives!

CAM celebrates the hard work and dedication of the awardee in midwifery activism. In no way should this award be construed as a determination of the midwife's skill nor as a recommendation to use her services.

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