Then she heard a calm, familiar voice.

"It's really hard, I know," Dianne, her nurse-midwife said. "But you can do it."

With the next contraction, Nancy gave one more push. Then one more. Her husband Donald moved to the foot of the hospital bed. "It's beautiful," he gasped as the crown of their baby's head pushed its way into the world.

Nancy shut her eyes and focused on her nurse-midwife's voice.

"Don't push now, just breathe," said Dianne, as she eased out the baby's head. Next came a stubborn shoulder. "Now push," Dianne said. "Slow, slow."

Then Donald took over. With the final push, the father grasped his own baby - a daughter! - and placed her on Nancy's belly. He covered the squirming infant with a warm receiving blanket as Nancy moaned and laughed with relief. With hugs and caresses, the parents welcomed 8-pound, 3-ounce Rebecca.

How different it had been when their first daughter was born. They had been shuttled from one hospital room to the next, Nancy groggy form medication and hooked up to an intravenous line and electronic monitoring equipment. In the delivery room, she was scolded when she instinctively reached down to touch her baby. Donald was not allowed to hold the newborn until the child was bathed and swaddled.

With this second baby, their hospital room felt festive. In labor, Nancy padded around in her flowered kimono as she played her favorite Bette Midler and Barbra Streisand tapes. Because Dianne encouraged her to sip juice and water, she needed no intravenous lines. She did not even think about pain medication; until those final few minutes, the contractions seemed manageable. When the pains came closer together, Nancy sat in the rocking chair, while Dianne breathed with her and coached her through each one.

Nancy was wide awake when Rebecca was born. She nursed the baby immediately. Within minutes, three-year-old Rachel joined her family, climbing onto the bed for a hug from her mother and a wide-eyed hello to her baby sister.

Diane stayed with them, making sure mother and baby were all right. Nancy loved how Rebecca never had to leave her sight. She felt connected to her baby, and proud of the calm, joyful and healthy birth. She had felt that same calm and confidence throughout pregnancy with her nurse-midwives Dianne and Sharon. As childbirth experts, they performed checkups and provided a never-ending stream of advice, encouragement and information, including Nancy and Donald in all decisions. Nancy liked that feeling of control. As a woman and mother, she felt responsible for the life growing inside her and liked being part of her baby's care from the very start.

By the time of that second pregnancy, Nancy was a successful lawyer who had tasted all sorts of achievements in her thirty-three years. But none was as sweet as the birth of Rebecca.

"This was different," she said. "I felt a real sense of accomplishment, as a woman. I gave birth to this child. And she and I are very close."

A joyful and healthy start is what having a baby with a nurse-midwife is all about. Childbearing is a normal part of life and need not be treated as an illness. But a pregnant woman does need professional guidance and emotional support. Nurse-midwives know the strength of women and the natural beauty of childbirth. With the guidance, assistance and understanding of a nurse-midwife, pregnancy and birth can be made even healthier and more joyful.