Madelyn Doyle doesn't know it now, but in kindergarten she can take a digital fish scale in for show and tell. Maybe her dad, Patrick, will even tell how he weighed her on that scale just after he delivered her at home. Most babies are born in a hospital, with a doctor and nurses assisting. That's where Daniel, Madalyn's older brother, was born three years ago. According to the Doyles, this birth would be different. Linda wanted to have this baby at home.

Patrick is a paramedic, trained in a variety of medical procedures. "Patrick delivered Daniel at the hospital," Linda said. "I just knew I would be more comfortable at home." The Doyles have a friend who has delivered her children at home, and they did a lot of research and talked to people as they made their final decision. They bought an obstetrics kit, studied everything they could find, referred back to Patrick's paramedic materials and he even attended an emergency medical services refresher training just before the birth. Both parents laughed and said they ended up with much more than they needed, but it was a fear of the little things that might go wrong that concerned them.

"Madalyn was born face up," Patrick said, "and had the cord wrapped twice around her neck. I knew what to do, though, and everything went fine after that." In many states, midwives are the ones who attend and manage a home birth. Nebraska only has certified-nurse midwives, and they must work out of a hospital and be supervised by a doctor. A certified-nurse midwife is a licensed profession in Nebraska, but a CNM cannot legally attend a home birth. Having a midwife come in for a home birth is neither legal nor illegal. A recent attempt by Sen. Adrian Smith of Gering to regulate and license midwives in Nebraska was killed by the 2005 state Legislature.

The Doyles are unusual in that Patrick has 10 years of paramedic training behind him. Many mothers who deliver their babies at home don't talk about it. According to Barbara Peckham, CNM, who practices in McCook, most home births are unassisted. Linda did get prenatal care from a physician and Patrick did call when the placenta wasn't delivered as quickly as it should have been. "My doctor came by after Madelyn was born and checked us both out," Linda said. "I think it was more to see the baby." On July 7, when Linda went in for her checkup she was told she had two options.

"I was dilated to five centimeters," Linda said, "I could either go to the hospital or go home." She went into labor early the next morning, and was able to do what she needed to make herself more comfortable. "I sat in the whirlpool for a little while," she said, "walked around a little bit. Patrick asked me twice if I wanted to go to the hospital." Linda said she had more control over Madelyn's birth than she did with Daniel's. "I didn't have strangers coming in or a duty change during the delivery," she said.

Patrick said they took Madelyn in for her PKU test - a test all newborns have to see if they have an inherited disorder of body chemistry that can cause mental retardation if untreated - and they will file a birth certificate with the state. According to the score sheet for the APGAR test, which rates the baby's activity, pulse, grimace, appearance and respiration, Madelyn was perfect - all fives. Linda's mother was there during the birth and Patrick said she kept telling him he wasn't a doctor. "After Madelyn was born, she said, 'Good job,'" Patrick said with a grin.