February Travels…and what the CPM Title Actually Means

February 2014 - Costa Rica 155

Beautiful palms and lots of green-we soaked it up while we could, and then returned to 12 in. of snow still on the ground at home!

Happy March to each of you! I am really ready for winter to be over, especially since this one seems to be stretching on and on. This past month has been busy, and I even enjoyed a 6 day reprieve from cold when I took my 15 mo. old to Costa Rica in order to attend a dear friend’s wedding. It was a great trip, though not without excitement (like when I realized I left my wallet behind when I arrived at the airport and was ready to depart…or when flights were cancelled due to weather…and other such things….so grateful for how the Lord took care of every detail!). The chance to reconnect with old friends was very special, and it was fun to introduce them to my little fellow, though it would have been even better if my husband and 2 yr. old could have joined us. They seemed to manage quite well on their own, but we were all ready to be back as a little family once again!

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The way to travel with a toddler…

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Matthias LOVED playing in the water-this same day it was -10 in PA!

I was trying to come up with a good idea to write about this month, and then I thought that perhaps I could blog about one of the items on my list of things that I want to add to my prospective client handout folder. One question, or series of questions, that comes up frequently during the initial interview has to do with my certification, and what exactly it means. There are so many different names and titles out there that it can be confusing at times! When you go to figure out what care provider is right for you, it is helpful to have an idea of what his/her qualifications are, and what all is entailed with those. So, here’s a brief look at what the Certified Professional Midwife title means…

The North American Registry of Midwives (NARM) was founded in 1987 by the Midwives Alliance of North America, and they oversee the certification standards of the CPM credential. In order to become certified, one must first show that she can provide competent, safe, and qualified care to mothers and babies throughout the birth and postpartum process, both by completing academic studies and by demonstrating care in a clinical setting. This requires that a prospective midwife both study through a NARM-approved academic institution, as well as complete an internship under the supervision of other certified midwives. Proving that one has the mastered the skills necessary to provide knowledgeable care takes time, and there is an extensive set of qualifications that must be met before one can sit for the final exams that cover questions relating to each phase of maternal and infant periods. Once the exams are passed, re-certification must take place every 3 years, which requires ongoing continuing education and re-certification of CPR and NRP.

When I first looked into obtaining midwifery education, I decided to pursue getting certification, even though the state I was working in did not recognize the credential. It was important to me that I do my best to provide the best care possible, and submitting to the qualifications necessary to become a CPM helped prospective clients to know that I took my job seriously and that I had demonstrated the ability to pass the national standard for midwifery care. In areas where licensure is not offered for homebirth midwives, this certification also gives clients the assurance that a certain level of training has been taken, instead of not having any idea of what a midwife’s qualifications may or may not include. Interestingly, many of the states that offer licenses to midwives are using the CPM as the basis for their training requirements. While many midwives who do not have the CPM title are competent and experienced, I feel like having a standard of competency for certification helps to ensure safety and high standards of care for each mother who desires to birth out of the hospital.

Finally, I like the way this quote sums it up, taken from http://www.nacpm.org/what-is-cpm.html
“A Certified Professional Midwife (CPM) is a knowledgeable, skilled and independent midwifery practitioner who has met the standards for certification set by the North American Registry of Midwives (NARM). CPM is the only international credential that requires knowledge about and experience in out-of-hospital birth.”

If you’re interested in looking into this topic further, I’d suggest you check out these links:
http://narm.org/advocacy/narm-brochure-text/  gives a good overview of the Midwifery Model of Care and how CPM’s help to promote this, and http://midwifeinternational.org/how-to-become-midwife/certified-professional-midwife-vs-certified-nurse-midwife-whats-difference/  details the differences between the CPM and CNM titles.

Feel free to let me know if you have questions, or if you’d like to add a comment regarding this…thanks!

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Little M ready for his newborn exam…a March baby who will be having a birthday soon!

Learning Empathy…

A big thanks to each of you for your interest in helping to get Gentle Delivery Childbirth Services off to a great start here in State College! During this past month I’ve had a chance to interact with a number of new friends, and I’m enjoying the opportunity to learn more about what this general area offers as far as birth choices. If you haven’t done so, take a minute to check out and like the new Facebook page: www. facebook.com/gentledelivery  I’ve also added another testimonial to the website-feel free to read through that as well!

As many of you know, I practiced midwifery for a couple of years before I married and had children of my own. During that time, I occasionally met a prospective client who wasn’t sure about using someone for care who hadn’t experienced birth herself. In all honesty, being a single midwife allowed me to give much more to my clients, as I didn’t have the same pressing schedule-it didn’t matter if I disappeared for 2-3 days at a birth, as no one was depending on me to be around! Sometimes when I think about those days, it dawns on me how much more freedom I had to spend time learning, talking on the phone, answering questions, making home visits, spending hours with clients, taking classes, teaching, etc.

But the flipside does have some advantages-I now have an increased level of empathy. I don’t think that I wasn’t sympathetic before. But, my ability to feel with another mom the challenges she is going through has dramatically grown. And the realization of how much growing a baby, giving birth and adding a new member to the family changes things. So, for those of you who have been curious (there were many times a client would tell me, “I want to be there when you have a baby yourself! :), here are a four specific ways my perspective has changed:

1. I now know what it means when someone says “nothing works!”. During my first pregnancy, I had severe morning sickness. The kind that lasted and made you throw up and generally wish you weren’t alive anymore. I would lay on the couch feeling terrible, and cry just thinking of EVER having another baby, because if I was this sick with the first one, how would I ever take care of another baby while going through this. Not exactly the best thing to be thinking at that moment-“sufficient unto the day are the evils thereof”, right?! 🙂 Before I went through this, I would freely hand out suggestions on what helps to relieve morning sickness. After, I just listen, and then offer a list of things “that might help, but they may not work for you.” And feel really bad that I can’t just take it all away or give them a cure-all!

2. When a mom is experiencing the last few weeks of her pregnancy, and comes in with that I-can’t-take-another-day-of-being-pregnant attitude, I take her seriously. Until I was pregnant myself, I didn’t realize how awful you could feel, and how desperate you could be to just get the baby out. But you do really feel like this will last forever during those last days, and a shoulder to cry on can mean the world!

3. Giving birth naturally hurts! Not that I didn’t realize that before. And not that it’s not a beautiful experience. But the intensity of the experience amazed me. I still remember right after my first baby was born, the midwife instructed me to move so she could place fresh pads under me. She kinda grinned and said, “hey, you know what to do!”, and it dawned on me that there was no way I could move those two inches off the bed…I was WAY too sore and tired…and I told her “I know what I’m supposed to do, but I was under the impression that I’d still be able to move after I had a baby!” That made her laugh-but it didn’t seem very funny at the time! During the actual births of both of my children, I also remember how easy it was to feel over-stimulated, and I made me realize how much I personally appreciated quiet during labor and delivery…and it gave me a greater desire to try to carefully understand what really made each individual mom I’m working with feel able to relax and concentrate on her birth.

4. Having a baby changes your life! And here I’m not talking about the birth…but the fact that this little person has come here to stay. And he is totally dependent on YOU for everything. I really thought I knew what it was like to be tired…really tired…I mean, seriously, being up for 48 hours at back-to-back births makes you exhausted! But I had no idea what it meant to be up every 2 hours around the clock for days on end. Now, this is another subject for another time…as both of my babies have struggled with nursing/sleeping/tummy issues….but I do remember when one baby was 2 weeks old, wondering if I would ever know what it would be like to sleep solid again. But I understand now what postpartum depression can be a real live thing to deal with, and why a new mom needs lots of understanding, a listening ear, and sometimes just assurance that what her baby is doing is normal…maybe she knew that herself at one time, but it’s hard to remember when your life has just been turned upside down!
Matthias Johann 447 2 (5)
Well, these are just a few things that come to mind when I think of how I look at things differently from this perspective….while it’s been a change, it’s been a good one, and I love my little ones and the experience of carrying them and being able to deliver them at home. But it’s not always easy, and requires alot of work and sacrifice. And when I do a birth now, it means nursing baby comes along, and I don’t get to sleep until I feel caught up…but those days will come again…and quickly, I’m told, by moms further ahead than I am!

In closing, I feel like there were definite advantages to being a single midwife to being a midwife who is married with children. But there are advantages to this stage, too. And I can’t say that I feel like one is way better than the other-it’s just a different perspective, and different time in life. I’d be interested in hearing your perspective in the comments…what do you see as advantages/disadvantages to using a care provider who hasn’t had children herself? or how has your perspective changed since having children yourself?

Matthias’ Birth Story

Matthias’ Birth Story

With this being the start of a new year, I’m attempting a new start at keeping this blog more up-to-date. My hopes are to at least post once a month, so we’ll begin with this, and see if I can keep it up! Blessings to each of you in 2014!

Having just celebrated Matthias’ first birthday, I thought you all might enjoy hearing a few of the details surrounding his birth…

They say that being a midwife to a midwife can be a challenge, and I’m afraid I’ve proved that to be true once again. My second pregnancy, while easier during the first half of the pregnancy, was definitely more uncomfortable during the last several months. My friend/neighbor was expecting as well, and since we were due the same day, we joked about who was going to have hers first. In hindsight, I don’t think I was really joking-I thought I should be the first one, as I was certainly bigger and seemed to be more uncomfortable!

However, wouldn’t you know, but 2 weeks before our EDD, my friend calls me at 4am wondering if I’m having my baby, as she thinks hers is on it’s way. At the beginning of her pregnancy (before I knew I was pregnant myself!), she had asked if I would deliver hers, but with our due dates being so close, it was pretty much impossible to commit to it, which was disappointing for me, as births have been pretty few and far between since moving to PA. Once she found out I wasn’t in labor, she said she’d call if things progressed before her midwives arrived (they had 45 min. to drive), and sure enough, things progressed rapidly, and I was soon on my way up the hill and had the sweet privilege of delivering a little boy about 10 min. before the midwives arrived. It really was humorous, me, who was so big and cumbersome I hadn’t cleaned my own tubs in weeks, was leaning over a large tub delivering a baby without any thought at all!

Baby E - here about 1 hour old!

Baby E – here about 1 hour old!


I remember reading somewhere when I was initially beginning my midwifery training about there being strong hormones present at a birth, and how these sometimes made other pregnant women have their babies when they were exposed to a birth environment, so it wasn’t very hard to wish that I would have my own baby yet that day. However, it certainly didn’t work that way, and I began what turned into a very long week. With my first baby, I had no “false labor”, and everything was very straight forward. This time around, I had night after night of timeable contractions, little sleep, and an active toddler to care for during the day. Then Thanksgiving vacation arrived, and Joel was home from school for 4 days-and that would be a PERFECT time to have a baby. But that didn’t work either! By the end of the week I was a basket-case…exhausted, ready to be done, my blood pressure was going up and making me feel sick, and I was ready to do anything to get this baby out. My midwife suggested that I try to get some sleep, and wait to do anything until I was rested…which sounds like something I would have told someone else…but wouldn’t hardly hear myself.

Sunday morning I again had timeable contractions. Strong enough to be uncomfortable, but I wasn’t going to dare miss church, lest all the ladies wonder if I was home in labor, only to show up pregnant again next week. We had a Thanksgiving get-together with Joel’s family, and by the afternoon all my possible labor signs had died down. I hiked up our mountain trail TWICE (really desperate!), and gradually got grouchier as the day wore on (hormones kicking in, in retrospect). By afternoon we had decided to give castor oil a try, so I started chugging, and consumed more than I will recommend to anyone to take again. However, by the end of four hours of hoping something would kick in, it felt like nothing was happening. I cried again…and talked to my midwife …she lived 2 hours away and thought she should go ahead and come “just in case”, but I was just as adamant that there was no reason she should drive all that way only to turn around and go home again.

At 9:30pm I checked to find that was a good 4cm dilated-not much more than a few days before. So I let my midwife know that nothing was going on, and I was giving up and going to bed. Joel and I had a few minutes to talk, and then I had a contraction around 9:45pm. We thought, maybe things are actually going to start…and a few minutes later they did…this time I had a massive contraction, followed quickly by another and my water broke. Joel jumped up and said he’d better make sure Debby was on the way. She assured him that despite my wishes that she would wait, she was already on the road. By the time he came back to our room, contractions were coming so strong and so fast that I thought I was going to go crazy. At that point I asked him if we should go ahead and tell Rose to come (she was a midwife friend of ours who lived close by and was home in our area for Thanksgiving break-we had been hoping she could be there for our birth). He gently told me that I had contractions like this for a long time with Yoanna, so there really wasn’t any rush. To this I replied that if I had to go a long time like this I would just die, and I meant it.

Because he was teaching school, Joel needed to have a sub to take his spot the next morning since it looked like he wouldn’t be going in himself. So he quickly got on the phone to line one up-he had made some tentative plans but needed to make sure they were confirmed. It felt like he was on the phone forever…the contractions were incredible, and I didn’t even have time to move between them…every time I even breathed another one would start, and I never even got up off the end of the bed. By about 10:05, I started calling for Joel…not too loudly, as we wanted Yoanna to stay sleeping…but I didn’t know how I was going to make it. When Joel realized how serious things were, he tried to call Rose…which took longer than it should have, as I had scribbled her number on a scrap paper, and couldn’t tell Joel where to find it! I still remember him finally getting ahold of her, and hearing him tell her that she’d better hurry, as he didn’t think she had 10 minutes to get here (and she only lives 1 mile away!).

Right about then I realized that unless Rose really hurried, no one else was going to be around. This baby was COMING! Thankfully, I had set up my birth kit earlier that day, and everything was ready. Joel had the bowl of immediate supplies handy, and stepped right up to the plate. It was kinda weird…one minute I couldn’t think of anything, and the next minute I’d think, “oh, I need to make sure I…” Guess that’s the strange side of coaching so many other people through their births! Joel did especially well at helping me to slow down and breathe, allowing Matthias to be born slowly…I felt like my body was just pushing him out without me making any decisions. At 10:20pm, Joel caught his son, and handed him to me, and we both looked at each other a bit awed. It was just over 25 min. from the first major contraction! Rose walked in about 2 minutes later, about as surprised as we were to see the baby had already come.

We quickly called Debby, and told her we were in good hands with Rose, so she turned around and went home…good thing, too, as she had a quick one the next morning that she would have missed if she had been at our place. Rose took care of all the remaining things, and Joel said he was really glad to have her walk in and finish the job. We were so grateful for a safe birth, but for the record, my husband says he isn’t going to plan on delivering the next one solo. And we found out why the last weeks were so uncomfortable…Matthias weighed in at 9 lbs., over 1 ½ lbs. larger than his sister!

About an hour after his rapid arrival!

About an hour after his rapid arrival!


Big sister meeting baby brother

Big sister meeting baby brother

Matthias around 1 week old

Matthias around 1 week old


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If you’ve wondered about eye ointment used on newborns…

For those of you following this blog, you probably thought I had given up ever posting anything again! 🙂 Time seems to keep me from spending much time on the computer, and blogging is at the bottom of the priority list! But, I read this article today and just had to pass it on, as it refers to a question that often comes up during the newborn exam. Enjoy!

http://evidencebasedbirth.com/is-erythromycin-eye-ointment-always-necessary-for-newborns/

Link to article of interest…

I know I’ve not done well at keeping this blog up the past while…it’s been a busy summer! I had a baby of my own in June, which I will have to post about sometime soon. Being a mom has been a blessing and a challenge! But I came across this article, and wanted to share it:

http://erinmidwife.com/2011/03/31/if-i-were-at-home-i-would-have-died/

Enjoy!

Article Links

I thought some of you readers might be interested in looking at the following links….

Here’s an excellent article by ABC news that gives some good statistics about home birth and birthing options:

http://abcnews.go.com/Health/Wellness/cdc-home-births-rise-us/story?id=9998349

 

And here is an interesting video regarding the development of the new idea of a “family-centered Cesarean”. If you had to have a C-section, it would be lovely to have it happen this way! Just a note, it does show details of the C-sec surgery:

http://www.youtube.com/watch?v=m5RIcaK98Yg

Enjoy!

A long overdue update…

I realize that I have not written any posts for a very long time….and for those of you who have contacted me the past while, I feel like it’s about time to let you all know what has been going on in my life. It’s been an eventful past few months, to say the least!

On September 11, 2010, I had the special privilege of becoming the wife to Joel Martin, who is from PA. God had brought our paths together a little more than a year before then, and through an amazing journey led us to marriage after a courtship that began in January of 2010.

For the first few months after our wedding, we felt God’s leading to stay in Kansas for awhile in order for Joel to learn to know my family better, and to help ease some of the new adjustments for me.  God answered some specific prayers concerning work and housing, and we enjoyed the time of connection with friends and family in my home area. In November, I had the fun opportunity to be a doula for a friend, and thus be able to participate in another birth.

Welcome to little Isaac!

Later in the fall, we we all excited to find out that a little one of our own is on the way…followed by many weeks of severe nausea and vomiting.  Not exactly the most enjoyable way to spend our last few months in KS, but yet it makes one thankful for days in which I actually feel good. 🙂

The end of December found us packing up and preparing to move cross-country. We arrived in Joel’s home area of Juniata Co, PA just in time to see the new year come in, and are continuing to unpack, settle in, and adjust to our new surroundings. We have a sweet little home, and Joel is busy teaching 6th-8th grade at the nearby Christian school. The adjustments haven’t been easy, but the longer we are here the more it feels like home. I miss all of my dear friends, family and former clients from the mid-west, but we look forward to seeing what God has in store for our future together.

I still plan to continue posting, though since I don’t have a practice up and going here yet I hope to post helpful links and information as I come across articles and things. I’ve updated my contact info, and we are now hooked up with internet and phone service again, so if you’ve wondered why I’ve been hard to reach, you know why.

Blessings on each of you in this new year!

Summer Report…

Okay, I know it’s been forever since I’ve actually posted on this site, so my attempt now is to try to bring you all up to date with what has been going on in my life these past months. It would probably be easiest to do it in several shorter posts, so I’ll start with photos of some of the summer babies….

Kyler Maine

Sweet little Kyler was born in June, and after giving us quite a scare by her reluctance to breathe on her own, she is doing quite well. Her older siblings were delighted to have a baby in the house again!

Isabelle

Isabelle arrived in July-her mama was a real trooper! She has continued to grow into a beautiful girl, and I so enjoyed the time spent with her parents.

Jazmin

Little Jazmin came in August, being cooperative enough to wait until AFTER I had major wisdom tooth surgery and took a quick trip to PA. We were grateful for God’s timing in her delivery, and it was extra special to deliver this sweet bundle, as I had delivered her big brother close to two years before.

Here are Brandon & Jazmin & myself, when she was two days old.

Well, that should bring folks up to date with babies….and future posts will contain some other interesting, updated information about my life! 🙂

More Information about the Summer Childbirth Education Class

Alright, I finally have more detailed information regarding this summer’s childbirth education seminar. This all-day class will cover topics such as prenatal nutrition, exercise, explanation of the childbirth process, tips for couples on how to work together during labor, positions and comfort measures for labor and birth, suggestions on writing a birth plan, and much more! There will be opportunity for you to ask questions, meet other couples who are sharing similar experiences, and learn together about the miracle of birth. Designed especially to help those planning a natural childbirth, this class will help you to better understand and prepare for your upcoming birth from a Christian perspective. I strongly encourage couples to attend together, as well as any other support people who are planning to be present at your birth.

In order to enable the best concentration and involvement, please make other arrangements for your children, with the exception of nursing babies.

When: Saturday, July 10th, 2010
Schedule: 10am-Noon, break for lunch-we suggest you bring your own, as there aren’t many restaurants close by, 1pm-3pm
Location: the home of Heidi Nisly, cpm ~ 9101
W. Red Rock Road, Partridge, KS 67566
Cost: $75/couple (note: for those using Gentle Delivery Childbirth Services, this class is included in your total fee)

A workbook, drinks and snacks will be provided for your enjoyment!

Taught by Kelsey Hobbs, CPM
Please register by July 5th in order to ensure availability of materials.  Feel free to call if you need more information or have questions. Email: gentlemidwife@gmail.com ~or~ phone: 316-253-0099    Please pass this information on to anyone you know who might be interested!

Summer Childbirth Classes- Date is set!

Just wanted to let you all know….I’m planning to teach another childbirth class seminar on Saturday, July 10th. There are a few more details that are in the process of being figured out before I give you all more info, but go ahead and mark your calendars and let me know if you are interested!!  Feel free to let others know, as well!     email: gentlemidwife@gmail.com