2021 Year-End Update from Gentle Delivery

2021 Year-End Update from Gentle Delivery

As I think back over this past year, it is with a sense of gratefulness for the ways that God has led, protected and provided. 2021 has included more complications, challenges and adrenaline rushes than I’ve ever had in one year’s time since I began practicing as a midwife 12 years ago! The additional gray hairs accumulated over the months prove this, and I am ending the year feeling like I’ve gained a level of experience that I honestly wouldn’t have minded doing without. However, I’ve also been reminded that this is WHY a midwife takes training seriously, and I’m more committed than ever to doing my best to assist families in safe births, even when at times this requires a different birth location than what we had hoped for, or more invasive assistance than what I prefer to provide.

            Besides being the most intense year complication-wise and the most stressful year when it comes to constant changes & research due to the ever-changing Covid landscape, it was also my busiest year baby-wise! I had the honor of helping to welcome 6 girls and 11 boys by the time the last December babies arrived. Weight ranges were fairly average: smallest was 6#8oz and the biggest was 9#9oz. While a couple of little ones came a week or two early, most typically went on the later side with two babies waiting until 13 days past their due date. Three babies made child #6 for their families, and two boys were the first ones for their families. While there were several long labors and many hours spent with a family before the birth, one little guy was in a big enough hurry that he made his appearance in his home before I did! As usual, birth always has an element of surprise that keeps us all on our toes.

Lynelle, Myself & Lanna

            I was blessed to work with several great assistants this year! These ladies really help to lift my load, and add a lot to our team. After assisting with births throughout the past 6 years, Lynelle is sensing a need to step back for a time, so she won’t be seen as frequently in the next year. Lanna began helping this spring at the height of our busy season, and has been such a blessing! She will continue to assist as her schedule allows, and there’s the potential of another assistant joining the team in the near future. I’ve also been grateful for the continued help of the midwifery community here in central PA: other assistants and midwives have been willing to fill in as needed, and I’m thankful to have had help available whenever I’ve needed an extra set of hands or someone to cover for a trip or emergency. I was especially thankful for RoseMarie’s willingness to cover for me this fall when our family had COVID, and I was thankful for the baby who so beautifully cooperated in waiting to arrive until I was recovered and my family was past quarantine!

Guerrero, Mexico Summer 2021

            On the home front, my little family is growing and doing well! In spite of lots of babies and the craziness this adds to our calendar, we were thankful to get to spend some time camping over the summer, as well as taking a family trip to Mexico to visit missionaries serving with the organization my husband works for. I couldn’t serve as a midwife without the amazing support of my husband Joel, who graciously steps in to care for everyone when mama disappears at a moment’s notice. With children ranging in age from almost 2 to 10, life at home is always exciting and active, and my girls can’t wait until THEY are old enough to “help mama at births”.

            A big thank you to each one of you who have trusted me to support you as you navigated your pregnancies and deliveries—it is something I count a privilege and honor! I love to hear from families, so please feel free to send an update and picture when you have a chance!

Many blessings as you head into the New Year,

Kelsey Martin & Gentle Delivery Midwifery Services

Be sure to check out the blog and Facebook page to stay updated on current news, helpful information, health suggestions, birth stories, and announcement of special events such as playdates!

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Birth Story of our Christmas-time Baby

Birth Story of our Christmas-time Baby

As we enter into the Christmas season again, I have to think about the year we were anticipating our own Christmas baby, and what a delightful time of year it was to cozy up inside with a newborn! Our little Tirzah had quite the dramatic entrance into the world, and it almost makes me laugh every time I recount it…

By the time I was expecting my fifth baby, I knew to expect lots of contractions and discomfort, and this pregnancy was no exception. Thankfully my blood pressure was staying within normal limits, and everything else was proceeding smoothly. But after several nights with contractions and signs that labor could be imminent, I was getting TIRED. Once you loose that much sleep and feel heavy and uncomfortable all the time, you start to wonder how on earth you are going to make it through labor yet! One night I was pretty sure it was the “real deal”, after being up for hours with regular contractions, only to find everything stopped once the birth team was here and the pool was filled! Funny that it took the fifth child to experience that “false run”, but after not calling the midwife soon enough last time, we were trying to not repeat that scenario—only to send everyone home after a couple of hours!

My previous baby had come after an extremely intense labor, and I was trying hard to not allow fear to overcome my anticipation of this birth. Lynelle, my good friend and birth assistant, had told me that I really should try the birth pool this time around, and even offered to take care of all the set up and prep to make that happen. So we had set up the pool in the office, and had everything ready to go, and I was really hopeful that it would make a difference in the intensity, especially at the end.

Everything set up and ready go for round #1!

Fast forward a couple of days: after getting a good night’s sleep, I woke up on Saturday feeling like this baby needed to be encouraged to come. I’ve taken Castor Oil before, but every time I thought about that option it made me want to puke. So I figured there had to be an alternative: enter the Midwives Brew! I had read about this recipe (used often by European Midwives), but had always figured that the small amount of castor oil combined with the other strange ingredients wouldn’t actually be effective. But by this point I was willing to at least TRY it and see! My husband was on board (he was ready to see me up at night nursing a baby instead of up at night with contractions!), but I warned him that I really didn’t think it would work.

Mid-morning, I took my youngest for a little “mommy date”, and we headed to Wegman’s for a few groceries and the ingredients for the brew (see this post to find out what those are!). I had fun picking out a few things that I thought would sound good to eat or drink IF I was in labor later on, and we had a pleasant little outing. Once I returned home it was about lunch time, so while Joel fixed lunch, I blended up the brew, and sipped it down before eating a little lunch. While not the best flavor I’ve ever tasted, it wasn’t nearly as bad as downing large amounts of castor oil in juice!! My stomach felt a little funny, but eating some food and then chewing some gum seemed to settle things.

strange blend of ingredients!

This was the weekend that one of our little local Victorian towns always holds an event called “A Victorian Christmas”. That event combined with the opening of an exhibit of an Underground Railroad station in one of the museums there had made me want to take the children out for awhile if we were still waiting on a baby over that time. Since Joel had a Bible Study planned at our house for the afternoon, it felt like a great opportunity to take out the older children for some educational distraction and let me get a chance to think about something other than baby waiting! Since all I had been experiencing for two hours was some minor stomach discomfort, I decided to head out around 2:30pm, despite my husband’s slight misgivings. Laughingly I joked with him that if I called him he’d better answer the phone, as it might mean I needed him to come pick me up!

Bellefonte is about 10 min from our house, and we parked and went through the historical museum, only to find out that it did not contain the Underground Railroad Exhibit like I had thought. The curator pointed us up the road about half a block to the right museum, and the children and I headed that direction. Right as we hit the steps (around 3:30pm), I felt a slight “pop” and had a thought that perhaps my water had broken. But I wasn’t sure, and decided since we were RIGHT THERE we might as well go in. I felt a bit of dismay when the museum volunteer cheerily told us that the exhibit was on the top floor…UP THREE FLIGHTS OF STAIRS!! We started up the stairs when I felt my first real contraction, and I immediately thought that we’d better not stay long. The children were oblivious, of course, and thoroughly enjoyed exploring, while I tried to act like nothing was amiss as the contractions quickly started getting stronger and harder. I hurried them through the exhibit and back down the stairs, stopping briefly in the bathroom where I confirmed that indeed my water had broken. As we headed outside, my children excitedly discussed the next place we would go…and  I seriously informed them that we needed to get home NOW. They looked at me puzzled, and I told them I thought baby sister was going to be coming, to which my 6 year old son replied “how do you know? Your water hasn’t broken yet, has it?”. That made me laugh in spite of the situation, and when I told him it HAD, they all got really serious!

The half-block walk back to the car seemed to take forever, as the contractions were definitely picking up in speed and intensity. Once we pulled out and started on the road, I called Joel. The first time he didn’t answer, but then when the phone rang the second time he figured he’d better pick up! I told him that labor had begun, and to please have all the Bible study men out of the house by the time I got home and figure out where the boys were supposed to go…and to pray I could drive home safely! Next I called my friend Lynelle, as I knew that she would need to get a babysitter for her children, and I really wanted her free to get the pool started if things continued. Once I was finished with this phone call I knew I couldn’t make any more calls and drive, as things were just too intense. It was all I could do to stay focused on driving! I kept praying a policeman wouldn’t pull me over, as I had no bandwidth to explain why I was headed home instead of to the hospital!

I reached home, and our friend Daniel had his van running so he could pull out with the boys as soon as I arrived with Matthias. I pulled in the garage around 4:20, and had a massive contraction that made me unable to even get out of the vehicle. I heard Joel on the phone—he had called our midwife to see if I had called her yet (I hadn’t!! She was next, but I couldn’t make another call after I talked with Lynelle!), and she said she’d be on her way. I still remember running inside to the bathroom, trying to focus on relaxing, and coming to grips with the fact that at this rate I would not be having a water birth, then Joel calling through the door “the pool is warm and half way filled if you want to get in!!”  He had so sweetly started filling the pool, turning on the music, and getting things ready the minute I called home! I told him he’d better call Lynelle and Priscilla (our friend who was going to come help with our girls and take pictures), and they’d better hurry, and I still remember the relief of settling into the warm pool.

Just a minute or so old! Pink all over except for her slightly bruised face which was caused by her speedy birth!

Once I got in the water, the intensity and closeness of the contractions subsided, and I had a chance in between to catch up Joel on all that had transpired. Lynelle and Priscilla don’t live far, and arrived within a few minutes, and I still remember us all laughing in between contractions as the craziness of how fast things were happening! It wasn’t long before I felt the pressure of Tirzah’s head descending, and Lynelle was ready to help in anyway she could. Priscilla called our girls in, and they all clustered around the pool, quiet with excitement and anticipation. This time around I didn’t want anyone to touch me (other than squeezing Joel’s hand!), and I have never experienced the awareness during pushing as I did with this birth. It was an incredible experience to actually breathe her out and catch her myself—something I don’t think I could have done without the help of the water! I pulled her up to my chest, she cried right away, and we settled back in the warm water, both amazed at all that had happened. It was 4:42pm, only 20 minutes after I had arrived home!!

Sisters!

My girls were so delighted to help welcome their little sister, and their eyes shown as they stroked her head, and I thoroughly enjoyed the chance to sit back and relax and catch my breath. Being in the warm water seemed to decrease my usual after-birth shakes, and we had a long chance to connect and rest. Rose Marie arrived about 20 min later, and since I hadn’t delivered the placenta yet, daddy and the girls took baby sister to the other room while I transitioned to the birth stool where the placenta came easily. I was feeling good enough (and minimal blood loss!) that I showered quickly, and then cozied up on the couch while our midwife and friends did all the baby checks, and Joel popped a pizza into the oven. Eventually Priscilla went to bring the boys home to meet their sister, and we had a lovely evening rejoicing in our new gift. I had never had a daytime baby, and I couldn’t believe how good I felt and how I was hardly even tired! After everyone had some supper and everything was cleaned up and taken care of, I took our new baby upstairs, and we cuddled up together for the night-so thankful for the amazing experience, and still in a bit of unbelief!

Our Fantastic Birth Team!!
Preventing Group B Strep Colonization in Pregnancy

Preventing Group B Strep Colonization in Pregnancy

For clients of Gentle Delivery, you know that routine Group B Strep testing is offered to every expectant mom in accordance with the ACOG standards of care. While the pros and cons of testing and subsequent treatment plans are discussed in detail elsewhere, the purpose of this post is to help you to minimize your risk of developing Group B Strep colonization during pregnancy, thus promoting better health for you and baby (and increasing your chances of obtaining a negative test result!).

If you are interested in researching Group B Strep info, I’d strongly encourage you to read Aviva Romm’s article: Group B Strep in Pregnancy: What’s a Mom to do? You’ll find clear explanations of GBS, risks and benefits of antibiotic treatment, and tips on promoting health. This post by Wellness Mama also includes further links for study along with Katie’s suggestions for avoiding GBS colonization with natural methods: How I Avoided GBS Naturally  And finally, this article provides a few other options to consider while making decisions on prevention and treatment: Decrease Your Chances of GBS

As a practicing CPM in a state that does not offer licensure, I am currently unable to offer IV antibiotic treatment to GBS+ clients. This increases my desire to do all I can to help support a mom’s immune system and decrease the possibility of a GBS+ test result, as it greatly simplifies the care protocols and necessary decision making for clients and their families!

So here are the primary suggestions for making your vaginal flora inhospitable to Group B Strep:

  • High Quality Probiotics (if not started early on in pregnancy, then beginning at 28-32 weeks orally, adding vaginal support at 32-34 weeks)

“Many species of Lactobacillus have been shown to be beneficial to the vaginal flora; Lactobacillus reuteri and Lactobacillus rhamnosis are species known to be especially helpful for supporting healthy vaginal (and bladder) flora, while these and others, including L crispatus and L. salivarius strains, have been shown to to inhibit the growth of vaginal pathogens including Gardnerella vaginalis and Candida albicans, and also reducing the frequency of bladder infections in addition to vaginal infection.

In one study, 110 pregnant women at 35-37 weeks of gestation who were diagnosed by GBS culture as being GBS positive for both vaginal and rectal GBS colonization were randomly assigned to be orally treated with two placebo capsules or two probiotic capsules (containing L. rhamnosus and L. reuteri ) before bedtime until delivery. All women were tested for vaginal and rectal GBS colonization again by GBS culture on admission for delivery. Of the 99 who completed the study (49 in the probiotic group and 50 in the placebo group), the GBS colonization results changed from positive to negative in 21 women in the probiotic group (42.9%) and in nine women in the placebo group (18.0%) during this period. The researchers concluded that an oral probiotic containing L. rhamnosus and L. reuteri could reduce the vaginal and rectal GBS colonization rate in pregnant women.

In another study involving 57 healthy pregnant women, L. salivarus was taken daily by the 25 GBS positive women in the group from weeks 26 to 38 of pregnancy. At the end of the trial (week 38), 72% and 68% of the women were GBS-negative in the rectal and vaginal samples, respectively. The researchers concluded that this seemed to be an efficient method to reduce the number of GBS-positive women during pregnancy, decreasing the number of women receiving antibiotic treatment during labor and birth.”  (copied from Aviva Romm’s article here)

In light of these studies, and knowing that probiotics are vitally important to the health of both mom and infant for a variety of reasons, supplementing regularly with probiotics during pregnancy can be beneficial in more ways than one. For GBS specific support, it’s recommended that you begin supplementing orally at 28-32 weeks (though earlier is even better!), and then increasing your oral dosage and consider using a probiotic vaginally for at least 2-4 weeks before your Group B Strep test (and then continue the oral support through the rest of your pregnancy).

As you shop for probiotics, pay attention to the different strains it includes, as not all probiotics are created equal, and they will be most effective against GBS strains if it includes L. Rhamnosus, L. Reuteri and L. Salivarus.

Some brand suggestions that other midwives have given me are:

  • Diet Support
    • Eating a diet high in fermented foods/drinks (kefir, sauerkraut, kombucha, yogurt, etc.) help to promote a healthy gut flora.
    • Eliminating sugar and simple carbs are also effective in promoting beneficial gut flora.
    • Add 1-2 tbl of coconut oil into your daily diet for it’s antibiotic properties, specifically in the few weeks prior to testing.
    • Apple Cider Vinegar consumed daily or in capsule form may be helpful.
  • Vitamin C
    • Consuming 1000-2000mg of high quality vitamin C daily (in divided does) can help to increase your body’s immune response, which makes it more difficult for unhealthy microorganisms to grow. You can begin this regimen around 30 weeks.
  • Garlic/Allicin (active component of garlic)
    • Garlic has been used as an antimicrobial agent for generations, and for good reason. However, high doses of garlic can cause blood thinning, so I don’t recommend staying on high doses of garlic or allicin after obtaining your GBS test. But it is a treatment to consider to reduce the possibility of GBS colonization before getting tested. Currently there is a midwife practice conducting a study where participants are instructed to use Allicin Gel 2x daily for 12-14 days along with ingesting 180mg of Allicin capsules 2x daily for 12-14 days prior to testing. The basis for this study is from a preliminary study done in 2009 where Allicin was shown to reduce the possibility of early rupture of membranes and chorioamnionitis, both of which can be complications of GBS infection. Other methods of using garlic include: taking garlic capsules daily, consume raw garlic daily, and/or insert a raw garlic clove vaginally at night before going to bed.

            While we still have a lot to learn about Group B Strep (how exactly it is transmitted, best ways to treat it, and how to prevent it from the beginning), and while there still seem to be a few moms who naturally carry Group B Strep bacteria in their vaginal tract no matter what they try to do about it (antibiotic or otherwise!), one of the benefits of utilizing these suggestions is that they promote health for mom and baby regardless of the GBS presence (or lack thereof). While obtaining a negative Group B Strep test does eliminate a certain amount of worry, risk and decisions, the benefit to your body of increasing the good bacteria and gut flora through healthy foods, probiotic supplementation and other factors may provide long-term benefits that you will see later on. I’d highly encourage every pregnant mom to consider these suggestions, and wish each of you a healthy and safe pregnancy and birth!

            I’d also love to hear: did you try any of these prevention methods? How did it affect you and your GBS status? Did you test positive in one pregnancy and then negative in another? What was most beneficial for you?

Preparing for Postpartum Recovery

Preparing for Postpartum Recovery

The first few hours, days and weeks after having a baby are special times to treasure as you recover from birth, transition to mothering baby from the outside, and spend time bonding and adjusting. Being adequately prepared ahead of time can make a key difference in helping postpartum to flow smoothly and successfully. Here are a few tips to consider as you prepare and plan for AFTER baby arrives. Remember that adequate rest, low stress, nourishing food, good support and planning ahead will help you to heal and promote a better overall experience for baby’s first few weeks. It’s important for your physical & mental health to take recovery seriously, and provide your body with the things it needs to continue nourishing a baby while recovering from the demands of pregnancy & birth. You won’t regret being adequately prepared!

Before the Birth:

  • Consider your support system. Do you have a close friend or family member that would be willing to be a resource to answer questions, let you talk with when you’re feeling low emotionally, or just need a listening ear? Is there someone you can trust and feel comfortable with who could come into your home to help care for the household (especially if there are other children) for a few days or weeks so that you can adequately rest and recover? Is Daddy able to take some extended time off of work? How does support look to you? Do you have some babysitting options?
  • Meal Planning: consider having some wholesome family favorites stocked in the freezer so you don’t need to think about cooking. Does your church or support group have a plan for after-baby meals? Do you need to reach out to someone to coordinate this? Would you have a friend willing to start a “meal train” after your birth? And just a note to Gentle Delivery clients: if an online “meal train” is something that would bless you, your midwife is very glad to start this after your baby arrives!
  • Consider stocking up on disposable plates, cups, silverware, etc. in order to simplify clean up and household chores.
  • Shopping (consider the below suggestions, and try to have these things together before your baby is due):

Immediate Postpartum (first hours after birth)have these things handy in a basket or box for immediately after delivery.

  • Newborn Diapers & Baby Wipes
  • Preferred first outfit for baby, along with a swaddle blanket, socks and hat.
  • “Adult Diapers” or Depends (or whatever type of pad you prefer for heavier postpartum bleeding).
  • Comfortable Nightgown or Pajamas that are nursing accessible and easily work for skin-to-skin contact with baby.
  • Ibuprofen and/or tincture (such as AfterEase or After-Pain Relief) to help with after-pains.
  • Pre-made “padsicles” or perineal ice-packs and/or an herbal healing spray such as this one from MotherLove.
  • Heating pad or rice sock to help with sore muscles and after-pains.
  • Rhoid Balm, Tucks or other soothing support for hemorrhoids.
  • Large Water bottle that is easy to use, to remind & encourage you to drink lots of fluids!
  • Nourishing foods, drinks and snacks (think bone broth, energy bites, juice, etc.).

First Few Days since you’ll be resting and nursing and taking it easy the first few days, you’ll want to consider having some of these items purchased ahead of time, and ready to be used during the initial few days after baby arrives, in addition to the items above (which you’ll continue using throughout the first few days/weeks).

  • Comfortable nursing-accessible clothes and nursing bras (remember that you may go through multiple changes of clothes due to leaking milk, bleeding and/or baby messes!). Comfort is key, since you will be resting and sleeping whenever possible.
  • Belly Support Binder (can use a Rebozo or scarf, or you can purchase something like Belly Bandit or MamaStrut).
  • Breastfeeding helps:
    • Disposable or reusable Nursing Pads for your bra.
    • Small flexible ice packs or Breast Soothies to relieve engorgement the first week.
    • If you have experienced challenges with milk supply, have supplements such as MaxiMilk or Legendairy products available to start once your milk begins to come in.
  • Stool Softener or Magnesium to help the first stools pass easier.
  • Pads/period underwear for a lighter flow (be sure to check out non-toxic options such as these JewelPads).
  • A journal or baby book to jot down thoughts and memories.
  • Something to read or do as you spend hours nursing your baby!

And finally, feel free to print/download and post this list of visitor guidelines to aid you in navigating the stress and joy of baby visits during those first days!

Questions to Ask When Interviewing a Potential Midwife

Questions to Ask When Interviewing a Potential Midwife

Baby Tirzah helping Mommy do office work!

Are you looking into the possibility of working with a midwife, and trying to decide if it’s the right choice for you? If you’re blessed to live in an area with several options, it can be a great idea to take the time to “interview” each one, and see which one feels like the best fit for you and your family. Most midwives (myself included) offer free consultations that can give you a chance to sit down and ask your questions in person, and this can be a great opportunity to explore whether or not you and this care provider will be a “good fit”.

While I think it’s a good idea to look into your options for ANY medical provider, it can be especially important when thinking about a homebirth. Your midwife will be coming into your space, and you want both yourself and your husband to feel completely comfortable with this person, which facilitates clear & open communication, thus providing you with the best care possible. So besides some specific questions (which we’ll get to below!), also think about the intuitive side of how you connect and communicate throughout the interview. Another important component in this interview is dad’s perspective, so whenever possible please have him attend this initial consult, as this can give him the opportunity to ask questions he might have, and help establish a good working relationship from the beginning.

There are many posts out there that cover long lists of questions, but I want to get you started by giving you a few basic questions, which might bring up more as you go along. It’s a good idea, too, to do your own research before you meet with a perspective midwife. For instance, does she have a Facebook page or website? Are there reviews you can read by previous clients? Is there information listed about the types of services she offers, or things that set her apart from other options in your area? What type of credentialing/training does she have? Do the philosophies expressed on her website correspond with what you are looking for? Do what you can to find out as much as possible before meeting up, as this will enable you to get the most information out of your time together, and may raise specific questions that you might have missed otherwise. It will also keep you from wasting time that you could be spending looking into other options!

So let’s get started:

  1. What kind of training did you go through to become a midwife?

Some midwives have attended midwifery school, others have been trained strictly through apprenticeships. Some midwives have credentials that indicate a certain level of training, and require a stated number of continuing education hours to be maintained. There are midwives who have gone through rigorous school programs and have delivered few babies outside of the hospital, and others who have done minimal studies and have only delivered babies at home. This question is not meant to dictate which type of training and educational experience is best, but rather to help you think through whether the training this midwife has received is adequate for your own comfort and safety concerns and desired birth location.

  1. How would you describe your style during labor & delivery? Hands-on or hands-off?

Depending on your preferences, this may help you determine if you can work together well. If you know you want someone very involved, or you want to be left alone as much as possible, the midwife’s answer may shed some light on how her style could affect your labor. Some midwives are very good at adapting to their client’s wishes, and some have their own set way they want to see things happen.

  1. What do you provide or include in your services, and what will be my responsibility?

Depending upon your state, local regulations and/or your community options, a midwife’s care package may include the ability to obtain lab work and/or ultrasounds or refer you to providers for these items, or you may be responsible to figure these things out for yourself. Some midwives include a “birth kit” as part of their package, while others ask clients to purchase this separately. A birth pool is included in some midwives care bundle, while others provide options for rental. Some midwives are able to give your baby vitamin K or provide mom with RhoGam if needed, while others need you to get these items from your pediatrician if you want them. Most midwives are able to file the needed paperwork to obtain a birth certificate and social security number, while there are a few who need you to do this legwork. Asking clear questions and getting an idea of what is and isn’t included will hopefully eliminate unmet expectations and surprise expenses as you continue through your pregnancy!

4. What tests & procedures do you routinely offer, and am I given the freedom to decline when I prefer?

It’s great when your midwife is willing to discuss the pros and cons of different tests and procedures, and allows you to make a true informed choice on each of these. Depending on the political environment, local standards of care, protocols, etc the midwife may have more or less freedom in these areas, or she may have personal preferences as to certain tests.

  1. What are some of your recommended resources for pregnancy and for birth preparation?         

This question may give you some insight into the birth philosophies the midwife has, as well as indicate how in-touch she may be with more up-to-date resources and educational material. Some books and resources are old classics, but there is also a wealth of more recent publications that can help you to be prepared. Are her health suggestions in line with your perspective and preferences? Does she require certain books to be read or DVD’s to be watched? Does she provide some resources for clients, or are you expected to purchase certain materials? Does she encourage a parenting style or lifestyle that you may be uncomfortable with, or that you find helpful?

  1. What is her client load typically, and what happens if two mamas are in labor at the same time?

While this doesn’t happen often, it does occasionally, and it’s a good thing to discuss. This question will reveal what sort of back-up plan the midwife does or doesn’t have, and will give you some indication with how well she works with the midwifery community around her. It also helps you to think about the “what-if’s”, since birth can’t always be controlled like we wish!

  1. What do you see as your role during labor, and would you encourage me to hire a doula?

It’s great if a prospective midwife can be honest about the support she can provide. Some midwives operate with a large team or a small client load that allows them to spend more time coaching and supporting a mom throughout labor. Most midwives are glad to support in whatever way they can once you’re in active labor, but they need to conserve their resources so that they have the energy and alertness they need for the time of birth, which means that if you really want hours of support early on, you’d probably be best served by considering a doula. This question can help you determine what the midwife’s expectations are for when she would come to you, and what sort of support you can expect, and will help you to define the role she would see herself filling at your labor.

  1. What are some of the reasons I would be risked out of care?

This gives you an idea of the midwives range of comfort, and whether she takes a more cautious or more relaxed approach. Each approach has it’s place, but you need an approach that makes you feel most comfortable and safe. It’s also good to remember that each midwife should only operate within a realm that they truly feel is providing safe care, so this is not a “good vs. bad” topic, rather a way to understand and communicate. Is this midwife comfortable with breech delivery? With a mom that goes past 42 weeks? With a baby that decides to come before 37 weeks? Continuing if gestational diabetes develops?

  1. What happens if I need to transfer care for some reason?

Does the midwife typically accompany clients to the hospital, or send them in by themselves? Does she have a doctor she works with, or a preferred hospital? Why or why not?

  1. How do you handle emergencies, and which ones have you encountered the most often?

This question will give you some insight into the midwife’s perspective: does she rely only on herbal remedies? Does she carry medications? Is she trained in NRP? Does she take a proactive approach to prevention? Does she see many emergencies? The answer may vary according to your area, too, as some incidents of complications can depend upon the clientele and area the midwife works in.

I hope this list can help you as you think through what is most important to cover as you interview your potential midwife! If you find it helpful, or if you have other questions you think should be added, I’d love to hear from you. Feel free to comment below, and be sure to share this list with others that might be looking into hiring a midwife for their maternity care!

answering questions after a birth…
2019 Year End Update

2019 Year End Update

img_3054.jpgDear Friends & Clients of Gentle Delivery,

As we come to the end of the year, I have to think about how blessed I have been to work with so many families during 2019 and to experience the special privilege of being involved as you welcome new life into your homes and families. Thank you for allowing me the opportunity to participate in these sacred times!

I’m also grateful for the women who have served alongside me as assistants.  Due to a variety of reasons (maternity leave, relocation, etc.) there were a number of faces to the assistant role, and I am thankful for each one! I also enjoyed getting to involve several students who were completing their requirements for certification, and I’m grateful for those of you who allowed these young ladies to participate in your care. A big thank you to Kristina, Marcile, Hannah, and Lynelle, as well as to my back-up midwife, RoseMarie, whose willingness to cover several times made it possible for me to enjoy some quality away-time with my own little family throughout the year.

It’s always fascinating to see how a year plays out and the variety that it can contain. Baby sizes ranged from 6lb 10oz up to almost 9 lb. Families served were expecting everything from baby #2 to baby #7, and I especially enjoyed serving several families for the second and third times-it’s special to be able to work with families for multiple pregnancies, and to see the older babies growing up! As usual, there were fast births (one little lady didn’t wait for me to arrive!) and those who took their time, and smooth pregnancies & births as well as those who experienced numerous complications—we were so thankful to see God answer specific prayers for the health of these moms & babies who are all thriving and doing well now.

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One of our recent playdates!

I’ve enjoyed the opportunity to continue connecting with clients during our quarterly playdates throughout this past year. If you haven’t joined us, please consider it! You can watch the Facebook page for updates, or email me to be put on the update list. It’s a great way to stay in touch and meet other moms and homebirth babies who are in similar stages of life!

My own family is doing well, and the children are growing up so quickly, making us want to treasure this time we have while they are young. The biggest event in our lives this year was welcoming Tirzah Raquel into our home on December 14! Once she IMG_0933decided to make her appearance she came quickly, and we were once again thankful for Lynelle’s help as there was no way our midwife could arrive in time. I had really hoped to try using the birth pool this time, and was so grateful for how this helped the intensity! (I’ll post her birth story on the website sometime this next year, so be sure to follow so you get the notification, or watch the Facebook page!) We are thoroughly enjoying time to relax and recover as we adjust to adding a fifth child, and our older children are thoroughly smitten with her. It’s so special to see how much they love having a baby sister to snuggle and love on.

IMG_2695    As 2020 begins, I’ll be taking some time off call to concentrate on my own newborn, and to do some traveling as a family. But I’m already looking forward to the anticipated arrival of babies as we head towards the summer months. In closing, thanks again for your support, and blessings as you head into the New Year!

~ Kelsey Martin for Gentle Delivery Midwifery Services

“The First Birth”: A Story from 18 Years Ago

“The First Birth”: A Story from 18 Years Ago

Not the baby featured in this story, but another baby born early on in my training!

From the time I was young (8 years old or so!), I had an interest in midwifery. I’m sure it stemmed from the fact that my mother used midwives for her pregnancies and the births of my five younger siblings, which gave me exposure to this “alternative” type of care. This was back in the day when having babies at home was NOT the popular, photographed and blogged about way to have your baby as it has become today! The midwives that cared for my mother seemed like an extension of our family, and as a young girl growing up, they were certainly some of my heroes that I wanted to become like when I “grew up”.

I think I was about 14 when I seriously felt like midwifery was something I wanted to pursue. Still very young and extremely inexperienced…with no idea what all this profession entails! I had read lots of missionary biographies, and a common experience in most of them included helping in some way (either unexpectedly or because they were prepared!) in childbirth in various countries.  So it seemed to my 14-yr-old mind that this was certainly a skill that would be good to know, and I pictured myself helping women in some far-off jungle or desert clinic someday. As I got older, I continued to feel a major pull towards midwifery that wouldn’t go away.

By the time I was 16, I was convinced this is what I needed to start pursuing. My parents wisely recommend that I begin by doing some reading, and they told me that they thought I should probably try to attend a few births before diving in head-first in a midwifery study program. Their reasoning was that perhaps this was just a passing whim, and why sink all sorts of time, energy and money into something only to find out that I would faint at the sight of blood, or have some other sort of aversion to what all comes with the birth territory. This is no joke. I personally know people who were SURE midwifery was what they wanted to do, but when they faced the nitty gritty, it didn’t take long to realize that it wasn’t their calling after all!

So, the next question was how on earth was I going to get any birth experience in, seeing as I was so young and inexperienced?!? I figured I would have to wait years for the opportunity, though I was reminded that if God wanted it to happen, He could figure out a way. That’s what makes my first birth experience so special-it was completely unexpected!

The summer that I was to turn 17 found me helping several families out on a weekly basis, going in to care for children, clean, cook, or do whatever was needed as a mother’s helper. One family was expecting their fourth child that summer, and they were excitedly planning their first homebirth in our state. Seeing as they had several young children, and that I had been spending a lot of time with them over a number of months, they asked if I would be on call to come and help babysit when the mom went into labor. This was the plan, with a backup plan being set where the children could go to a neighbor family’s home if the mom decided she could relax better without children in the house.

So one hot (Kansas is REALLY hot in July!) day, I got a call that the mom was in early labor, and that they would be glad if I could come care for the children so she could concentrate on resting and relaxing. I went over and made supper, took care of some household things, and entertained the children so mom and dad could focus together. An hour or so after supper, the mom decided that she would prefer the children leave the house, which left me thinking that I should probably go since my job was done. But the mom looked at me and said “I want the children to go, but you are to stay. I don’t want you going anywhere.” I sure wasn’t going to argue with that! She then went on to tell me that she wanted me to rub her back “just so” while her husband finished setting up the birth supplies and called the midwives, which I was more than happy to do. All of a sudden things kicked right in, and I vividly remember both parents bemoaning the fact that they hadn’t studied better on how to catch a baby if the midwife didn’t make it! I was blissfully ignorant, as I was only aware of my own mother’s very long labors, and figured we still had a very long night ahead of us. Little did I know!

I continued my “job” applying back counter-pressure as dad set up birth supplies, sweated nervously as he watched the signs of his wife progressing rapidly, read his childbirth class manual, and gave his wife emotional support. Thankfully, the midwives arrived just as mom started feeling more pressure, and all the last details were quickly set up and ready to go. About half an hour after the midwives arrived, a beautiful, howling, red little boy made his safe and smooth appearance, and I was in awe. I had no idea birth could be this beautiful, and I was so very, very grateful for the amazing opportunity. I was flying pretty high for days after this experience, and as you can imagine, I was totally convinced that this was what I wanted to do.

What is really hard to believe is that this baby will turn 18 this summer…I cannot believe that time has flown, and this many years have passed. After this first birth, I attended random births that I was invited to (word started getting around that I was interested, and some very sweet, very brave women invited me to share in their experiences, for which I will always be grateful!), and eventually began midwifery school when God opened the doors. It’s now been over 10 years since I graduated and started my own practice, and I continue to be thankful for those who initially helped me to start down this path by allowing me to be present at such personal, private life events.  As I continue to reflect back on memories and celebrate 10 years of practice, I want to especially thank each of you moms and midwives who took this very young girl under their wing and gave her experiences that will last a lifetime!

I’m so privileged to be involved in this work of ushering life into the world!

A Peek into a Local Home Birth!

A Peek into a Local Home Birth!

I’m tickled to share these photos with you this month! While birth photography has gained in popularity in many of the large cities across the US, it’s not a very common thing in our area. So it’s pretty rare for one of my client families to hire a photographer to be present at their birth. Earlier this year, I was privileged to help Maria’s family for a second time as they welcomed their newest addition, and they graciously allowed me to post some of the photos from the birth here. One fun & unusual aspect of this birth is that my assistant for this birth and the photographer are both involved with the local doula agency that Maria administrates. Check out the Doulas of Central PA  if you are looking for local birth & postpartum doula support! And if you’re looking for a birth photographer, check out Denae at Vigilante Photography

The twinkle lights added a festive atmosphere, and I love seeing how moms relax when they get into the water.

 

Kristina has been helping as my birth assistant in between her doula babies, and you can see her here jotting down notes on the labor & delivery chart.

 

First good look at each other!

 

Older siblings watch excitedly, all excited to see baby brother!

 

He’s here!

 

Traditional sling scale to weigh baby…look at big sister’s face of concentration!

 

Newborn exam…always done within sight of mom and any interested family members!

 

Checking out feet reflexes and creases!

Foot prints for the records!

 

Born at Home!

Midwife gets a little chance to snuggle baby before handing him back to mama.

 

Great birth team-thanks, ladies!!

 

Midwifery and Mom Life: 10 Year Anniversary Interview ~ Part 2

Midwifery and Mom Life: 10 Year Anniversary Interview ~ Part 2

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Interview: 10 Year Anniversary of Gentle Delivery ~ Part 2

Thanks again to each of you who contributed questions for this “virtual interview” as Gentle Delivery celebrates 10 years of practice! I’ve enjoyed this opportunity to connect with various readers, and I’ve loved hearing from so many of you. If you missed the first post, you can check it out here.  Here is installment two as I continue working my way through the questions entered:

How do you manage being a midwife and a mom?

Sometimes I’m not sure that I do! But seriously, it comes down to having a very supportive and involved husband. I could not do it without his help & support, and without him having a flexible job. He works from home, and generally speaking is able to set his own schedule. Without these key factors, I don’t think it would be possible. We both feel strongly that our children need to be our priority, especially while they are in their young, formative years, and Joel’s job situation allows us to almost always have one parent present. If I need to run off to a birth or client emergency, than Joel changes his schedule for the day and takes care of the children, which greatly simplifies my life! I honestly do not know how midwives serve year after year with a busy client load combined with stress of needing to figure out babysitting, especially at the last minute. A few months ago, I was called to cover for another midwife who had two moms in labor at once, and the second mom was moving fast. Without having the ability to just load up the car with my gear and run, I would have missed the birth! But since Joel was working from home (his office in our basement), I was able to be out the door in ten minutes, and he took over managing the children. His work-from-home arrangement also allows me to sleep in after a birth, and he will sweetly get children up, feed them breakfast, and care for things while I get some rest.

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Hot breakfast made by Joel and snuggles with the baby after being gone all night at a birth!

There are also some practical ways we have found that help to maintain balance, as well. As much as I am able to, I schedule appointments during my youngest children’s nap times, and I try to keep appointments confined to one day each week. This way I am limiting the amount of scheduled time I need to spend away from my children, especially since I never know how much unscheduled time I will be away at actual labors/births/emergencies. Another practicality is hiring cleaning help during especially busy months. My husband maintains that if I’m enjoying midwifery work and getting paid for it, then I might as well pay to get some of my other work done, instead of getting exhausted and stressed out! Oftentimes after a birth we will purchase supper (or take the family out) as a way to get some quality family time AND as a way to provide me with some extra time to do paperwork and miscellaneous business projects. I also get help with school, which is HUGE! My school-age children are part of a hybrid model co-op, where the parents help to teach classes, but they also have a classroom teacher who covers the “basics” and stays on top of the school details. If I was homeschooling full-time there would be NO WAY to do midwifery on top of it.

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Each of my children have attended births with me as babies…quite the adventures we’ve shared together!

Balancing midwifery and mom life includes another factor when I have a nursing infant myself. Whenever I interview with potential clients who would be due after I have a baby, I make it clear that if you hire me, you’re also getting my baby.  I always have an assistant or specific helper along who can care for my baby whenever I need to focus all energies on the laboring mom (and who needs a baby crying in the background when they are ready to push?!?), but otherwise I keep my tiny ones close so they can nurse and be with mama as much as possible. Some families are not okay with this arrangement, and that is their choice. I would much prefer they know what to expect ahead of time, and decide if they are comfortable with my boundaries, are there are always other options out there for them to consider!

One more key factor has been working with a midwife who is willing to trade call at times, which provides me with occasional time off to take trips and spend some focused time with my family. Without this arrangement, I would be tied to my phone and location almost 24/7 all year round! But this has allowed me to still spend some quality time making memories with my children, while knowing that clients are cared for, which is a tremendous blessing. While I still try my best to make it to my clients births, it’s also a relief to know that I can go “off call” occasionally for special events such as a school program.

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Twice I’ve caught babies just before delivering my own…one time a week before, and another time two days before!

 Is it realistic to consider being trained as a midwife, and starting your own practice as a midwife, with small children? What advice would you give?

This is a good question that deserves considerable thought. I had the opportunity to do my midwifery training when I was single, which was ideal. In my opinion, training to be a midwife was decidedly more of a time and energy commitment than practicing as a midwife. Here’s the reason why: when you are training, you need LOTS of experience. You need to be able to be completely available to your preceptor midwife, and willing to take advantage of every opportunity you can be part of. The only way to get the experience you need to be a good, safe midwife is by spending an incredible amount of time immersing yourself in pregnancy, birth, postpartum and women’s health. There are a number of midwives who did this training while they were balancing a family, but it is HARD, and you need to be prepared that it will take a long time. As a single young woman, I had the flexibility of time & energy which enabled me to finish my studies and obtain my required clinical experience in about two years. But this included spending 18 months at a birth center where we literally immersed ourselves in the world of birth by living, speaking, and breathing everything birth related. Seriously! I don’t remember a day passing that didn’t include a significant discussion about something to do with an ongoing client situation, lab values, birth stories, complications, etc.  This type of immersion would have been impossible had I been trying to spend time with family, and it certainly sped up the training process.

Now that I am an independent midwife, I can make my own decisions about how many clients to take on in a month, what risks I am comfortable with, what my parameters of practice will be (for instance, when I do prenatal appointments, or what seasons I may not be available for first time moms), and when I want to take personal time off to give my family some breathing space. In most apprenticeships, a supervising midwife counts on a student midwife to be available whenever needed, and the student cannot set these types of parameters and still get the training she needs along with keeping a good preceptor/student relationship. So these factors all need to be considered, and I think there needs to be some serious conversation with your husband and family about whether your family is at a good place to make the sacrifices that training would require. I don’t think one will ever regret spending quality time with her children while they are young, but you might regret not spending that time later on!

I would encourage any young mom interested in midwifery to read as much as you can, as learning more about your body and about the birth process is going to be beneficial no matter what. There are excellent books out there that can lay a great foundation of knowledge about how the pregnancy and birth process works. Watch videos & documentaries, read birth stories, connect with other moms and learn about their birth experiences. Look for opportunities to get involved on a small scale. Perhaps you’d be able to provide doula services for a friend, which would give you and your family the opportunity to experience what it is like to live an “on call” lifestyle (ready for mom to leave at any time day or night!), seeing how it works to have mom leave and how to figure out babysitting fast. This would give you a chance to see what this aspect of being involved in birth can be like. I don’t think any birth experience is wasted time, especially if you’re hoping to be a midwife, so slowly looking for opportunities and taking advantage of them as doors open can help as you consider further commitment. Always remember that if God wants to be a midwife, He will make a way for you…but in His timing, and in a way that it will be a blessing to your family. Be patient, pursue the small opportunities as they arise, and see how He directs as time goes on…one older midwife told me once that “women will always be having babies, but you won’t always have young children, so make sure you don’t regret not enjoying them while you have them.” Excellent advice!

I’d also recommend that any aspiring midwife read A Midwife in Amish Country, as Kim does an excellent job of detailing her experience training to become a midwife as a homeschooling mom of young children, relating her experiences and lessons along the way.

How many births do you take on, and why that many?

This really ties in with the whole mom/midwife balance topic, as this is another way we try to walk this line. As a general rule, I cap a month with two due clients. Occasionally I will take on a third, if my family is at a stage where this is more possible, and if I have a slower month before or after. As a mom approaches her due date, her prenatal visits need to take place more frequently, resulting in more mamas needing to be seen each week. Then you factor in a home visit (an additional afternoon besides my usual appointment day), the birth (for anywhere from 3-30 hours), birth paperwork, another visit to their home for a postpartum check, and the frequent contact via phone/text/email that takes place over this time, doing this more than twice a month in additional to caring for other moms is about what I can do and still enjoy my work. Here again, if I didn’t have young children, and all the unexpected things that factor into life as you care for little people, it would be much easier to add more clients due in a month. But I want to enjoy both my own children and the opportunity to do births, and this number seems to be working well for this stage in life!IMG_0031

Thanks for taking the time to read this second installment in this interview series! If you’d like to contribute a question for a future post, feel free to add it in the comments below. As always, thanks for sharing, and feel free to check out Part One if you haven’t read it yet. See you next month!