February 26, 2021 by gentlemidwife

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:
- Breast Shells or Nursing Cups to help with engorgement and sore nipples.
- Disposable or reusable Nursing Pads for your bra.
- Small flexible ice packs or Breast Soothies to relieve engorgement the first week.
- Nipple cream such as MotherLove
- 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.
- Haakaa Milk Collector/Pump
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!

December 31, 2020 by gentlemidwife

End of Year Update for 2020!

Dear friends and clients of Gentle Delivery,

As 2020 comes to a close, I am reminded of the fact that we really do not know what the next day or year will hold. Last year at this time our family was anticipating the arrival of our fifth child, little knowing how many strange twists and turns the New Year would bring to everyone all over the world. I am grateful to rest in the confidence that nothing takes God by surprise, and that He cares about the details of our lives, which provides strength & courage to press ahead into the future!

After adding baby Tirzah to our family last December, I enjoyed a lengthy maternity leave, and felt so blessed and cared for during those first postpartum weeks. Thanks to many of you for your part in this! It’s true that you learn some things by experience that you couldn’t learn through academic study, and I am more committed than ever to encouraging moms to get adequate rest, adjust expectations, and take the time to really recuperate during those first postpartum weeks. It really is worth it! This baby has been our most contented, too, and while there are many things that probably play into this, one key factor that seemed to make a difference was the addition of infant probiotics into her daily routine from the very beginning. If you have struggled with fussiness in your baby, please take a minute to check out the blog post I wrote where I detailed this information—I really want to see more families benefit from my own challenging experiences!

As you can imagine, the COVID pandemic has affected midwifery in more ways than one. After the initial quarantine I have been doing prenatal and postpartum care visits for local clients in their homes, as it reduces the exposure for those coming in and out of my home office. I’ve also had more inquiries into homebirth this year than ever before, as many families are concerned about hospital restrictions and germ exposure. Between this added level of interest in midwifery care and my added family responsibilities, I have needed to limit the distance I can travel for births, which has meant turning down requests in outlying areas even for a few clients I’ve worked with before.

One fun aspect of care this year has been the large amount of repeat clients I’ve been privileged to serve! It was really special to catch my first “fourth baby” for a family, and have the opportunity to see babies that I have caught in years past welcoming baby siblings. With one more 2020 baby left to go, the current stats for the biggest baby this year was 8#14oz, and the smallest was 5#14oz. The earliest baby came around 2 weeks early, and the latest was almost 2 weeks late, which goes to show that there is much variation in the range of “normal”. Assisting my back-up midwife with the home delivery of twins was another extra-special experience this year! Speaking of my back-up midwife, I am grateful to have the assistance of RoseMarie Spicher to care for clients when I am unavailable, and I’ve been glad to have a working relationship with a community of midwives in the general area who have all needed to pull together to cover for each other at times due to COVID exposure or for other reasons. I’m also excited to be working regularly again with Lynelle, as she plans to attend births as my assistant this next year after taking some time off to welcome her own baby this past summer.

Heading into 2021, I’m anticipating meeting many sweet babies, and I’m enjoying making new connections with many families who are choosing midwifery care and homebirth options for the first time. I continue to feel a sense of gratefulness towards each of you for giving me the privilege of working with your family as you journey through this intimate season of life. It truly is a gift to witness the miracle of birth and the wonder of that first cry, and the wonder of that moment never grows old!

As I close, I also want to thank my family for their support as I do this work, and in particular thank my husband as he quickly and competently cares for our home and children during my random absences. It takes a special family to deal with the unpredictable aspects of having a midwife for a wife and mother, and I’m grateful for all they do behind the scenes to make this option available to the families I serve. It’s a joint effort, and I could not do what I do without Joel’s encouragement and work behind the scenes.

May God bless you and your family throughout this next year!

~Kelsey Martin/Gentle Delivery Midwifery

Be sure to regularly check out this blog and the facebook page to stay updated on current news, helpful information, health suggestions, birth stories, and announcement of special events. I’m really hoping that playdates can resume again sometime in 2021!

November 30, 2020 by gentlemidwife

Natural Induction Protocol: When Labor Needs to Happen

Introduction: To begin this post, let me start by saying that for most healthy moms and babies, there is NO need to interfere and induce (“bring about or succeed in persuading something to happen”) labor. If you have done your homework, you know that induction can bring about a cascade of interventions that can ultimately result in a different outcome than you may be hoping for. I also want to make sure that you realize the importance of discussing even the possibility of “natural induction” with your care provider, as this person will have valuable information to consider in your particular situation.

With those disclaimers, I want to also mention that there are situations that arise where it is in the best interest of mom and/or baby to get labor started sooner rather than later. These factors can include increasing blood pressure, presence of concerning signs of liver stress, prodromal labor (mom getting exhausted from nights of contractions), nearing 42 weeks of pregnancy, PROM without labor, and more. There are also moms who, due to being high risk or under an OBGYN who has strict protocols, want a more “natural” alternative to encouraging baby’s eviction over the traditional route of Pitocin or other medical induction methods, and the higher risk of interventions that accompanies these inductions. For moms who fall under these categories, I want to share with you a protocol that I have been following that has had great success with those needing an option of induction at home or without medication.

One of the biggest keys to making a “natural induction” successful is preparation. You can’t decide today that you need to have a baby and have it work nearly as well as preparing ahead of time as signs arise. For more information on general preparation (which can help make a needed induction that much more successful), check out my post HERE. For this post, I’m going to detail specific suggestions for induction. Each of the things I’ll mention below can help your body prepare for labor, and may even encourage things to happen without needing to get more aggressive. I use these methods in this way: if there are reasons to encourage labor (such as knowing you have a hospital induction date scheduled, or are post-dates and need to deliver by a certain date), we start this protocol about 4-5 days before we absolutely need to get baby out. Also keep in mind that the more ready your body is, the more likely natural resources will work. To me, that is a reassuring aspect of using natural methods to encourage labor, as if your body is not ready, it will NOT work. And if it doesn’t work, you’ll need to be patient for awhile longer, which is so very different that using Pitocin, for instance, where it is turned up in increasing increments forcing the body into labor, and creating contractions that are much stronger than what the body can naturally produce on it’s own. Experiencing contractions here and there and having a higher Bishop’s score definitely increase your chances of these suggestions working.

Now on to the method (and remember throughout these days that frequent sex and vaginal insertion of evening primrose oil gel caps at night can also help!):

The “Midwives Brew” is a vast improvement over the old method I used in my early days as a midwife. Up until recently, when faced with the need to induce, we used the castor oil recipe that was basically 2 oz. of castor oil mixed with EmergenC (or some drink/shake) which was repeated 2-3 times with a dose every 1-1 ½ hours, for a total of 6oz of castor oil consumption. Do you know how nasty that is?!? And it causes massive diarrhea, which is a miserable way to start labor! But the midwives brew doesn’t work the same way. You can research it further online, but it includes just enough castor oil to cause contractions, but the theory is that the oil binds with the almost butter to keep it from making you miserable. I also feel like the minimal amount of castor oil in this recipe also makes it safer from any concerns of causing the baby to pass meconium in utero, which is another positive aspect. The crazy thing is that this recipe really does work if your body is ready for labor, and it actually has an 85% success rate (see the link above for more info).

Day 1: MasterGland by Nature’s Sunshine taken in the following dosage: 2 capsules every half hour for 3 hours followed by 2 capsules every hour for 3-4 hours. Discontinue if you get a headache. This is an induction preparation method mentioned in Shonda Parker’s book “Naturally Healthy Pregnancy” with a quote from the book here.
Day 2: Labor-Prep Capsules (such as these by Traditional Midwife @ Sunstone Formulas, though there are other similar brands available online) taken 2-4 capsules every hour for 6 hours.
Day 3: Sip on Mama Natural’s Labor Day Tea throughout the day, and consider having a membrane sweep (sometimes referred to as stripping membranes) from your care provider.
Day 4: Either repeat the previous cycle beginning with Day 1, or proceed with the Midwife’s Brew (recipe and information below).

Midwives Brew:

10 oz Apricot juice (Goya brand Apricot Nectar found in the Mexican section of the grocery store works well)
8 oz. Lemon Verbena Tea (hard to find, but you can use 4 bags of Bigelow “I Love Lemon” tea steeped in 8 oz of hot water for 10-15 min. Alternatively, some midwives use 3-4 drops of Lemon Verbena essential oil such as this one.)
2 Tbl. Almond butter
2-3 Tbl. Castor oil

Blend ingredients together in blender until well combined. Some prefer this over ice, but I’ll be honest that when I tried it, it was easier for me to get it down at room temperature.

The ingredients I have used for this recipe.

My suggestion is that you try to get some rest, eat a good breakfast, and then drink this mix around lunch time when your stomach is somewhat empty. A completely empty stomach can make it hard to handle, but if you’re too full you won’t be able to get it down either. It honestly isn’t as bad as it sounds, though it is a strange combination of flavors! After you’ve drank it, then eat whatever sounds good, and consider taking a good walk (avoid laying down for a bit until it’s settled).

Once you’ve taken this concoction, though, please be prepared! When this stuff works, it works much more gently than Pitocin, but it can cause efficient contractions…when I took it, my midwife missed my birth, and I almost didn’t make it home (a story for another day!). So learn from my experience, and don’t wait too long to get to the hospital or get your midwife on the way once contractions are consistent. Many of the moms I’ve seen take it end up with about 3-5 hour labors, though I’m not making any promises. Just wanting to not have anyone caught off guard!

So there you go! If you’ve used this method and it worked for you, I’d love to hear about it! Be sure to share this post with someone who might want to know that there are other (and much safer!) options out there than a medical induction, as this may help prevent them from heading down the cascade of interventions with their delivery!

May 27, 2020 by gentlemidwife

Boosting Energy During Pregnancy

If you’re like me, one of the huge challenges of pregnancy (especially early pregnancy!) is the severe lack of energy. Honestly, if you stop and think about it, your body is pouring so much into making a tiny baby that there just isn’t enough energy to do much else! While you might KNOW that your productivity can’t be measured by what you get done visibly, it can be hard when you feel like there isn’t enough of mommy to go around to all the needs at home.

In this post, I want to share a few tips that might help you get through pregnancy while keeping your energy levels up. There are many different factors in the equation, and honestly each one could be the subject of a separate post. For instance, a diet that is low in simple carbs & sugars, and has a good array of healthful fats and proteins can make a big difference for some women. To get more pointers on this, I’d highly recommend reading Lily Nichol’s book Real Food for Pregnancy. Another factor is getting some sunshine and movement (a walk outside can help immensely!). Yet another factor is finding ways to curb morning sickness (this is another topic on my mind for a future post).

While you may find that early on in your pregnancy you may have to forego your prenatal vitamins due to sickness (did you know prenatal vitamins can sometimes make you feel worse those first months?!? My personal philosophy is that if the vitamins keep you from keeping food down, then it’s best to scrap them for awhile!), once you’re able to take pills again, it’s key to find a quality vitamin. Getting adequate levels of minerals, as well as easy-to-absorb forms of folate, B12 and other vitamins can all contribute to boosting your energy levels. Check your labels to make sure that your vitamins contain folate (and NOT the synthetic form called folic acid), and that the B vitamins are methylated in order to promote absorption. This article on Folic acid vs. Folate may help you to better understand the difference, and why it matters.

Whether you can take your prenatal vitamins or not, I’ve found that supplementing with additional B vitamins can be a huge help, especially during the early months when your body is working so hard and fetal development is so rapidly taking place. During one of my pregnancies, I found that B vitamin injections provided me with some relief from morning sickness as well as boosted my energy levels, and when those weren’t available for me for my most recent pregnancy, I spent some time researching other options. I stumbled upon this gem, and found it to be an incredible energy boost: Max Stress B is a fermented, liquid B complex that provides a combination of B vitamins in a form your body can utilize quickly. Another helpful supplement is a B complex lozenge, which you can slip under your tongue before getting out of bed in the morning, and/or take throughout the day. Two brands I have appreciated are Jarrow and Seeking Health. If you are only looking for B12, I find that these lozenges are great when you need an extra boost and mama doesn’t have time or opportunity for a nap: Jarrow B12. I even keep these on hand and use them when I’m up all night at births!

Low iron (anemia) can also be a reason for low energy, though sometimes this can even be corrected by the above B vitamins, as some types of anemia are actually caused by a B12 and folate deficiency (your midwife or care provider should be able to determine whether this is the cause by looking at your prenatal blood work). If your hemaglobin is actually low, then some suggestions would include supplementing with a plant-based whole-foods iron supplement such as Garden of Life Iron, adding daily doses of liquid chlorophyll, and even regularly consuming Blackstrap Molasses , all of which can help to gently increase your iron levels. If you need more iron suggestions and information, check out this article from Mama Natural on anemia during pregnancy.

These are just a few suggestions to get you started, and if you’ve found something that helps you with maintaining good energy levels during pregnancy, I would love to hear about it. And if you try any of these recommendations, let me know how it works for you. I love getting feedback and knowing what works for different people!

January 31, 2020 by gentlemidwife

Tips for Boosting Your Milk Supply: Recipes & Supplements

As I write this, I’m sitting here nursing my fifth child who will be 7 weeks old tomorrow. My experience with nursing and milk supply has been different with each child, as you may know if you’ve read this blog over the years. All of my babies have had issues with tongue and lip-ties, some of which were quickly resolved, and others where that wasn’t the case. One nursed well and gained quickly, another nursed okay, but I had to be very careful as my supply would tank quickly if I was extra busy or exercised much. Both of my boys struggled for months, with both of them needing to be supplemented and then fully bottle-fed by around 4-6 months (you can read about their stories and some of the things I learned and experienced here and here). With both of them, the challenges of poor nursing/latch also resulted in really low supply on my part. Those days were so long & discouraging. If you’re in the position of facing lots of challenges with feeding your baby, I totally get you!

So in preparing for baby #5, I had no idea what to expect. I did know I wanted to be prepared for lots of challenges just in case. We were also planning to do a significant amount of traveling when baby was still very young, and I wanted to make sure to have things on hand to boost my supply if it was needed, as I’ve learned from experience that it is MUCH easier to encourage a robust milk supply if you don’t let it drop too far to begin with! Before baby Tirzah was born, I spent some time researching additional options to add to my list of things to help boost supply.

This experience has been different yet! The first few weeks found baby gaining really slowly (she lost a pound after birth, and took three weeks to regain it!), which of course had me worried after everything that happened with my previous baby. But around 3 weeks old, things began to shift, and her suck got stronger and she began to gain weight! By now, at 7 weeks, she is a healthy, chunky 11 pounds, which means she has put on 2 pounds in just over 2 weeks! I thought perhaps there might be some other moms out there looking for ways to increase and improve their milk supply, so I’m going to share some of my favorite suggestions…some of these I found helpful when I was exclusively pumping for baby #4, and they have gone on to be helpful this time around.

If you are needing to establish or boost supply, your first step is to nurse frequently!! Lots of skin-to-skin time, especially in those first weeks, really helps to establish that supply, as well as nursing whenever baby is interested and for however long (and make sure the don’t go longer than 3 hours during the night those first few weeks!). Next, remember to drink lots of fluids. I would keep a water bottle at my bedside so that I would drink throughout the night (along with a snack!), which I continued to do until I was confident that my supply was adequate. Throughout the day make sure to keep drinking large amounts, as it really helps your body as it manufactures milk for that little one! And don’t forget that your body needs lots of nourishing calories to feed a second person-remember that your baby is still depending upon you for all of his/her nutrition, and baby is now bigger (and growing rapidly!), so now is not the time to cut back or diet. You actually need an additional 500 calories than what you needed while pregnant!

Besides these three things, here are some other supplements that I have found really give my milk production a boost (and just a side note, these are NOT affiliate links, so I’m not benefiting in any way by suggesting these!):

Maxi-Milk by Mountain Meadow Herbs has been one of my favorite supplements over the years. I began taking it twice a day around day 3 postpartum this time, just to give my body a boost since baby was loosing weight and I wanted to get my milk supply off to a good start as it started coming in. This is the one supplement I have always kept on hand after each baby, and any time I feel my supply dropping, I start taking it, and can see a difference within 24 hours. It’s especially helpful during those days when baby has a growth spurt and wants to eat all the time, and you can feel your body struggling to keep up with baby’s demands!

Legendairy Prouducts offers several different supplements for helping build and maintain milk supply. I had heard about them in the past year, and had them recommended to me by other moms who had tried them. I knew I would be dealing with more stress and less sleep while traveling with such a young baby this time around, so I started adding the “Liquid Gold” supplements to my daily routine. I’m now trying the “Cash Cow”, and both seem to be helpful! I was especially intrigued by their formulas and the lack of fenugreek, as my babies tend to have very sensitive tummies, and have not always done well with the traditional high-fenugreek content of other supplements.

Moringa is a green super-food type supplement, that has been used for a variety of health reasons, but has a history of helping to encourage milk production. Check out the link to find out more about it! I take it each morning at breakfast.

Spirulina is similar to Moringa, and is recommended for boosting supply and the nutrition-density of mom’s milk. This is the first time I’ve tried taking it regularly for this purpose, but it’s one of those supplements that has so many benefits that it sure can’t hurt to add it to a new mom’s daily regimen! Once again, click on the link to find out more of it’s benefits.

When it comes to adding some nutrient-dense calories, AND keeping good, quick snacks on hand for a hungry (and busy!) nursing moms, these two recipes below are my favorites. They include such things as nutritional yeast, oatmeal (oatmeal is an old-time favorite to boost milk supply!), flax-meal, coconut oil, and other great ingredients to feed and nourish a new mom and baby. The first recipe is one that my mother-in-law perfected during the year I was trying desperately to increase my milk supply for my little guy who had so many nursing issues. They are super yummy while also having great ingredients. When I was exclusively pumping, I could see first-hand how these helped to keep my supply up! The second recipe is a variation of a granola bar that a friend brought to me after I had my third child-ever since then, I always make a big batch of these around the time baby is due, as it is a wonderful snack to have on hand for those first weeks of nursing round the clock (I keep one beside my bed for nighttime feedings during the first few weeks!).

Grandma Martin’s Lactation Cookies

1&1/2 sticks softened butter
4 TBSP coconut oil
1 & 1/2 cups organic sugar (I use coconut sugar)
5 TBSP Brewers Yeast
3 TBSP ground flaxseed (golden tastes the best!)
2 eggs
2 tsp Vanilla
1/2 tsp EACH salt, baking powder and soda, cinnamon
1 TBSP ground Fennel seed
1tsp ground Fenugreek (I grind these 2 together in coffee grinder)
1 & 1/2 cups flour (for Gluten Free cookies use 1/2 cup each of brown rice flour & whole oat flour and 1/2 cup of another flour)
3 cups rolled oats
1 cup coconut
Chocolate chips or raisins as desired.

Roll into balls, place on ungreased baking sheet. Bake at 350 for about 10 minutes. Makes 3 dozen. These freeze well, and taste delicious frozen!

Energy Bars/Balls

1 cup warmed honey

1 cup natural peanut butter (or almond butter)

½ cup oat bran (or oatmeal ground really fine)

1/2 cup golden flax meal

1 cup unsweetened coconut

1/3 cup seeds (sunflower, chia, etc.)

1 c. chopped nuts (I like to use a blend of mixed nuts, though just almonds or pecans work as well)

1/2 tsp Celtic or Himalayan Pink salt

2 + cups old fashioned oats (enough to make mixture thick enough to form balls or press)

1 cup chocolate chips

Mix all together and form into balls or press into a pan to form bars, refrigerate until firm. I like to cut these into bars and wrap them individually for a quick on-the-go snack.

In closing, I’d love to hear about what has helped you to maintain a good milk supply for your little one(s)! If you try any of these supplements or recipes, let me know what your results are. Blessings as you nourish your baby today!

December 30, 2019 by gentlemidwife

2019 Year End Update

Dear 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.

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 decided 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.

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

March 30, 2019 by gentlemidwife

Miscarriage Questions: 10 Year Anniversary Interview Part 3

Interview Pt 3: Miscarriage

This month I’m continuing to answer questions that were submitted by readers for Gentle Delivery’s 10^th anniversary “ask the midwife” series (feel free to check out Part One and Part Two if you haven’t read them yet!) There were several questions asking about miscarriage and how that affects future care, and I’ve decided to make that the focus for this month. Sadly, miscarriage is a reality for many moms, and I’ve had more moms than usual experience miscarriage throughout this past year. Hopefully some of these suggestions and this information can be a blessing to those of you walking through this valley, or those of you wondering what happens next…

What is your approach when a client has a miscarriage? What do you say or do to help her through the process, and if she gets pregnant again later, does your prenatal care for her and the baby look different in any way?

This is one of the “flipsides” of midwifery practice…it’s not always dealing with excitement and new babies. Oftentimes miscarriage occurs “out of the blue”, and usually there is no obvious explanation, even though we usually wish we knew why, or what happened.

Typically, a client will have just been in touch to let me know that they are excited to set up a time to talk about homebirth (or resume care if they were a previous client), and then they let me know that they are having some spotting. Spotting in and of itself can indicate an impending miscarriage, or it can be indicative of an irritated cervix, or it can be sign of a “subchorionic hematoma” (which usually results in spotting/bleeding without harming the baby, and resolves on its own). Quite honestly, if a miscarriage is going to occur, there really isn’t much that you can do, as oftentimes if it is indeed going to progress into a miscarriage then the baby has already died by the point you are experiencing spotting. But the unknown is not easy, as you want to KNOW what is going on. Our options at this point include doing labwork to see where the progesterone and Hcg levels are by now and going in to an OBGYN or an ER for an ultrasound (usually this is a vaginal ultrasound in order to get the best look at the uterus in early pregnancy). If the mom is 5 or 6 weeks or more, they should be able to visualize the baby, and be able to tell if the heart is beating, and labwork can reveal whether the pregnancy hormones are continuing to increase as they should. If mom prefers to wait, then there are some herbs that can be taken, and some moms choose to also use progesterone cream to help support the body until we know for sure what is going on.

If the ultrasound or labwork shows that miscarriage is inevitable, then I try to offer support and encouragement while the mom walks through the next several days. In most cases, mom is able to pass the baby on her own, and we stay in touch via phone or email. Spotting usually progresses into bleeding, and cramps accompany the bleeding as the cervix dilates enough to pass everything, which typically happens within a week of the initial spotting. In the event that it takes a longer amount of time, then we can use herbs to help encourage things to move along, we closely monitor for infection, and occasionally we need to transfer to an OBGYN for further care.

Once a miscarriage has taken place, I really encourage moms to take it easy, and make sure that they give their body time to heal both physically and emotionally. Oftentimes a mom can be left feeling very tired and anemic, as the body usually loses a significant amount of blood, and the intensity of labor can leave her worn out. There is also the emotional side of processing the loss, and this combined with the hormonal swings that go along with pregnancy followed by delivery can create quite a roller coaster of emotions to work with, and mom needs to know that this is normal and okay…and that her body is grieving and adjusting, which takes time!

The good news is that a previous miscarriage in and of itself does not negatively affect care for a future pregnancy. As I mentioned before, we usually don’t know what the root cause was, but there are many moms who go on to carry a healthy pregnancy following a miscarriage. Sometimes it can help a mom to relax more if she has more frequent monitoring during the early weeks of pregnancy after a miscarriage, and I am glad to do progesterone and Hcg testing to make sure that these levels are increasing like they should during the initial weeks. Oftentimes these moms also want to get an ultrasound performed earlier, in order to know that everything is looking good and that baby is growing like he should. Other than these factors, there isn’t much different for prenatal care, unless a mom has had several miscarriages in a row.

If a mom has had several repeat miscarriages, I highly recommend consulting with a NaPro Fertility Specialist (these providers concentrate on helping to achieve and maintain correct hormonal balance in order to prepare a mom’s body for and help in maintaining pregnancy). Many moms have inadequate progesterone levels, and having a specialist helping to monitor levels and provide prescription strength progesterone when needed can be a tremendous blessing, and prevent the trauma of further losses.

In closing, here are some suggestions if you are walking through a miscarriage:

Drink red raspberry leaf tea frequently in order to help balance your hormones and increase your iron as you recover (although stop drinking if you become pregnant again, until you reach the second trimester).
Take Evening Primrose Oil to help regulate hormones and support the body.
Consider taking an herbal-based iron supplement for several weeks to help restore your iron levels.
Take time to rest, don’t push yourself too hard, drink a lot of fluid, and take time to reflect on the short life you were given to carry, and allow yourself time to recuperate and heal before trying to resume your normal responsibilities.
Check out these sites that have further tips: Healing After Miscarriage and Healing Naturally.

And if you are preparing for pregnancy following a miscarriage, here are some ways to support your body:

Take folate (not synthetic folic acid!) and methylated B vitamins regularly.
Start taking a high-quality plant-based (not synthetic!) prenatal vitamin to build your body’s supply of needed vitamins and minerals.
Look into the benefits of using a quality, natural based over-the-counter progesterone cream to help promote healthy progesterone levels.
Consider having some herbal tincture on hand (such as C & B formula from Mountain Meadow Herbs) that you could take at the first sign of any cramping or spotting-this tincture helps to calm the uterus.
Check out this blog post for more practical tips: Preventing Miscarriage

In closing, would you have any suggestions you would add? If you have experienced a miscarriage, what was the best information and advice you were given? Any suggestions for moms hoping to get pregnant soon after going through a loss? I’d love to hear your answers if you would be willing to share!

February 28, 2019 by gentlemidwife

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

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.

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.

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.

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!

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!

Gentle Delivery Midwifery Services (Centre Co. PA)

"…He shall gather the lambs with his arm, and carry them in his bosom, and shall gently lead those that are with young." Isaiah 40:11

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