April 29, 2020 by gentlemidwife

Probiotics: A Key for Fussy Babies?

Note: I am sharing this post from my own personal experience, in hopes that it might encourage another mom and perhaps give you some ideas as you research options and solutions for colic and fussiness. This is not to be taken as medical advice, but rather an introduction to provide you with a foundation for further investigation and research. I also want you to keep in mind that this post deals with just ONE aspect of what can cause extra fussiness in an infant…there are often a multitude of factors that can be part of any situation, so I’m just tackling this particular aspect in this post! The products that I mention are ones that I have used myself, and I am not receiving any incentive or gain by recommending these!

As I was preparing to welcome our fifth child at the end of last year, I was resuming my usual research into how to help prevent excessive fussiness in infants. If you’ve followed my blog for long, you know that all of my babies have tended to be fussy and “high maintenance”. Nursing challenges have been part of that, and so have issues with sensitive tummies (I’ve ended up needing to go dairy free at some point in my breastfeeding journey with each of them!), but there’s always been this underlying fussiness that has not tended to improve until they reached 6 months or older. This has presented a number of challenges, as it really takes away from the joy of adding a new baby, if the baby needs constant juggling, bouncing and soothing!

While reading anything I could find on how to help soothe fussy babies, I came across this article that talks about a study that showed b.infantis linked to reducing inflammation in infants.

Shortly after reading the article, I saw a post on a Mommy group that I am part of, where a friend of mine recommended an infant probiotic, noting that it had made a world of difference in the temperament of her baby. Earlier in the year, I had a client who told me how her youngest baby has been her happiest ever, and credited a nightly bottle of goats milk kefir as part of what made a difference.

I also kept running into articles such as this one on babies needing L. reuteri, and others that talked about how different probiotic strains can help with colic such as this one: Can Probiotics Soothe Colicky Babies? Then there is this article that, while encouraging people to purchase their company’s products, has some good information on why fermented foods and probiotics are essential components of health, and in particular infant health: Introduce Babies to Probiotics.

I found it interesting to think about how years ago our typical diets contained more fermented foods (think about the sauerkraut and other fermented products that were a necessity in the days before refrigeration), and how antibiotic usage is so much more common these days. We are still figuring out what all the possible long-term effects are caused by frequent antibiotic usage over the course of our lives, and how these effects may come into play on our children. Here’s some interesting data looking at long-term effects of antibiotics on our micro-biome: Long-term impacts of antibiotic exposure on the human intestinal microbiota.

After reading and researching these articles and more, I decided that it was worth trying for my baby, as it obviously couldn’t hurt! There are many different products available on the market, and it can be hard to determine which one is best. I was searching for one that specifically had the strains B. infantis and L. reuteri, and would also be easy to give (with five children I knew that I wouldn’t make it happen faithfully if I had to be mixing and syringe feeding anything!). I ended up trying Humarian Probonix that my friend had recommended, and I started giving baby Tirzah a few drops beginning on the third day after birth. I gradually increased it to the 6 drops recommended, and she’s been getting that daily ever since. Occasionally I will give her another brand/type, but the Probionix drops are by far the most convenient. While there may be many other factors at play, this baby has been my happiest by FAR, has had regular diapers, hardly any skin issues, and has not had nearly as sensitive of a tummy as my other babies. I have to think that regular probiotics have been one element in helping her, so I wanted to share this in case it can help another mom out!

There are plenty of other brands out there, and Mama Natural has a whole blog post devoted to discussing the pros and cons of these and other probiotics specifically for infants here, along with her own brand of infant probiotics which can be found here. Mary Ruth Organics also offers a good broad spectrum option here. By reading about them, comparing ingredients and determining your own needs, you should be able to find something that can work for your baby. And if you’re looking for more info on the benefits of cultured foods for baby, there’s a great article here.

Have you given your baby probiotics? Do you feel like it’s helped? What else have you found beneficial for fussy babies? I’d love to hear about your journey! And if you end up using probiotics for your infant, I’d also be interested to hear what brand you used, and whether you saw it make a difference.

March 27, 2020 by gentlemidwife

Resources and Info on COVID-19: Links, Practice Changes, Recommendations & More

With the COVID-19 crisis in full swing, it can be hard to know where to go for good information. As a midwife wanting to give my clients the best, up-to-date, evidenced based care as possible, I have found it extremely challenging to navigate all the information being thrown around as everyone scrambles to learn what they can about this new virus. Even information from reputable sources can contradict each other, leaving one’s head spinning, and making you unsure of what measures should be taken to protect your clients and your loved ones from any unnecessary exposure, while also caring for the emotional and physical needs of expectant moms! I’m sure you’re probably in a similar boat, so I’m wanting to make available some information sources for you as you try to understand how the current crisis may or may not affect you, your baby, your care, and your birth.

Here are some links that I have found helpful:

Aviva Romm Series on Covid-19 Info

WHO info for Pregnant and Nursing Mothers

National Association of Certified Professional Midwives: Covid-19

WHO Info-graphs

While information is changing on a day-to-day basis, I am currently implementing the following changes to my practice in order to minimize risk for my current clients, and enable safe midwifery care to continue in my community:

I am available to answer any questions clients might have via email or phone/text at any time.
Pushing prenatal visits further apart to minimize person-to-person contact.
Practicing social distancing and limited exposure for myself and my family, and not seeing any clients if myself or one of my family members are sick.
I will be performing April prenatal visits in client’s homes to reduce the risk of transmission or exposure. My current client load is light as I am just coming off of maternity leave, so this feels like the best option as I look into ways to make my home office space more practical for office visits due to the stringent recommended disinfectant protocols.
I am not taking on new (non-repeat) and/or long distance clients during April. I hope to resume new client consults and prenatals in May, but will base this on information as it becomes available, as well as on how able I am to handle the extra time needed to maintain the possible new protocols, etc. Having to unexpectedly homeschool two children this month, as well as juggling the demands of a nursing infant (and trying to understand what risk there could be to her health) all combine to make my days extra full right now, without adding in the hours of research needed to stay on top of current medical news!
If you are just beginning to look into the option of homebirth due to concerns with exposure at the hospital, I would suggest you begin by reading these two links:
- Midwives Swamped with Homebirth Requests
- NY Homebirth Statement

I am also asking clients to follow these guidelines:

Please reschedule your visit if you or one of your family members are experiencing any of the typical Corona symptoms, including:
- Fever
- Coughing
- Shortness of breath
- And remember that Covid-19 care is outside of the scope of practice for your midwife to advise you on, so please contact the proper medical authorities if you suspect you may have contracted it!
Try to limit your exposure to illness by practicing safe social distancing from ill persons, and practicing good hygiene and hand washing.
Due to the unknown severity of respiratory complications for both mom and infant, a home birth will be out of the question if you test positive for COVID-19 over the time you are in labor.
Realize that there may be some changes in birth practices as more information and studies become available, so feel free to reach out with any questions, and stay tuned as I continue to research and keep you up to date on current research and practice guidelines/changes. Some of these changes may include restrictions on children attending prenatal appointments, amount of people in attendance at your birth, etc. As time goes by, I hope to have more concrete information to guide our practice protocols for the safety of everyone.

I would also strongly encourage all expectant moms to do what you can to boost your body’s (and your family’s!) natural ability to fight any virus (there are other illnesses out there you don’t want to catch, as well!). I don’t think we need to just sit back and hope we don’t get sick-you can be proactive in assisting your body in being able to resist and fight illness right now. There are some great resources available that help you to consider how healthy eating (low sugar, lots of whole foods) combined with adding some immune-boosting supplements (such as high-quality vitamin C, regular vitamin D, probiotics and others) and regular exercise can help you and your family to stay healthy and strong. Here are some resources to get you started in thinking about the possibilities:

Advice from a Pediatrician

Aviva Romm on Natural Remedies

If you’re interested on hearing additional perspective on the crisis from a well-known, more “naturally minded” pediatrician, then you may appreciate Dr. Sear’s podcast series: Coronavirus Update: Are We Doing it Right? Pt. 1

And finally, some practical ways to help you handle the extra challenges from social distancing right now, tips on reducing anxiety, and helps in understanding more about the virus: COPE Updates on Covid-19

If you have found a source to be especially helpful as you navigate the news surrounding Covid-19, I’d love to hear about it. And if you are in a different area, I’d love to hear how your midwife/care provider is implementing changes to their practices. Blessings to all of you expectant mamas navigating this new territory during this time in your life-I know it’s a challenge, and I am committed to continuing to provide you with personal, safe, gentle midwifery care!

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

August 31, 2019 by gentlemidwife

Pregnancy Health: Red Raspberry Leaf Tea

For a bit of a different post this month, I’m passing on one of my favorite ways to drink Red Raspberry Leaf Tea. Perhaps you’ve heard of this “women’s health” herb-there are seriously so many reasons why you should be consuming Red Raspberry Leaf on a regular basis, even when you’re not pregnant! It’s high in minerals and vitamins that your body needs, and has the added benefit during pregnancy of helping to tone and prepare your uterus in preparation for labor. In light of this fact, it’s wise to avoid this herb during the first trimester, as that is one season in which your uterus needs no extra stimulation. But once you reach the second trimester, I highly recommend making this supplement part of your daily routine. You can receive benefits by taking this herb in capsule or tincture form, but tea form is a great way to get the maximum benefit out of this particular herb.

If you’re wanting to learn more about the benefits of Red Raspberry Leaf, here are some great resources to check out:

One of the downsides to this tea, though, is that it doesn’t remotely taste like raspberry! And if yours does, the you’re drinking the wrong thing! If I drink red raspberry leaf tea straight, it doesn’t take long to be turned off-which is why today I’m sharing with you my favorite way to make it. If you have a favorite method, share it in the comments below so we can benefit from it, too!

First, gather your ingredients:

Organic Cut & Sifted Red Raspberry Leaves (I use Frontier Co-op brand that I purchased through Amazon)
Raspberry Zinger Herbal Tea Bags from Celestial Seasonings
Lemon
Stevia or your choice of sweetener (honey also works)-pictured above is the NuNaturals Pure Extract Stevia that I use.
Purified Water

Fill a small pot with about 4 c. of purified water, bring to a boil. Turn off and add your tea: I like to use several re-usable tea strainers, that I fill with Red Raspberry leaves. For one batch, I use about 1/3c. total of loose leaves. Then I add four bags of Raspberry Zinger tea, to help improve the flavor. Stir this around, then cover and let steep for about 20-30 min.

Pour your concentrated tea into a glass pitcher (about a half gallon), and add the juice of half a lemon. Next, add a few dashes of stevia or other sweetener to taste. Fill the rest of your pitcher with purified water, and let sit until cool. Pour over ice, and enjoy! I store this in the fridge, and drink it cold, and I can consume so much more tea this way. Even my children love it!

July 5, 2019 by gentlemidwife

“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!

April 27, 2019 by gentlemidwife

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!!

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!

January 31, 2019 by gentlemidwife

Interview: 10 Year Anniversary of Gentle Delivery, Part 1

The year 2019 marks ten years since I started my practice as a midwife, after having spent several years studying, training and preparing to serve families in this way. I still remember the excitement of catching my first baby as a graduate midwife in January of 2009, after having moved home from TX (where I completed my academic training & clinical experiences here in Dec. 2008), and I cannot believe how quickly ten years have passed! Since that birth, I have been privileged to catch babies and care for moms & families in four different states, I’ve moved crossed country, married, and have had four babies of my own. All of this has certainly helped to mold, shape and broaden my experiences and skills, and I am so very grateful to each of the families I have been privileged to work with.

In honor of reaching 10 years, I thought it would be fun to see what questions some of you might have, and I was delighted by the questions that were thrown out on the Gentle Delivery Facebook Page. Here is Part One of a series in which I’ll start answering these questions…and I would love to hear yours, so if you haven’t left a question yet, feel free to do so below in the comments!

How and why did you get started in the field?

The “how” is the fault of my mother, who pursued homebirth after two negative hospital experiences, back when birthing at home was not such a popular idea. After her first birth at home with midwives, she went on to use them for care with the rest of my siblings (there are 7 of us!), and I grew up with the idea that having babies at home is a normal experience, and much preferred over the standard hospital setting! The midwives became close family friends, and were certainly heroes one would aspire to be like, in the eyes of a 7 to 14 year old girl growing up watching these women serve, care for and love on our family.

My 11# 8 oz cousin!

The “why” part is two-fold: one, I had a dream of serving God on the mission field somewhere, and thought that having a skill to offer would be an amazing way to connect with and become friends with women, while hoping to make a difference in an area where women were at high risk during pregnancy & birth. I was interested in pursuing midwifery with this dream/idea in mind, and several friends and relatives knew of this interest. My dear aunt then invited me to be present at the birth of her son, and I still treasure the memories of the time I spent with her and my uncle while we waited on my cousin to make his appearance. This not-so-little cousin of mine still tops the record as the largest baby I’ve ever witnessed being born, and it required a great amount of skill on the part of the attending midwife to not only deliver him, but also to help him breathe and recover from his rocky transition. While this was not your typical smooth, low-complication normal birth, I learned a tremendous lesson through this experience: a skilled midwife can make a difference between life & death, and that this is a serious responsibility to consider. After this birth, the thought that kept playing in my head was that I never wanted to be in a situation surrounding birth and wish I had learned what to do to help. It also helped to solidify that this was something I wanted to pursue, but it also gave me the reality check I needed as I began.

In light of the fact that my original dream was to work with women in another country without access to good maternity care, I do find it a bit humorous how God has taken me down a completely different path as I serve women in a very prosperous, beautiful little university town in Central Pennsylvania!

What changed in your approach / practice as a midwife from before you had children to after you experienced birth first-hand?

This is a good question! I find that I have a totally different perspective on the intensity of labor…there were times I seriously wondered if I could actually do it when I was in labor myself, and experiencing that has certainly helped me to understand what moms are going through. I also don’t look down on anyone for getting an epidural after experiencing labor myself! Before I had children, it was like “why would you do that?!? Don’t you know the side effects??” but once I was in labor I totally understood why that option would be considered! I’ve also found myself trying to be more sensitive to each mom’s individual preferences, spoken or unspoken, as I found out in my own labor that just because someone thinks they are helping, it’s not always the case. I think it’s helped to soften my opinions, too, as I’ve realized on a different level how many things are actually outside of our control. For instance, while not specifically about birth, I always thought that any mom could nurse if she tried hard enough. Well, I learned the hard way that trying hard isn’t always enough, and nursing has been a complete battle for me, which has taught me that each mom must figure out what actually is right for her and her baby, and that might look different than what you anticipated. So maybe the simplest answer to this question is that it’s helped me to grow in empathy!

What is one “bucket list” experience you haven’t had yet but hope to in your midwife career (e.g. delivering triplets, delivering a breech birth, an en cual birth, etc.)?

Newborn exam on a baby that I caught during my first year of practice.

To be honest, I don’t mind the un-eventful and un-exciting ones these days! All midwives know that at some point they will attend a breech birth (usually a surprise baby that turns between that last appointment and birth, or when the head is mistaken for a butt), and I experienced my first surprise breech two years ago (I was called to cover for another midwife, so it was a REAL surprise!), so that one is off the “bucket list” with plenty of gray hairs to prove it. I’ve missed several babies that didn’t want to wait for me to arrive (even if I was driving fast…my brother used to say he thought it would be fun to drive for midwives, so he’d have an excuse to drive FAST!), and I had the special privilege of catching twins & assisting with several sets. Two things I would love to witness yet would be an en-caul birth (I still haven’t had a baby born before the membranes have ruptured…though I’ve had plenty that ruptured JUST before birth, providing me with a shower of fluid!), and I’d like to top my current highest repeat client number of three babies for the same mama. One downside to moving across country (and then moving across several counties a few years later!) is that you don’t get to continue care with the mamas you might have started with. Up until recently, two had been the record I had been able to deliver for the same family, and I finally caught my third baby for the same family in 2018. If we can stay put long enough (and I can convince my clients to keep having babies-ha!), maybe that record will be higher eventually…though I’m guessing that not of all my clients want to help accommodate my wishes on that one!

So, after reading these, what are your questions?? Feel free to let me know, and stay tuned for Part Two of this 10 Year Anniversary Interview. Thanks for sharing & adding your comments!

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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