November 16, 2015 by gentlemidwife

Midwife + Nursing Baby = Crazy Stories!

For a little change of pace, I thought it’d be fun to recount some of the craziness that took place in my life over this past summer. With my third-born arriving in February, I took a break from delivering babies while we adjusted and recovered. As the summer came closer, and the due dates of those fist mamas approached, I’ll admit that I had some misgivings. For starters, it wasn’t like I was getting vast amounts of sleep. 🙂 Then, you add my dear, intense, unpredictable baby to the mix. The plan had been to bring the baby along, and make sure I had an assistant along to help out, should my baby need help while I was unavailable. I had these lovely visions of those “crunchy” midwives that you see doing everything toting their happy baby around on their back…but that’s not reality in my case!

my baby girl when these stories start…

My babies have all been of the “high needs” class, and baby #3 has been no exception. But that adds another dimension to the situation when you’re talking of bringing an extra little person along to something as unpredictable and intense as a birth! Thankfully, I was blessed with very understanding clients, and they were all duly warned beforehand that if I was hired, so was my baby…but I also promised to do my best to keep distractions to a minimum. So here are some tales from this past summer as I toted my little companion with me at all hours of the day and night!

As it turned out, I didn’t have alot of time to stress over how it was all going to work out, as my first mama went early. When I took the early morning call, I had to think that the timing was beautiful, as I had JUST finished feeding Talitha, and had just gone back to bed. (On another note, it also happened that my sister was staying the weekend, so Joel didn’t even have to babysit the other children!) This meant she was ready to be buckled into the van, where she promptly fell asleep-and she slept long enough for me to arrive at the house, unload, set things up and have my babysitter/assistant arrive to help me out. And it just happened to be my dear friend/helper who can now say she’s cared for ALL of my babies at births over the years. Beth did a great job of playing with Talitha, taking her outside for a walk when she was fussy, and acting as my second set of hands at the same time.

Beth entertaining Talitha

It felt like an answer to prayer, then, when my baby slept in the new baby’s nursery during the birth itself, and for the hour after. She even sat in her Bumbo while we finished cleaning up! With the exception of crying while the mama was in transition (this was when Beth took her for a walk!), she did really well. This made me figure that maybe this whole thing of bringing a baby along wouldn’t be so challenging after all…

Until the next birth! It was that evening that I realized that my baby girl does not appreciate Chipotle’s spicy chicken. I already knew that dairy products caused her stomach to protest, so I had forgone any cheese and sr. cream on my burrito the night before. But the chicken must have been too much. This time, a good friend from my church was along to help babysit, and provide any additional help we might need at the birth. All was well when we arrived, but as the evening wore on, Talitha protested everything…nursing…sleep, you name it. Lynelle ended up walking her up and down the road, and finally baby calmed down and went to sleep. But once she was down, she awoke for her usual night feeding, and blissfully slept through the birth and ensuing clean up. The biggest challenge, then, was getting home when it was her usual time to get up, and now mama wanted to sleep!

Fast forward several busy weeks…by this point, I had two mamas that could technically go anytime. And then at the last minute, I ended up taking over care for another friend, as her midwife had a planned trip out of town (planned well in advance-the hope was that this baby would arrive before she left!), and her baby had decided to take her own sweet time to arrive. Wouldn’t you know, the day this baby decided to come, all of my back-up helpers were either out of town or busy…and my own family was in the middle of helping to host a youth group of 20 from OH, as well as prepare for a big open house that the ministry my husband works for was hosting that evening. Timing can be amazing sometimes! 🙂 It’s also amazing, though, how God can work out all the details…a friend helped

Amy & Talitha

with my older children so my husband could finish his projects for the day, and one of the youth group girls graciously consented to being pulled into a totally unexpected job. Amy ended up not only caring for my baby, but also caring for the laboring mama’s older toddler, as well. The baby came in the middle of the afternoon, once again finding Talitha sleeping during the birth, and we made it back to the open house that evening just as they were ready to ask the blessing on the meal.

I had a couple of weeks to wait, then, as the next babies weren’t in any hurry to come. In fact, I had pretty much given up on being at either of them, as we had planned to be out of town for a weekend (again, this was planned before these mamas started care), and with both of the babies still inside, I figured the chances were slim that they would both wait on my return. But when we returned home from our little trip, both babies were still waiting! The amazing thing was that they also waited until after the following afternoon, when our church was having an ordination that my husband was part of…I wasn’t sure what I was going to do if I had received a call during that time! That evening, after a big, busy day in which Talitha missed a good nap, I got a call-and we decided that this time I should leave her home sleeping (she had just gone down), and hope that either I would be home by the time she got up, or else we’d figure out a plan B. I went on out, and after awhile realized I wasn’t going to be home to feed her, so my babysitter went by my home and brought Talitha to me, around 2am! She looked rather puzzled when she arrived, but after taking everything in, she nursed and went down for a good nap, waking once and needing some attention.

waiting patiently for mommy to finish paperwork

We went on to have a baby, and soon after I got another call-this time from the other mama. Things were happening fast, so after checking things over again, I left my newly-delivered mama in the hands of my assistant Gretchen, pulled Talitha out of bed and tucked her into her carseat, and raced across town. By the time I reached this home, I knew things were moving quickly, and since Talitha was sleeping, she just stayed in her carseat while I went in and joined my assistant (Lynelle) for the birth, which took place within half an hour of my arrival! Once Talitha awoke (about an hour later!), Lynelle brought her in and she was happy as a lark, and she did well the rest of the morning as we returned to the first mama and completed another appointment before we got home.

But the next birth was not so rosy from Talitha’s perspective…I had hoped that if things happened in the night, I could just let her sleep. My usual babysitter was unavailable, and after calling around, I found a friend who was willing to help out, and she brought Talitha to me when it was time for her to eat. Teething was in full force, and my little girlie was not a happy camper. I honestly don’t know what I would have done with out Heidi, who patiently walked her around the neighborhood until she went to sleep…

The last two births of the summer took place about a week apart, and both ended up being similar stories…both took place at some time during the night, both places Talitha protested being put to bed (I have a travel pack n play that would always take with me), and both times once she finished protesting, she went to sleep and was fine.

Sleeping peacefully in her bed

So thus ended the adventures of Talitha joining mommy at births!

As a general rule, I only take on 2 clients per month, as I find more than that very stretching…partly due to demands on family time, partly to the difficulty in sleeping after a birth when you have little ones at home, and partly because I want to enjoy being a mom besides being a midwife. 🙂 So doing 8 births in 3 months time was a record since I’ve been combining midwifery with family life. My husband and I marvel as we look over the summer…there were so many other things going on, besides these births, and yet we’re amazed at the way God directed and orchestrated these events. There is a dear older midwife around here that tells me God always s

eems to work things out in a perfect way…if I could just learn that from the get-go, it would eliminate alot of stress in my life! But this is a little picture of how things came together this summer, from just one perspective-that of having a nursing baby. Now that my baby is getting older, it will hardly happen anymore. On one hand, it looks much easier to not have that additional unpredictable factor included at births-and on the other hand, I’m going to miss my little buddy!

September 3, 2015 by gentlemidwife

My favorite conveniences for the first days postpartum…

If you’re like me, sometimes you roll your eyes at yet one more advertised item deemed a “necessity” for baby. Seriously, what more does a newborn need than diapers, a few blankets, and mama to snuggle with, sleep close to, and nurse whenever he wants? I’m not saying some of these accessories aren’t helpful-I have my favorites gizmos that I find to be a blessing (the bouncer and Bumbo being at the top of the list!), but I think we can forget that babies don’t need 101 items in order to survive the first days and weeks. That said, after having my third child earlier this year, I was reminded once again that there are some things out there, that while not necessities, can help in easing the transitions and recovery process during the initial postpartum period. I keep thinking I need to write them down, in order to share them with other mamas-to-be, so here’s my attempt at listing some of my very favorite postpartum items to have on hand:

Note: this list is totally of my own making, and the links given are solely for your benefit-these are NOT affiliate links, nor do I receive any compensation for posting these!

For Mom:

Depends/Disposable Underwear:
- No joke! This may be the only time in your life when disposable underwear seem wonderful. They are comfortable, keep you and the sheets clean, and make life easier…
  Snuggling with my littlest and the new big sister
A good quality, comfortable nursing bra:
- It’s been my experience that higher cost = higher comfort when it comes to nursing bras. My absolute favorite is the Bravado! Seamless Body Silk. It’s adjustable, has no wires, is easy to use, and adjusts to your continuing adjusting size during those first weeks!
Nursing Cups:
- These were new to me, recommended by a client. But I’ve found them to be a life saver during the days your milk comes in and your body is trying to adapt! They relieve some of the pressure, giving you some relief, and make it easier for a newborn to latch on. Depending upon my milk supply and the infant, I’ve used them for anywhere between 48 hours to 3 weeks as we get the latch/supply/demand/initial soreness figured out. If you struggle with inverted or flat nipples, these can also help to pull the nipple out, making nursing go much better. Here’s the ones I use: http://www.amazon.com/Pharmics-0813-0099-00-O-cal-ette-Nursing-Cup/dp/B002UKXLJK
Wish Garden New Mother’s Salve:
- Nothing beats this salve in being the ultimate for nipple care and repair. Used after every feeding, it helps relieve soreness, heal trauma, and is a general all-purpose healing salve for about anything else, to boot. We keep it around and use it for wounds, bruises, etc. when it’s not being used for a newly nursing mommy! Find it here: http://www.inhishands.com/new-mothers-healing-salve/
Maxi-Milk herbal tincture:
- Whenever I sense my milk supply is low, a few days of using this supplement always makes a difference. I keep it on hand for those times when baby is experiencing a growth spurt, sleep is in short supply, or when the schedule is unusually hectic. A hungry baby is an unhappy one, which then makes for a stressed mama! Nothing else I have tried works like this stuff does. Order it from: mountainmeadowherbs.com
Nursing pillow or several extra pillows:
- Having a good pillow handy during those first days of breastfeeding can help get baby in a good position, and keep your back from the strain of bending over…sometimes you don’t even realize you are bending over or getting uptight as you help baby nurse…but this can help you relax and save you from some stressed muscles!
A few good books:
- The first 2 weeks after baby comes are a critical time for you as a mom to lay low, rest, and enjoy these first days with your baby. I’m always amazed at how long it takes a newborn to nurse those first weeks, and I find that I enjoy having a few good books around from my “reading wish list” to enjoy makes that time feel like a mini-vacation.
Thank you notes:
- I know, you need to rest those first days, but I find, too, that those first 2 weeks while I have extra help around and meals coming in are the best times to write little notes. Once I start getting back into “real life”, that time evaporates. So I like to be prepared ahead of time, with blank note cards so I can keep from getting behind on writing notes to those who bless us!
  Enjoying my little “vacation”…you can see my little tote on the end table
Postpartum Tote:
- Before my baby came, I prepared a little portable tote basket with the essentials I would need, in order to eliminate trips up and down the stairs. It contained nursing pads, salve, diapers, wipes, and a few other items that I might need, and I kept it on the end table by the couch. It saved me many steps, as the rest of the baby items were upstairs!

For Baby:

Coconut Oil:
- This stuff is amazing for baby skin care! With the antibactieral properties, it helps to keep cradle cap and baby acne at bay, as well as nourishing baby’s tender skin, and adding moisture during dry months. This time I purchased the liquefied oil, in order to make it easier to use, and sometimes I’d add a drop or two of some sweet-smelling essential oil to lather baby with after her bath.
  All cozy in her muslin blanket while big brother holds her hand!
Bulb Syringe:
- The 2oz. size works the best, in my opinion. Many times your midwife will include one in your birth kit, but they can also be purchased from medical or birth supply companies. These are great for the occasional gagging babies due on mucus, or for cleaning out stuffy little noses so baby can sleep better.
Muslin Swaddle Blankets:
- I love these! While the name brands do seem to be the softest, the “off brands” work as well! The cotton is breathable, allowing baby to be comfortable while still feeling secure when wrapped tightly. And they make great nursing covers, or sun shades for baby…and they are big enough they can still be used when baby is past the newborn stage!
Baby Book:
- If I don’t have a baby book ready to write in, then I miss so many little events of those first few days. Plus, the extra time mama has to sit and hold baby also translate into a few extra minutes to jot things down as they happen, rather than trying to remember after the fact!
  Lots of love and kisses!

So, what are your favorite items? Anything you would add, or give to a new mama? I’d love to hear your suggestions and thoughts!

July 20, 2015 by gentlemidwife

So, you’re interested in a VBAC….

This is a subject that I get asked about frequently. There are many mamas out there, who, for a variety of reasons, are looking into their options concerning a pregnancy and birth after a previous cesarean section. The first question usually centers around whether or not I will take on a VBAC client…so let’s start with that, and then look into some ways to make achieving a VBAC a reality.

When it comes to considering a VBAC mom as a possible homebirth candidate, it’s helpful to have an idea of why the c-section was performed in the first place. You have the legal right to your medical records, so ask for them! Sometimes they don’t shed light on the subject, but frequently you’ll have a clue as to what actually happened, which may not have been clearly explained to you at the time. Was it due to a surprise breech? Was baby’s head in a bad position (such as posterior or asynclitic)? Did your water break, putting you on the clock, and labor didn’t start in time? Was it a case of “failure to progress”, where labor didn’t proceed, or you got “stuck” and then were tired? Or perhaps baby’s heart tones dropped, making it a fast emergency? Whatever the case, understanding what all took place helps to paint the picture, and give me an idea of what hurdles you might face in this next birth. And it might help you in knowing what to prepare for-for instance, if your c-section was due to a bad position of the baby, then we’ll be much more proactive at integrating exercises to help with optimal positioning. There are very few situations which risk a mom out of the option of a homebirth, but getting a clear picture of what happened before helps us to determine your eligibility. And perhaps you would feel more comfortable pursuing your first VBAC in the hospital setting…either way, these next suggestions can be beneficial and productive in helping you prepare for your birth!

I like to tell VBAC moms the same thing I tell first time mamas…preparing for birth is like preparing for a marathon. You don’t just decide to run a marathon today and achieve it tomorrow. It takes WORK to prepare your body for it! Most mamas planning a VBAC have not yet had a baby vaginally, so in that respect, we focus on preparation in the same way we do for a first birth. Not to make things sound negative, but it’s good to be prepared for the long haul-and prepare your body to be able to cope with it. Eating a healthy diet and consistent exercise both contribute to this. Regular walks, workouts, squats, etc. can all help to build up your stamina for labor and pushing. I’d also suggest seeing a chiropractor, especially during the last trimester, which can help to ensure good alignment of your pelvis and good positioning for baby. I highly recommend checking into Gail Tully’s website: spinningbabies.com, as well as following her suggestions in her DVD entitled “Daily Essentials”.

Besides getting your body ready, you need to prepare mentally and emotionally…and this includes educating yourself about the particular risks and concerns that affect VBAC mothers and babies, as well as talking with others who have gone through similar experiences. This support can be invaluable in helping you to work through your past disappointments and set realistic expectations. Some excellent resources that I encourage all VBAC moms to consider are:

VBAC Facts by Jen Kamel (She teaches an amazing class based on research surrounding VBAC safety. You can attend a live seminar, or take a webinar at your convenience.)
Read books on the subject:

C-Section by Mark Zawkowski, MD, Natural Childbirth After Cesarean: A Practical Guide by Karis Crawford

Look into the “International Cesarean Awareness Network” (ICAN) and glean from their website…there are chapters throughout the US that meet regularly, where you can talk with other moms and learn from their experiences.
Join a facebook support group for VBAC mamas, and ask questions and hear about how other mamas achieve their VBAC.
Read evidencebasedbirth.com, and consider taking the class they offer online regarding “Failure to Progress”.

This information is hopefully enough to get you started with resources…blessings as you pursue your quest for a beautiful, natural and safe birth!

January 21, 2015 by gentlemidwife

Suggestions for a Healthy Pregnancy

Recently I’ve been searching for a short, easy-to-read handout on nutrition and exercise. I was having trouble finding what I wanted…something that hit the high points, but wasn’t so detailed that no one would take the time to read it. Here’s what I came up with, though there is SO much more that could be said. I encourage each of you mama’s to research nutrition, supplements and exercise so that you know WHY you are doing what you’re doing for you and your baby!

During pregnancy, your body faces extra demands and nutritional needs. Making wise choices in caring for your physical needs can help to build a healthy baby, improve your energy levels, experience less complications during birth, and have a more rapid recovery. How is that for motivation?

Diet Recommendations:
There are many varied suggestions out there as far as pregnancy diet goes. While it is important for you to do your research and make the best choices for your particular situation, the following are a few principles to go by when it comes to what you eat:
– Major on high-quality protein. Protein helps to give you sustained energy, builds good skin integrity, and keeps your blood sugars in check. Some ideas include: Greek yogurt, cheese, nuts, nut butter, chia seeds, eggs, meat, and seeds.
– Consume a variety of vegetables, preferably organic whenever possible. This helps to provide you with more fiber, and the multitude of natural vitamins and minerals that vegetables contain.
– Add quality oils to your diet. Recent research has proven that quality fats are good for us, contrary to what we used to be told! Coconut oil, olive oil, and butter (esp. if it’s grass fed!) are examples of good fats to be consuming.
– Reduce your intake of carbs-especially simple carbs. While carbohydrates are good in moderation, they shouldn’t be considered the foundation of your diet. Carbohydrates tend to elevate blood sugar levels, as well as adding extra pounds to you and the baby during the last several months of pregnancy. When eating carbs, do your best to make sure they are made of whole grains whenever possible, which provide you with fiber and a slower sugar release. Using a variety of organic grains (such as oats, spelt, rye, etc.) are better choices than only consuming wheat products.
– Stay away from artificial sugars, and limit your intake of refined sugar. Try using maple syurp, honey, coconut sugar or other more natural-type sugars when you need something sweet!
– Try to limit fruit juices, and eat whole fruit instead.
– Keep healthy snacks on hand, so that it’s easiest to make good choices when you’re hungry!
Supplements:
Ideally, your nutritional needs should be met through a healthy, balanced diet. But most of us can still use a bit more help!  The basis of your supplements should include a high-quality prenatal vitamin, one made from natural food sources instead of being chemically engineered. Seeking Health, New Chapter Organic, and Thorne Research are good brands, but there are more out there. Most moms are also lacking in sufficient calcium and magnesium, and I recommended taking a minimum of 1000 mg. of calcium each day. This can also help you to sleep better at night, and experience less muscle cramping and discomfort. Other supplements are normally suggested and added as needed, and we can discuss your particular needs during our prenatal visits.

Exercise:
In preparing for your labor and birth, it’s good to keep in mind that it is similar to preparing for a marathon. No one decides to run a marathon and then does it the next day-it takes lots of preparation and training for the big event. It’s much the same with giving birth. The more prepared and equipped your body is, the better able you’ll be able to handle the challenge and the easier your recovery will be. I highly recommend the following:
– Take a brisk walk at least 3 times each week, trying to go at least 1 mile in distance.
– Incorporate some type of exercise program (even just 10 min. long!) into your daily routine, and make it happen at least 3 times a week. There are many different 10 min. pregnancy workouts on youtube, and many other options you can take advantage of. A routine that incorporates lots of squats and leg-strengthening moves can be especially helpful in getting your body prepared for birth.
– Visit the “spinningbabies” website for information on daily exercises that encourage good alignment for mom and good positioning for baby. I have an excellent DVD on this subject that I encourage each of my clients to borrow and watch.
– Consider visiting a chiropractor during the last trimester to ensure your body is ready for birth!

November 24, 2014 by gentlemidwife

Frequently Asked Questions

If you are considering a home birth, perhaps the following are questions you have wondered about. Don’t hesitate to contact me with any specific questions…I’d love to help you in any way I can! Please note, these questions and answers pertain specifically to my practice here at Gentle Delivery Childbirth Services, and may not apply to other midwives and practices.

Q. At what point in my pregnancy should I contact you?
A. You are welcome to contact me at any time-with preconception questions or as soon as you find out your pregnant. A free no-obligation consultation where you can ask questions and see my office can occur at any point, but I typically schedule your first actual appointment once you are between 10-12 weeks along, as that allows the baby to be mature enough to hear the heartbeat. The earlier you are in touch, the greater chance I will have an opening over the time you are due, though it’s never too late to talk with me about your options, either…we can begin care late in the pregnancy when necessary, too!

Q. What does a normal prenatal look like, and where does it take place?
A. Prenatal appointments normally take place in my home office, usually on Tuesday and Thursday afternoons, although other times are possible. I generally expect to take anywhere from 30 min. to an hour, with the goal being able to spend enough time to answer any questions or concerns a couple might have, as well as including education regarding exercise, nutrition, positioning, childbirth, etc. At each visit a urine sample is checked, weight is recorded, BP is taken, and baby is listened to, measured, and palpated to see his or her position. Other testing and/or procedures will be performed as needed. The normal schedule for visits is every month until 28 weeks, followed by bi-weekly appointments until 36 weeks, and weekly visits thereafter. A home visit is performed at 36 weeks, in order to give myself and any other birth attendants a chance to see your location in normal daylight hours! 

Q. Do I need to see a doctor besides seeing you for prenatal care?
A. That honestly depends upon your personal preferences. The prenatal care I give would be similar to what you would receive from a doctor, including labs and referrals for things like sonograms. Most of my clients do not see a doctor while receiving care from me, as it keeps costs down and keeps them from multiple prenatal care visits. If your OB office is open to co-care, it can provide you with a seamless transition in case of transport, especially if it is covered by your insurance provider. If care with an OB is covered in full by your insurance provider, you may benefit from continuing care with them in order to have the costs for your labwork and other testing covered completely.

Q. Will my insurance cover your services, or how can I afford it?
A. Sadly, many insurance companies do not cover home midwifery care, though it is always worth checking into thoroughly. I would be happy to provide you with some information on how to best discuss this with your insurance company, and I am also willing to give you a written statement complete with insurance codes to submit to your insurance company. In order to keep my own costs down, I do not file insurance, but I do try to make care accessible to all families by charging a sliding scale fee based upon your family’s income. Keep in mind, too, that when using insurance, you will have a co-pay, and for some people the cost of my services are either similar or lower than the co-pay amount you would be paying with a hospital delivery.

Q. I notice you have a student working with you. How does that influence my care?
A. When a student is interning for midwifery training, their level of involvement varies according to where they are at in their studies. A student midwife begins by observing all aspects of midwifery care, and applying the academic knowledge she has already received to practical, hands-on situations. As her experience expands, so do her opportunities-she assumes more responsibility depending upon her level of experience and skill. Students are always grateful for any opportunity afforded them to learn, and would love to be as involved with your care as you feel comfortable with. I always strive to make sure the client feels completely comfortable with any care provided by a student, whether that is allowing the student to feel for baby’s position and fundal measurement, or whether it is as extensive as allowing the student to participate in a high level of care during delivery. Whether you prefer lots of involvement or minimal involvement, a student generally acts as my birth assistant during the actual labor and delivery, helping to provide labor support, take notes, and in general act as my second set of hands. 

Q. Who will attend my birth? Is is okay to invite others to be present in addition to the birth team?
A. Normally I attend births with one or two qualified assistants. These ladies are usually either skilled students or birth attendants, and enable me to know you are getting the best care possible, allowing both baby and mom to be cared for in case of emergency. Besides this, whomever else you choose to have present at your birth is up to you. I’ve been at births where it was the bare minimum of people, and I’ve been to births where there was a crowd! The main issue is that you feel totally and completely at ease and comfortable with whomever is present, as that can majorly impact your experience.

Q. Are children welcome to attend the birth?
A. It’s your birth, so you get to decide if you want your children present or not! If you are planning on having your children attending, I strongly recommend you having an extra person handy whose sole responsibility is caring for your child(ren) so that you can focus on the delivery.

Q. Do you do waterbirths?
A. Yes! Laboring and delivering in the water are both options. For many people, their home tub is comfortable enough, but if you’re wanting to use an actual “birth pool”, I can put you in touch with rental possibilities.

Q. I had a cesarean with my previous delivery, does that rule out a home birth?
A. I am happy to help women VBAC whenever possible. For most women, a VBAC at home is statistically safer than a repeat c-section. Make sure you get a copy of your previous medical records, and we can discuss your particular situation in person in more detail.

Q. What birth positions are options at home?
A. There are about as many options as there are women! One benefit to delivering at home is the flexibility to figure out what works the best for you…whether that is squatting, laying in bed, standing in the shower, or wherever you are the most comfortable. I have a traditional “birth stool” that I bring along to births which gives you the option of a low squat, but most women instinctively find a position that works the best for them.

Q. Are you prepared for possible emergencies?
A. Yes. I maintain current certification in both neonatal resuscitation and CPR, bringing along emergency equipment in case of a baby with breathing difficulties. I also carry equipment to assist with stabilizing a mom in the rare case of hemorrhage. It’s my goal to make your home birth experience as safe as possible, which includes careful monitoring of both baby and mom during and after labor, so as to catch any concern that is out of the scope of “normal”. Consistent prenatal care combined with healthy, low risk moms lowers the chance of emergency procedures drastically, but your birth team stays alert for any signs of possible surprises. We can discuss this question in more detail during your consultation if you wish.

Q. So, laboring at home sounds nice, but what about the mess that comes along with birth?
A. Most people are surprised at how little mess is involved. I have families purchase disposable underpads (available at most drugstores) and a cheap shower curtain, which we use to protect surfaces such as the bed and carpet for the actual birth. These things get thrown away afterwards, and myself or my assistant will start laundry before we leave your home. We also make sure to tidy things up so that you aren’t left with clean up!

Q. How do I go about getting documentation for my child?
A. I will file all needed paperwork with the state, which includes the official birth certificate and request for a social security number. I also perform the newborn screening test on your baby during the home visit which occurs 24-48 hours after birth.

Sweet baby feet as baby is being weighed during the newborn exam!

October 16, 2014 by gentlemidwife

Remembering seven years ago…a thank you to many of you!

I had to stop today and remember what happened on this date seven years ago…it’s actually hard to believe it’s been that long! I’m sure the fact that it’s also one of my grandmother’s birthdays helps to remind me of the actual date, but it’s fun to take some time and think about and remember some of the dear people that played such an important role in the midwifery aspect of my life. It was on October 16 in 2007 that I had the great privilege and wonder of “catching” my first baby…

As a student midwife, I had been eagerly anticipating when this time would come. By that point, I had finished almost one year of the academic work required to complete my training, and I had been working, living and training at Family Birth Services, a birth center/training center since the end of May of that year. Living at FBS was like studying midwifery by immersion…that was seriously most of what you did all the time…live, talk, think, dream and study birth, babies and mothers. Since my arrival at the birth center about 5 months before this, I had spent many hours sitting in prenatal appointments, talking with other midwives, attending births in a variety of settings, and trying to take in everything I possibly could.

Family Birth Services was a wonderful setup for aspiring midwives. Besides being staffed by a lovely group of ladies (who didn’t mind questions and discussions going on into the wee hours of the night!), those of us who were students were offered the opportunity to truly get our hands into the work as the birth center offered discounted rates for those families who chose to have a student provide them with care. When I think back to the families I had the joy of working with (many of whom still stay in touch today!), it makes me incredibly grateful for the investment they made in my training. Getting the opportunity to learn how to care for mothers and babies while assuming a major portion of responsibility is one of the best ways to learn! And I’m grateful, too, for the midwives who tirelessly gave of themselves to supervise and ensure that the clients were still receiving safe, quality care while allowing the student to provide as much care as they were capable of.

So, come October, I was feeling mixed emotions about when I would get to play the primary role in my first client’s birth. At this point, I had already had two primary care clients who had already delivered…one who went preterm, and another who ended up delivering while I was gone at a required midwifery training workshop. I should back up here, too, and note that while I had been assisting with other births, each of us students especially savored the relationship we had with our “own” primary care clients-these were the ladies we were providing care to under supervision, and whose births we were the most involved with. Due to the fact that I had some ability to communicate in Spanish, I was give the opportunity to take on my own primary care clients earlier than most students, as there were no other students available at that time who were able to offer Spanish speaking care. My dear Spanish-speaking supervising midwife, Sorani, had her hands full as she not only worked to help me communicate with clients, but also worked to make sure I was covering all the details needed especially since I was so early in my clinical training.

Given the fact that my two previous clients had not turned out the way I was hoping, I was beginning to wonder what might possibly happen with my third client. Sorani patiently encouraged me to trust the Lord with the timing and outcome, and relax while we waited for this baby who was taking her own good time to come. I still remember getting the call on my phone in the wee hours of the morning, and thinking that here was my time to put into practice the things I had been learning! Things seemed to be progressing well, and since this birth was planned to take place at the birth center, my client decided to come on in.

I’ll never forget the thrill that went through me when, just about 2 hours later, I helped this beautiful little girl enter the world during a lovely picture-perfect birth. While the difficult births would take place later, this first one was beautiful…totally breathtaking to me as a new midwife, and thrilling as I realized again how much I was drawn to the birthing process and how fulfilling this work was-even at 4 in the morning! 🙂 I’m sure Sorani (who was supervising) and Peggy (the other student assisting) won’t forget how they had to pull me down to earth and remind me that I really should eat something before my blood sugar crashed due to the high I was on! 🙂 We had a special celebration with hugs and ice cream in the kitchen early that morning, and I was reassured that this was indeed the work that I thoroughly enjoyed doing.

While there have been lots of other experiences in the years since, this birth still stays clear in my mind. And on this day when I remember this particular birthdate, I also want to thank all of those who invested in my training…the families who allowed me to be a part of their birth experiences, the midwives who allowed me to be part of their practices, those who spent hours teaching/instructing/coaching me, the other students who I trained alongside of, and the Lord who opened the doors and allowed me to be involved in the beautiful & intense work of assisting new lives into the world. Thank you!

Baby L just a few hours after birth…dressed and ready to go home!

July 26, 2014 by gentlemidwife

Preparing for your birth…

This information is written specifically to give first time mothers and first time VBAC moms suggestions for how to improve their chances at achieving a natural, easier delivery. But that doesn’t mean this is just for them! All of these suggestions can help ANY mom as she prepares for an optimal birth! Pregnancy and childbirth is such a special and exciting time, and it is also something to be prepared for ahead of time. It is good to keep in mind that a woman’s body was designed to give birth, and that, normally speaking, your body does know what to do to get the baby out. On the flip side, though, is the fact that this is the first time your body has ever experienced this process. Because of this, labor can sometimes last longer, and be more physically demanding, as your body takes the time it needs for all of the muscles and bones to work together and stretch to allow your baby to enter this world. If you have invested time and effort into preparing ahead of time, your body will benefit, both in the labor and recovery processes. Just think, you wouldn’t run a marathon without giving adequate training and preparation-and so it is with childbirth. You must condition your mind and body to give you the best results.

Throughout the pregnancy:

– Read and educate yourself! Take childbirth classes, together with your husband. This will help you both to be informed about the physical and emotional processes, and allow you to discuss ideals, hopes, and dreams before labor begins. I believe that education can also help to reduce the level of pain, as it helps you to understand what is going on in your body, instead of fearing the unknown. The more you can find out ahead of time, the more able you will be to relax, knowing your body is doing what it was intended to do. There are many books, DVD’s, and classes available-talk with me if you need suggestions!

– Eat a healthy diet. A diet full of good, healthful foods (vegetables, protein, and complex carbohydrates), and low in sugars, fats and simple carbohydrates, can help you in several areas. One, it doesn’t build a huge baby. A smaller baby is easier to push out! Secondly, it allows your body to be able to function at it’s optimal ability, as your energy level is increased. Thirdly, good nutrition can build better skin integrity, which decreases your chances of tears.

– Exercise regularly. Exercise is an extremely important factor, as labor and birth are very much physical events. Stretching, and building up your endurance level throughout the pregnancy will enable you to persevere if your labor gets long and tiresome. Throughout the last few weeks, walking briskly (until your pelvis hurts!) for at least 45 min. every day, can help to encourage the baby’s arrival to happen sooner rather than later.

– See a Chiropractor-if your body is not in alignment before labor, this can really slow things down and keep the baby from descending. While having regular adjustments can be helpful, it’s an especially good idea during the last 3-4 weeks, as it can help your body to relax and get the baby into the best possible position before labor begins.

– Visit http://www.spinningbabies.com and try some of Gail’s suggested techniques for helping baby to achieve the best position. Regularly implementing techniques such as inversions and belly sifting can help to reduce your overall labor time by helping your body to stay aligned and encouraging good position of the baby!

– Practice relaxation. If you can learn to relax, go limp, and let your body work before labor begins, then the better able you will be to do this during labor. Remember, fighting pain and discomfort works against you during labor-you must open up, let go, and relax in order for your uterus to function the most efficiently. And the more efficiently it works, the easier it will be on you! In practicing, pick times of the day when you can work on letting each area of your body go limp. Find out what helps you to relax: water, music, massage, etc., and then have these available during labor.

During the last 5 weeks:

– I encourage moms to take the following supplements:

Gentle Birth Formula ~ this is a specially formulated blend of herbs in a tincture form that work to help prepare the uterus for the upcoming birth. You begin at 35 weeks by taking 2 dropperfulls a day throughout the first week, and increasing the amount to 2 dropperfulls 3x/day for the remaining weeks. Mothers who take this herb usually have more “warm-up” contractions, which help the cervix to begin dilation and effacement before actual labor. This tincture can be purchased through In His Hands Birth supply at the same time that you order your birth kit.
Super Primrose Oil or Borage Oil ~ this supplement is in a soft-gel form, and you begin taking 1-2 capsules orally beginning at 35 weeks. Around 36-37 weeks, you may begin inserting one capsule vaginally at night when ready to go to bed. The high GLA content and natural prostaglandin that these oils contain helps the cervix to soften, making dilation easier. It’s a great way to give your body a head-start towards dilation!

In closing, remember to keep yourself hydrated, rest often, and take care of yourself. And when labor begins, try to get some rest before getting excited. You need to conserve the energy for later. So think about some activities that provide fun distraction (games, movies, going out for supper, etc.), and try to focus on other things until the contractions become consistent and strong enough that you can’t be distracted through them….

April 29, 2014 by gentlemidwife

Pictures from the “Office Project”

Today I’m taking a break from educational and informative posts…I finally had a chance to take some pictures of my newly finished office, and thought it would be fun to let you all take a peek! When we moved into this house, I was excited about one room that had built in counters and cabinets, plus a little desk that faced a window. The room had alot of potential, but it also badly needed lots of work and paint! It was one of the big projects that my husband and I tackled this winter, and as usual, it took longer than what I was anticipating. 🙂 But now that it is finished, we are both really pleased with the results! So here’s a little peek, along with an updated family picture that my sister took this weekend…

My favorite corner-it’s perfect for studying, sewing, paperwork and so many other things!

The lovely tree that my mom painted while she was here visiting

The “baby wall” with many pictures of babies that I’ve either delivered or given care to

The beautiful exam table that we just purchased…it even matches the color scheme!

More of the “tree wall”-the angles in this room make it hard to get good pictures

Another side of the room

Our little family – April 2014

April 7, 2014 by gentlemidwife

Fussy Babies, Tongue-Ties and Nursing Challenges

Recently there have been alot of articles floating around on Facebook and other blogs regarding tongue ties and the challenges they pose for nursing babies. Reading these have reminded me of the very difficult six months following my last baby’s birth. In the past few months I’ve been wanting to write about this phase of my life, and I’m hoping that maybe it can be a help to others who might find themselves in similar shoes. While our family found some answers, I still have questions that I’m studying and researching…so this may end up being part one in a series! 🙂

For starters, a little background: my first pregnancy was challenging, especially for the first 20 weeks during which I was very sick. Towards the end, I ended up being border-line preeclamptic, and we were grateful that our little princess came safely, and a week early. Quite honestly, my labor and delivery the first time was “textbook” perfect: 8 hrs from start to finish, no complications, and with what we call in birth lingo an “uneventful postpartum”. While I never had an abundant supply of milk, nursing was fine, and she gained slowly but surely, being more of a petite little girl. She was on the fussy side (which, incidentally, runs in my husband’s family), and around 4 months I cut dairy out of my diet, which made a big difference in her personality. I still can’t say she was an “easy” baby, but she wasn’t excessively difficult, either. So, when little brother was on the way, I was happily surprised with how much better the pregnancy went the second time around. While I was queasy at times, and felt a bit picky about what I ate, I didn’t have the months of throwing up and severe nausea and weakness that I had the first time. The last couple of weeks I once again struggled with keeping my BP from going too high, but all in all everything went extremely well. Which, in turn, made me expect that nursing and baby care would go that much better the second time, as well. However, that was not to be the case…

When our little boy was born, he was an even 9 lbs, and nursed well right off the bat. Because he was doing so well with nursing those first two or three days, I made what I believe was my first mistake: I gave him a pacifier so I could sleep at night. I figured that he was nursing so well and so strongly, and since he was so chunky to begin with, and that it wouldn’t cause any problems…he was nursing constantly, and I just wanted a little bit of sleep! By week two, nursing started to become a battle. He would latch on for a second or two, then howl, arching his back, and fighting it. It wasn’t every time, but it increasingly got worse, so that by the time he was 3 weeks old I didn’t want to try to nurse him in public anywhere, as it took so much work. Like most babies, he lost weight the first week, but it took him an entire 3 weeks before he was back to his birth weight. At that point, we took his pacifier away, hoping that we were dealing with a case of nipple confusion, and that maybe after a few days we would be nursing fine. Those days were rough…he cried SO much, and wanted to suck constantly…and yet would fight me when I tried to nurse him. After a few days it got a bit better, but still not that great. By that time I wondered if maybe he was dealing with a sore tummy and food allergies, so I went off of dairy, hoping it would make a difference. After several days he seemed to be a little better, but not the drastic difference that his sister had made when I cut those foods out.

I still remember the day when he was about 6 weeks old. Joel was gone all day for a meeting (it was a Saturday, which normally was my day for a “break” in having daddy’s help with two little ones!), and I was expecting company for supper and for the night. My baby seriously cried ALL DAY LONG. I think he wore himself out enough to take two short naps, but that was it. Feeding was a battle, and I didn’t have a CLUE what to do with him. I laid him on the bed, and watched him cry, and all of a sudden it dawned on me that he could hardly move his tongue! He was howling, and his tongue literally looked as though it was tied to the bottom of his mouth. Now, being a midwife, I had seen tongue tied babies before, but all of those I had seen had been what they call “anterior ties”, meaning that you could see the membrane that tied the tongue. My baby had what I came to find out was a “posterior tie”…you could only see the membrane when you used your finger to lift his tongue up. After consulting with several midwife friends, I decided to take him to a doctor to have him checked out, and hopefully take care of the tie.

Monday morning I took him in to see the family practice doctor, which proved to be a disappointing visit. The doctor was very concerned about baby’s lack of growth, but totally shrugged off the tongue tie possibility, and instead wanted to do testing for a heart defect. I told her that I didn’t think a baby with a heart defect could scream as long as my baby could without wearing out, and declined the testing, telling her I would continue to monitor his heart and growth, and bring him back if there was any other concerns. I then returned home, called my dear nurse friend/fellow midwife down the road, and she agreed to come up and help me attempt to take care of the tongue tie. We did, and all of a sudden he could move his tongue unlike he had ever moved it before!

I was hoping this would be the end of the struggles, but it wasn’t the miraculous cure that I was hoping for. While he latched better, it still wasn’t where it needed to be. I could feel my milk supply dropping, despite eating quality and quantity foods (I gained 7 lbs. just trying to increase my supply!), and taking different herbs. A week later, my sister came to visit, which was a huge boost as I felt like all I was doing those days was trying to feed and console a crying baby. By the end of the week, after another long crying spell, my husband said “I really think you need to feed him a bottle of something and see if he needs more to eat.” Now, he had suggested this before, but I adamantly refused. I always taught that breastfeeding is the BEST way to go…once you start a bottle you’re on a downhill slope…etc, etc, etc. I had all the arguments as to why I would never feed my baby a bottle. But here he was crying, and we were desperate. So, I used some of the formula samples I had on hand, and decided to try it….and the little man ate as if he was starving. He drained the bottle dry in no time, and looked the most happy and content as he had ever looked. I cried. Here I was, thinking I was doing the best thing by pushing nursing, and my baby was starving. And talk about eating all the words you ever said…how could I EVER feed this baby a bottle in public?!?

But I wasn’t ready to give up on nursing…and the next several months held quite the times, as I continued to try to get him to nurse first, and get a bottle last. I tried a nipple shield-that really helped, but I felt like I had so much “equipment” along for nursing that it was no fun to go places. And after awhile I realized that not only dairy would cause his tummy to get upset, but so did wheat. So I kept to a very strict diet, which helped alot. But after dropping my milk supply so much, I never was able to get back enough to feed him 100% breastmilk. So that prompted another journey…researching formula alternatives. With all the additives, corn syurp solids and other things in powdered formula, I did not feel right giving it to my baby, and I was delighted to find the recipe for home-made formula on the Weston Price Foundation website (www.westonaprice.org). We were blessed to live just down the road from an organic, grass-fed dairy, and I began mixing up home-made formula on a daily basis. While it was more work, it was amazing the difference it made…no more constipation, and his stools and spit up were identical to a 100% breast fed baby. And he started gaining weight!

We continued the partial breast-fed, partial supplement feedings until he was about 6 months old, when one day he refused to nurse, and continued to refuse. I bemoaned the lack of bonding that would come from not nursing…and my husband wryly commented that he thought giving the baby a bottle peacefully was more bonding than forcing a screaming, back-arching baby to the breast. 🙂 Good point! Little Matthias continued to grow and develop normally, and once he could crawl around and eat solid food, he no longer had any food allergies. When he was 10 months old, I one day read an article about how lip ties can also affect nursing…and sure enough, he has a very pronounced lip tie. Which finally makes sense to me why he never was able to get a really good latch…his upper lip never was able to flare very well.

In retrospect, I feel like I’ve learned a number of things: first, I won’t quickly give another baby a pacifier. It really is best to let nursing get off to a really good start, even if you’re tire. Next, I wish I would have thought to investigate the tongue tie sooner. I am paying really close attention to the babies I deliver these days, to make sure it looks right! I also wish I would have searched longer and harder for a professional who could have maybe found both his tongue and lip tie and taken care of it right away. I think if it would have been done when he was 3 wks old, we would have had many less problems. I have also learned to never criticize another mom for the way she feeds her baby. Many times you have no idea what she has been through, and what may have brought her to the point that she is at. As mothers, we want to do what is best for our babies, and sometimes it looks different in other situations. I also STRONGLY recommend looking into making your own formula if you need to bottle feed! And lastly, I’m doing some research, and I haven’t figured it all out yet, but I’m really hoping that by possibly taking a different form of folic acid during my next pregnancy, I may be able to help reduce or prevent the significant food sensitivities/stomach issues and tongue ties in the next baby. I haven’t read enough to be able to share it yet…but I’m hopeful that maybe things can be different the next time around!

So, that’s the story…God’s grace was sufficient, though I really thought I was going crazy numerous times during those months. A fussy baby equals little sleep, and I went months without sleeping more than 2 or 3 hrs at a time. But our little fellow is worth it all, and brings us much joy…and I know I’ve learned an extra level of sympathy for those experiencing nursing difficulties and challenges with fussy babies!For more information on tongue ties, check out:http://www.cwgenna.com/ttidentify.htmlhttp://kiddsteeth.com/dental_topics.html#evaluate_and_diagnose_a_posterior_tongue_tie

Matthias around 1 week old

March 3, 2014 by gentlemidwife

February Travels…and what the CPM Title Actually Means

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

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

The way to travel with a toddler…

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

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

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

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

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

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

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

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

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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