It’s hard to believe another year is almost completed! As we head towards the New Year, I wanted to take a few minutes to update you all on happenings here at Gentle Delivery, as well as thank each of you for your continued support. Whether it’s returning clients, new clients, supportive local services (lactation consultants, medical teams, ultrasound technicians, etc.), back-up midwives, students or assistants, I am blessed to be part of the local midwifery community, and I’ve been grateful to see the way this community works together!
So far in 2022 I’ve been privileged to assist in welcoming 15 babies, most of whom were little girls. Several of these were born to first-time mamas, and once again I was amazed, humbled and stretched throughout the experiences of assisting these families with the unique challenges and victories that accompany the unknown journey of becoming parents for the first time. Besides the first time babies, the rest ranged from being sibling #2 to sibling #8 for their families, and I had the special privilege of attending 3 moms for the 3rd time. Seeing children that I remember catching as tiny babies become big siblings is a fun perk that comes from providing ongoing care for client families! The smallest baby this year was 6# 4oz, and so far 8# 14oz was the biggest, with one more baby pending who could change these statistics!
The teamwork of our community stood out to me in greater ways throughout the pregnancies and births this past year. Over and over again I have been thankful for good working relationships both with other midwives and the medical community—which is such a key factor for providing sustainable, safe midwifery care options. There were times this year where additional medical help was needed in order to provide us with the ultimate goal of having a healthy mom & baby, which made me especially grateful for several MFM’s and CNM’s willing to provide consultations, input & care for clients as well as for a welcoming hospital environment when complications necessitated a transfer of care. Along the lines of providing good care options, it was exciting to add the services of a diagnostic ultrasound tech who has been able to regularly perform scans right in my office!
Birth teams have varied this year depending on availability of different assistants & midwives, but each one of these ladies have added to the birth experiences and help me in so many different ways, bringing their own special support and care to births. There are many behind-the-scenes details that these women take care of, besides their willingness to drop whatever they have going on to come help me in any way they can at any hour of the day or night, and I couldn’t continue to provide midwifery services without them! Due to a family emergency for one local midwife, I ended up covering at various times for her over the year, and catching several babies while she needed to be out-of-state. While I know it can be disappointing to not have your expected team for your birth, it was also a blessing for these families to still be able to continue with their homebirth plans despite the need for the original midwife to attend to important family needs. Along similar lines, I was very thankful for midwives willing to cover for me so that I could spend a few weekends away with my family, both for vacation and a family wedding. The strain of on-call life is challenging (especially with young children!), and being able to rest knowing that your clients are in competent hands while you take a break is a huge factor in maintaining a sustainable midwifery practice!
In closing, I also wish to express my thankfulness to my supportive family. The way they pray for me when I’m at births, pick up the slack when mama needs to rest or is away, and adjust their lives and schedule is such a vital part of midwifery work, and it really is a family effort. Also, I realize that none of this could happen without God’s continued blessing, provision and care. As we head into 2023, my children are very excited about the addition of a baby sister arriving in early spring, Lord-willing. I’ll be taking a few months off for maternity leave, and trying to put into practice the things I tell all of you about rest and recovery postpartum! Blessings to each of you in the New Year!
As I think back over this past year, it is with a sense of gratefulness for the ways that God has led, protected and provided. 2021 has included more complications, challenges and adrenaline rushes than I’ve ever had in one year’s time since I began practicing as a midwife 12 years ago! The additional gray hairs accumulated over the months prove this, and I am ending the year feeling like I’ve gained a level of experience that I honestly wouldn’t have minded doing without. However, I’ve also been reminded that this is WHY a midwife takes training seriously, and I’m more committed than ever to doing my best to assist families in safe births, even when at times this requires a different birth location than what we had hoped for, or more invasive assistance than what I prefer to provide.
Besides being the most intense year complication-wise and the most stressful year when it comes to constant changes & research due to the ever-changing Covid landscape, it was also my busiest year baby-wise! I had the honor of helping to welcome 6 girls and 11 boys by the time the last December babies arrived. Weight ranges were fairly average: smallest was 6#8oz and the biggest was 9#9oz. While a couple of little ones came a week or two early, most typically went on the later side with two babies waiting until 13 days past their due date. Three babies made child #6 for their families, and two boys were the first ones for their families. While there were several long labors and many hours spent with a family before the birth, one little guy was in a big enough hurry that he made his appearance in his home before I did! As usual, birth always has an element of surprise that keeps us all on our toes.
I was blessed to work with several great assistants this year! These ladies really help to lift my load, and add a lot to our team. After assisting with births throughout the past 6 years, Lynelle is sensing a need to step back for a time, so she won’t be seen as frequently in the next year. Lanna began helping this spring at the height of our busy season, and has been such a blessing! She will continue to assist as her schedule allows, and there’s the potential of another assistant joining the team in the near future. I’ve also been grateful for the continued help of the midwifery community here in central PA: other assistants and midwives have been willing to fill in as needed, and I’m thankful to have had help available whenever I’ve needed an extra set of hands or someone to cover for a trip or emergency. I was especially thankful for RoseMarie’s willingness to cover for me this fall when our family had COVID, and I was thankful for the baby who so beautifully cooperated in waiting to arrive until I was recovered and my family was past quarantine!
On the home front, my little family is growing and doing well! In spite of lots of babies and the craziness this adds to our calendar, we were thankful to get to spend some time camping over the summer, as well as taking a family trip to Mexico to visit missionaries serving with the organization my husband works for. I couldn’t serve as a midwife without the amazing support of my husband Joel, who graciously steps in to care for everyone when mama disappears at a moment’s notice. With children ranging in age from almost 2 to 10, life at home is always exciting and active, and my girls can’t wait until THEY are old enough to “help mama at births”.
A big thank you to each one of you who have trusted me to support you as you navigated your pregnancies and deliveries—it is something I count a privilege and honor! I love to hear from families, so please feel free to send an update and picture when you have a chance!
Many blessings as you head into the New Year,
Kelsey Martin & Gentle Delivery Midwifery Services
Be sure to check out the blog and Facebook page to stay updated on current news, helpful information, health suggestions, birth stories, and announcement of special events such as playdates!
As we enter into the Christmas season again, I have to think about the year we were anticipating our own Christmas baby, and what a delightful time of year it was to cozy up inside with a newborn! Our little Tirzah had quite the dramatic entrance into the world, and it almost makes me laugh every time I recount it…
By the time I was expecting my fifth baby, I knew to expect lots of contractions and discomfort, and this pregnancy was no exception. Thankfully my blood pressure was staying within normal limits, and everything else was proceeding smoothly. But after several nights with contractions and signs that labor could be imminent, I was getting TIRED. Once you loose that much sleep and feel heavy and uncomfortable all the time, you start to wonder how on earth you are going to make it through labor yet! One night I was pretty sure it was the “real deal”, after being up for hours with regular contractions, only to find everything stopped once the birth team was here and the pool was filled! Funny that it took the fifth child to experience that “false run”, but after not calling the midwife soon enough last time, we were trying to not repeat that scenario—only to send everyone home after a couple of hours!
My previous baby had come after an extremely intense labor, and I was trying hard to not allow fear to overcome my anticipation of this birth. Lynelle, my good friend and birth assistant, had told me that I really should try the birth pool this time around, and even offered to take care of all the set up and prep to make that happen. So we had set up the pool in the office, and had everything ready to go, and I was really hopeful that it would make a difference in the intensity, especially at the end.
Fast forward a couple of days: after getting a good night’s sleep, I woke up on Saturday feeling like this baby needed to be encouraged to come. I’ve taken Castor Oil before, but every time I thought about that option it made me want to puke. So I figured there had to be an alternative: enter the Midwives Brew! I had read about this recipe (used often by European Midwives), but had always figured that the small amount of castor oil combined with the other strange ingredients wouldn’t actually be effective. But by this point I was willing to at least TRY it and see! My husband was on board (he was ready to see me up at night nursing a baby instead of up at night with contractions!), but I warned him that I really didn’t think it would work.
Mid-morning, I took my youngest for a little “mommy date”, and we headed to Wegman’s for a few groceries and the ingredients for the brew (see this post to find out what those are!). I had fun picking out a few things that I thought would sound good to eat or drink IF I was in labor later on, and we had a pleasant little outing. Once I returned home it was about lunch time, so while Joel fixed lunch, I blended up the brew, and sipped it down before eating a little lunch. While not the best flavor I’ve ever tasted, it wasn’t nearly as bad as downing large amounts of castor oil in juice!! My stomach felt a little funny, but eating some food and then chewing some gum seemed to settle things.
This was the weekend that one of our little local Victorian towns always holds an event called “A Victorian Christmas”. That event combined with the opening of an exhibit of an Underground Railroad station in one of the museums there had made me want to take the children out for awhile if we were still waiting on a baby over that time. Since Joel had a Bible Study planned at our house for the afternoon, it felt like a great opportunity to take out the older children for some educational distraction and let me get a chance to think about something other than baby waiting! Since all I had been experiencing for two hours was some minor stomach discomfort, I decided to head out around 2:30pm, despite my husband’s slight misgivings. Laughingly I joked with him that if I called him he’d better answer the phone, as it might mean I needed him to come pick me up!
Bellefonte is about 10 min from our house, and we parked and went through the historical museum, only to find out that it did not contain the Underground Railroad Exhibit like I had thought. The curator pointed us up the road about half a block to the right museum, and the children and I headed that direction. Right as we hit the steps (around 3:30pm), I felt a slight “pop” and had a thought that perhaps my water had broken. But I wasn’t sure, and decided since we were RIGHT THERE we might as well go in. I felt a bit of dismay when the museum volunteer cheerily told us that the exhibit was on the top floor…UP THREE FLIGHTS OF STAIRS!! We started up the stairs when I felt my first real contraction, and I immediately thought that we’d better not stay long. The children were oblivious, of course, and thoroughly enjoyed exploring, while I tried to act like nothing was amiss as the contractions quickly started getting stronger and harder. I hurried them through the exhibit and back down the stairs, stopping briefly in the bathroom where I confirmed that indeed my water had broken. As we headed outside, my children excitedly discussed the next place we would go…and I seriously informed them that we needed to get home NOW. They looked at me puzzled, and I told them I thought baby sister was going to be coming, to which my 6 year old son replied “how do you know? Your water hasn’t broken yet, has it?”. That made me laugh in spite of the situation, and when I told him it HAD, they all got really serious!
The half-block walk back to the car seemed to take forever, as the contractions were definitely picking up in speed and intensity. Once we pulled out and started on the road, I called Joel. The first time he didn’t answer, but then when the phone rang the second time he figured he’d better pick up! I told him that labor had begun, and to please have all the Bible study men out of the house by the time I got home and figure out where the boys were supposed to go…and to pray I could drive home safely! Next I called my friend Lynelle, as I knew that she would need to get a babysitter for her children, and I really wanted her free to get the pool started if things continued. Once I was finished with this phone call I knew I couldn’t make any more calls and drive, as things were just too intense. It was all I could do to stay focused on driving! I kept praying a policeman wouldn’t pull me over, as I had no bandwidth to explain why I was headed home instead of to the hospital!
I reached home, and our friend Daniel had his van running so he could pull out with the boys as soon as I arrived with Matthias. I pulled in the garage around 4:20, and had a massive contraction that made me unable to even get out of the vehicle. I heard Joel on the phone—he had called our midwife to see if I had called her yet (I hadn’t!! She was next, but I couldn’t make another call after I talked with Lynelle!), and she said she’d be on her way. I still remember running inside to the bathroom, trying to focus on relaxing, and coming to grips with the fact that at this rate I would not be having a water birth, then Joel calling through the door “the pool is warm and half way filled if you want to get in!!” He had so sweetly started filling the pool, turning on the music, and getting things ready the minute I called home! I told him he’d better call Lynelle and Priscilla (our friend who was going to come help with our girls and take pictures), and they’d better hurry, and I still remember the relief of settling into the warm pool.
Once I got in the water, the intensity and closeness of the contractions subsided, and I had a chance in between to catch up Joel on all that had transpired. Lynelle and Priscilla don’t live far, and arrived within a few minutes, and I still remember us all laughing in between contractions as the craziness of how fast things were happening! It wasn’t long before I felt the pressure of Tirzah’s head descending, and Lynelle was ready to help in anyway she could. Priscilla called our girls in, and they all clustered around the pool, quiet with excitement and anticipation. This time around I didn’t want anyone to touch me (other than squeezing Joel’s hand!), and I have never experienced the awareness during pushing as I did with this birth. It was an incredible experience to actually breathe her out and catch her myself—something I don’t think I could have done without the help of the water! I pulled her up to my chest, she cried right away, and we settled back in the warm water, both amazed at all that had happened. It was 4:42pm, only 20 minutes after I had arrived home!!
My girls were so delighted to help welcome their little sister, and their eyes shown as they stroked her head, and I thoroughly enjoyed the chance to sit back and relax and catch my breath. Being in the warm water seemed to decrease my usual after-birth shakes, and we had a long chance to connect and rest. Rose Marie arrived about 20 min later, and since I hadn’t delivered the placenta yet, daddy and the girls took baby sister to the other room while I transitioned to the birth stool where the placenta came easily. I was feeling good enough (and minimal blood loss!) that I showered quickly, and then cozied up on the couch while our midwife and friends did all the baby checks, and Joel popped a pizza into the oven. Eventually Priscilla went to bring the boys home to meet their sister, and we had a lovely evening rejoicing in our new gift. I had never had a daytime baby, and I couldn’t believe how good I felt and how I was hardly even tired! After everyone had some supper and everything was cleaned up and taken care of, I took our new baby upstairs, and we cuddled up together for the night-so thankful for the amazing experience, and still in a bit of unbelief!
If you’ve followed my blog for long, you’ll know that tongue & lip ties and nursing challenges are a passion of mine, especially after having experienced challenges with all of these factors with several of my own children. I’ve also been in contact with many moms who are struggling with nursing issues or fussy babies, and so many times there is a connection to either a tongue or lip tie (or both!). Recently, a mom shared her story in a Facebook Group for Moms that I’m part of. Her story touches on so many of the factors that I have seen and/or experienced, that I contacted her and asked for her permission to share her post with you all. I am so grateful, as Tanisha covers many factors to consider in her story, and I think it will be beneficial for many moms who might be struggling. If you are struggling with nursing issues, I really want to encourage you that you aren’t alone, and that there are answers out there!! And if you resonate with this story, I would love to hear about your experiences! It can help other moms when they can hear first-hand what worked for others in similar situations.
Now on to our guest post, written earlier this year by Tanisha Gingerich:
**Shared by the author’s permission**
I thought I’d make a post for whoever it might concern, about our journey sofar with tongue and lip ties. They are becoming increasingly common it seems, and I thought sharing my experience might be a good way to bring awareness so that any other moms going thru something similar can benefit from (or add to) what I’ve been learning.
A week post partum, I was scabbed from nursing, and in a lot of pain every time I fed Micoma. She was gaining well, so we probably could have made it work (a lactation consultant can help you and baby work past a multitude of feeding problems), but I knew from experience that although I could “make it work,” my milk supply was going to tank around 4-6 months. Ties can also cause speech, dental, and sleep issues down the road, along with a host of other problems.
So in the interest of short-term pain for the long-term good, I took Micoma in at a week old for a consultation and ended up getting her lip and tongue ties lasered right away so we could begin the healing and retraining process as soon as possible before bad nursing habits were formed.
I cried and prayed over her before they did the 3 minute procedure, and sobbed compulsively while they swaddled her and used a laser to cut the ties open. The woman doing the procedure was a mom too, and was so compassionate and kind with Micoma. Then they left us alone in a cozy room to nurse, and I heaved more sobs as I comforted my baby. Being able to hold and nurse her was probably just as healing for me as it was for her.
Her latch was instantly better. Over the next few days I had to continually remind myself of the long term good, as I did stretches on her wounds. To my relief, the stretches were done in under 30 seconds, and Micoma always recovered quickly… I soon realized she was screaming louder over getting her diaper changed than she was over the oral invasion, so that made me feel better. I told her all the time how brave she was, and gave her every comfort to guide her through the rough patch.
That first week dragged on for me. I hated having to keep stretches in my mind every 4-6 hours even thru the night—got kind of sick with dread thinking about it. I kept Micoma on Tylenol the first 2 days, and again on day 4 when there was a flare up of discomfort. Other than that though, she continued to eat and sleep very normally (not everyone has it so easy, some babies will hardly eat for a day or two, and cry all the time. Thankfully Micoma nursed for comfort, and seemed to tolerate gracefully any discomfort she was feeling). At one week we had a follow up appointment and they said everything was healing well and there was no reattachment. I was so relieved.
By the second week all was routine, and the scars were nearly healed up. Sometimes she wouldn’t even wake up when I did the stretches so I knew they weren’t painful. Currently we have just passed the 3 week mark, which means I can de-escalate the stretches rapidly and they will disappear in a few days. Hooray! One hurdle over. Now on to the next. I had a lactation consultant come at week 3, to help me teach Micoma new nursing/sucking habits. I learned so much!
First of all, babies begin practicing how to suck from week 12 in utero. This is how they build the oral strength they need for nursing. Unfortunately, when a part of their tongue is tied down, they are unable to fully lift and tone those muscles. When they are born and begin nursing, the restrictions to their lip and or/tongue, make it hard or impossible for them to latch correctly or suck efficiently. As a result, nursing is laborious for them. You may hear a “clicking” noise or notice milk dribbling out the sides of their mouth, these are telltale signs. They frequently fall asleep while nursing, just from the strain it, and are unable to properly empty the breast. This can obviously cause low-weight issues, milk supply issues, and severe frustration to the baby. The baby will often resort to chomping or some other measure in an attempt to get milk, resulting it a lot of discomfort or pain for the mom.
But even after ties are released, there is still some work to do. Baby’s latch will probably be better right away, but you’ll need to help hertone her oral muscles and relearn how to suck correctly with the new range of motion in her mouth. I was given a series of simple tongue exercises to do with Micoma every day… they are more like games, and activate her reflexes to get her tongue moving, especially in the places she’s not used to lifting it.
Now, to back up a bit, there are two kinds of ties—lip ties and tongue ties. I’ve also heard of buchal ties (cheeks) but know very little about them at this point. A lip tie is easiest to spot (example of one in comments) and if a lip tie is present, a tongue tie is almost always present too—they tend to go hand in hand. Keep in mind that some care providers are not trained to look for *posterior* tongue ties (these are in the back of the mouth and not as obvious as anterior ones), so those often get missed. Ties vary in severity (where they are attached and how drastically they are affecting function of the lip/tongue. Sometimes it may be negligible).
Next thing I learned, tongue tied babies are notoriously “tight.” The tongue sits at the very top of the spine, and if there are restrictions in the tongue, you will see restrictions all the way down through the body. Sure enough, Micoma is very tight in her shoulder/neck area, has over compensated for it in her lower back, and has tight hips. Once again, I was given a series of simple rhythmic motions and stretches to loosen those areas up and bring everything into alignment. She has a bit of a “C” shape curve when she lies down, that’s another common sign of tongue-tie related tightness. (Pic in comments) I wish I would have known this with my oldest daughter Verona. She was incredibly C-shaped, and these stretches would have loosened up her uncomfortably tight muscles.
Looking back, both of my children before Micoma had ties of some kind. I always had to use a nipple shield with Verona, and I remember Benny getting so angry when I nursed him. My supply going down around 4 months was another telltale sign. Both children despised tummy time, which was most likely because of how tight they were in their neck and lower back. I suspect “ties” is some of why they slept so poorly and aggravated colic symptoms early on… In-efficient nursing brings more air into the stomach and causes gas discomfort/excessive spitting up. And in a very strange twist of fate, if the tongue cannot reach up to the top of the pallet and rest there while sleeping, the top of the mouth becomes domed, crowding teeth and restricting airway. This can lead to mouth breathing, sleep apnea, and dental issues.
Verona’s lip tie comes all the way down between her teeth, which is why she has a gap between her front teeth. Neither of the children seem to be having difficulty eating, speaking, or maintaining good dental hygiene and structure other than that. So I’ll just keep an eye on them, and only resort to doing anything about theirs at this point if I see it’s going to cause them major problems down the road. But I do grieve the suffering we all went thru with months of screaming colicky baby, and the eventual loss of breastfeeding bond. That pain far surpasses whatever me and Micoma went through the last month in laser-correction and recovery.
So for that reason, I would support moms in pursuing tie-releases if you feel it would be beneficial for your baby. As with everything child-related, there is controversy surrounding the issue—whether ties are really a thing, whether they’re a big deal, clipping or lasering, stretches or no stretches. In my case, I saw enough consequences in my last 2 children that I was willing to believe ties affect quality of life enough to warrant a minor surgery. Lasering has a lower rate of re-attachment and requires no stitches, so I went that route. And the stretches I did because Micoma tolerated them well and I was determined not to let the fibers re-attach while they were healing… and I grilled my caretaker about whether it was necessary, and she says she does see a fairly high rate of reattachment if stretches are not done. Albeit, I did the bare minimum I thought I could be get by with, and with good results. That was my story, you get to write your own. Decide what’s best for your child, whether that’s therapy to work past a tie, or a surgery to correct it, or whatever and don’t let people throw a lot of shame or fear onto you for it.
Currently I am pumping a few times a day and using an SNS (supplemental nursing system) several times a day to stimulate my supply and simultaneously get Micoma the extra food she sometimes can’t get herself. I’ll keep working with Micoma’s body and tongue to get everything loosened up and toned… hopefully within a month we’ll be at a place where she can keep my supply up on her own. In the mean time we’re not goning to go many places this month, just stay home and focus on the task at hand.
Many people take their children to chiropractors pre and/or post tie release for body work. It helps with nursing if your baby is aligned properly. For the time being, since I have bodywork I can do at home with her, I am skipping that… see if I can get by without it. Cranial Sacral therapy is another thing highly recommended… I don’t know, it could possibly be a legitimate thing with babies since their skulls are still un-fused and somewhat mobile, but I have heard of enough occultist ties connected to this practice done in adults that I plan to avoid it all together.
This post was not meant to diagnose or treat any illness. It’s my personal story and some things I learned along the way, left here for people to sift thru and take whatever is for them.
If, btw, you decide lasering is the right option for you (and you are local to central PA), I had a good experience with Dr. Katherman in York. Her office felt like such a warm and caring place to me, and she was on call at all hours if I had questions later. Also, do yourself a favor and hire a lactation consultant. You won’t regret it! Do a bit of research first and find one that people you know have had good experiences with (there are a few bad eggs out there). Again, I had a wonderful experience with the one I found, and I’ll link her website for reference.
The cost to get two ties lasered was $750. I am going to turn it into my insurance sharing plan, but I do not know yet if they will cover it. The lactation consultant fee for an hour and a half session was $175. So it is a good chunk of change. But when compared to the potential costs of not doing it, it is a very reasonable investment.
I hope that’s everything. My mind is still kind of whirling from all the things I’m learning, so this was my way of processing it. Hoping it will be helpful to someone else.
P.S. Out of curiosity, I asked both the doctor and lactation consultant if ties have become more common recently or if they’re just being diagnosed more, so we’re more aware of them. They both said ties are becoming increasingly common. I don’t think even my mom’s generation would have seen very many, so this seems to be a rapidly developing problem. Presumably, Western diet and lifestyle as well as the declining quality of foods (grown from nutrient-depleted soils) plays a role. There seems to be evidence to support that lack of folate and other B vitamins in the early stages of embryonic development contributes to ties forming—or the presence of the synthetic B vitamin folic acid commonly in prenatals and fortified foods. And others say there are indications that genetic mutations (the MTHFR gene) play a role. But no definitive studies have been done, that I know of. Everything is speculation at this point. Someone gave me two articles so I’m linking them below. My midwife gave me some resources to dig into and I’m hoping to do more research to see if this plague is avoidable.
I maintain a decently healthy diet and take quality supplements including methylated B vitamins so it’s hard to believe that was the cause of all 3 children having ties. Except that I was under exponential stress the past few years, and as I understand it B vitamins are created in the gut… if you have bad gut health or are under stress, B vitamins do not form well. So that could be a factor. Like I said, I’m going to keep digging and see what answers I can find.
The first few hours, days and weeks after having a baby are special times to treasure as you recover from birth, transition to mothering baby from the outside, and spend time bonding and adjusting. Being adequately prepared ahead of time can make a key difference in helping postpartum to flow smoothly and successfully. Here are a few tips to consider as you prepare and plan for AFTER baby arrives. Remember that adequate rest, low stress, nourishing food, good support and planning ahead will help you to heal and promote a better overall experience for baby’s first few weeks. It’s important for your physical & mental health to take recovery seriously, and provide your body with the things it needs to continue nourishing a baby while recovering from the demands of pregnancy & birth. You won’t regret being adequately prepared!
Before the Birth:
Consider your support system. Do you have a close friend or family member that would be willing to be a resource to answer questions, let you talk with when you’re feeling low emotionally, or just need a listening ear? Is there someone you can trust and feel comfortable with who could come into your home to help care for the household (especially if there are other children) for a few days or weeks so that you can adequately rest and recover? Is Daddy able to take some extended time off of work? How does support look to you? Do you have some babysitting options?
Meal Planning: consider having some wholesome family favorites stocked in the freezer so you don’t need to think about cooking. Does your church or support group have a plan for after-baby meals? Do you need to reach out to someone to coordinate this? Would you have a friend willing to start a “meal train” after your birth? And just a note to Gentle Delivery clients: if an online “meal train” is something that would bless you, your midwife is very glad to start this after your baby arrives!
Consider stocking up on disposable plates, cups, silverware, etc. in order to simplify clean up and household chores.
Shopping (consider the below suggestions, and try to have these things together before your baby is due):
Immediate Postpartum (first hours after birth)– have these things handy in a basket or box for immediately after delivery.
Newborn Diapers & Baby Wipes
Preferred first outfit for baby, along with a swaddle blanket, socks and hat.
“Adult Diapers” or Depends (or whatever type of pad you prefer for heavier postpartum bleeding).
Comfortable Nightgown or Pajamas that are nursing accessible and easily work for skin-to-skin contact with baby.
Pre-made “padsicles” or perineal ice-packs and/or an herbal healing spray such as this one from MotherLove.
Heating pad or rice sock to help with sore muscles and after-pains.
Rhoid Balm, Tucks or other soothing support for hemorrhoids.
Large Water bottle that is easy to use, to remind & encourage you to drink lots of fluids!
Nourishing foods, drinks and snacks (think bone broth, energy bites, juice, etc.).
First Few Days–since you’ll be resting and nursing and taking it easy the first few days, you’ll want to consider having some of these items purchased ahead of time, and ready to be used during the initial few days after baby arrives, in addition to the items above (which you’ll continue using throughout the first few days/weeks).
Comfortable nursing-accessible clothes and nursing bras (remember that you may go through multiple changes of clothes due to leaking milk, bleeding and/or baby messes!). Comfort is key, since you will be resting and sleeping whenever possible.
Belly Support Binder (can use a Rebozo or scarf, or you can purchase something like Belly Bandit or MamaStrut).
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 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!
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!
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!
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!
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!
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.
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!