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!
For clients of Gentle Delivery, you know that routine Group B Strep testing is offered to every expectant mom in accordance with the ACOG standards of care. While the pros and cons of testing and subsequent treatment plans are discussed in detail elsewhere, the purpose of this post is to help you to minimize your risk of developing Group B Strep colonization during pregnancy, thus promoting better health for you and baby (and increasing your chances of obtaining a negative test result!).
If you are interested in researching Group B Strep info, I’d strongly encourage you to read Aviva Romm’s article: Group B Strep in Pregnancy: What’s a Mom to do? You’ll find clear explanations of GBS, risks and benefits of antibiotic treatment, and tips on promoting health. This post by Wellness Mama also includes further links for study along with Katie’s suggestions for avoiding GBS colonization with natural methods: How I Avoided GBS Naturally And finally, this article provides a few other options to consider while making decisions on prevention and treatment: Decrease Your Chances of GBS
As a practicing CPM in a state that does not offer licensure, I am currently unable to offer IV antibiotic treatment to GBS+ clients. This increases my desire to do all I can to help support a mom’s immune system and decrease the possibility of a GBS+ test result, as it greatly simplifies the care protocols and necessary decision making for clients and their families!
So here are the primary suggestions for making your vaginal flora inhospitable to Group B Strep:
High Quality Probiotics (if not started early on in pregnancy, then beginning at 28-32 weeks orally, adding vaginal support at 32-34 weeks)
“Many species of Lactobacillus have been shown to be beneficial to the vaginal flora; Lactobacillus reuteri and Lactobacillus rhamnosis are species known to be especially helpful for supporting healthy vaginal (and bladder) flora, while these and others, including L crispatus and L. salivarius strains, have been shown to to inhibit the growth of vaginal pathogens including Gardnerella vaginalis and Candida albicans, and also reducing the frequency of bladder infections in addition to vaginal infection.
In one study, 110 pregnant women at 35-37 weeks of gestation who were diagnosed by GBS culture as being GBS positive for both vaginal and rectal GBS colonization were randomly assigned to be orally treated with two placebo capsules or two probiotic capsules (containing L. rhamnosus and L. reuteri ) before bedtime until delivery. All women were tested for vaginal and rectal GBS colonization again by GBS culture on admission for delivery. Of the 99 who completed the study (49 in the probiotic group and 50 in the placebo group), the GBS colonization results changed from positive to negative in 21 women in the probiotic group (42.9%) and in nine women in the placebo group (18.0%) during this period. The researchers concluded that an oral probiotic containing L. rhamnosus and L. reuteri could reduce the vaginal and rectal GBS colonization rate in pregnant women.
In another study involving 57 healthy pregnant women, L. salivarus was taken daily by the 25 GBS positive women in the group from weeks 26 to 38 of pregnancy. At the end of the trial (week 38), 72% and 68% of the women were GBS-negative in the rectal and vaginal samples, respectively. The researchers concluded that this seemed to be an efficient method to reduce the number of GBS-positive women during pregnancy, decreasing the number of women receiving antibiotic treatment during labor and birth.” (copied from Aviva Romm’s article here)
In light of these studies, and knowing that probiotics are vitally important to the health of both mom and infant for a variety of reasons, supplementing regularly with probiotics during pregnancy can be beneficial in more ways than one. For GBS specific support, it’s recommended that you begin supplementing orally at 28-32 weeks (though earlier is even better!), and then increasing your oral dosage and consider using a probiotic vaginally for at least 2-4 weeks before your Group B Strep test (and then continue the oral support through the rest of your pregnancy).
As you shop for probiotics, pay attention to the different strains it includes, as not all probiotics are created equal, and they will be most effective against GBS strains if it includes L. Rhamnosus, L. Reuteri and L. Salivarus.
Some brand suggestions that other midwives have given me are:
Eating a diet high in fermented foods/drinks (kefir, sauerkraut, kombucha, yogurt, etc.) help to promote a healthy gut flora.
Eliminating sugar and simple carbs are also effective in promoting beneficial gut flora.
Add 1-2 tbl of coconut oil into your daily diet for it’s antibiotic properties, specifically in the few weeks prior to testing.
Apple Cider Vinegar consumed daily or in capsule form may be helpful.
Consuming 1000-2000mg of high quality vitamin C daily (in divided does) can help to increase your body’s immune response, which makes it more difficult for unhealthy microorganisms to grow. You can begin this regimen around 30 weeks.
Garlic/Allicin (active component of garlic)
Garlic has been used as an antimicrobial agent for generations, and for good reason. However, high doses of garlic can cause blood thinning, so I don’t recommend staying on high doses of garlic or allicin after obtaining your GBS test. But it is a treatment to consider to reduce the possibility of GBS colonization before getting tested. Currently there is a midwife practice conducting a study where participants are instructed to use Allicin Gel 2x daily for 12-14 days along with ingesting 180mg of Allicin capsules 2x daily for 12-14 days prior to testing. The basis for this study is from a preliminary study done in 2009 where Allicin was shown to reduce the possibility of early rupture of membranes and chorioamnionitis, both of which can be complications of GBS infection. Other methods of using garlic include: taking garlic capsules daily, consume raw garlic daily, and/or insert a raw garlic clove vaginally at night before going to bed.
While we still have a lot to learn about Group B Strep (how exactly it is transmitted, best ways to treat it, and how to prevent it from the beginning), and while there still seem to be a few moms who naturally carry Group B Strep bacteria in their vaginal tract no matter what they try to do about it (antibiotic or otherwise!), one of the benefits of utilizing these suggestions is that they promote health for mom and baby regardless of the GBS presence (or lack thereof). While obtaining a negative Group B Strep test does eliminate a certain amount of worry, risk and decisions, the benefit to your body of increasing the good bacteria and gut flora through healthy foods, probiotic supplementation and other factors may provide long-term benefits that you will see later on. I’d highly encourage every pregnant mom to consider these suggestions, and wish each of you a healthy and safe pregnancy and birth!
I’d also love to hear: did you try any of these prevention methods? How did it affect you and your GBS status? Did you test positive in one pregnancy and then negative in another? What was most beneficial for you?
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.
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.
It’s hard to know where to start with Darius’ birth story, as there were several starts-and-stops along the way during the last week or so of my pregnancy. Joel will shake his head and say something along the lines of “shouldn’t a midwife know when she is in labor?”, but once again I had trouble figuring it out.
To give some background (especially if you’ve read my previous birth stories), we had used our dear friend Rose as our midwife with our girls, and she ended up being the first one on the scene after Matthias was born (she was home on a school break THAT weekend, and our midwife was on her way from Lancaster, but Matthias came in a hurry-read his birth story here). We love her, but due to a variety of reasons (especially the fact that Joel has no desire to ever catch one of his own babies again) we decided that this time we needed to use a midwife who lives closer to us. In the past two years I have been blessed to meet and work with Rose Marie Spicher, a midwife who lives half an hour away, and who worked for years in TX (where I did my midwifery training). She provided the “mothering” care I needed throughout my pregnancy, and it gave Joel a sense of relief to know she wasn’t too far away. With me being on maternity leave the month of May, and the fact that everyone else was expecting in May as well (I have NEVER received so many inquiries for one particular month!), I was just hoping that she wouldn’t be tied up whenever our baby decided to come!
So fast-forward through all the months of sickness, fatigue, finding out that we were expecting a baby brother (the children are still certain this was a direct result of their prayers, as I was convinced it had to be a girl given how sick I was!), and everything else until the beginning of May. By early May I was reaching that totally-done-being-pregnant stage where I wasn’t sleeping at night, having lots of cramps & contractions, felt extremely emotional all the time, and we were wondering just when this little fellow would decide to make his appearance. Between 34-36 weeks I was experiencing enough cramps and contractions to know I needed to take it easy, and once we hit 36 weeks I had a couple of times where I thought perhaps we were getting started-I distinctly remember one night when I couldn’t sleep because of contractions, so Joel & I slipped outside to take a walk in the moonlight. It would have been so romantic if I hadn’t been so uncomfortable! But everything always fizzled away, and left me feeling tired and discouraged.
At this point we were preparing for a visit from my parents, who live in Kansas. My sister had her first baby the month before, and my mom wanted to come out to help her over the time my brother-in-law was graduating and they were preparing to move. So she flew into northern PA, spent a few days with my sister, and was then joined by my dad. The plan was that they would drive down to see us before they headed back to Kansas, and of course we hoped that baby would arrive before they left, though we knew it was entirely possible that he would wait until they were home again. However, with all the early labor signs I had been experiencing, I’ll admit that I was getting my hopes up! Mom & Dad planned to arrive on Mother’s Day, and the night before I was trying to encourage things along, and ended up with a night of contractions with no baby to show for it. Everything was regular enough that I actually called my midwife to give her a heads up, but then it all petered out.
Mother’s Day 2017
I really had to work through the disappointment of knowing that perhaps my folks wouldn’t get to meet their grandson on this trip. We didn’t know when we would be seeing them next, and I hadn’t realized just how much I had my heart set on them getting to be here to see MY baby while he was new and tiny. It took some talking, praying, crying and processing with Joel to get to the point of being okay with the fact that perhaps this time with mom & dad was to be spent enjoying their company and not stressing over whether baby was here or not. So for the next few days, my parents helped to take my mind off of waiting for baby, and we enjoyed some lovely family time at the park, taking walks, picnics, a backyard barbeque, and some time for Joel & I to be together while our children were cared for.
The last night of their visit, they took our two oldest children back to stay the night with them in their cabin. In the interest of full disclosure, I had taken some castor oil in the afternoon, knowing full well that there was a good possibility nothing would come of it, and yet hoping that perhaps it would give my body the nudge it seemed to be waiting for. I was NOT going to get my hopes up, though, and I tried to just go to bed to get some sleep. I think it was around midnight or 1am when I woke up with a contraction, and yet I tried to sleep, as it sure wasn’t the first time that random contractions had woken me up at night! After an hour or so of not really sleeping, I figured I might as well get up to see if moving around made them go away or get stronger.
Joel sweetly got up with me, and fixed me sourdough toast with strawberry jam-his mom had given me jam and sourdough bread the week before, and it was becoming a regular midnight tradition to eat a piece when I couldn’t sleep! After another hour or so, Joel commented that these contractions seemed to be pretty regular and close together. I did NOT want to give another false alarm to anyone, and didn’t feel sure that this was anything more than what had happened on previous nights. Looking back, they were coming close together (every 2-4 minutes!), but they weren’t very intense, and they didn’t last long, so I wasn’t convinced they were doing anything. With my previous babies, my water had always broken either before labor began or at the start of active labor, so I kept waiting for that to be the clue that this was the “real thing”.
At 4:00am, Joel really felt like we should call Rose Marie, as he said he thought this seemed more serious, and he did NOT want to wait until it was too late! So I called Rose Marie, and I told her I still wasn’t sure this was “it”, yet Joel would feel better if she came, but she didn’t need to rush. The contractions were starting to get a bit more of an “edge” to them that took my breath away, but I still felt like I could make myself talk through them, though I preferred not to. Another sign I should have paid attention to!
Within 15 min of calling Rose Marie, all of a sudden things kicked in with a vengeance. Up till now I had still been puttering around, but hadn’t gotten birth stuff out yet, as I had gotten it all out and then had to put it all away a few nights before. I wanted to make sure I was in REAL labor before getting everything set up again, and figured I could do it in between contractions as a distraction. Well, that’s not how things happened. Labor went from being “not sure this is it” to “we’re in seriously active labor” in a few minutes! Joel called Rose Marie back and told her to step on it, and then he promptly called Lynelle (my birth assistant who was planning to assist Rose Marie with our birth-she lives less than five minutes away) and told her to come. I think it was around 4:30am when Joel called Lynelle, and boy did she know how to get over to our place in a hurry! Joel said he has never in his life been so happy to see Lynelle walk into a room, and it was just in time.
By this point my contractions were one on top of another, and I felt like I didn’t have any time to collect myself, catch my breath or get a break in between. Joel kept encouraging me to breathe through them (he didn’t want me pushing!), and I was leaning over the birth ball squeezing his hands for all I was worth, just praying that God would make it stop so I could catch my breath. Lynelle quickly realized things were serious, and started pulling all the birth supplies together. All of a sudden I told them there was no way I could keep from pushing any longer. It had been taking everything I had to blow through contractions, and I was done. I distinctly remember saying “you all are just going to have to catch this baby ‘cause I can’t keep him in any longer!” Lynelle calmly replied that everything was okay, and with the next contraction my water broke. Now I can laugh about it-that was the clue I had been waiting for all along to tell me if I was actually in labor! With the next contraction Lynelle could see his head, and she did an awesome job of coaching me through as I tried to breathe him out. Right at the point his head was delivering, Rose Marie walked in the room! Lynelle started to move out of the way, but Rose Marie just smiled and said it looked like she was doing a great job, so she might as well continue. Rose Marie guided Lynelle through the rest of her “first catch”, and the official birth time was 4:56am.
Those first moments after birth…
I can still remember the absolute relief that comes from being finished, and laying down with my baby on my chest. He cried just enough for us to know he was great, and then he snuggled on my chest, and we all exclaimed over his head full of strawberry blonde hair-that was a surprise! We had a really special next hour or so as we reflected over the crazy labor, the special-ness of the unplanned “first catch” for Lynelle, Rose Marie’s perfect timing, and Joel’s relief that he didn’t have to do this birth alone. We had invited another family friend to be present at the birth, and sadly she didn’t make it time, but her sweet & joyous spirit added to the atmosphere in the room as Joel fixed breakfast and baby Darius had his first meal. Thanks for coming, Mary!
And then it was SO amazing to call my parents and tell them that their grandson had arrived! Having them able to bring our oldest two over first thing that morning was so special. They were able to watch the newborn exam, meet our midwives, and see the children as they delighted in meeting their new sibling. It was the “icing on the cake” to have them around, and able to snuggle their newest grandbaby that morning, before they had to leave that afternoon to catch their flight home.
Yoanna & Matthias and Grandma & Grandpa meeting baby Darius. Yoanna was delighted to help Lynelle give him his first bath!
We had struggled with finding the right name for our little guy, and settled on Darius Rafael just a few weeks before his birth. Darius means “Upholder of Good” and Rafael means “God is Healer”. It is our prayer that our little son will grow into a man who does good, and is used to provide God’s healing to others. He checked out at 8# 10 oz, and measured 20 in long. Matthias was absolutely delighted to have a baby brother, and they continue to have a special relationship as brothers.
Here’s a few more snapshots of Darius’ “birth” day…enjoy this glimpse into our little family’s life, and feel free to check out the birth stories of our girls, Talitha & Yoanna.
Big sister Talitha was pretty excited to wake up and find that baby brother had “come out!”
Rose Marie checking baby out
Our amazing birth team-thanks so much for everything!!
If you’ve been following the Gentle Delivery Facebook page (go like and follow here), you’ll remember seeing some photos this month of adorable newborns. April has brought some really cute babies! And there is something so precious and amazing about how these babies look in the first minutes and hours that can’t be captured at any other time. I am personally SO grateful for the dear ladies who took photos during those initial moments with my babies (one of my highlights of my baby born last year!), and it’s been something that I wish more women could have access to.
However, when I moved to State College, I was quite surprised to find out that birth photography itself isn’t a “thing” in this area. There are some great photographers willing to do newborn and “Fresh 48” sessions, but there’s not options for the mom who wants professional photos taken immediately before, during and after delivery. Now, to be fair, birth photography is a challenge-you’re asking someone to be on call, drop what they’re doing whenever you call, and to commit without knowing when, how long, and all of those details that make planning challenging.
But today I’m delighted to introduce you to some local options for birth photography that have very recently surfaced in this area! So, if you’re interested in hiring a photographer for your birth (one that can take lovely photos instead of the inexperienced shots that your midwife and her assistant get!), hopefully this list can help you by giving you some leads. If you’re wondering what all is possibly entailed in having a birth photographer at your birth, or what types of photos, etc., I would highly recommend you check out the sites of a few birth photographers that work in other areas of the country. A few of my favorites are T. Marie Photography , Monet Nicole, and Lyndsey Stone.
Catherine Malizia:Catherine recently contacted me, telling me of her interest in the area of birth photography. She stopped in my office for a visit, and I had a delightful time chatting with her and hearing about her vision to capture the amazing and special moments of birth for families. She is acquainted with birth in various settings, especially after spending some time serving with Midwives for Haiti. I think Catherine would do a beautiful job of respecting a family’s space and wishes in a birth setting-she definitely had the type of rapport that I think many moms would connect with. If you’re interested in hiring her, I’d recommend getting in touch and asking questions…she may be running some specials as she gets her “birth side” of her photography business off the ground! Besides her website (linked in her name), you can also contact via email: catherine@CatherineMaliziaPhotography.com
Denae Vigilante: Denae also works as a doula with the Doulas of Central PA agency. I had the privilege of attending a birth with Denae, and was impressed by her kind, gentle mannerisms. Birth photography is something Denae is doing more of these days, and you can check out some of her albums on her website!
Photo Credit: Denae @ Vilgilante Photography
Sara Blose: Sara has recently joined the State College community, and is exited to offer the option of birth photography to her photography options beginning with due dates in November. I’m looking forward to meeting Sara in person, but am glad that there is yet another option for families in this area.
Are you planning to hire a birth photographer for your birth? Or are you local to the Central PA area, and you used a birth photographer? I’d love to hear about your experiences, how you chose your photographer, and what you’re looking forward to the most, or what you appreciated the most about utilizing a photographer. I’m sure other families would love to hear of your experiences, too, so thanks for sharing!!
In January, I received a request from a photo-journalism student at Penn State, who wondered if she could photograph me and some “cute babies” for a project. The day after she emailed, little Brielle made her appearance, and Brielle’s family graciously gave permission for Baidi to join us at their home for the second half of their home postpartum visit. Baidi was absolutely tickled to get to see a brand new baby, and gave us all the gift of numerous photos of our time together. For those of you who have wondered what a typical postpartum visit looks like, here’s your peek!
Generally, this visit takes place sometime between 24-48 hours after delivery, as the required tests need to be performed during this window. First mom gets attention, and we talk about how things are going, any issues/concerns, and make sure her physical condition is within normal limits. Then mom or dad checks over the birth certificate info I bring (double checking spelling and any details) while baby gets checked over.
If baby is happy, we start with the pulse oximeter screening for congenital heart defects, a newer requirement in PA for all babies.
Then comes an exam, where baby’s heart rate & respirations are listened to, skin/cord/eye condition are noted, and overall condition is assessed.
Next, baby is weighed in preparation for the newborn metabolic screening (current weight must be listed along with birth weight). Here you can see daddy holding the baby while the blood samples are collected-our hope is to keep the baby feeling safe & secure throughout the experience!
Lastly, baby is snuggled and we go over any other questions or concerns. All the necessary paperwork is gone over and a copy of the newborn exam and newborn screen info is given to the parents for their pediatrician. And all of this without the family needing to leave their own home!
A big thank you to Kelly, Daniel & Brielle for their willingness to share this experience with you!
As a midwife providing home birth services, I hear this question frequently. It is my goal to provide families with the information they need in order to make the right decision for them-home birth is not for everyone, just like hospital birth is not for everyone! Ultimately, the choice of where to give birth and which care provider to use is the responsibility of the parents seeking such services, and it’s my desire to assist you by providing accurate information that can assist you in making this decision.
Since this question is one of the foundations of whether or not to pursue working with a midwife and planning towards a home birth, I thought it might be helpful to provide links and resources that may help you in determining the answer to this question. As always, I am happy to sit down and talk with anyone who wants to ask specific questions and discuss their options in person, but I know that many of you would like to gather some more detailed information before a formal meeting. Thanks to the availability of information via the internet, great books, educational videos and more, there are many resources that you can access to learn about the potential risks and potential benefits of midwifery care, and specifically the home birth option.
FILMS & DOCUMENTARIES:
Why Not Home? The Surprising Birth Choices of Doctors and Nurses: This is THE current film on home birth and why some families make this choice…and this film in now available to watch online and/or be purchased for home viewing! From the description on the website: Why would doctors who attend birth in hospitals choose to have their own babies at home? What do they know about birth that others don’t? Join Jessicca Moore, filmmaker and nurse practitioner, on a compelling journey through maternity care in the United States. Told through the lens of doctors, nurses, and midwives, Why Not Home? examines the latest evidence on risks and rewards of different birth settings. The film presents a balanced and accessible view on the latest research, along with moving personal stories of medical practitioners faced with big decisions for their own growing families. Viewers are challenged to move beyond preconceived ideas, and to envision a fresh future for maternity care in America. Watch it here.
The Business of Being Born: This film has been out for a number of years now, but it still contains some great information on birth choices, interventions, birth locations and more. You can watch it free on youtube here.
Natural Born Babies: short video of several moms and dads describing what influenced them to make the choice to deliver at home. Watch here
Your Best Birth: Know All Your Options, Discover the Natural Choices, and Take Back the Birth Experience by Rikki Lake & Abby Epstien. An easy-to-read overview of options available to moms, this book covers all the possibilities (hospital, home, OB/GYN, midwifery care, etc.) and why different options may work best for different situations and individuals.
Ina May’s Guide to Childbirth by Ina May Gaskin. Ina May began her career as a midwife back in the hippie movement of the 1970’s. Since then she has delivered thousands of babies, and has done extensive research in the field of natural birth, and she shares her wisdom in this book. She highlights the need to make a choice of birth location in which the mom feels totally comfortable, be that home, birth center or hospital. Great information about routine procedures, tests, and how to have a healthy pregnancy and wonderful birth experience.
Pushed: The Painful Truth About Childbirth and Modern Maternity Care by Jennifer Block. While not a very positive or light-reading style book, this one can really help you understand how medicalized maternity care has become in our country, and enables you to think through some of the routine policies and procedures that are in place in our countries hospitals. Very eye-opening and thought-provoking.
WHAT MIGHT IT LOOK LIKE?
And finally, some couples wonder about what a home birth might look like. What about “the mess”? How can it work at home, if we’ve only experienced the hospital setting? How do midwives adapt to different settings, positions and environments? How does the medical side of midwifery care happen in a home setting? These videos, pictures and personal stories can give you a glimpse of what home birth with a midwife looks like for some families:
I’d love to hear from you-what helped you to determine whether home, birth center or hospital was the right location for your birth? What resources would you recommend to help other families make their decisions? Feel free to comment below, or send me an email with your suggestions. I love hearing from my readers!
There have been lots of things happening around here this spring, and I thought it would be good to give you all some updates on exciting new developments at Gentle Delivery Childbirth Services. Here’s a brief summary of assorted news items…take a minute to check out what is going on!
Addition of Pulse Oximetry Screenings for Critical Congenital Heart Defects (CCHD):
My new Pulse Oximeter just arrived in the mail last week, and I’m excited to be offering at-home CCHD screenings in keeping with PA legislation. These screenings have been mandatory in hospitals since Act 94 was passed in 2014, and this year midwives are being asked to join in reporting these screening results. This is a simple, non-invasive test that I will perform at the home postpartum visit within 24-48 hrs of your baby’s birth. To find out more about the testing, click here.
Matthias helping me try out the new pulse oximeter!
New Apprentice for 2016!
As some of you know, I’ve been working on confirming a regular assistant/student, and I’m glad to be able to introduce you to Lynelle Martin. You can find out more about her by clicking on the “Current Assistants/Students” page, and those of you with babies due this year will be meeting her as she helps out with prenatals once a month and attends home visits. She recently finished her Neonatal Resuscitation Certification, giving clients the added benefit of two CPR and NRP certified attendants at births.
Midwifery Today Conference:
I’m looking forward to writing up a more detailed report about some of the things I learned as I attended a day of the Midwifery Today Conference in Harrisburg, Pa. I enjoyed lively conversation with Lynelle and Rose Marie (another midwife I want to introduce you all to at a later time!) on the drive down, and was encouraged as I visited with many other midwives from all over the country-including Kathy, the midwife who delivered several of my siblings and was instrumental in getting me started in this field. Midwifery conferences tend to attract an extremely diverse group of midwives (ranging from Amish to Hippie and everything in-between!), and there are so many things to learn from each one. The added benefit is more CEU’s that I am required to get each year in order to keep my certification.
Lynelle, Myself and Rose Marie after a long day at the conference!
YourWaterBirth.com Account Set Up:
I now have an account with Your Water Birth, a business offering affordable waterbirth and homebirth supplies, and if you are a client you can contact me for a code that will give you a 10% discount on your order! While there is a very affordable option in State College for those wishing to rent a birth pool, this company offers a great deal for those wishing to purchase their own pool and supplies. Check them out!
Travel Dates for Winter 2017
Just giving you all a heads up that my family will be taking a 3 week trip to the Midwest from Jan-Feb 2017 in order for my husband to teach at a Bible School for young people. We’re excited about the opportunity, and I will be glad to give you referral information if you are looking for a midwife over that time. For those who like to plan ahead, here’s your chance! <smile>
Advertising Cards Available:
I recently printed up some post-card sized advertising cards that contain contact information, a testimonial and information about the CPM certification. These will be on display at the area kids’ consignment sale at the end of April, but if you would like some yourself to pass out to friends, family and/or local home-birth-supportive businesses, I’d be happy to provide you with a stack!
And lastly, no update is complete without a few pictures of sweet spring babies! Blessings as you enjoy the lovely spring weather that is here at last!
Nothing like a peaceful newborn!
so sweet and tiny
Ready to call it a night and tuck everyone into bed!