Pregnancy resources

Miscarriage Questions: 10 Year Anniversary Interview Part 3
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Miscarriage Questions: 10 Year Anniversary Interview Part 3

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Interview Pt 3: Miscarriage

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

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

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

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

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

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

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

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

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

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

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

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

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

 

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

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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.

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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.

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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.

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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!IMG_0031

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!

The Return on Your Midwifery Investment
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The Return on Your Midwifery Investment

KeoniThe beginning of October found us celebrating “National Midwifery Week”, and the posts on social media about midwives and the personal care that they provide to so many moms and families got me thinking about the investment that midwifery care requires, on the part of both midwives and clients. Of course, one of the biggest investments that clients make is the cost involved. Sadly, many insurance companies are not willing to cover the costs of midwifery care, especially when it comes to delivering at home. This means that families have to weigh the costs, and determine if they can afford care out-of-pocket.

Oftentimes, it is easy to see the price tag (midwives are good at giving you all the costs up front, so you know what you are paying for at the beginning!), and think that a midwife must be making pretty good money.  But I wonder, have you ever stopped to think about all the “hidden costs” that are involved with midwifery? It’s easy to think that the only time the midwife is investing is the time you are with her…your appointments, your birth (and maybe you’re one that has quick births, so it doesn’t seem like THAT much time!), and a handful of home and postpartum visits. In communication with other midwives, I have realized that many clients don’t realize all the “behind the scenes” time and costs that a midwife incurs in order to offer safe, up-to-date, competent  & individualized care to each of the families she serves. So here’s an attempt to help you realize how much you are actually receiving in return when you choose to invest in midwifery care:

  • TIME: and not just the time you see her for your appointments and birth. On average, I spend about a minimum of 20-24 hours total with a client in-person (8-10 prenatal visits, 3-4 postpartum visits, and the birth…and of course, this amount of hours can be much more than this depending upon many factors!). However, there
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    After-birth paperwork

    are many hours spent on each client that you don’t see: writing notes about your history and ongoing care, filing paperwork for records, birth certificates, & tests, research when clients have questions or develop issues, answering questions via email, text & phone, submitting reports when required, attending state-required conferences, creating handouts with updated information, and the list goes on…

  • ONGOING TRAINING: if you stop and think about it, you don’t want to trust your life and the life of your baby to someone who practiced something 10 years ago, but has never reviewed her training OR has not continued learning, right?? But ongoing training takes time & money, especially when it oftentimes requires traveling for classes. Maintaining current CPR, Neonatal Resuscitation Certification and accumulating the needed CEU’s to keep your NARM certification current, CPM re-certification fees, and regular peer reviews are all ongoing commitments and costs that a midwife must stay on top of.
  • COLLABORATING CARE & NETWORKING: When a client develops a complication the requires more medical intervention, it can take a number of hours to locate medical professionals willing to see them, copy and fax records, contact the proper offices, and obtain referrals.
  • COMMUNITY RELATIONSHIPS: Another aspect of good midwifery care that is oftentimes overlooked is that of having good relationships with the local midwifery community. In order to have back-up arrangements (both for planned trips AND for unpredictable emergencies, which will occur at some point in a midwife’s career), a midwife MUST have a solid relationship with other midwives, and facilitating these relationships doesn’t just happen. Another aspect of community relationships is the side of the local medical community. To facilitate good transports when needed, a midwife needs to have a good relationship with local care providers.
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    Grateful to have good relationships with my back-up and colleague, Rose Marie!

    This translates into taking the time for peer reviews, staff meetings, staying up to date on local situations and politics, taking the time take thank you gifts and notes personally when services are received, and so much more. Having a positive relationship with local hospitals and doctors translates into better, quality care for clients, so it is a very worthwhile investment of the midwife’s time and energy.

  • OFFICE FEES: These costs are more obvious, but real nonetheless. You want to be able to reach your midwife anytime, ASAP, right? So she must maintain cellphone service and a working phone. Then there is the fax service that most medical offices require for sending/receiving medical records. Internet for research, copier for providing records for other medical providers & clients, ability to print forms, handouts, etc. I might also add that most midwives are doing all of their own office work, too, so time to order supplies, keep track of bills, payments, answer inquiries and all the paperwork that is required to run a business has to happen at some point!
  • EQUIPMENT & SUPPLIES: quality equipment must be purchased and maintained in order to provide excellent, safe care. Dopplers, birth stools, testing machines, ability to sterilize instruments, repair of equipment when needed…all of these go into maintaining a midwife’s supplies.
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    Birth supplies ready during a labor

    Medications also need to be purchased in order to always have them on hand (even if you don’t use them frequently, you want your midwife to have them-and many of these items are not cheap!). Keeping emergency supplies to deal with the unexpected is also a real cost, as these things need to be keep up-to-date, which mean some items need to be purchased regularly, whether they are consumed or not.

  • RELIABLE TRANSPORTATION: You want your midwife to be able to get to you anytime…which means she needs a reliable vehicle in working order. Just last month we replaced all the tires on our vehicles, as my husband felt they were getting too thin to count on them during the winter weather. We also pay more to run an AWD vehicle as we have lots of snow & ice in PA. A midwife always needs to keep her gas tank full, and regular maintenance is a must.
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    A flat tire meant new tires for the vehicle had to be purchased ASAP!

    Oftentimes a midwife will routinely drive a separate vehicle to events in order to be able to leave at a moment’s notice, instead of driving with friends or family. This is additional expense she must pay for!

  • HOME & FAMILY COSTS: Another aspect of midwifery life, especially if your midwife has a family, is that of having reliable and available babysitting at a moment’s notice. Meals that can be prepared quickly, or household help during times when mom has missed lots of sleep attending births are also very real costs. A family certainly must work together in order to let mama help other families, and I am blessed to have this type of support from my husband and family. But we do pay for it-bringing in food/eating out at times and getting regular cleaning help are two ways our family has made midwifery life sustainable.
  • ON CALL STRAIN: The last item I will mention on this post is the physical, emotional and mental strain of being on-call. While most midwives stay in this field because they genuinely love serving families as they bring their babies into the world, there is the very real downside of always being on-call. If a midwife has a small, independent practice, this generally means that she is the one who always answers the phone unless she has arranged back-up. No matter how much you love what you do, there is a toll that it takes on your body to always be available. You honestly never know when the phone will ring, and you will need to totally re-arrange your plans and be ready for whatever is at hand, day or night. Most midwives’ friends get used to all plans being made with the contingency of “unless I’m at a birth”, but the honest fact is that sometimes it’s not a birth. Sometimes a client has an emergency right when you’re in the middle of a much-anticipated event, or right as you closed your eyes after being up for 40 hours, or…you name it! I’m not sure how one can put a price tag on this aspect, but it’s well worth whatever your midwife charges!

My hope is that this post can encourage families that they are making a wise investment when they utilize midwifery services, and perhaps give you a greater appreciation for all your midwife is doing to ensure that you receive quality, informative, excellent care. I’d love to hear your thoughts as you’ve read through this. If you’re a midwife, what would you add to this list (I know I haven’t covered everything!)? If you are a client who has benefited from midwifery care, what would you add or comment? Did any of these factors surprise you? Thanks for sharing your comments!

New Resources to Help You Achieve a Healthy Pregnancy, Lovely Birth & Successful Postpartum Recovery!
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New Resources to Help You Achieve a Healthy Pregnancy, Lovely Birth & Successful Postpartum Recovery!

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Some of the resources featured in this post

Hoping for a Healthy Pregnancy, Lovely Birth & Successful Postpartum Recovery? Here’s some resources to get started!

**Note, I am NOT affiliated with ANY of these resources, and I do not receive any financial gain or otherwise for promoting these products!**

As you might know, I love trying to stay up-to-date on current research and information about having a healthy pregnancy and postpartum recovery. I really want to be able to give clients good, solid information, and help them to achieve their desires for a low-risk pregnancy, beautiful birth, and end up with a supported, successful period of postpartum recovery. None of these things just happen, though. It takes concerted effort on the part of mom and her support team, and having some quality resources available to you can make all the difference in the world to achieving these goals!

These days, there are so many resources available, that it’s often hard to know where to start. And so many places have conflicting information, which only adds to the confusion about who to believe, and what is actual fact. Between blogs, articles, mommy boards, books and free advice, you might be wondering just where to concentrate your efforts in getting some basic information.

I have been so delighted to be made aware of some great resources that are available, and the purpose of this post is to introduce you to a few of these. This is by no means an exhaustive list, so if you have more resources to suggest, please add them in the comments so we can all learn from each other!

Nutrition:

This is a MUST READ for all pregnant women, and anyone even thinking about having a baby. Optimal nutrition starts now, and builds a foundation for a healthy mom and healthy baby. Real Food for Pregnancy: The Science & Wisdom of Optimal Prenatal Nutrition by Lily Nichols is the BEST book on nutrition that I’ve read in a long time. She will help you to understand how lacking our standard American diet is in real nutrients, and why so many moms end up with gestational diabetes, high blood pressure & pre-ecclampsia. For all the incredible information, it’s written in a very easy-to-understand style. She will help you understand why you need quality vitamins that utilize activated forms of B vitamins and folate, how much protein and good fats you need, what type of salt your body actually needs, how to reduce your carbohydrate intake, what type of exercise you need, and so much more. There is seriously so much more in this book than JUST nutrition, and your body will reap benefits from applying the information it contains! There is another book by the same author entitled Real Food for Gestational Diabetes that is especially geared towards helping moms to balance their blood sugars and manage gestational diabetes through quality diet changes.

Pregnancy Guide:

Have you seen the old “What to Expect” series for expectant moms? Well, you can think of The MamaNatural Week-by-Week Guide to Pregnancy & Childbirth by Genevieve Howland as a new, up-to-date version from a natural, holistic perspective. It’s great, and I think it should be a standard baby shower gift for every expectant mom (though they should probably have it well before the baby shower, honestly!). With input from a CNM and a doula, this guide goes through all the typical questions you face week-by-week, and gives advice on nutrition, tests to consider (and why you’d do them or why you might opt out), what you should be thinking about and preparing for, and how to go about choosing the right caregiver, birth location and options that are right for you. I love the fact that the book gives great info on home, birth center and hospital options, helping moms to achieve a great birth no matter where their location, but helping them to do so as healthily and naturally as possible.

Exercise:

So, while the other two books I mention touch on exercise, there are also some resources available that FOCUS on exercise. As I’m sure you know, exercise is important during pregnancy especially as you prepare for birth (you wouldn’t expect to run a marathon without training for it, right? We should think the same way about training for birth…), but did you also know that exercise is important for your body AFTER pregnancy? Our bodies go through some pretty amazing transitions as they grow a tiny human from smaller than a speck to 7-9lbs, which pushes our stomach up, our bladder down, and challenges our circulation. And then the baby has to come out…and our internal organs all must shift and readjust, and the muscles are stretched and then must get smaller…which means that there is A LOT of changes and stress for the body to recover from!

You’ve probably read or seen articles that talk about healing from diastasis after pregnancy, and/or about incontinence issues, pelvic pain, etc. that can occur postpartum, which can increase in possibility as you have more children, or have babies fairly close together without a lot of time for needed healing. But did you know there are actually things you can do about these issues? And that there are answers out there which can help you recover from pregnancy, and help you go into and through another pregnancy in even better physical condition than before?

One of the resources that can help is to take a prenatal or postpartum class through BirthFit. I love their motto: Giving birth might be the most athletic event of your life. Train for it. Isn’t that true?? In our area, classes are taught by Julie Kulig, a local chiropractor who uses her extensive knowledge to help moms develop a program that works for them. Her prenatal classes focus more on exercise, diet and birth options, and her postpartum classes focus specifically on helping the body to heal and recover from birth. She helps moms to strengthen their core in the correct way to heal any disastasis recti,  guides you in exercises to tone and strengthen the pelvic floor, and teaches you how to move (picking up fat, chunky babies off the floor, anyone??) correctly so as to prevent injury. I personally took her BirthFit Postpartum class, and have been very excited with the benefits I received…and it was really good for me to realize I was capable of doing more than what I realized I could do when it came to good workouts. You can check online to see if there is an instructor near you, and you can also access a lot of the BirthFit information on their website-they offer online classes, as well.

Now, maybe you don’t have access to a BirthFit class, or have lots of little people around, and wonder how you could ever fit something like this into your life. I get it! I’ve been on the lookout for years for a good, tailored-for-moms exercise program that could be done in 20 min. or less each day. Honestly, there are times in my life where I just don’t have more time than that, and if an exercise program is going to take longer, it just won’t get done. So I was really excited to get ahold of the Trim Healthy Mama “Workins” DVD series. What has been fun is to see so much of what I learned at BirthFit being re-affirmed by Serene & Pearl, only this program is one that I can do at home, and working along with the DVD helps to provide me with more motivation than going at it alone.  Each exercise routine can be completed in 19-20 min, using mostly items you have at home, and they are geared specifically towards moms in the childbearing stage. This means they are specifically targeting pelvic floor strength & core stability, and they include modifications to use during pregnancy, or if you’re just getting started postpartum or in exercising regularly in general. I love their down-to-earth style-it makes you feel like you’re working out with your girlfriends. You can find out more and watch an intro video about the program here.

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I hope you can find some of these resources helpful in your own journey to better health, especially in relation to pregnancy & postpartum! I’d love to hear what you would recommend, so please feel free to share!

Birth Photographers: Local Options!
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Birth Photographers: Local Options!

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!

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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!!

Natural & Nutritious Formula Options: Resources & Info for Families Needing a Healthy Alternative to Breastmilk
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Natural & Nutritious Formula Options: Resources & Info for Families Needing a Healthy Alternative to Breastmilk

Before I had children, I would have said that breastmilk is the absolute best choice for feeding a baby, and that a mom should try everything possible to breastfeed…and that if you tried hard enough, you would be able to succeed. However, once I entered the realm of motherhood, and actually experienced the things I had only previously read/observed/seen, I have learned that ideals are not always reality. My youngest baby just turned 10 months old, and I have once again faced the challenges of tongue-ties, latch issues, lack of sufficient supply, colic, fussiness, food sensitives, and more. Some of those subjects will be material for future posts, but I mention them to give you the background as to what inspired this post. As we have worked through these challenges, my husband has encouraged me that perhaps the things we learned will benefit others, so this is an attempt to do just that!

If you’ve struggled with nursing challenges, you totally understand the emotional roller coaster that is included. For some reason, the inability to feed and nurture your baby via the way in which you were designed to nourish him cuts deeply into our mother-hearts. As we tried one thing after another, I also felt like I was mourning a loss…I WANTED to nurse my baby, and I wanted to feed him the best, and know that I was nurturing him both emotionally and physically. I mean, breast milk is the best, right?!? And on top of those emotions (and who is not hormonal and emotional when you have a baby, aren’t sleeping, and are worried about your baby’s health?!?), there are all the questions about what to do, and if you’re going to supplement, what are you going to use??

This is where I want to help! While I know it can take a while before you can look at your situation objectively, there ARE other options available by which you can feed your baby and know that you are giving him something that is actually going to help him thrive and will meet his nutritional needs. I think that moms in the midst of feeding challenges have enough on their plates that they don’t need to add sorting through all the supplement information on top of it. My hope is that I can give you some pointers, and put some information at your fingertips in order to simplify your quest to figure out what is best for you and your baby.

As I spent time researching different options available, here are the three categories that I would recommend checking out:

  1. Weston Price Foundation Home-Made Formula: (find info here) This is what I used with my second child, who had similar nursing challenges and needed to supplement. At the time of his baby-hood, we lived in a rural area and had access to organic, raw milk from a dairy I trusted. He did really, really well on this formula, and I liked the fact that I knew exactly what was in it, and that it was REAL food. It took a bit to get the rhythm down and purchase all the ingredients, but once the pantry was stocked it didn’t take long to whip it up, and was actually a low-cost option long term. When he reached 6 months he used this formula exclusively until he was eating table foods, and was healthy and happy.  Once I used this, I figured my quest for a good supplement was over, but I didn’t count on the individual baby involved! My current baby could not tolerate it made with the milk I had available, and was also unable to tolerate it when made with goats milk. So the research continued as I tried to figure out how to help THIS baby and his own personal needs…
  2. Mt. Capra Goat Formula: (Info here) As I was continuing to research my options, I came across a number of recommendations for this formula. While it is not made using raw milk, you still assemble it yourself according to a specific recipe, thus allowing you to know exactly what it is in it, and still sticking close to the “real food” ideal. There is a kit available to simplify the process of acquiring all the ingredients, and the Mt. Capra website supplies high quality resources. After my baby didn’t tolerate the goat’s milk, I decided against the investment needed to try this, but it still looks like a really good, healthful option, and I’ve heard that there are many happy, thriving babies using this formula!
  3. European Formulas: I eventually stumbled across the realm of imported baby formulas from Europe. I’ll warn you, they aren’t cheap. And they are powered (that part still bugs me if I think about it long-what about feeding your children REAL food?!?). But they have been a literal answer to prayer for me and this baby. One of my big objections to using traditional formula is the fact that most of them are sweetened using corn syrup solids. Corn syrup!?!? We don’t even eat that ourselves, so why would I feed it to my little baby? And then there are the issues of soy, additives, and the list goes on. So I was amazed when I realized that there are several options of formula available that are made from organic milk, sweetened with lactose, have pre/probiotics, and are soy free. Instead of repeating information about these formulas myself, I’m going to include some links where you can see the brands available, along with their features and ingredients:

I will admit, too, that while powdered formula might not fit my ideal, it has been a helpful simplification to our life! My baby actually really liked the taste, and I happily observed that his diapers were hardly different in texture/smell than the usual breastmilk diapers. At 10 months (he started using formula exclusively at 7 months) he is a solid little guy that is SO much happier than he was before. There are several different suppliers in the US, and I have been happy purchasing from www.buyorganicformula.com.  Their customer service has been excellent, and my order always arrives promptly, and I’d highly recommend checking out their site. If you sign up for their mailing list, they will frequently send you coupon codes that can be quite helpful!

My happy fellow at 9 months!

My hope is that my experience and time spent searching can help to lift the load for another mom wading through her options! May you be encouraged today, and remember that you can still have a special bond with your baby AND know that you are meeting his/her nutritional needs even if you need do it in a different way than nursing.

I’d love to hear your thoughts-and what worked for you. Please feel free to comment with your own resources, experiences, stories and information-it’s great when we can help each other this way. Thanks for your contribution!

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Topics for 2018 & a Give Away!

Since my fourth child arrived in  May, I’ve been pretty quiet on this site! But now that baby has reached 6 months, and life is settling into more of routine, I’m thinking about the new year. Here’s where I need your help: I would LOVE to hear your ideas of what you would like to see covered in future blog posts! I’d like to realize my goal of one post a month throughout 2018, but I could use some input as I try to sketch out a plan for the next year. I often try to post about topics that are relevant & beneficial to my clients, and for families who are considering midwifery care and/or healthful, natural living. So send me your ideas, and topics you would like to hear more about!

And here is your incentive: each person who submits an idea (either in the comments below, or on our Facebook post with this same title) will be entered into a drawing to receive a copy of one of my favorite pregnancy/birth related books that was published this year. The Mama Natural Week-by-Week Gide to Pregnancy & Childbirth is a wonderful addition to your pregnancy and birth library. Think of it as a “natural version” of the old “What to Expect” favorite. “Mama Natural” covers everything from nutritional needs, what is happening to baby & mom each week of pregnancy, how to prepare for natural birth, pros and cons of multiple caregivers and birth locations, and so many of the questions that moms wonder about during pregnancy. I think you’ll love it, and if you don’t need it yourself, you just might have a friend that would enjoy it!

So here’s the details: submissions can be entered until midnight on Sunday, December 10, and a winner will be announced on Monday, December 11 (unless a baby changes my schedule-I’m a real life midwife, so there’s always the possibility that I may have to announce the winner later!). Entries can be made below in the reply/comments section, or you can enter by leaving a comment below the facebook post with this headline. I’m looking forward to finding out what you all want to discuss, learn and/or find out more resources about in the next year. Thanks for helping me out!

Feel free to share this with friends, so they can enter too!

Is Homebirth the Right Option for Me?
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Is Homebirth the Right Option for Me?

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

ARTICLES:

BOOKS:

  • 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!

Preparing for birth-some excellent resources!
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Preparing for birth-some excellent resources!

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I love collecting birth resources-be it books, DVD’s, magazines, articles-you name it! The only problem is, with the limited amount of “extra” time I have (or don’t have!), I don’t always get a chance to preview and read the resources I collect right away. And I find myself hesitant to pass along information to clients and friends that I haven’t read or previewed myself.

    This winter I’ve found myself in the remote hills of Arkansas, with more time on my hands than usual, as my husband is teaching at a small winter Bible School for young people. Keeping the children occupied is my main job here, but with the absence of our usual activities and schedule AND having all our meals provided, I’ve enjoyed the chance to finally dig into some of the resources that have been sitting on my shelves at home waiting for me to get to them.
    So, with that introduction, I want to mention a few EXCELLENT resources that would be worth any of you expectant moms, or anyone wanting to learn more about birth, to take time to watch or read. I can’t believe I’ve had these around this long and didn’t realize what treasures they were!
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The first one I’ll mention is the Parent Class DVD by Spinning Babies teacher Gail Tulley. I’ll confess that this one I have recommended to clients as I’ve taken one of her classes in person myself, and know she has alot to offer. But I didn’t realize how many jewels were in this educational presentation! It was a great refresher to me as a midwife, as Gail does and excellent job of teaching you how to help “make room” for your baby in your pelvis, and help your entire body to function more efficiently with less discomfort. The only drawback with this DVD is that, while she is teaching this class to a participating group of expectant couples, she does get fairly technical with some of her explanations. But in the long run it is helpful, as I think it helps you to get a better idea of WHY some of her positional suggestions and exercises help to eliminate certain issues. Using a great variety of teaching aides, examples, charts and object lessons, Gail shows you how exactly the uterus, baby, brain and body all work together, and how you can help. This would be great DVD for an expectant couple to watch together, or for any midwife or doula to watch in order to give you some great ideas of how to help your clients through specific issues and achieve better positioning for babies. It is well worth the $ you would need to invest, in my opinion! You can find out more about Gail, and purchase this DVD here.
    Next in my pile of resources was a book by Ina May Gaskin. If you’ve been in the childbirth realm long, you’ll recognize this name as one of the most famous midwives in the USA. Ina May has been practicing since the 1970’s, and is probably most well known for her involvement with births on “The Farm” in rural TN. People have come from all over the world to have their babies in this community that has come to be known for it’s amazing work with natural childbirth. I’ll admit that while I’ve appreciated many of the things I’ve read or heard taught by Ina May, I was still a bit skeptical of her book “Guide to Childbirth”. I think I was expecting it to have a real “back to earth” or “hippie” type flare, which I know can turn off families who are looking for evidence-based and scientific information on preparing for birth. I was in for a big surprise! Ina May’s Guide to Childbirth has been amazing. Written in an easy-to-read manner, it is full of so much helpful information. Starting with birth stories to help women realize that birth is both natural and do-able, it then proceeds to teaching you about the things you really need to know about how your body works, how to care for yourself during pregnancy, how to understand tests and the “whys” behind them, helpful suggestions for choosing both caregivers and birth locations, ways to prepare for labor, and the list goes on. I love her honest, down-to-earth style of writing, yet all of her information is based on evidence, research, and studies, and she includes citations and information for further study. If you are wanting just one book to help you understand pregnancy and prepare for birth, this one is it. And it’s not just for moms planning to birth at home-there is information in this book that would help anyone to be better prepared and ready for the amazing experience of labor and delivery.
    The last resource I’ll mention here is a DVD that was given to me by one of my clients. She had purchased it during her last pregnancy, and wanted to pass it on to other moms when she was done with it. “Practicing for an Active Birth”  is basically a childbirth class presented by Instructor Neri Choma by Birth Coach Method. While Neri could probably be a bit more dynamic in her teaching style (I’d suggest watching 30 min. at a time-the DVD is about 2 hrs. and 15 min. long), she does a very good job of helping  you to understand the process of labor and the terms used to talk about each stage, and gives couples LOTS of great position and relaxation techniques. Using charts and models, she helps you to learn how to visualize what is happening during each stage of labor, and how you might be able to help facilitate comfort and relaxation during each stage, working together as couples. While I think that it is best for couples to take a live childbirth class whenever possible, this would be an excellent option for those who might not have that opportunity in their area.
    I personally feel like much of preparing for a great labor and birth involves understanding how your body works so you are not tensed with fear of the unknown. If you KNOW what is happening, understand WHY you are experiencing certain sensations, and have IDEAS for what to do and when, you and your partner will be able to relax and work together much better. Moms (and dads!) that are prepared tend to do much better emotionally and physically through the marathon of labor. I would strongly recommend you look into any or all of these resources as ways to prepare for a wonderful experience of bringing your baby into the world.
    I’d love to hear about what worked for you. Do you have any favorite resources you would care to share with others? Tell us about it in the comments! And consider sharing  this post with your pregnant friends to help them hear about ways they can prepare for labor and birth from the comfort of their own home.
2016 Highlights for Gentle Delivery
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2016 Highlights for Gentle Delivery

What a year 2016 turned out to be! I’m very thankful for the many clients I was privileged to work with, and for the many special memories that were made. When it comes to births, 2016 was extremely unpredictable, and I’ll be thankful if 2017 isn’t quite as adventurous. We had one very early baby, one very late baby, a set of twins, a baby that came so fast we didn’t make it in time (!), and about everything in between. 🙂

A few highlights and items of interest from the past year:

– Great birth team and back-up midwife:

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Rose Marie, Lynelle & Myself with twins!

I was grateful to have the ongoing help of my current student, Lynelle Martin, as well as the help, support and back-up services of Midwife Rose Marie Spicher. These ladies are great to work with! Since relocating to PA several years ago, I have really missed the network of midwives that I used to assist and work with, and Rose Marie has been such a blessing to fill this niche. I’m grateful to know that clients are in caring, capable hands during the times I need to be off-call or out of town.

 

– Opportunities to further my education: Attending one day of Midwifery Today’s International Conference in Harrisburg, PA was a great way to meet up with other

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Bridge Certificate 

midwives, listen to lectures on issues and complications during labor, and make new friends in the midwifery world. I also had the opportunity to attend the Midwives Alliance of PA Educational Retreat, where we spent two days learning about a variety of subjects such as congenital heart defect screening, perinatal mood disorders, atypical findings in newborn exams, and more. Updating my Neonatal Resuscitation Certification and CPR at the local Mt. Nittany hospital is always a great way to get better acquainted with the closest hospital in my area, and I enjoy the learning opportunities these occasions afford. Finally, towards the end of the year, I submitted the needed proof of 50 hours of continuing education credits in certain areas (pertaining specifically to emergency and complications during labor and immediate postpartum) and applied for and received my “Midwifery Bridge Certificate”. This ensures that my education and training as a Certified Professional Midwife are also up to the standards set forth by the International Confederation of Midwives to ensure competent and qualified care for women.

– Addition of CCHD screening at postpartum home visits: 

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Trying out the Pulse Oximeter

One new requirement for midwives providing out-of-hospital births in PA is that of submitting Critical Congenital Heart Disease screening result along with newborn blood screening test. This year Gentle Delivery added a Pulse Oximeter to our kit, and we’ve been successfully performing this test on all of our babies since this fall. We’re happy to be able to try to offer our moms and babies a full range of services-did you know that free hearing screenings are also now available for our clients?

 

– First Public Event: “Birth Expo 2016” & “Why Not Home?” Film Screening 

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Celebrating Birth Expo 2016

We are attempting to help educate the public on the full variety of choices they have locally when it comes to birth-this includes support (such as doulas), care providers (CNM’s, CPM’s and OBGYN’s), choice of birth location, and resources that help them to succeed in parenting (such as breastfeeding and babywearing). With these thoughts in mind, Gentle Delivery hosted the first “Birth Expo” for Centre County in July 2016. We were very excited about the support of over 30 businesses and birth professionals that came together for the day, and we’ve received alot of positive feedback from parents who found out about resources they didn’t know were available in this area. Viewing the new film “Why Not Home?” also provided a way for more families to hear about the option of home and midwife-attended birth. The big question now is whether to host something similar in 2017…if we did, would you be interested in helping to make it happen? Please contact me with your interest!

– New Resources in the Library

The library in the prenatal office continues to grow, with more books and resources added in 2016. Some of my personal favorites include “Redeeming Childbirth” by Angie Tolpin and “Your Best Birth” by Rikki Lake. Check out the list of Recommended Reading  to see all of the titles available for clients to check out.

– Gift bag for Newly Expectant Moms 

Helping moms to connect with local support services and resources is something we are passionate about! Due to being located in a university town, many of the families we interact with don’t have any family or previous connections in the area. One way we have attempted to help with this is by giving each family who comes in for an initial interview a free bag full of samples from natural-minded companies, coupons, and lots of cards, brochures and information from many area birth professionals and mommy/baby-centered support groups and businesses. If you or your business would like to be included in this welcome bag, send us an email or message and let us know!

– Our own special gift to new babies… instagramcapture_ee2d01d4-3eb4-45ec-8440-8612375dcf01

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And while not necessarily “important” news, we’ve had fun giving our babies in 2016 special onesies to commemorate their big event! I have fun taking the time to make each of these little shirts for our babies, and clients in 2017 can also look forward to this little “thank you” gift that we pass on to our families.  img_0348

Thank you for allowing us to serve you all in 2016, and blessings to each of you as you head into the new year! Remember, too, to follow this blog for future updates, “like” us on Facebook to receive current info and informative articles (Gentle Delivery), and watch for our photos of new arrivals on Instagram @gentlemidwife . We’d love to keep in touch!