home birth

2018 End-of-year Note
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2018 End-of-year Note

Recent & current clients received this letter in December. I’m posting it here to keep readers and followers current with Gentle Delivery as we head into a New Year:

Dear past & present clients of Gentle Delivery,

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Many of my #bornathome babies from 2018!

As the year draws to a close, I want to express my appreciation to each of you for allowing me to work beside you as you have welcomed new members to your family, or are anticipating new arrivals. It is such a privilege to be included in these beautiful times of life, and I am grateful to each of you for your continued trust and friendship.

In 2018 we welcomed many more boys than girls, with the smallest arrival being 7#1oz, and the biggest being 9#12oz. An interesting note is that about 75% of our babies were born in water this year! Lynelle continued to assist me with births this year, until she welcomed her own little boy in September. Since she has been taking a break, I’ve been grateful for the help of several other ladies including Kristina (who has been working with a local doula agency for some time) and Hannah, a midwifery student from the Lewisburg area. My latest birth was assisted by Rose, a long-time friend and soon-to-be licensed CNM!

I also continue to appreciate the help of my back-up midwife, Rose Marie. Having her available to cover when there is a special occasion, or being able to travel knowing that clients have someone local to call in case of emergency is a gift I don’t take for granted!

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Thankful to have such an array of great assistants and back-ups!

Another new feature that I was excited to add this year was connecting with an actual insurance biller who specializes in billing for midwifery care. This will hopefully result in better coverage and faster payment for those wishing to utilize insurance. More info is available at Napier Midwifery Billing.

I’ve enjoyed seeing many of you at the playdates we held every few months! This has been a great way to connect other local homebirth-minded mamas, and will hopefully help to build relationships in the community. I hope to facilitate more of these throughout 2019, so stay tuned for details.

My own family continues to keep me busy, with my oldest two being in 1st & 2nd grade. They attend a small co-op type school each morning, and I’ve enjoyed spending time helping out with some classes there, too. The two preschoolers are trying their best to catch up to their older siblings! We enjoyed several family trips this year, and are trying to treasure this time while our children are little. My husband, Joel, continues to work full time for All-Nations Bible Translation, and he’s been busy this fall finishing up his graduate work online. I am thankful for his support and help in making midwifery work feasible, as without his flexible work schedule and willingness to babysit, there would be no way I could keep up with midwifery responsibilities!

I’m looking forward to meeting a number of new babies already in the new year, and it looks like 2019 will be a busy one! May your new year be blessed, and thanks again for your interest in midwifery and home birth options in Centre County and beyond!

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The Martin Family – Fall 2018

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!

Frequently Asked Questions
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Frequently Asked Questions

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

 

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

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

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

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

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

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

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

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

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