Welcome Jack Walker

Another beautiful baby born in water at the birth center. Welcome Jack Walker who was born on January 24th at 5:59 pm. Jack weighed 8’4″ and was 20 inches long. Congratulations to Nicole, Max and big sister Lila!

Welcome Nathan Garrett

Congratulations to Stacy and Mike who welcomed a son, Nathan Garrett on January 16th at 2:45 am. Nathan was born in water at the birth center and weighed 8’14″. He is little brother to Abigail who was also born in a birthing center.

Nathan

Dangerous or Safe, Part III

I’ve talked at length with some really awesome midwives and we’ve all came to the same conclusions and encountered the same problems. There are two major issues with the midwifery profession that seems to be the same whether you’re in California or Georgia or anywhere in between. Both issues stem from the training and nature of what midwives do.

Midwifery seems to draw two types of women – amazing, hardworking women who sacrifice a lot for the sake of midwifery. Most midwives fall into this category and are loving, caring and almost universally express a deep desire, or calling, to do this type of work. On the other hand, the other type of woman borders on what we call the ‘crazies’ – women who have deep-seeded need to be loved and validated through others. You probably know the type – they are the ones that people envision when they think of midwives and become afraid for their daughters. These women might be too odd, too illiterate, too lazy, too you-fill-in-the-blank but they wouldn’t be the ones who could get into medical school or even a good nursing program. Midwifery is an easier path into the health care professions. There typically aren’t prerequisites or degrees required other than a passion and willingness to learn and it can be done fairly quickly compared to nursing or becoming a doctor. Birth is some heady work. There is nothing more amazing than bearing witness to the miracle of birth, new life emerging and taking its first breath. For the unstable, it is an easy draw into what can be a very powerful position that often flies under the normal radar. These midwives NEED the validation that comes with being a caretaker or even worse, the savior figure. These ladies are the ones that I believe Carla Hartley describes in a recent Facebook post.

With birth endorphin and oxytocin levels at all-time highs, women typically become very bonded to the ones caring for them. Robert Bradley, MD talked about this effect and was instrumental in getting the fathers into the delivery room in an effort to redirect their passions back to their husbands. Take someone with a narcissistic personality and you’ve got the perfect birthing cocktail to quench her thirst for being needed, validated and loved.

Virtually every seasoned midwife that I know and respect has had issues with midwifery students. Partly because the crazies can be hard to distinguish until you’ve spent some time with them and partly because the ones who aren’t bordering on the edge of being a good CSI character fall into the other student category – the ‘midwifery is a really cool way to make money’ mindset.

Over the years many midwifery students have passed through my doors. Some have gone on to become midwives, many have not. Sadly a few have ditched the hard work of apprenticeship and gone on to ‘practice’ without finishing their training. These are the scariest and most dangerous of all! One student attended about ten births with me over a 6 month period. After completing a few weeks of midwifery school, she felt she was competent enough to become a ‘spiritual midwife’ which knowing her, I translated as too lazy to do the work, can’t wait that long, my husband wants me to earn money type of midwifery. She hung out her shingle and took on clients. One of her ‘clients’ told me about her birth and the horrors she endured under her care. After a long, arduous labor and against the midwife’s persistence, the client went to the hospital and ended up with a cesarean. It was found that she was experiencing a uterine rupture. Had this woman not listened to her own body and intuition, the results could have been disastrous. As it is, it was another blow to the competency of ALL midwives in the eyes of the medical establishment who cared for the client upon her transport.

I’ve trained some pretty amazing midwives and after many years have come to the conclusion that it really doesn’t have much to do with me or the training I give them. It has to do with their commitment, their drive, dedication and passion combined with a stable homelife and supportive family. I don’t make great midwives; great women learn to be midwives! Wonderful women like Debby Hervey, Lisa Showalter and Jeanne Anderson who I am honored to have been part of their midwifery training. These three women exemplified what it takes to be a good, or SAFE midwife. Secure in who they are, they didn’t need midwifery to make them feel more important, they understood what dedication entailed, they were willing to do the hard, tedious tasks and put in long, hard hours in spite of long drives and physical ailments.

On the flip side I’ve had students who gave many excuses why their coursework wasn’t completed. It’s hard work for sure. I spent nearly 30 hours a week reading, studying, answering questions and writing papers when I was training to be a midwife. I had four children at the time and was homeschooling as well. Often I would sit on the floor with my toddler playing and infant nursing reading a midwifery textbook. Each night my family would go to bed at eight and that’s when I would begin my computer work, answering questions and writing term papers until midnight. I know it’s not easy, but it can be done if you’re determined to do it and are striving to be a SAFE midwife. One midwifery student spent two years giving me every excuse possible why she couldn’t get her coursework done and finally asked me if I could just sign her off without her doing the work. It was silly of me to think that after two years things would change and she’d step up to the plate of responsibility. Instead she was looking for entitlement and handouts, neither of which I was willing to give her. The final blow was asking to be paid for the privilege of catching my clients babies in order to get her numbers. Another student out my door – another student now playing midwife, taking clients for pay and not willing to do the hard things required to provide the best possible care.

I wish I had answers in how to deal with these problems. Don’t tolerate their bad behavior and you’re labeled as mean. Attempt to hold them accountable and you’re accused of being a bully. I agree with Carla Hartley’s statement, “I am convinced that the only way to eliminate a dangerous midwife is to educate parents so that they ask the right questions and choose their birth attendant carefully. After a while, the dangerous midwives’ business will decrease and people will be choosing someone else. Then she will have to decide to change or quit.”

So I will continue to educate women and families to ask the right questions. Don’t be afraid to ask about training, experiences, transport rates, etc. The internet is also making it easier to get referrals and learn about problem midwives. Even a good, safe midwife can’t please everyone all of the time so an occasional or odd complaint might not mean much. Once I googled myself and found a disgruntled ex-client had written all kinds of nasty about me on a mothering board. She neglected to mention that she hadn’t paid me a penny for her birth, was sent to collections and then became infuriated when I refused to care for her next pregnancy until she paid for the first one – or that any of her complaints were fabricated in retaliation. But if you find repeated complaints about a certain midwife, then take heed. Another good source of recommendations would be childbirth teachers and doulas.

Bless the women who have what it takes to be good midwives! Bless Debbie, Jeanne and Lisa who have gone on continue to do the good work. May God bless you and the women and babies you serve!

Jeanne and Lori

Lisa

Dangerous or Safe? Part Two

I was pleasantly surprised to read a blog post by Carla Hartley entitled “Dangerous Midwife or Safe Midwife”. She says in her blog, “I am in a position to hear about all kinds of midwives, all kinds of apprenticeships, and all kinds of information about childbirth educators and doulas. A big part of the enormous amount of emails and texts and calls I receive every day have something to do with dangerous midwifery practices.” This is one of those taboo areas in midwifery and I applaud Carla for taking a stand on it. Through the years (14 now) that I’ve been involved in the birth field, I’ve seen my share of wonderful midwives. But sadly I’ve seen an equal share of what I call ‘scary midwives.’

Early in my journey I worked with midwives who had no formal education. This in itself isn’t a bad thing; there are many wonderful midwives who did not complete any formal education programs. Through really good apprenticeship training, many well equipped midwives have emerged. I also acknowledge that attending a good school doesn’t make a good student. That being said, there are some pretty scary things going on out there that shouldn’t be done, regardless of training or licensure!

Recently I reconnected with a woman on Facebook that had taken a childbirth class with me about 13 years ago. She asked if I remembered her. I could never forget her or her appalling story. She planned a homebirth with a midwife but the midwives were not happy with her progress and were giving IM injections of Pitocin to make her labor progress. I thought that was an isolated instance but sadly while apprenticing I witnessed midwives doing things they knew they shouldn’t be doing.

The “Ghost” was a common practice amongst the older midwives. One instructed me how to do it by taking a piece of gauze saturated in pitocin and while doing a vaginal exam, insert it and place it over the cervix. She said later you could remove the gauze and the mother would never know. As a baby midwife I was too stunned to respond to her ‘wisdom’ but knew in my heart that I would not follow down such a deceptive and dangerous path. Other times I just saw really shoddy practices; fundal fiddling (massaging the uterus before the placenta separates/delivers), nasty cleanliness habits (packing away bloody instruments to be brought out and scrubbed, then boiled at the next home birth – yes that was my apprentice duty before I integrated the homebirth toothbrush concept and began cleaning instruments BEFORE packing them away, sigh) and just plain ignorance in a variety of things.

Other times there was outright deceptive practices meant to ‘beat the system.’ A former colleague would intentionally instruct all women to clean the vulva with obstetric towelettes before obtaining a GBS culture – the towelette removes the bacteria, ensuring negative results. How many women have falsely believed to be GBS free because of this ‘simple’ yet erroneous practice? This same midwife would not begin to chart second stage until well over an hour and sometimes two, of active pushing. Something simple but if a baby isn’t moving down the birth canal or making progress, what’s the difference if it’s two hours or four hours? This might not seem like anything big, but it’s the little things we see, the big things are often hidden.

I think I’ll leave this here and pick it up again later. Maybe I’ll talk more about the big things and about students. I’m happy to hear your thoughts as well. Blessings!

Dangerous or Safe? Part One

It’s been awhile since I’ve sat down and blogged about anything other than the birth of a baby or upcoming childbirth class. It’s been a very blessed season of business that has not afforded me the luxury of pondering and writing. This morning was spent lounging around, catching up on Facebook. I had been tagged in a note written by Carla Hartley titled, “Dangerous Midwife or Safe Midwife”. Inwardly I groaned as often I’ve felt Carla’s perspective and mine do not entirely mesh. Reading Carla’s posts in the past, I’ve felt a professional condemnation for the type of midwifery I practice. I don’t know Carla personally, we’ve never met and I don’t take her viewpoint personally and at the same time, I don’t condemn her for her beliefs – even admire her at times for her courage to speak out. Now before you jump to conclusions that I’m ‘one of those midwives’, what I’m talking about is my position on Trust Birth and some of the technology I use in my practice.

The Trust Birth initiative has been around awhile and although I understand the passion and purpose behind it, I don’t fully agree with it so can’t endorse it. I confess that I don’t trust birth itself; I trust the Creator of birth. Because of this difference, I can’t honestly and fully support the TB initiative. I realize it’s a wording issue, but like Carla, I’ve seen ‘midwives’ take something that is meant to be good and use it in ways that are harmful.

I believe that we as women were created perfectly for giving birth – that we are intricately and wonderfully made from the womb to womanhood. But I also believe that we live in a fallen world where due to the consequences of sin, things can go wrong at times. My job as a midwife is to be there with-women to help them have the birth they desire, but to also be the guardian and caretaker when it’s needed. If I fully trusted ‘birth’ then there wouldn’t be a need for midwives and everyone would be able to birth unattended and without any bad outcomes. As a midwife my job isn’t to trust the birth itself, it’s to trust God in heaven who orchestrates birth, who knows the numbers of hairs on each babies head and the day and moment they will be born and will return to the here-after.

The majority of times, birth works just fine, but it doesn’t always. Sometimes women don’t take care of themselves the way they should and complications arise. Poor positioning of the baby due to bad posture, injuries or musculature can inhibit the normal progress of labor. Infections, blood pressure and blood sugar issues as well as past trauma can also change the normality of birth. Cord or placental issues can further complicate things. These things are rare but I feel it’s my calling to be the watchman and first responder if they do. Through education, discussions and informed consents I can help women understand their responsibility and hopefully provide a measure of prevention. Other problems can be helped through monitoring of her pregnancy, labor and birth. Just this week I’ve helped two women who have lost their pregnancies and another who potentially has a hernia that might influence her pregnancy. Do I blindly trust that all will be ok or do I help these women navigate the waters of technology and time and healing?

This presents the second area where I often feel professional condemnation – I use technology in my practice. Laboratory work, pelvic cultures, listening to the baby’s heartbeat with a doppler and the offering of ultrasound are part of my practice. For some, this warrants me a ‘medwife’, for others I don’t do enough because I allow the woman to choose and be part of the decision making process. Before I even read Carla’s note I was pretty sure that it was going to be another diatribe to how bad a midwife I am (professionally, not me personally) because of some of the technology that I use.

It was a pleasant surprise that she was hitting on an area that has been dear to my heart for many years. She says in her blog, “I am in a position to hear about all kinds of midwives, all kinds of apprenticeships, and all kinds of information about childbirth educators and doulas. A big part of the enormous amount of emails and texts and calls I receive every day have something to do with dangerous midwifery practices.” This is somewhat of a taboo area in midwifery and I applaud Carla for taking a stand on it.

End of part one – I’ll continue my thoughts in another blog
Ending Note: I just want to say that I DO understand the purpose for the Trust Birth Initiative and agree that there is an overuse and abuse of technology in birth and that women need to be empowered to stand up and fight the system or things will never change. The tide is turning and we need women to become educated and informed.

Charlotte’s postpartum visit

Welcome Malachi Steadfast

On January 9th, 2011, little Malachi Steadfast was born in water at the birth center. Not long after his birth we sat in the room, his Daddy playing the guitar and sang praises to our Father in heaven. What a joyous way to welcome new life!

Malachi weighed 8’4″ and has a big sister Alethia. Congratulations to Torrey and Aaron on the birth of their son!

Lori and Malachi

Jennifer and Malachi

Malachi

Lori and Malachi

Jennifer and Malachi

Malachi

What we did this afternoon

After the birth today we had a postpartum visit and got to enjoy 3 new babies all at the same time. Did I mention I love what I do??

Welcome baby Saaya

Congratulations to first time parents Matt and Ariana on the birth of their daughter, Saaya Natsume. Saaya was born in water at the birth center on January 3rd. She weighed 7’15″. We’re so proud of your hard work and thank you for letting us be part of your birth!

Auntie taking the video

Just born!

Daddy holds his new baby girl

Newborn exam

Saaya

Jennifer loving little Saaya

Soooo sweet

Saaya Natsume

Lori and baby Saaya

Welcome Mateo and Maya

Mateo Levi and Maya Luna were born on January 1, 2011. Mateo was born at 9:23 pm and weighed 6’8″ and was 19 inches long. Maya was born at 9:27 pm, weighed 6’4″ and was 19 and half inches long. Congratulations to Jessica and Mel on your precious, instant family!

Mateo and Maya

This is how the babies were lying inside of Jessica just 2 days ago! Hard to imagine those babies inside of her.

Maya

Jessica, Melanie, Maya and Mateo

Lots of little feet

Mateo