I’m just gonna leave this right here…

 

If ‘rocking your birth’ sounds like something other people do, and you just want to “get through it” with a healthy babygirl, raise your expectations.  You’re both too valuable to whiff on this one.  If this is your first baby, it’s even more important, because it will set the tone for your future births and may determine your options for the rest of your life.

Dear Friend, Birth Doesn’t Have to Suck

 

Int’l Day of the Midwife 2018

This Saturday, May 5, is International Day of the Midwife.  The idea for this day began with the International Confederation of Midwives and was formally launched in 1992.  This year’s theme is “Midwives, leading the way with quality care.”

I find this theme appropriate in light of a recent recommendation that came forth from the American College of Obstetricians and Gynecologists annual meeting that was held last weekend in Austin, TX.  The recommendation that “To optimize the health of women and infants, postpartum care should become an ongoing process, rather than a single encounter, with services and support tailored to each woman’s individual need,” is not a “new paradigm in postpartum care” as they propose.  This continued regular care during the “4th trimester” is something that midwives have understood and implemented for a long time.  Standard of care in my area is three postpartum visits between 2-3 days and 6 weeks postpartum.  Midwives truly lead the way in this type of care as well as many other recent ACOG recommendations, such as delayed cord clamping, limiting interventions during normal labor, and the benefits of water immersion during labor.

As I do every year, I will remember the midwives who have influenced my life and yes, my desire to be a midwife for other women:

  • Penny Armstrong, who wrote the book A Midwife’s Story, that was my introduction to the path of a midwife and home birth
  • Marimikel Potter, the midwife who cared for me through three pregnancies and assisted me during my two home deliveries.
  • Thalia Hufton, Teresa Smith-Short, and Sylyna Kennedy, my preceptors and wise counselors as I studied, learned and grew into a professional midwife with my own practice.
  • Ina May Gaskin, who shares her knowledge and women’s stories to the benefit of many, and
  • Gloria Lemay, a renegade midwife by some standards, but a tireless fighter for physiologic birth and intactivism.

Happy Day of the Midwife, y’all!

Nuchal Cord (Cord Around the Neck)

I often hear stories from people about how they or a woman they knew had a cesarean and “the cord was wrapped around the baby’s neck two (or three) times!”

Having the cord wrapped around the neck is called a “nuchal cord” and is present in about 30% of all births. In most cases, it is not associated with a significant increase in the rate of adverse fetal/neonatal outcomes. Continue reading →

Expanding My Business!

I am finally, seriously on the hunt for a location to put a birth center here in Mt. Pleasant!

I’ve been looking at some old houses that are in “neighborhood services” zoning, and while they’re pretty, cozy and homelike, they often come with defects that need correcting or a layout that is less than optimal.  I mean, I expect to have to do some minor fix-up, and there are times when you can make a floor plan work even if it isn’t ideal, but I want to try to find the best place possible.

I also am having a hard time finding something that is within my budget.  Ideally, I’d like to stay under $100,000 for the price.  Unfortunately, if it’s commercial property, it’s pretty much guaranteed that it will cost more than that.

So I’d like to ask for help from my clients, former clients, and visitors to my website.  If you know of any property that might make a nice birth center, either for sale or for lease, within 10 minutes of the hospital here in Mt. Pleasant, please let me know!  If you don’t know of any place like this, then just pray that my search would be successful and that I find something acceptable!

New Discounts for Those in Need

One of the questions I am frequently asked is “Do you accept Medicaid?”

I always respond with “Medicaid will not pay for my services,” and when I say that I mean that they do not cover the services of a licensed midwife.  But even if they did, I’m still not sure I would accept it.  And my answer would be the same, “Medicaid will not pay for my services.”  And by that, I would mean that Medicaid would not pay me anything even close to what my services are worth.  If what other states’ Medicaid programs pay midwives is any indication, they would probably pay me somewhere in the neighborhood of $500.  For everything.  I couldn’t do what I do for that price.

However, I realize that my regular fees may be beyond the budget of some people.  In the past, I have had one or two clients who asked if I could give them a reduced fee because they couldn’t afford my services otherwise.  I worked with them and was glad that I could help.  But a lot of people don’t ask.

To help with this situation, I have decided to offer two new discounts to my regular fees.  Clients may qualify for one or the other, but not both.  I will offer a $500 discount off of my base fee for those who are enrolled in Texas Medicaid.  And I will offer a sliding scale with two fee options (payment plan or pay in full by 36 weeks) for families whose household income is at or below poverty levels.  In both of these instances, I will not be offering any other discounts.

Women often come up with some very creative ways to earn/find/borrow the money they need to get the birth they want.  If you really want midwifery care and a home birth, please talk to me.  I can’t give my services away for free, but I’m hoping these discounts will help more women be able to afford the care they deserve.

 

 

Birth Story!

Shared with the gracious permission of my client.  🙂

8/24/2017- I woke up just before 6am on Thursday morning. It was strong contractions that woke me up. For a few minutes I thought maybe I just had a bad stomach ache. (Which kind of makes me giggle now…I think the appropriate phrase would be “in denial”) As it turns out, I was already in active labor and transitioning for delivery. I’m blown away at my body and still processing how in the world I slept through early labor. Anyway, I made it through about 4-5 contractions before I woke Brandon up. I couldn’t make it through another one alone.

We had dropped B and J off with my in-laws the night before. The universe knew what it was doing. (The original plan was for them to go Friday evening instead of Wednesday… I’m so thankful)…. I called Diane, our midwife, our birth assistant, Jennifer, and my mom and dad, but by the time I was finishing the last call, I couldn’t contain the pain in any other way but screaming and walking. The walking was questionable. Nothing seemed to help the kind of pain I was experiencing. By this point, very little time had passed, but I was progressing so quickly. I begged Brandon to go find Diane and “GET HER HERE!” I would try to lean in to him for comfort all while I said “Don’t touch me.” This was a tough time for Brandon.

Diane arrived and she just knew. There’s no other way to describe the look. She dropped her bags and gave me everything I needed. Her voice was so calm and her support was magnificent and so solid. I knew the birth tub was no longer an option. We had started filling it up as soon as we realized labor was happening, but it was just all so fast. I leaned over on the tub crying and begging for help. I said to Diane “I can’t do this.” She said “You CAN do this. You ARE doing this.” I followed with, “Does it get worse than this?” She said “No, this is the worst, this is it, you ARE doing this.” It was the most calm phrase I’d ever heard and probably the most comforting. I kept replaying it… “YOU are doing this”

The next thing I said was “He’s coming” and in that instant, my water broke and it was time. I made it into my bedroom floor feeling like I couldn’t go one more step, but somehow, I managed to climb onto my bed all while Diane seamlessly got her equipment, our birth kit and comforting me all at once.

I was on my hands and knees in the middle of our bed. Brandon stacked some pillows in front of me to lean on for support. He was so incredible. His eyes were all the comfort, support and motivation I needed to keep going. He spoke softly to me, he held my hands, but he also said nothing and everything at once with just one look. We were doing this. My body was on auto pilot. It was incredible. Even more incredible was the resting between pushing. I have a whole new awareness/sense/respect and appreciation for my body.

One of my best friends, our photographer and also daughter to our midwife, Madlen showed up in time to capture the delivery of our sweet boy. Oh how special it was to share this with her, how much my heart swells to know she was here for me and somehow was able to capture perfect frames of this experience for us.
Jennifer, our birth assistant and also a midwife, but even more, a new friend to us, remarkably made it all the way from Dallas just in time for the birth. When you hear the short time frame, you’ll see just how awesome this is….

Everyone was here. The room was so full of intense, raw emotions. There was pain, happiness and an immense amount of love. The screams are something I don’t think I could ever mimic. I could feel our baby moving down and I knew his arrival would be soon. In some of the last pushes, I reached down and felt my baby was almost here. That was the last motivation I needed. I gave out one more big push and his head was here. 2 more pushes and he was here.

I could hear his small cry and the feeling is something I can never describe. The sense of accomplishment, happiness, love, pain…. I did it. I delivered our baby in our bedroom, surrounded by love in one of the most amazing experiences of my life. He made his entrance at 8:17 AM.  Just 2 short hours after I made the initial call to Diane.  It was perfect, absolutely perfect.  I am elated and so in love.

Community building

I’ve been a midwife for almost 10 years now. I get a lot of women who come to me who live in the southern portion of my range…Longview, Gilmer, Tyler. There is also a very strong community of natural mamas in that area.

 

But the northern part of my area is remarkably quiet. I have had almost no phone calls from the Paris area. I’ve done a few births in Texarkana, but I’ve done more in the New Boston and Mount Pleasant area. There also doesn’t seem to be a whole lot going on in the way of support for women who choose a more holistic lifestyle, regardless of where they choose to birth.

I was thrilled to see a breastfeeding support group open up here in Mt. Pleasant a year or so ago. They have a wonderful group of ladies and a fabulous lactation consultant who leads the group and is always available to answer questions. My own daughter has made some good friends through this group and I have no doubt that they were important in her breastfeeding journey with her son.

I would love to see more doulas in this area (I only know of one right now) and I would love to see the demand for doulas in this area grow.

I find it hard to believe the Red River area doesn’t have any crunchy mamas that want to find other crunchy mamas to talk to! Am I just out of the loop? Or are they hiding because they think they are all alone out there? I’ve started two Natural Mama groups on Facebook hoping to start creating a supportive community of like-minded women in this area. Please feel free to join the Paris Natural Mamas or the Texarkana Natural Mamas and let’s get these groups rolling!

Newborn Hearing Testing Available

I have just spoken with Brooks Hearing Clinic and they have informed me that they have the ability to perform newborn hearing testing at their office.  The charge for testing is a very reasonable $45.   

I encourage all of my clients to have their babies’ hearing tested in the first month of life to detect any problems and develop a plan for care.  This is a very simple and non-invasive test for detecting hearing problems before they cause developmental delays.  I have known mothers whose babies had hearing problems, but they weren’t diagnosed until the child was older.  The delay in treatment can compromise language development and reduce communication and school performance.

Their office is located at 301 W. 19th St. in Mt. Pleasant, near the hospital, and their phone number is 903-717-3597 in Mt. Pleasant or 903-737-8800 at their main office.

Every mother wants a healthy baby…every mother deserves one!

Gestational Diabetes

Gestational diabetes mellitus (GDM) is defined as a carbohydrate intolerance of varying severity that occurs in about 6% of pregnancies in the U.S.  

When women develop GDM, they are at higher risk for adverse pregnancy outcomes and long-term negative outcomes for mom and baby. Potential complications  of GDM include preeclampsia, polyhydramnios (excess amniotic fluid), higher weight gain in the fetus (possibly leading to C-section or shoulder dystocia), newborn complications (jaundice, nerve damage, low blood sugar), and of the mother developing Type II diabetes after pregnancy.

When we take in nourishment, we convert it into glucose, a fuel immediately usable by our bodies. Insulin metabolizes and regulates glucose levels. Diabetes can be simply defined as the result of a weakened pancreas producing too little insulin. This causes an abnormally high amount of glucose in the blood.

There are several factors that may contribute to an abnormally functioning pancreas, the primary ones being family history and obesity. Genetic weakness can be aggravated by a diet high in sugars, processed foods, and alcohol along with smoking, emotional stress, and lack of exercise.

Insulin is the key that tells our body to either store extra glucose in the liver as glycogen, use it immediately, or release glycogen for energy in the absence of enough glucose in the bloodstream. During pregnancy, placental hormones that peak around 28 weeks suppress insulin levels raising the mother!s blood glucose level. This occurs because the baby will be gaining the most weight and needs the most fuel to grow during the last 12 weeks of pregnancy.

I have spent the last couple of weeks researching information and guidelines on gestational diabetes, in an effort to create a guideline to use in my practice.  There is much new information and research available and this has led me to a change in thinking and new recommendations for my clients.  My plan is to use a simple screening algorithm to allow low-risk clients to avoid testing, while moderate and high risk clients are screened a second time and finally tested if necessary.

While gestational diabetes can have serious consequences, it is usually very easily controlled by diet and exercise.  The risk of complications decreases dramatically when GDM is controlled.   And the lifestyle changes that are required to control GDM are positive ones that many of us would do well to follow  (yours truly included!) and to continue even after the birth to help reduce the risk of Type II diabetes later.

I still recommend that my clients eat 70+ grams of protein in their diet each day and to avoid refined flours, starches and sugar.   Your focus should be on protein, fruits and vegetables for optimal health!

Evidence Based Birth  – notes on the NIH Consensus Conference, Day 1

U.S. Preventive Services Task Force recommendation (2014)