Update on International Midwifery

Well, my trip was a success! The birth went well, and I had a wonderful stay with my client and her family, as well as having a little time to do some sightseeing.

This is something I can definitely see myself doing more of in the future, but I need to hash out some of the details. I need to proceed a little differently for traveling births than I do for my local business, however. I need to have a different fee structure and will provide a different type of care for distant clients. I also have to consider my local business and clients and how to make sure they continue to get good care while I am away from home.

It is always exciting to travel to new places, at home and abroad!  If you are living in another country and don’t have access to local midwifery care, feel free to contact me.  I also have connections with other midwives who work internationally, so if I can’t come to you, perhaps one of them can.

A New Tool in My Birth Bag…

I recently made an important purchase that I hope will help me give the best care possible to my client’s babies. This piece of equipment was expensive, but it is something that I know can be a useful tool in helping to screen for problems before they become life threatening. It will also help guide my care if a baby has problems transitioning to life outside the womb.

I bought a pulse-oximeter that is specifically meant for monitoring newborns and infants, though it can also be used on adults. My pulse-oximeter tells me the baby’s pulse and oxygen levels. This type of pulse-oximeter can be used during resuscitation to help guide efforts to get the baby breathing on its own. It can also help to detect serious heart defects that may not show symptoms in the first week or two of life. The sooner a heart defect is detected, the sooner the baby can get help.

A pulse-oximeter takes the pulse and oxygen measurements by the means of two sensors that are placed on the baby’s skin on the hand, wrist, or foot. It is simple and non-invasive, but very effective.

I would like to begin screening all newborns for critical congenital heart defects at the 2 day home visit. The test usually takes about 5 minutes and is done when the baby is awake and calm.  This testing is currently required by law to be offered for infants born in birth centers and hospitals in Texas.  You can read more information about this testing and critical congenital heart defects at the CDC website.

My pulse-ox will have a place in my resuscitation bag as well, so that I can monitor a newborn’s oxygen levels during resuscitation or whenever it becomes necessary in the hours immediately after the birth.

Openings available

In looking at my calendar for the coming year, I have some months that are not filled…yet! If you are thinking about having a home birth, it is better to contact me earlier than later.

I currently have a few openings in April, May, June, and July. I am happy to set a time for a free consultation for you and your partner to meet me and ask any questions you may have about my services.

Call today!

Twins and Breeches?

I am occasionally asked if I would attend twin or breech births.  Let me begin by saying that I have attended such births, but never as the primary midwife.  Out of six births, the outcome in each was fine, but at one, the mother had problems with bleeding afterward.

That said, I do not feel that I currently have the experience or skill level needed to attend breeches or twins at home.  Could I, in the event of an emergency or a surprise?  Yes, and I think I have enough knowledge that I could do it without causing harm.  But I would not intentionally plan to midwife a woman having twins or a breech baby.  Twins and breeches carry a somewhat higher level of risk than your average head-down delivery.  The provider MUST have knowledge of what can go wrong and know exactly how to assist in each situation to provide the safest birth possible.

I would like to go in search of training and experience with breech deliveries.  This will likely require travel and expense, but I believe that it would be a valuable skill to have in my practice.  I do not agree that cesarean birth is the best and safest option for all breech babies.  For some breeches, yes, but not all.  I would have a selective policy for breech birth in my practice, and I would still do everything possible to encourage babies into a head-down position before labor.  The parents must also be fully informed of the risk and complications that could occur.  It is not something to be treated lightly or glossed over.

While I completely disagree with the current obstetrical policy of planned cesarean at term for all twins, I am not sure that home birth is a wiser or safer option.  Even when the babies are full-term and in an optimal position, there is plenty that can go wrong for both babies and mother in a twin birth.  Problems can require quick and sometimes invasive action to correct, which may carry further risk of harm.  Better to find a doctor who supports natural twin birth in the hospital, even if it means traveling to find one.   At this time, I do not plan to attend twin births at home.

Here is a brief list of some of the risks and complications of twins and breeches:

Twins:  placental abruption before the second baby is born, turning of the second baby to an unfavorable position for vaginal birth, hemorrhage, obstructed birth due to position of babies

Breeches:  cord entanglement, cord prolapse leading to asphyxia, cord compression leading to asphyxia, arms stuck over or behind the head, entrapment of the head in a partially dilated cervix, extension of the head

International Midwifery

 

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Many people don’t know, that in addition to being a midwife in Texas and attending births here, I am occasionally asked to attend births in other countries.

My first international birth was for a former client who moved to Japan.  It was a wonderful adventure and I loved the time I spent there.  Now it appears that I may be called to attend another client in southeast Asia early next year (2017).  There are still some details to hash out, but I will have a backup midwife covering my practice in Texas while I am gone.

Just in case someone out there is looking…  I’d love to attend a birth (or births) in Brazil!