What birth with a midwife looks like….

   Successful out-of-hospital birth begins in the early months of pregnancy. In an ideal situation, midwife clients eat wholesome food, stay away from substances that abuse the body, and exercise regularly, working toward the goal of a wonderful labor and birth experience. Not all women are candidates for natural, medication-free birth, nor do all women get their wish for a spontaneous medication-free birth, even if they try.  As birthing mom, receiving gentle, familiar care, whether in a home, birth center birth or hospital setting with someone you trust is called continuity of care. As a midwife, I am committed to “being-there” for women, regardless of her choices in birth. Having your own midwife means support from the first prenatal, to holding baby in your arms.

Here are some “hall marks” of vaginal, spontaneous labor and birth.  Most of these ideas can be implemented in whatever birth setting you choose.

·        The ability to move around during labor, to adjust into more comfortable working positions.  This can be done through walking, standing and rocking, hanging, hands and knees, sitting backwards on a toilet (with a pillow for supporting head), sitting on a birth ball, sitting on the edge of the bed, using the tub, side-lying or semi-sitting.

·        We use the Doppler to check FHTs every hour in early labor, every 15 minutes in strong working labor, and every other contraction during pushing, if all is well.  We check more often, if concern arises.

·        LOTS OF PILLOWS.  The goal is total relaxation during very active labor, so the cervix can open without a women’s body tensing back.  May mean semi-sitting, totally relaxed. This means a big pillow under the knees, pillows under the forearms and pillows behind head. If side lying, pillows under upper knee (pulled up), pillow behind back, and behind head.  The goal is to “let go” all parts of the body, being relaxed without having to work to hold up any body part. 

·        The fear-pain-tension cycle is reversed by using lots of verbal positive reinforcement, gentle touch, massage, pressure on the back, or just helping mom stay focused, working though each contraction, one at a time. 

·        Women in labor work hard, so nourishment is very important.  We eat things that are easy to digest such as yogurt.  Sometimes women feel better with just good-for-you drinks.  We let women listen to their bodies, eating and drinking according to their energy needs. 

·        Pushing positions vary, according to prudence and preference.  We do encourage moms to move around during pushing, and to avoid lying on her back (it means pushing uphill through the Curve of Carsus).  We may use a birthing stool to get baby’s head around the pubic bone or the side-lying position.  We may have mom stand, putting one leg up on a chair and lean into a contraction. We may press simultaneously in on both of her illiac crests during a contraction, to allow just a little more room in her pelvic outlet.  Whatever works best for mom, bringing descent of baby in a safe manner.

·        Moms may appreciate hot compresses on the perineum during pushing.

·        Some moms like to feel baby’s head as he or she is crowning.  Some moms like to finish getting baby out, after shoulders are born, pulling baby on her chest.  Dads can also catch at this point.

·        Cord stops pulsing, before clamping.  Dad cuts the cord.

·        Immediately after birth, mom is given nourishment to help the uterus find the energy to finish the job of detaching placenta, getting it out and clamping down well.

·        Baby is dried off and nursing begins immediately, to help placenta detach.

·        Placenta descends naturally, if all is safe. It is given to parents to take home to use according to their wishes.

·        All weighing, measuring, footprints or baby exam…all of those touching, special moments that moms cherish, are done several hours after birth, ON HER BED, or beside her, so she is included. 

·        Baby is allowed to snuggle, skin-to-skin, with mom, for at least an hour after birth.  This is to facilitate bonding and encourage the production of oxytocin which helps prevent postpartum depression in the long run.  We feel this is an important detail for moms who are at risk for PPD.  When all is stable, we will turn down the lights and let the new family bond, spending some quiet moments together, with minimal interruption.

·        Baby is not bathed, or lotioned, especially with anything that has a scent that obliterates mom’s wonderful smell.  Vernix is healthy for baby and a wipe down is all that is necessary at first.  Parents diaper and dress baby when they are ready.

·        Mom is given a good meal whenever she feels like eating.

·        Nursing is on demand, with baby staying nestled beside mom at all times.

Midwife care is a birth choice. Laboring women are beautiful. Birth is awesome.  Babies are precious.

How we treat women and their babies,…...what we say, how we respect birth (and women’s laboring bodies) all send a message.

As a midwife, I want my clients to know that they are incredible and able to gently birth with love.