Births that make me smile...

There are some births I have that I can’t help smiling throughout the entire labor. I had one of those births the other night. The mother came in with her second baby already in what I call fast and furious labor. She had a birth plan, requesting an unmedicated, non-intervention birth with skin to skin contact immediately after birth, delayed cord clamping, basically what as midwives we do anyway whenever possible. 

What I loved about her birth was that she was CLEAR about her needs. She verbalized, sometimes vehemently to her husband, her mother, the nurse, and me what she needed. She was not apologetic or polite. It was awesome!  When her mother kept talking, she asked her clearly to please stop talking. She and her husband were working through each contraction with a system that worked for them as a couple. He would say, relax your belly, relax your chest, relax your back, and she would breathe deeply and focus. At one point when he strayed from her side, she told him clearly I need you here. While these points of reference would not work for most women, it worked for her. Then when the nurse kept talking about IV placement, she told her, "I don’t care! Just do it."   I know from years of experience that when a women is clear about her needs, sometimes impolite that she will birth her baby. It makes me smile to myself and congratulate her in my mind.

When it came time to push, she loudly welcomed her baby into the world. Some people would call it screaming but I just thought to myself, "Yes, go for it!"  When someone is letting their air out through moaning and yelling I know it works because they are allowing the baby’s head to be born slowly. You can’t push as hard when you are letting all your air out through vocalizing.

After the birth she apologized to me for screaming and I told her, "No, you did great! That’s what I wanted."  We usually try to have women blow as the head is being born to minimize or prevent tearing, but yelling also works. No one said birth should be quiet! You are welcoming a new soul into this world. Celebrate it any way that works for you!

It was a beautiful birth, this mother embodied everything I know about childbirth. She was unrestricted and unencumbered and welcomed  her daughter with everything she had. 

With love,

Karen

What Does it Mean to be a Midwife in 2018?

What is a Midwife in 2018?

I am always saddened to discover that in 2018 many people do not know or understand what a midwife is or does! The term itself mid….wife means with…women.  I became a midwife over 30 years ago because I wanted to make a difference for women wherever they chose to birth their baby. At that time I was working at a large urban hospital with residents, obstetricians, and one midwife. The difference between the births that the midwife did and everyone else was so moving to me that I chose to follow her path.  Much has changed in the past three decades, but the principals of midwifery have not. Our commitment to support the mother and family unit, to encourage a woman to trust her own instincts and birth in whatever position/location that feels right for her while being surrounded by the people important to her has not. 

Today, there are over 12,000 women and a few men who are midwives in the United States. Certified Nurse Midwives (CNMs) are the most common type, but there are also Certified Midwives (CMs).  Both CNM’s and CM’s have graduate level midwifery degrees, have passed a national certification exam, and can prescribe medications and treatments. About 95% of the births done by midwives occur in hospitals, but another 5% safely birth at home or in birth centers.

Although midwives are best known for their role in pregnancy and birth, we also provide care for women from puberty through menopause. This can include routine gynecological care, birth control,  and  yearly visits after menopause.  Many women become so attached to their midwife that they follow the same person through all the stages of their life. I always say that once you see a midwife you will  be sold on the difference in your care.

Often I am asked to explain what the difference in birthing with a midwife vs a doctor might  be. Many people think it means they cannot have an epidural or drugs, which is not the case.  During pregnancy, my goal is to assist the mother in feeling healthy on all levels, physically, emotionally, mentally, and spiritually. There is so much more to birth than just the size of the baby and the mother’s pelvis. A woman's emotions, needs, past experiences, etc. are all major players in the birth process. I seek to educate her about her body, nutrition, exercise, and to understand her desires for the birth. I am there to support her in birthing in whatever way she feels is right for her. It is her birth, and I while I cannot control the course of labor, I can control that she feel supported during the process.  I believe that the only way to manage labor is to be present with the woman during the entire process. Pushing with a midwife can be different in that we encourage you to push in any position that works for you. We limit interventions to necessary medical problems, and rarely will cut an episiotomy.

Although most birth is normal, we recognize that sometimes there is intervention needed in the form of C/Section. I am grateful to work with a group of five Ob-Gyn’s and four other Certified Nurse-Midwives.  Just as there is always a midwife from our group on call, there is also a obstetrician available if we need them. In this way our patients are always cared for by members of our group that they have met before labor.

Suzanne Arms wrote this in the 70’s and I have strived in my 30 years of practice to practice with this philosophy. 

“Childbirth is an experience in a woman’s life that holds the power to transform her Forever.  Passing through these powerful gates –Each in her own way-Remembering All the generations of mothers Who walk with her She is alone- Yet not alone.”

Love,

Karen

The strength you find...

CJ Lewis wrote,  "A strong woman knows she has strength enough for the journey, but a woman of strength knows it is in the journey where she will become strong!"

A good friend, also a midwife, gave me this quote on a plaque. It resonates with me in so many ways.  It is about accepting that yes, life can be hard sometimes. It is about knowing that in the challenges the universe presents we can choose to grow stronger or we can wallow in our own self-doubt and judgments.

For all the pregnant woman I am blessed to be connected to the message is clear. Women have the strength, they were born to birth and mother their children, it is in their genes;  but it is in accepting the challenges along the way that they truly grow strong. Carrying, nurturing, and birthing a baby requires great strength and endurance but even if a woman perceives herself as not strong she will have her baby. However if she embraces the entire journey and accepts that it will have ups and downs, that it may not be a straight line, she will be empowered  and transformed by the birth.

I have raised four children and lost one more. Each birth taught me something different.  Each child in their formative years and on into adulthood has also challenged me. For example, each one of my children was very different with different needs, personalities, and strengths. I learned that when my girls came to me with a problem, they wanted me to “fix it.”  My boys just wanted me to listen. My teenage son stopped me dead in mid sentence when he said to me “I don’t want you to fix it. I just want you to listen.” I recognized that when I allowed my eldest child to decide on her own, she would always go in the right direction. I also found that my eldest son would never choose the way I hoped so, therefore, needed more forceful direction if it was an issue of safety. My second daughter was so difficult at 3 that I read every book on child development. It convinced me her behavior was very normal and she ultimately morphed into the easiest child at 4 and ½ and stayed that way all through school. Finally, I learned that sometimes if you try to push your children too hard, they will just push back harder. You have to let go and allow them to learn their own lessons. When my youngest son was in high school I could not get him to take grades seriously, so I said to him I cannot want this more than you want it for yourself.  He told me that was the most important thing I said to him.

In some ways each experience has made me the strong woman I am. When there were health issues, I learned that the more “experts” you spoke to, the more you could make an informed decision. When there were no clear answers, I learned to let go and trust there was a reason. I have taken these lessons and embraced them to enable me to give the support to pregnant women and new mothers that possibly someone without the same challenges would not be able to give.

I always say birth is not easy because motherhood is not easy!  Birth requires great strength but motherhood asks for 100 times that strength in accepting that our children will teach us the lessons we need to learn; and that it is not always easy but it is incredibly fulfilling. We continue to grow with each stage and through the journey, we are transformed into mother and eventually wise woman.

Love,

Karen

Mothering the mother

Mothering the Mother

 “The health of every family begins with the mother.

She is the tree from which the healthy fruit must come “

   Juliette De Bairacli levy

From the moment a woman even contemplates wanting a child she begins to enter into her mothering role.  Her heart expands and she begins to look beyond herself.  It is the single most important role and often the most difficult one that women have.  I have been delivering babies for over 30 years and am always in awe of watching a mother see her baby for the first time. She is almost always overwhelmed, scared, excited, and completely in love with her baby.  I never get tired of delivering a baby and seeing the pure love pouring from a new mom as I place her baby in her arms.

When talking to pregnant women, we often focus on the pregnancy and birth and fail to consider the first 6 weeks postpartum. My daughter Kendall, who has 2 children, reminded me of how challenging this time can be.  The mother has just willingly signed up to be awake for days on end, to endure physical pain after childbirth, while simultaneously loving this new person with her entire being and then questioning, is she doing it “right"?  Often, the new mom wants her own mother to come help her. After my first granddaughter was born, my husband told me Kendall would want space to be with her baby. I thought that was wrong, but agreed. The first night home with her baby, Kendall called me crying to please come over because she needed help.  I looked at my husband, said some form of “I told you so” and drove over to her house.

The job of a mother wears so many “hats." They are constantly loving unconditionally, serving as a role model, instilling confidence and compassion, providing discipline and structure,  usually the chief cook and housekeeper,  and of course meeting everyone’s physical and emotional needs. It can be exhausting.  As a mother of four children, I can certainly speak from experience.  One of the key phrases in our house was “Where’s Mom?” For there is a certain comfort, only the mom can provide.

Only since my mother passed last year, did I truly recognize the power of the maternal bond, especially between mothers and daughters. I was blessed to have my mother for 58 years. She nurtured me, supported me, and helped me raise my children.  She was my best friend and listener. In later years I spent a great deal of time caring for her. But when she passed, I realized the void of being “motherless."  She was the person who always accepted me for who I am, loved me unconditionally, and told me I was doing a great job. Now trying to fill her shoes and assume her role as matriarch, I truly know the importance of the Mother!

Individually and as a society I would like to remind all of us to support all new mothers by encouraging them to trust their instincts and their intuition. They will know their baby better than anyone. To help new mothers in the physical , bring them food, offer to clean, take their other children. Remind them of the amazing work they are doing.  And to support all women, as we move through the stages of our life, without criticism or judgement, recognizing the nurturing bond we all share.

With love,

Karen