midwife

7 Reasons Why Families Choose to Birth at a Birth Center

 
birth room.jpg

When a potential client comes to tour the birth center, sometimes they are sure that’s the route they want to go, and sometimes they are exploring their options and trying to find the right fit. Here are 7 reasons that you may want to birth at a birthing center:

1. The ability to relax - Let's face it. The bright lights, beeping machines, and incessant intrusion of strangers in your hospital room is not the best way to promote peace and relaxation. At a birth center, the entire space and experience is designed to be calm and comforting.


2. The comforts of home without being at home - Some families aren't comfortable with the idea of birthing at home, but want to birth somewhere that feels as comfortable as home. The birth center fits that bill, and it has all of the equipment, technology, and experienced care providers needed to keep you safe.


3. Freedom of movement - At the birth center you can move around freely, and even give birth in whatever position feels most comfortable for you. You aren’t restricted to the bed. Additionally, the birth center has birth balls, birth swings, and labor ladders to help you move your body into supported positions that are great for labor.


4. Water! - The birth center has deep birth pools in each room that are a lifesaver for many women. We call water “the midwife’s epidural” because it is so effective at providing pain relief! You even have the option to give birth in the pool if it feels right. Water birth has been shown to be safe for both the birthing person and the baby.


5. Support for a natural birth - You don’t have to fight with your provider about your desires for your birth. Natural birth, delayed cord clamping, immediate bonding with my baby - these and more are all the norm at the birth center, not the exception.


6. Knowing your birth team - Unlike at a hospital, you will know the midwives who will care for you during your birth. In fact, you will likely spend many hours with them over the course of your pregnancy at your relaxed 45-minute prenatal visits.


7. Cost - There's no way around the fact that finances came into play when choosing where to give birth, and the birth center is actually far cheaper than a hospital birth. The birth center is also covered by many major PPO insurance plans. All the amazing benefits, plus cheaper to boot.

It's a marvel everyone isn't having their babies at a birth center!

 

HOME BIRTH STORY: Trust, Surrender and the Magic of Home Birth with Melissa Thormahlen

Melissa Thormahlen, who had her son, Tyler, at home with us last year, shares her birth story on the Doing It At Home Podcast. Thank you Melissa for telling your beautiful story so other families can learn about home birth! <3 <3

Hear Melissa's home birth story here

Below is a written excerpt from the podcast:

Melissa Thormahlen knows how to give me “all the feels.” I knew her story would impact many when her first email to me about her birth story had me tearing up.

 
melissa and tyler
 

She experienced most of her birthing experience at home with her first baby Emmeline, before transferring to a hospital and having a beautiful birth.

For Tyler, baby number 2, she knew she wanted to go for a home birth again because she trusted her body and her amazing birth team. 

In Tyler’s birth story, Melissa explains the trust and surrender to the process. She also took time to be close and intimate with her husband, Paul in the time before active labor.

When baby Tyler was born in the bathtub after a strong surge that took everyone by surprise she exclaimed, “I DID IT!”

 We even get to hear from baby Tyler as he chimes in a couple of times. We love when the babies make little appearances, they’re the reason we’ve come together to chat after all!

BONUS! Melissa emailed me a written version of her birth story before we got into it on the podcast. So for you readers out there, you can check out a very beautiful and detailed summary of Melissa's birth story below : )

 Melissa Thormahlen's Home Birth Story

I'm sure you'll get lots of stories but I feel compelled to share mine. My little home birthed man, who is 11 weeks, is sleeping on my chest as I'm writing to you.

Tyler was born at home on October 22. I have an older daughter who is 2.5 years old and I also planned her birth to be at home but she had different plans. She was posterior and my labor with her was long and exhausting so we ended up transferring to the hospital with her at 9.5cm. When we decided to have our second I knew I could birth at home I had so much faith in my body and my team. I used the same doula but since we had moved I had a different midwife. With Tyler I got the amazing homebirth I always wanted.

I'm not sure how much of the story you wanted people to share via email but here is my birth story:

Baby Tyler

 

On Thursday October 19th at 1:30am my water broke. I was due October 26th. I got up to go to the bathroom and when I got back in bed I felt a blurb of water roll down and out. Then there was quite a bit of fluid. Not an alarming amount but enough to know I wasn't peeing myself. For about an hour after that I had contractions, but then they petered off and I feel asleep. 

In the morning I called my mom to come pick up my 2.5 year old for her stay with grandma while we had the baby. Then called my midwife and doula and we we made a plan. Since my water had broken I was on a clock and I knew my labor had to start within 24-48 hours. Luckily my midwife felt comfortable waiting the 48 before going to the hospital for a medical induction. Shortly after my mom left with Emeline, Firen (my midwife) came to the house to check on baby, double check it was in fact my waters that ruptured, and bring herbs that were supposed to bring on labor. 

All that day I tried to induce labor naturally. I took a combination of cotton, black cohosh and a labor tincture every 15 minutes for about 4 hours. I also was advised to do some nipple stimulation. I only had contractions if I was laying in bed on my left side. If I got up or moved they went away. I was beginning to become hard on myself. So at some point I told Paul (my husband) I wanted to get up and go for a walk. We got up and dressed and out we went. Because it was so close to Halloween we looked at all the decorated houses and talked about how fun it will be that our son will have a birthday so close to Halloween. We live relatively close to downtown so at the end of our walk we decided to go out to dinner. We had a wonderful time just the two of us. We came home and crawled into bed. I went to sleep that night and didn't have any contractions. 

When we woke up on Friday Paul asked what I wanted to do and I said go get eggs Benedict so off we went. We had a wonderful love filled breakfast at a local restaurant, Chows. We snuggled and ate leisurely something that is harder to do with a toddler. After breakfast I figured I'd try one labor inducing activity, so I plugged in my breast pump. Besides the feeling of sore nipples and some very light contractions nothing came of it so I gave up. I decided instead that I should get my nails done so off I went. On my way into the nail salon I had my first good surge! 

After getting my nails done I went home and took care of some things around the house. Alli my amazing doula came over  around 2 and we walked to town. I was having some sort of regular contractions at this point but it still seemed like they could go away at a moments notice so it wasn't alarming. We went to The Coffee Shop and had smoothies, tea, Alli got a salad and a coffee and we sat outside and talked about random things. She was my doula with my first as well so we have a strong relationship. I had a few contractions while at the coffee shop where I needed to stop talking which meant I was making some progress. 

We walked back to the house after that and I got into the shower. It was nice to rinse off and upon getting out I had a really nice strong surge. They were still about 20 min apart, but it was a welcome feeling. Even if they stopped I had a feeling they would return. Firen came and checked me out while Alli was still there and it was perfect to have the team together. The baby was doing great and so was I so there was no reason to change our plan of heading to the hospital the next morning for the Rupture of Membrane Test unless I went into labor that night....

Once Firen left we took Alli to Walnut Creek to meet her family. When we were heading home we noticed Skipolini's  Pizza was in the area and they serve a Preggo pizza that is supposed to put you into labor. Since I was already having some contractions I figured it wouldn't hurt to try that too. We went in and had another nice meal together just Paul and I. I was having more regular surges and they felt like they were getting a bit more intense. 

We went home after the pizza to regroup. We were supposed to go to a movie but it didn't start for a while so we came home first. Then we both realized how tired we were and crawled into bed. Amy my sister arrived at 9:00 we chatted with her for a bit and around 9:30I told everyone to get some sleep. My body must have know what was coming because I feel asleep fast and slept hard for 2 hours. At 11:30 I woke up to a really strong contraction. Paul immediately jumped into gear and supported me through each contraction. He lit candles around the house and put on Enya. It was so romantic and sweet. He supported me through each surge and told me sweet things after each one. He was my rock.

My sister had slept until around 2am when things became more serious and I needed help. Mentally I was having a hard time staying on top of the contractions. We called Alli to come over and she gave me two more positions to try. I got into the shower first and it felt like one long continuous contraction. I think there was too much pressure and it didn't feel good to stand. Then I sat backward on the toilet and Paul massaged me from behind. It was ok but I was having lots of thoughts of self doubt so I made Paul call Alli back and demand she come over. She arrived at 2:45. She witnessed a few contractions, had Amy make me oatmeal and bring me drinks. After a particularly strong contraction she decided to call Firen to tell her it appeared I was already bearing down. Firen came immediately arriving at 3:50. When she arrived I was laying on the bed, Alli behind me, Paul on my front and Amy by my feet. I was so supported. Firen began setting up and checking my vitals. She listens to baby and determined everyone was happy and healthy!

I made her wait a little before checking for dilation and when she finally did I was 7cm. Which was great progress for a second time mom. They all ensured me I would progress fast but I couldn't bare down anymore. So Alli would breath, hiss and huff through each contraction with me helping me to keep from pushing. Which I have to say might very well be the hardest part for me, not pushing when your whole body is screaming to do so. At some point Paul suggested I get into the bathtub because it could help me relax and keep me from pushing. So they set it up and I got in. It was wonderful but the surges were really strong and I kept saying how I was dreaming of an epidural. This is transition! My doula handed me a small elephant figurine and I clutched onto it like my life depended on it. In my head I kept saying "if an elephant can be pregnant for 2 years then I can do this".

At this point in the tub my surges were so strong I was having a hard time fighting the urge to push and they were coupling. It was a lot. I asked how long until they could check me again and my midwife told me she'd wait 10 more contractions, 30 more minutes. I didn't want to go a second longer without being able to push, so this was hard. I sunk into the water and clutched my elephant. I powered on. After only 4 more contractions she said she'd check me but I had to turn over to the other side of the tub.

When I got up to turn over I had the strongest surge yet which was immediately followed by another one. Once I laid back down in the tub Firen checked me and announced I was 10cm. She looked at me as said, "do you want to have this baby here or..." and just then another surge came and I pushed with all my might. I reached my hands down and got in two more pushes feeling my son's head emerge. Then at the tail end of the surge I pushed once more and out came his body. My doula describes this moment as Tyler swimming up into my arms. I pulled him onto my chest and felt overwhelming rush of joy and love. "I did it" was all I said for a good 5 min.

I wanted more than anything to have a homebirth and this experience was pure magic. After Tyler was born my husband and I and baby Tyler crawled into bed where I birthed the placenta. My doula made us a delicious breakfast and we ate and rehashed the whole night. Tyler came into this world at 5:29am in the bathtub at our home surrounded but love and faith in my body. I wish everyone could experience the joy that is natural birth in a way where the woman feels completely supported.

I hope you enjoy my story! Thank you for all you're doing to normalize homebirth. And congratulations on your precious little girl. 

 
melissa family
 

Pregnant? Get. A. Doula.

It’s that simple. And it’s something I can’t stress enough....

Having a natural home birth? Get a doula. 
Having your baby at the hospital with an epidural? Get a doula. 
Having a natural birth at the hospital? Definitely get a doula.
Having a C-section? Get a doula.

In the ten years I’ve been attending births, I have never seen a more effective way to increase your chances of having a positive birth experience. Doulas are unique among the birth team in that they are trained professionals that provide continuous support for the laboring mom. This means a doula will never leave your side. Your midwife, your OB, the nurses, everyone else - they have other tasks to attend to - charting, prepping, making sure everyone is safe, not to mention other patients/clients (if you’re in the hospital). But a doula, she is there with you from the moment you need her until well after your baby's born and you've done your first breastfeed. She will rub your back, breathe through contractions with you, help you stay calm and focused, help you talk with hospital staff, support you in breastfeeding, get you something to drink, get your partner something to eat, and the list goes on and on and on. 

One of the most important things a doula does is to help your partner support you. Let’s face it, sometimes partners get tired, or they get overwhelmed, or they plain just don’t know what to do because they’ve never been to a birth before! Have no fear. Doulas have often been to many births, and are experts in managing the interpersonal aspects of labor. They are very intuitive about knowing how to support partners and help them feel comfortable, as well as helping to manage relationships with other family, friends and birth team members, all according to the mother's wishes, of course. 

A few things a doula does not do: 

  • She doesn't do anything clinical - no vaginal exams, blood pressure checks, fetal heart tones, etc.
  • She does not replace your partner. 
  • She does not speak for you or represent you to birth team staff. She can help hold space for you, and help you to think through decisions, but you or your partner are still responsible for communicating directly with your birth team about your needs and desires.

I know a lot of you out there are numbers-oriented folks, so let’s look at what the statistics say about having a doula at your birth. A meta-analysis of 22 studies comprising over 15,000 births showed that overall, women who had a doula at their birth experienced a:

  • 31% decrease in the use of Pitocin
  • 28% decrease in the risk of C-section
  • 12% increase in the likelihood of a spontaneous vaginal birth
  • 9% decrease in the use of medications for pain relief
  • 14% decrease in the risk of newborn being admitted to the nursery
  • 34% decrease in the risk of being dissatisfied with the birth experience

I advise all of my clients to get a doula. They are worth their cost many times over. I have never heard a mom say she wished she’d saved the money she spent on a doula. In fact, I’ve often heard women say that they would have paid much more if they had known what a valuable service a doula provides.

In recognition of World Doula Week, I urge everyone reading this to learn about doulas and get out there and spread the word. Educate yourself and the women and families you know about the amazing benefits of having a doula. ALL mothers deserve a doula!

P.S. In this post I am specifically talking about birth doulas, but I also want to acknowledge postpartum doulas, who are equally as wonderful, and are often a godsend for families who are learning how to incorporate a newborn into their lives.

NYT And WSJ Weigh In On Home Birth As Midwifery Keeps Making Media

Yet another article popped up today on midwifery - one of several over the last months. This one is an opinion piece in the New York Times.  In it, seven contributors weigh in on the safety of home birth versus hospital birth - four obstetricians (one of whom is the president of the American Congress of Obstetricians), a certified nurse midwife, a certified professional midwife (who is also the president of the Midwives Alliance of North America), and a home birth mother. Not surprisingly, opinions are pretty clearly demarcated along professional lines, with OBs arguing that home birth is too risky and midwives (and mother) arguing that home birth is a safe alternative to the hospital. 

Despite the frustratingly biased title (jeez, NYT), the opinion piece, for the most part, lacks the nastiness and contempt that the home versus hospital debate so often stirs up. The most balanced opinions are offered by Aaron Caughey and Marinah Valenzuela Farrell. Both acknowledge that no matter the location, there is inherent risk around birth. Caughey, chair of the department of obstetrics and gynecology and the associate dean for Women’s Health Research and Policy at Oregon Health and Science University's School of Medicine, asks what risk is acceptable, and concludes that "as long as women are being properly educated about the risks and benefits of location and birth, hopefully they are able to make a decision that reflects their preferences." Farrell, a certified professional midwife and the president of the Midwives Alliance of North America, reminds us that hospitals carry risk too - a reality that anti-home-birthers often ignore. Several of the contributors articulated the need for better collaboration and care integration among different provider levels.

The NYT opinion piece follows a strongly pro-midwife article that appeared in late January in the Wall Street Journal. Using the Frontier Nursing Service, a noteworthy midwifery and nursing program started in Appalachia in 1923, as an example, the WSJ article nails it when it explains what makes the obstetric and midwifery models so different:

The great strength of American-style obstetrics is in reacting to catastrophe. But we're terrible at preventing catastrophes before they happen. While our traditional obstetric mode is reactive, the style of midwifery [...] is proactive. A low-tech, high-touch approach has been shown to effectively lower rates of C-sections and early births in several modern cases. Moreover, this personal, coaching approach is the most effective way to address chronic problems like obesity and diabetes.

Like just about everything else in our culture, our "standard response to health problems in the U.S. is more: more hospitals, more highly skilled surgeons, more access to the top technology. But we know for sure that at least some of the increasing danger of birth has been driven by the medicalization of the process."

 

 

Genesis

When I was 11, I met my midwife. She had thick, grey hair that fell in waves all the way down her back. She was gentle and motherly. Her name was Kristin, and, for me, it was love at first sight. 

It is hard to explain the feeling of meeting the person whose hands were the very first ones to ever touch you. And most people never get that chance. I felt the most special connection to her, and a deep sense of wellbeing, because she had been the one to ensure that I made it safely into the world very, very early on a Friday morning in 1981. 

 
My mom, my dad, my sister and I the&nbsp;night of my birth in our home

My mom, my dad, my sister and I the night of my birth in our home

 

I was my mom's second kid. My older sister, Deena, had been born in the hospital 11 years earlier. Now my mom was in her late twenties, and had decided to have me at home in my family's tiny rental house in Austin, Texas. The house was tucked away behind the Austin Books & Comics store on a cul-de-sac called Capitol Court (the store is still there today). Only a handful of people would be at the birth - my dad, my sister, Kristin and a family doctor who was also a close friend. So it was an intimate affair - and it turned out to be a quick one. After four hours of labor, at 1:53 am on October 16, I slipped out calmly and without drama. My dad remembers the night like this:

 
 

My parents told me the story of my birth many times when I was a kid, and they talked about it like it was truly a miraculous experience. I think my birth had a profound impact on them. And not just in the way that the birth of a child changes all parents. That is to say, it wasn't really of my doing; it was the experience itself. Here's my mom:

 
 

My mom used to tell me she thought I "must be on vacation here on Earth." From the way I entered the world, to how I moved in the world, quite literally from continent to continent, she felt I lived a charmed life. I definitely have not always felt charmed, but I have sometimes wondered if there was some truth to that. 

There is no doubt that the way I entered the world affected me. It shaped my worldview in such a deep way that I actually became a midwife. My beginning - a story of peace, trust and intimacy - laid the foundation for my vision of who I was and what I represented, and I took it on as an identity.

I also took it on as a challenge. I used my birth story to push my own limits, and as a rationale for taking risks. It is what has allowed me to do and see many things by age 33 that many people will never do or see. Because I have always believed that no matter what I do or where I go, or how difficult or scary things get, the true me is the person who made her arrival without fear, without fuss, and definitely like she was meant to be here. 

 
Me in a basket

Me in a basket

 

That's why when I met my midwife at 11, I was awestruck. She had been at my birth too! And not only that, but she had helped orchestrate that experience for me and my family. She had welcomed me here and made sure that my journey was safe, peaceful....even... magical. "She must really love me," I remember thinking.

I've looked for Kristin since. I lived in Austin again as an adult from 2011 to 2013, and I asked around about her. Some of the older midwives remembered her, but didn't know how to get in touch with her. By this time, I was a midwife myself, and I really desired to come full circle and connect with the woman who had inspired me. I found her on Facebook and wrote her a long email. No response. I guess a hippie midwife living on a commune in central Texas probably doesn't check her Facebook all that often.

Even though I haven't been able to connect with her, I feel satisfied. I was eventually able to connect with the family doc who was at my birth (interestingly enough, he ended up helping me with some of the paperwork I needed to obtain my California midwifery license). I feel like I was given an immense gift for my very first birthday - better than any gift I've gotten since. My very first moments in this world were protected. My transition was gentle. And the first hands that touched me were hands that loved me. For me, that has made all the difference.

Love,
Firen

 
firendoingthedishes