Once again, ACOG realizes that the Midwives Model of Care is what families need...(but they never actually say Midwives!)

I'm pleased to see yet another ACOG (American College of OB-GYNs) Committee Opinion basically saying that maternity care in this country needs to mirror the care that midwives, particularly homebirth community-based midwives already delivers. In this latest statement, ACOG (largely due to the recent and overdue increased attention to the horrific maternal and infant health outcomes in this country, particularly for families of color), acknowledges that postpartum care in the US system needs to be "redesigned" and that a continuum of support throughout the entire fourth trimester is needed, vs a single postpartum encounter around 6 weeks postpartum. Once again, ACOG, basically summarizes the midwifery approach to care without any reference to midwives (they do say "other obstetric providers" though) or that this model of postpartum care using midwives successfully exists around the world and in our own country already. In fact, while recent great strides are being made with regard to Midwife/OB collaboration, the reality is that this professional organization has a history of working against the integration, licensure and utilization of community-based midwives like myself who are deeply steeped in the reality that the birth is just the beginning and the support of the still interdependent dyad of the person who gave birth and the baby is a HUGE part of our work! It is heartening and hopeful that this recognition of the need for holistic and sustained postpartum care is getting the attention it warrants--hopefully resources to make these services available to a wide range of the birthing population will follow and we as Certified Professional Midwives can be a part of the solution in shifting this paradigm for families regardless of where they give birth. I look forward to participating in the CPM Symposium next month to discuss and strategize around this and many other important issues and ideas for getting the Midwives Model of Care to more families to help save lives and improve health for new families.

And I hope that rather than trying to design something on their own, ACOG can be called in to learn from, amplify and magnify the collective wisdom that already exists within impacted communities about what is needed and what works to save the lives of mothers, birthing folks and babies, especially the work of midwives of color, like Jennie Josephs, Claudia Booker, Shafia Monroe and organizations like Southern Birth Justice Network, Uzazi Villlage, ROOTT, and Ancient Song Doula Services, and so many more amazing, powerful people and efforts that need to grow and be supported. Just in the past year several powerful reproductive-justice oriented reports were released from communities of color laying out the solutions to the challenges women, birthing people, babies and new families face (will share those reports in another post soon and link from the resources section on this site). This listening and gathering of experts on the ground who are already providing this model of care should be the starting point for this redesigning and reimagining of postpartum care, and indeed of the entire approach to the childbearing year (because midwives know that the seeds of a healthy postpartum time are planted throughout the pregnancy, not just once the baby has arrived!).

From the Committee Opinion-- sound familiar? 

“New mothers need ongoing care during the ‘fourth trimester.’ We want to replace the one-off checkup at six weeks with a period of sustained, holistic support for growing families,” said Alison Stuebe, M.D., lead author of the Committee Opinion. “Our goal is for every new family to have a comprehensive care plan and a care team that supports the mother’s strengths and addresses her multiple, intersecting needs following birth.”

Here is the press release and here is the full Committee Opinion. 

Check out my new website highlighting Fourth Trimester Services for all families!

Discrimination is Bad for Your Health

Photo by Andrae Ricketts on Unsplash

Code Switch's recent podcast highlights maternal death and the impact of weathering from racial stress on black and brown mothers and birthing people along with their need to be constantly vigilant in a racist world, as well as how racism impacts black and brown folks' concerns and symptoms being taken seriously. Half of maternal deaths happen in the postpartum period...You've probably seen the recent story of Serena Williams [...]...as so many studies have shown, education and income levels don't mitigate the negative influence of racism when it comes to poor outcomes for babies and birthing people of color.

What many of these powerful stories and podcasts and articles don't highlight, is how there already is a model of care that serves families for the entire childbearing year and that recognizes that birth is just the beginning and where a cornerstone of the care is to LISTEN TO WOMEN. MIDWIFERY!!! Fourth trimester (the first three months after birth) care is basically non-existent for the 90% of people who get mainstream obstetrical care in this country. Postpartum care for the mother-baby/parent-baby unit is such a huge part of my work as a midwife, it is infuriating that this care isn't valued or supported for new mothers and parents and their babies in our culture. We need to change that, especially for families of color, and that is going to be the focus of my professional work and advocacy and organizing/activist work as a midwife/mother/human in the coming months and years. More on that coming soon...

Why Not Home?

Why Not Home? is one of the best and most balanced films around homebirth I've seen- it's the film that speaks to the issues of the moment around client-centered care, collaboration across settings, informed consent and shared decision making. It also does a good job of highlighting how homebirth midwives offer more than just a place of birth but a model of care for the childbearing year. And now it is available for viewing on iTunes and Amazon Video!

From Susan, mom of Eli, born February 2014

Daddy Han cuts Eli's cord after the Golden Hour after the birth has passed!

My homebirth experience with Christy and Janeyne in one word would be uplifting. To me, having a homebirth was not about putting down hospitals or western medical practices. Rather, it was to seek and uplift a more suitable and natural way to bring my child into the world. To uplift core human values of how pregnancy should be treated as we prepare to take on one of the toughest roles we face as women. To uplift the empowerment that comes with childbirth that society has made us so afraid of. The moments leading up to becoming a mother and motherhood itself parallel each other in that just as motherhood is challenging as it is rewarding, child birthing is profound and miraculous as it is simple. Beyond being stellar midwives, Christy and Janeyne are two individuals that completely uphold and honor these truths. Their care is genuine and sincere. And most importantly, they listen.

Janeyne weighing baby Eli while Christy holds her baby Elio!

From Cara, mom to Paz, born December 2012

Charli n Paz

My homebirth with Christy Santoro was one of the most memorable experiences of my life. After having the great experience of giving birth naturally to my first child, Lucia, at 34 weeks in a hospital, I felt especially lucky to have been able to carry my second child, Paz, full-term, and to give birth to her at 39 weeks in the comfort and safety of my home. The night before the birth, after having been on modified bedrest for six weeks, I realized that - sooner than later - I needed to go back in to work for a couple hours to wrap some things up. My husband, Charlie, and I went on a date afterwards (our last for quite awhile!), and after filling my already full belly with two huge bowls of noodle soup, the walk home was pretty challenging. Finally made it home after several rest stops, watched a thriller (of all things), then at 4 am, my water broke. When I called Christy, she said "Happy Labor Day!", (which warmed my heart), told me to go back to sleep (yeah right!), and by sunrise, the contractions started picking up in intensity.

luci n cara

We called Christy again, plus our sisterfriend/doula, and "sibling doula" for Lucia, filled up the birthing pool, and waited to greet our guests. After Christy, her assistant, and the doulas arrived, the contractions started to slow down, and thank goodness that Christy gently encouraged me to stop playing hostess and start birthing our baby! They gave me and my husband a whole lot of space and privacy in the birthing pool (the water was so soothing!), kept me hydrated and fed, and with some massage, position suggestions, acupressure, and lots of love, Paz finally emerged into the world.

Paz & Lucia having fun.

Throughout the prenatal and birthing process, and post-partum, I felt so well cared for, respected, and doused with love. While I believe that all things happen as they do for a reason, I know that I carried Paz full-term and had a safe birth very much due to Christy's amazing expertise and wisdom. I will cherish her and my doulas forever!

From Lorraine, mom of Mira, born March 2011

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I chose Motherland Midwifery because I wanted midwives who would provide guidance and support, but ultimately give me the space to labor and birth in my own way. Mira was my third baby, my second born at home, and I trusted my body to know what to do. I had not anticipated my mind getting in the way.

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When labor began early in the morning it was clear to all of us that it would not be long. Everything moved quickly and smoothly until it came time to push. I pushed for what seemed like hours, and Meredith and Christy helped me through so many positions—squatting, standing, sitting on the birthing stool. I pushed for so long with seemingly no progress. I pushed until I thought I couldn’t push anymore.

And as I approached that point of wanting to give up, Christy said to me, “With every contraction, you’re shaking your head No. Whatever you thought this was going to be, let it go. Accept what it is.”

After that there was a kind of release, and I felt my face, my entire body relax. Moments later I was pushing my baby out into the world. I hadn’t realized how tightly I’d been holding on to a certain idea of that labor and birth until Christy helped me see it. I’m so grateful for her wisdom, and for giving me the support I didn’t know I needed.

Lorraine helps catch her own baby! Christy caught this cool shot!

A Little Bean Grows into a Rose...from Debbie, mom of Rose, born December 2012 and Gus, born October 2014

Photo courtesy of Tammy Bradshaw Photography.

A Little Bean Grows Into a Rose

(This is Debbie's story of her first birth. For baby number two, her labor went so fast I arrived two minutes after baby Gus emerged into his father's hands in the birth tub! What a range of birth experiences she has had!)

I have started to write this story down so many times, but always stop because I’m not sure exactly what to say.  I planned a homebirth, but did not birth my daughter Rose at home.  After we brought her home and people came to visit, I had some friends and family tell me they were sorry that things didn’t work out and I remember not knowing exactly how to respond because although she wasn’t born at home it didn’t mean something went wrong.  In fact, having her at Jefferson was always part of the plan.   

As I look back now and how my birth story ended, I realize now it only makes sense when I take the time to explain how it began.   I am a planner by nature.  In fact, it is what I’ve done as a Project Manager professional for almost 15 years.  I love projects, I’m good at making lists, checking them twice and making sure everything is done.   So, you can imagine my surprise then, when I found out I was pregnant and due Christmas Day.  As a Christmas time baby myself, this is not what I would have planned.    As my pregnancy advanced I was startled at how little “planning” I actually wanted to do.    My husband would laugh to see this written down because of course I prepared for our baby’s arrival, but I know how I usually plan and for me this wasn’t planning.   We even decided to let the baby’s sex stay a surprise and referred to our baby as Little Bean.

Now don’t get me wrong, I had a general idea of how I hoped things would go, but for some reason was content to have just the big pieces in place and let the rest come together in its own way.   We agreed up front that unless there was an issue that we like to welcome our baby into the world at home, because neither of us viewed pregnancy as an illness to be managed.   It was that simple belief that led us to Christy’s door.   We loved her approach to maternal care and we knew that she was the best person to help guide our Little Bean into this world.   Just in case, I also saw an OB through Jefferson Women’s Center.  My Dr. there was very nice and supportive of me planning a home birth, which was wonderful given some of the challenges we face today in maternal care.   I learned a lot about the state of maternal care in the US and wanted to use my birth as an opportunity to share this experience with people in the hopes that it might have a positive impact on them and their view of child birth.  And so my birth plan was to be home with a birth pool on hand,  Christy and a merry crew of supporters including my niece Courtney, who at 21 was very interested in seeing her new cousin be born; a medical student, who might otherwise not get a chance to see a natural birth; my doula Morgan, who has to be one of the sweetest people I’ve ever met; Christy; Christy’s assistant and a midwifery student because at this point it was shaping up to be quite a party.   

Since this was our first child, I thought it would be wise to take a class.  Now we did attend a child birth preparation class for parents planning a homebirth, but I’m ashamed to say we were both distracted and I really only remember Bill hurting his knee practicing a comfort measure called “Milking the Cow” and dealing with that for several weeks.  Despite all the really good advice I got, I failed to write up a birth plan, didn’t practice any comfort measures in advance and never visualized a safe place to go during labor.   I was planner who just didn’t want to plan.  

I did however buy into what people told me about my Due Date because to be honest I didn’t want my baby born on Christmas.  Given it was my first pregnancy, the general consensus from family and friends was that Little Bean would be born late and if we made it under the wire for the 2012 tax year we’d be lucky.    So you can imagine my surprise when I woke up on December 21st and thought I felt a contraction around 7:30am.  I dismissed it as Braxton-Hicks and went about my day since I was still working, although thankfully from home.   I was seeing Christy that morning for a check-up, so I wasn’t too concerned.    By 9:00 am I started keeping track of the contractions and by 11:00am a pattern had definitely emerged.  I still wasn’t worried, it was my first baby and I was expecting a long labor.   My check-up went well and Christy confirmed I was in early labor so I reached out to let a few people know and went into wrap-up mode for work and puttered around the house.   Bill came home to check on me and I remember sending him out of the house around 1:00pm to get a haircut since he wasn’t going to get that chance again anytime soon and pick up Christmas presents because even with a Due Date of Christmas, I hadn’t finished my shopping yet.   I can’t exactly remember when things changed, but by the time Bill got home around 3:00pm I was very uncomfortable and wanted to get in the shower for pain relief.  My doula was on her way and he put out the call to Christy to let her know what was going on.   I remember being totally surprised by how bad my back hurt and all I wanted was my birthing tub and I wanted it now.  I went into labor believing I had a high tolerance for pain, but this was taking my breath away.  Details are fuzzy now, but my hero husband cleared the area for the tub and got it all set up and ready for me to go in record time.   I do know that once I climbed in, I didn’t want to get out.  Sometime during my long soak my birth guests arrived and I remember the murmurs of conversation throughout the house.  My contractions stayed intense and close together and it would be hours before Christy finally coaxed me out of the tub to check on my progress.   I think it was around 8:00 pm when she checked to find me 8cm dilated and laboring hard.   I was allowed back in the tub since it wasn’t slowing me down and Bill remembers the midwives being happy and expecting the baby to be born before midnight.    A few more hours passed and Christy confirmed I was fully dilated, my water had broken and I could push whenever I felt the urge.   So I waited, I was ready and my Little Bean was on her way!  And then I waited some more.   What I thought was just a period of rest turned out to be my contractions abandoning me right before show time.   I couldn’t believe it and even now I still can’t.  My contractions which had in my opinion mercilessly beat the crap out of me for hours just puttered out.   I remember working with the midwives to coax them back into some kind of useful pattern with walking, different positions, herbs and something I referred to as “shakey-shakey”.    When those efforts didn’t work, Christy advised we go to the hospital for pain relief and Pitocin.   I didn’t want to go, but at that point we felt that was best for me to go to the hospital under my own power and my now infrequent “f-you” pains as I had taken to calling them were doing nothing more than keeping me awake.   So I said goodbye to everyone at home and headed off to the hospital with Bill, my niece Courtney and Christy.  

Upon arrival at Jefferson around 1:00am I was admitted to Labor and Delivery and given my advanced state taken directly to a delivery room.   I consented to the epidural for some pain relief, which surprised Bill because I had said it was the one thing I didn’t want since the idea of being numb with things in my back terrified me.   I agreed because I knew I needed rest and understood it would help prepare me for the Pitocin, since the expectation was contractions would return intensely once administered.   By 2:00am I was numb and everyone settled in for a much needed nap.  Despite what I had most feared about being placed on a strict schedule for progression at the hospital, it just didn’t happen.   The on-call OB and staff were supportive of me continuing to labor and deliver vaginally as long as Little Bean and I were doing well.    I think it was around 4:00am when they came back and asked me if I was ready to meet my baby and started the Pitocin.  I clearly remember it being so odd to have the nurse tell me I was having a contraction and not feel anything, but was confident the Pitocin was doing its job and Little Bean would be born shortly.   Well my Little Bean had other plans, because even with Pitocin my contractions would not settle into a productive pattern to push.   I think it was around 5:00am when I decided I was pushing with every contraction whether it was good one or not.    On Christy’s advice I had them turn down the epidural around 7:00am to get rid of the numbness in my legs and let me feel my contractions starting to build again, which helped me  know when to start pushing.  At some point I remember Christy asking about forceps or vacuum extraction and being told I still had to push the baby farther down for that and I just didn’t understand why Little Bean wouldn’t come out.   I don’t know what finally changed but pushing was finally productive and slowly but surely Little Bean started to move down after 8:00am.  I can remember all the encouraging words from Bill, Christy and Courtney telling me I was doing great, that they could see hair and just a few more pushes and the baby would born and not believing a word of it.  The on-call OB came back in the room to prepare for delivery and I still didn’t believe it.  Bill held my hand, Courtney and Christy each had a leg and I pushed and I pushed like they encouraged me to do, but my Little Bean just wasn’t going to come out.  And then I saw tears in my husband’s eye and the word’s “It’s a Girl!” escape his mouth.  Christy was smiling, Courtney was crying and then I saw my Little Bean, my daughter Rose and it was true she was finally here.   

So there it was, the end of my birth story.   The mystery of why it took so long to push Rose into this world was never solved.   There was no indication that anything caused my contractions to putter out or that Rose was ever truly stuck on anything.    I like having concrete answers and I’m never going to get one.  I have to accept, it’s just the way Rose needed to be born.   Looking back if you ask me if it went how I wanted it to, I have to be honest and say No, it definitely did not.  I had wanted a homebirth and I delivered Rose at the hospital numb with an epidural, on a Pitocin drip, and pushing prone on my back with my legs up all of which I had never pictured in my mind.  But, no one needs to feel sorry for me, because I don’t feel sorry for myself.  After all it wasn’t unplanned, going to Jefferson was always part of the plan if that is where we needed to go.   I did not have an ideal birth story, but it’s mine and I was fortunate that I got to labor without fear, was treated with respect, supported by people who love me and guided by my midwife through all of its ups and downs.   I learned that labor is hard, definitely hard to plan for and despite all of that that I could do it and hope to do it again.         

From Becky, mom of Simon, born September 2012 and Oliver, born August 2014

Simon was two weeks early, so naturally, my due date with baby 2 came and went with little fanfare. I had remembered that with my first pregnancy everyone kept telling me I would KNOW I was in labor, but at the time, it took me well over an hour to figure it out. I was worried that I had forgotten what contractions felt like, that I wouldn’t know if I was in labor again. But when I woke up at 5am two days past my due date with that first dull crampy ache, I knew immediately that the baby was coming that day.

Simon and Andrew were still asleep and I knew there was no reason to wake them up so I went downstairs to make a snack. I rested on the couch for about an hour, but the contractions were very inconsistent: 9 minutes, 6 minutes, 8 minutes, and not painful. It went on like this for over an hour before I decided to text Christy and give her a heads up that I was in labor but that it was slow going. I remember feeling a little frustrated because I didn’t have an “early” labor the first time, I was in active labor almost immediately. Sometimes I think maybe I slept through early labor. Nothing about this second pregnancy was the same as my first; I don’t know why I expected labor to be the same either. Christy suggested that I go for a walk to try to speed things up. Simon and Andrew were up by this point, so we decided to go on a morning family walk. Simon ran ahead and we wandered through the woods, stopping to pick up sticks and rocks, and for the occasional contraction. I told Andrew that the baby was coming today, I just wasn’t sure when.

We got back to the house and I rested on the couch but the contractions slowed down again. I called my sister to tell her she should get on the road, and called our friends to come watch Simon. Then I went to try and get some rest. The contractions were getting stronger, but not any closer together. I wasn’t able to sleep through them, so I sat on my birth ball and texted all of my mom friends (I knew they’d be up) that I was in labor and that I was bored. They kept me entertained in between contractions (which were every 5-6 minutes or so at this point). I spoke to Christy, who said she was going to make her way over. “No rush,” I told her. That was at 10:45am. At 11:15am, something happened and my labor got VERY intense. The contractions picked up, and so did the pain. I was unable to talk through them, and I certainly wasn’t texting. My labor with Simon was easy. It was quick as far as first labors go, but the intensity ramped up gradually, giving me time to adjust and manage my breathing and pain. This labor happened fast. By the time Christy arrived at 12:30, I was swaying and breathing away. I can only guess that I was in transition at this point, because the contractions came so fast and furious that I couldn’t rest in between. Instead, I sang through them to help control my breath and calm me down.

The pain was far worse than my first pregnancy (and that is coming from someone with an exceptionally high tolerance for pain). It felt like someone was ripping a knife across my belly. If I had let myself, it would have been easy to panic. With each contraction, I reminded myself to surrender to the pain. I moved through them one contraction at a time. I sang when I could (and Christy joined in, which was nice) because I knew it would force me to relax my jaw and breathe deeply. By this point (about 30 minutes after Christy arrived) I decided I wanted to push. When I talk about my first labor, I always say how I think I just decided that I wanted to push, but that I don’t think I ever got the urge that I HAD to push. This time, pushing was the only thing that felt good, if that makes any sense. Maybe it was my body telling me that the baby was moving down and I needed to help it along. I sat on the birthing stool and deliberately pushed, while I rocked back and forth. Each push brought relief, which told me that it was the right thing to do. After a few contractions like this, Christy suggested I get up on the bed.

I assumed the same position I had when I delivered Simon (again, nothing about this was the same). I rolled on to my side and pushed through the next contraction. I thought it went okay but Christy told me the baby didn’t like that position and I needed to move. Being on my back was excruciating, so I rolled to my other side. I had a couple contractions there, but the baby didn’t like that, either. This time, Christy suggested that I get on my hands and knees (easier said than done at this point!). With lots of assistance, I got into position and pushed through another contraction. At this point, Christy said “Okay, Becky. The baby needs to come out now.” There was no panic or urgency in her voice, but I got that she wasn’t messing around. Andrew helped to lift one of my legs up, and on the next contraction, I dug deep and pushed baby’s head. It was as I remembered, but this baby wasn’t as eager to come earthside, so it required a great deal more effort, and a lot more vocalization. (Overall, this entire birth was more vocal than my first). With my first, I remember the body just slipping right out, but this baby wasn’t having that. His shoulders got stuck on the next push, so Christy needed to hook her fingers under his arm and help pull him out. It only took a few minutes for him to be born, but it felt like an eternity. It took almost a minute for him to take his first breath, but it was the most beautiful sound. Within minutes, Ollie was warm, wide-eyed, pink, and ready to nurse. He latched on right away and nursed for several hours that first day.

As I reflected on the birth in the hours, days, and weeks after, I recalled that it felt frantic. Fast, hurried, and I felt like I wasn’t in control. It was still an easy birth, as far as births go. I was only in active labor for about 2 hours, and I only pushed for 5 minutes or so. But the intensity was new to me. My first birth let me move through it in my own way. This one really required a guide. I was glad to have Christy and her expertise. I never felt panicked. I never felt scared. Only focused and determined. But when it was over, I felt confused, and in a way, unsatisfied. My first home birth was a magical, peaceful empowering situation. This one just felt so frantic and overwhelming. When I tell people about Oliver’s birth I always say, “faster isn’t necessarily better.” I know all women long for quick births: to get through the pain fast and hold their baby in their arms. But the truth is that labor takes awhile because our bodies have a whole slew of things that they need to do before the baby comes out. And part of that is opening up. When it happens so quickly, the intensity and pain can get overwhelming and have the potential to really derail the mindful, peaceful birth I expected. I do want to acknowledge that I did an excellent job of staying calm and focused through what was easily the most intense pain of my life. I surrendered to the pain, but not the intensity.

As I struggled in the weeks after to understand everything that had happened, Christy and I had a long talk. She explained to me how, had I had this same birth in a hospital, it certainly would have been traumatic. The heart rate dropping could have resulted in an emergency c section; had I been allowed a vaginal birth, his shoulder getting stuck probably would have meant an episiotomy; his delayed first breath would likely have resulted in him being taken to the NICU for observation. Had I been in a hospital, my baby and I would have been subjected to a series of precautionary measures that would definitely have traumatized me. Having Christy walk me through everything that happened, and how, brought me a great deal of comfort. Having the perspective of knowing how the birth would have looked in a different setting brought me a great deal of gratitude for the experience that I had, even though at the time it seemed less than ideal. I came to peace with it slowly, and talking about it and writing about it has helped immensely. When I reflect on it now, I feel gratitude and joy. I had two amazing, healthy, happy homebirths, and two amazing healthy, happy boys. What more could I possibly need?

All pics on this post courtesy of Jillian Schlacter Photography

From Nicole and Mark, parents of Julian, born May 2015

From Nicole... When friends/family learned I was having a home birth, they assumed my decision was motivated by the desire to give birth naturally. While that was partly my motivation, the greater reason was the kind of care offered by Motherland Midwifery, from prenatal to postpartum. While I spent more time in the waiting room of my OB/GYN than with her during my appointments, Christy devoted hours upon hours to getting to know me, my baby, my pregnancy and the type of birth experience I hoped to have. She later guided me through a long, challenging birth with unwavering support and tenderness. My husband and I are forever grateful for the breadth of her knowledge, which was certainly tapped deep during the birth of our son. Afterwards, I felt anchored. As a new mom, it can be very overwhelming, but Christy’s care (home visits, frequent communication, etc) made me feel that I was never alone. I can’t imagine navigating my postpartum recovery without her. Christy, in short, is a gifted midwife and a beautiful person: a shepherd of babies into the world and also of mothers.

From Mark...

My wife and I were already committed to the idea of a home birth but having Christy as our midwife was a truly transformative experience. There is no question that if we had birthed in hospital, my wife would have been given a c-section.

We hurdled some challenging moments during labor but every step of the way Christy was able to guide us and give us the confidence of getting over the finishing line. One example: her experience in understanding exactly where the baby was positioned meant that she could direct my wife with specific pelvic exercises to get the baby in position.

Professional, focused, and full of love are the first words that come to mind when I think of the experience. It’s not just a powerful combination, it’s a vital one.

From Liss, mom of Jesse, born October 2014

My second home birth was my first with Motherland Midwifery, and Christy's knowledge and warm humor helped to make it a healthy and - dare I say it? - FUN delivery of our baby boy. At each prenatal appointment, Christy & Janeyne checked in with me both physically and emotionally, helping me to keep tabs on the baby's development, my state of being, and all of the concerns and excitement that my husband, four-year-old son, and I had. By the time active labor began, the five of us were a solid team ready to rock this birth! And rock it we did.

I spent most of my active labor (about 4.5 hours - thank Christy's advice in regards to nutrition, exercise, resting & sitting positions, and my regular chiropractic appointments) on a physio ball in my bedroom while everyone else hung out downstairs. It was quite a party - husband, son, doula, photographer, midwives, pets - and I have to say that the midwives' graciousness to my carnival was incredible. And can I tell you how comfortable it is to hang out in one's own bedroom, knitting, snacking, and chatting with the occasional visitor from my crew? Christy and Janeyne are so good at giving exactly the level of support that is asked for or required. They gave me lots of space to labor how I wanted to, maintained the vibe I had going when checking our vitals, and offered very unobtrusive suggestions.

About 3.5 hours in, I was at 7cm and ready to use the birth pool. My son went to bed and the real work of labor began. I will always be grateful for the calm, quiet way the midwives went about *their* work while I got on with mine. As the photographer remarked, they are total professionals - competent and capable. As I began making some unbelievable noises, the atmosphere in the room was both sacred and joyful. The louder, deeper, and longer I groaned, the bigger my husband grinned. We all knew we were very close to meeting this baby! Big brother was brought into the doorway, half-asleep, to fulfill his request that he be there no matter what.

The moment of crowning was almost overwhelming, I remember locking eyes with Christy and she intuitively showed me just how to breathe through it. And then baby's head was born! Sweet relief. I heard but mostly ignored some excited whispering - it turns out that he was born with the bag of waters intact. On the next surge, he burst through, I caught him and brought him to my chest, and we all rejoiced! My son's first words to his baby brother were, "Don't worry, Baby Carrot, your mommy is right there."

I am so thankful for our healthy birth journey, and how it was truly our whole family's. Those first few hours, snuggled up in bed as a family of four, are etched in my heart forever, and so precious to me. Thank you, Christy. Thank you.

All photographs in this post are copyright of Jamie Siever Photography 2014.

From Kate, mom of Camille, born December 2012 and Penny, born March 2015

People often ask why I chose to use a midwife and do a home birth.  It is an extremely difficult question for me to answer in passing because it was not a decision I made lightly (if you know me, you know that I do not make any decision hastily). I wanted to labor and deliver without drugs; I wanted to be in an environment where I felt safe and supported; I wanted a provider that I knew, trusted, and felt comfortable with; I wanted a provider who would tell me if I needed intervention but would not push me to unnecessary interventions.  Those are just a few of the considerations that led me to a midwifery model of care and I cannot express how thankful I am that I found Christy. Christy has guided me through two pregnancies and the births of both of my beautiful daughters.  I cannot fully express how much these experiences changed me. I first found Christy when I was pregnant with my first child. I unfortunately miscarried in the first trimester- I was around 10 weeks pregnant and was seeing an OBGYN at a local hospital while also considering a nearby birth center or home birth.  Shortly after my miscarriage, I found out that I was pregnant again!  The first thing that I did was contact Christy, and luckily she still had openings in my estimated due date timeframe.  I remember the first day that my husband and I went to Christy’s house for a visit.  It was a strange but comforting feeling to be welcomed into her home instead of waiting in an office over an hour past my appointment time.  I immediately knew that I connected with Christy and that she would be a good fit for us.  With Christy, I never felt like a number or like I was being passed around to different Doctors who checked my vitals to make sure the baby and I were healthy but wouldn’t remember my name.  I didn’t have to worry which Doctor was going to be at the hospital when I delivered my baby, or whether my wishes for delayed cord clamping, immediate skin to skin, etc. would be considered.  My appointments with Christy covered all of the necessary check-ins for vital signs plus check-ins about my emotional well-being, nutrition, exercise, and all of the “real life” stuff that helps you prepare for bringing a new life into the world.  I am a very sensitive person and generally want to be left alone when sick or in pain.  Because of this, I knew that aside from Christy and her assistant the only people I wanted present at my birth were my husband, my sister and one of our best friends who also happens to be a doula.

Our first daughter’s estimated due date was December 7th, 2012.  Days came and went, with no signs that she intended to make an entrance anytime soon. I came down with the flu sometime around 41 weeks and, as you would imagine, was really fatigued and emotionally drained. Christy sent me for the non-stress tests every other day to ensure everything was going well with baby.  That Wednesday, December 19th the Dr. at the ultrasound clinic said that it looked like the placenta was aging and it would be best to have the baby by Friday, the 21st.  At that point, I had tried most of the recommended labor inducing strategies – long walks, intercourse, some nipple stimulation, etc. The only thing left prior to being induced was the one I dreaded, and feared the most…castor oil. Thursday afternoon I called my sister and asked her to come to our house.  She arrived at 5 pm, just as I was downing my castor oil milkshake. 3 hours later, I was in labor and it was INTENSE right off the bat.  I had grand plans of a water birth, but the oh-so-tiny water heater in the South Philly row home we were renting had a different idea.  My sister got out our biggest pots to boil water and help warm up the tub, which was situated in Camille’s closet-sized nursery on the second floor (spoiler alert: I never made it to the tub). I had taken up shop on the third floor –totally naked, windows open, pacing between our bedroom and bathroom for hours, making noises that my husband said he has never heard before.   Christy arrived around 11 or so and checked to see how I was progressing.  I was only slightly dilated and my support team hunkered down for what it seemed would be a long night. A few hours went by and my contractions became longer and closer together.  Eventually, I found my body bearing down on its own and was trying my best to hold back because Christy had checked me again and I was still only a few centimeters dilated. If I pushed prior to my cervix opening, it could cause swelling and pain and could potentially make the delivery more complicated. Christy and  my husband Josh helped me breathe through contractions and eventually had me lay down on my side on the bed. I remember feeling like a caged animal but Christy supported me, encouraged me to relax and directed Josh in helping me work through the pain. I begged her to break my water but she encouraged me to wait it out and trust my body. I still remember the empathy in Josh’s face as he slowly helped me breathe through contractions “hee, hee, whoooo”.  At some point, I ended up back in the bathroom, laboring on the toilet and some blood came out.  Christy said that was a good sign and that things were changing and decided to check my cervix again.  I will never forget the shock and joy on her face when she looked up at me and said something to the effect of “I don’t know how this happened so quickly, but if you’re ready to go…you can push with your next contraction”!  I quickly decided that I did not want my baby to be born on the toilet, so I asked to go into the bedroom.  I stopped before I crossed the threshold of the door and asked Josh to put the shower curtain down on the carpet so that I wouldn’t ruin it (I’m sure Angelo, our former landlord is out there somewhere thanking me for that moment of clarity).  Josh quickly obliged, I got into a squatting position, and with a few pushes I delivered our precious baby girl!!! Camille Evette Kwedar was born at 4:04 am.  She was 21.5 inches long, 8 lbs. 8 oz. of squishy faced perfection. Christy checked the baby and kept an eye on me while her assistants were like little elves, cleaning up all of the birth supplies, bringing me food to eat, and letting Josh and I have time with our sweet new babe while my sister captured photos of our first moments as a new family.  It was the happiest day of my life.

Last summer, my husband and I found out we were expecting our second child! I immediately reached out to Christy to let her know we were expecting as I know her schedule fills up quickly.  My husband and I were on the fence about another home birth because we moved from the city to the suburbs and did not live as close to a hospital in the event that I would need to transfer. Additionally, this pregnancy was a bit more rocky from the start because I needed an emergency appendectomy when I was about 6 weeks pregnant. I voiced my concerns to Christy we discussed them at length.  We both thought it would be best if I saw an OBGYN after my appendectomy.  I found a wonderful provider at a midwife-friendly practice and was told that I was at no higher risk because of my appendectomy and ultimately decided that I could not imagine having anyone but Christy attend my next birth. We were treated with the same kindness, thoughtfulness, and attentiveness throughout this pregnancy.

The weeks came and went much more quickly this time around and before I knew it, I was desperately waiting for baby to arrive.  Once full-term, I had some test results come back after bouts with nausea that showed slightly elevated platelet counts, so Christy sent me to consult with the OBGYN again.  The OBGYN gave me the clear to wait things out and see when baby decided to come.  41 weeks in, I woke up at 4 am to a bloody show.   I woke my husband up to ask him if he thought I should call Christy. He said “yes’’ and went back to bed.  I texted her a picture (something I’m assuming you wouldn’t do with an OBGYN) and she told me to keep her posted if my contractions started.  40 minutes later I was in labor.  I went downstairs, did the dishes, straightened up in the kitchen and labored until around 7 am when Christy encouraged me to wake my husband and have him take our older daughter to daycare.  Christy and Josh both arrived about 7:45 and by 9:46 am our second beautiful daughter was earth side! Penelope Rae Kwedar weighed in at 8 lbs. 7 oz., 21.5 inches long and delicious as can be. Labor and delivery were much different the second time around.  I totally opted out of the birthing pool because I didn’t want the stress of fussing with it and thought that I would probably want to pace around like I did when laboring with Camille.  This time I spent most of my time laboring over the toilet or squatting on the stool.  Christy eventually coaxed me onto my side on the bed (I was not very happy about it at the time, but I am thankful now) and I ended up giving birth flat on my back, which I totally did not expect!  Penny had her fist up by her face and the cord was wrapped around her neck and her body, but Christy and Asasiya were extremely diligent, making sure that she was healthy!

Christy absolutely practices compassionate, women-centered care.  I have felt so supported by Christy through pregnancies, post-pregnancy care, intermittent check-ins about emotional well-being, etc.  I truly love and respect Christy and am forever thankful for the impact that she has had in my life.

From Zoe, mom of Nomi, born September 2013

I was so thrilled when I realized I would be able to work with Christy for my second homebirth. Working with Christy felt like being with a kindred spirit. She has a calming presence, but her fierce protective instincts are visible just below the surface. And I really got to see her jump into action during my labor... I ended up having a VERY fast labor, with only Christy and my husband Ken in the bathroom with me, our 3-year-old son Naftali asleep down the hall. Shortly after Christy arrived that night, I went to use the toilet in the middle of very intense contractions. I stayed on the toilet for the next contraction. From the other room, where she was setting up, Christy could hear the sounds I was making and called to me "Are you pushing, mama?". It wasn't until she asked that I realized I was! I love that she knew what my body was doing better than I did, just from hearing the sound of my voice. She rushed into the bathroom, with Ken working to both support me and help her set things up.

I had told Christy that during my first labor, I felt like I didn't get to slow down and notice what was happening while I was pushing. This time I wanted to feel more like I was letting the baby slip out, rather than efforting so hard. So in between the three or four pushes it took to bring Nomi out, Christy reminded me to stop and breathe for a minute. What a powerful moment! Nomi's head was right there crowning and I got to really feel it. "Um, Ow!" I said, laughing. Then another push, and there she was. I feel so grateful to have had the strong and wise support of Christy in such a fast labor. We really got to do it exactly how we wanted it - in our home, with our family, and however my body needed it to go.

From Lisa Knolificek, MD

I could not be more thankful for finding Christy, and am so grateful she was able to be my midwife for my second pregnancy. With my first pregnancy I began doing research and realized I wanted to have a natural childbirth. Fortunately, I was able to have a natural birth at a hospital, however it was not quite the experience I had desired. I realized that the second time around I wanted an even more personal and less medical birth. I choose to have a homebirth with a CPM because I felt this was the best possible choice for me and my family. We researched CPM’s and homebirth and found that for a low risk mother such as myself, it is a valid and safe choice and one that fits with our wishes, much more than a hospital birth. We wanted a personal relationship with our provider as well as an approach to birth which treats birth as the normal and natural event that it is. As a physician myself I have a great appreciation for hospitals and medical intervention when it is necessary, and if I had needed such intervention I would have been grateful to receive it. However, I do feel that, at present, hospitals often provide more intervention than is necessary and that is something I wished to avoid. I was grateful to have a completely natural childbirth in my home with Christy, I would recommend her to everyone. I only wish I had found her for my first birth!

"Children Learn What They Live" or "Parenting wisdom from a bathroom stall at a farm on my vacation"

Hey families and friends...

I haven't had much time to blog this summer (is it really the end of August?!) and realize I'm about 20+ births behind on stories. We'll see if I get to catch up in the coming weeks but in the meantime I wanted to quickly share this happened-upon parenting wisdom we encountered on the last day of our vacation in SW Pennsylvania at the Laurel Highlands Garlic Festival at a quaint family farm.

I thought it was sweet and rang true (yes, I know too much random praise isn't good for kids and it's a bummer that the poem refers to all children with the male pronoun-this looks like it was from the 70s). But I wanted to share it with folks! Hope everyone is having a great end of August!

Enjoy!

Christy

Welcome Coraline Soleil!

Chrissy & Anam decided to have a homebirth a little more than halfway through their pregnancy. We are so glad they made the switch! About 10 days after her due date Chrissy called me at 6 am very excited that labor had begun! I was excited too as I had three mamas past their due dates and a couple others approaching their due dates and was ready for someone to get the birth boom going! Her mom arrived soon after I got there and was absolutely thrilled to have been invited to the birth and was so proud of her strong daughter.

Chrissy labored beautifully-- slow dancing, big hip circles, moaning out her beautiful birth song. The baby's in-utero nickname was "Bonkers" and Chrissy kept saying "Bonkers, we are doing it!". Anam was a sweet and steady presence. By 8 am the surges were closer and stronger and Chrissy continued to talk to her baby girl and saying affirming things to herself like "Ah yes, I can do it!" and "I'm doing it, I'm doing it!". Her low and open sounds helped things progress. Anam was looking at Chrissy with so much respect, awe and curiosity of the this heretofore unknown power in his partner. There was so much love between this mama and daddy!

By 10 am Chrissy was starting to bear down at the peak of the contractions and sure enough was fully dilated and the urge to push was beginning. It was a couple more hours before the baby made her way out as Chrissy tried a lot of different positions including some time squatting in her tub which really helped the baby drop down into the birth canal.

8lb 11oz Coraline Soleil Owili-Eger was born on February 15, 2012 at 12:47 pm with her mother, father and grandmother present surrounding her with love. What a lovely post-Valentine's Day birth! And the beginning of a busy month...more soon about the other two babies born that week!

Congratulations to Chrissy, Anam and Coraline!

Spring Potluck Photos!

The Veitch Family hosted another great Spring Potluck for the Motherland Community in April at their urban homestead in East Falls. Thanks Tanya, Rich, Nellie and Kestrel! We all had a great time! Enjoy these pics!

Stay tuned for a summer potluck date!

Welcome Lilianna May!

(It has been awhile since I've been able to post birth stories-- I'm about 13 births behind as I've been so busy catching babies and doing midwifery political advocacy work-- but hope to get a bunch up soon!-thanks for your patience!)

Kristen and Jude were expecting their first baby the end of January. Besides moving to a new (and lovely) home in Manyunk partway through the pregnancy, their little family was faced with the challenge that Jude injured his leg and was on crutches for the last several months of the pregnancy and into the birth and postpartum. But this sweet couple took it all in stride and prepared for life with a little one.

Kristen's labor began in the middle of the night and steadily intensified over the course of the day. By late afternoon the contractions were very, very strong and Kristen's friend Alais came to do some Cranialsacral Therapy to help her move through it and support both Kristen and the baby. Kristen was progressing but slowly and some concerns arose over her Blood Pressure, the baby's heart rate and meconium in the fluid so we made the decision together to transfer to Pennsylvania Hospital. The rest of Kristen's labor and the birth were a great example of how the judicious use of an epidural and pitocin can be so effective and helpful in preserving having a vaginal birth. Kristen was so strong and steady throughout and Jude (God Bless Him hopping around the hospital room on one-foot!) and Kristen's sister and Cranialsacral Therapist Alais were also great support. Once Kristen got some rest and the pitocin was started things progressed quickly.

In fact at one point when the baby dropped quickly into the pelvis her heartrate dropped. At first there was concern but then we realized it was head compression as this baby girl was ready to be born! Kristen pushed amazingly effectively and Lilianna May Alvarez was born on January 26, 2012 after just 30 minutes of pushing! She weighed in at 6lb 10z and was (and is!) cute as a button.

Congratulations to this sweet family!

Welcome Baby Madhava! Another Winter Solstice birth!

Sheila and Radha had a beautiful homebirth with Meredith for their first child Uma. You can read about it here.

Sheila had Uma early and didn't expect that would happen this time around so she was surprised when she started having contractions the morning of the Winter Solstice. I think that she was in a bit of denial about it really being labor and rather than call Meredith she just sent her a Facebook message as Meredith was showing up as being signed in. (Note--don't do this! Call or text us! ; )

Luckily Meredith saw the post and sure enough it was the real deal when she called this sweet family.

Meredith caught me just as I was leaving Sarah's birthin New Jersey so we all converged in Elkins Park. It was baby Nora's first birth with her mama midwife and soon-to-be big sister

Uma got some great practice entertaining a little one as she helped bounce Nora and keep her happy as Meredith and I attended to Sheila and Radha.

Sheila was in the tub rocking and moaning and singer her birth song. It was a sight to behold as she felt the baby moving down and her bright eyes shined with the intensity of the surges and the realization that indeed today was the day she would meet her new baby and be the mama of two lucky little ones!

Just about 30 minutes after we arrived Sheila powerfully and exuberantly pushed baby Madhava into her hands and there was a lot of joy in finding they now had a son! Uma and Nora were excited and happy too!

7 lb Madhava latched to the breast and soon big sister joined him.

What a happy family! And what a nice birth to welcome Meredith back from maternity leave too! Congratulations!

Baby Frog arrives Sunny-Side up!

Morgan and Keith switched to planning a homebirth at the beginning of the third trimester for their second child. I remember after our interview Morgan wrote me saying she just felt so happy and at peace and excited to have found this model of care for the rest of her pregnancy and transition into the next chapter for her family after a very medicalized first birth in the hospital.

Morgan went into labor on a Saturday evening and I headed over around midnight. She is a very laid back mama and it was hard to tell how far along she was at first but the contractions were regular and felt strong. She is a crafty mama too and we enjoyed seeing some of the latest additions to the room including a mural of Ganesh on her closet door by the birthing tub. Ganesh--the overcomer of obstacles is a good god to be watching over you in labor!

Around 4 am on January 8, 2012 Morgan began pushing and soon after her bag of waters released. Often when the water breaks at that stage of labor and one has already had a vaginal birth the baby comes very soon after. When that didn't happen it seems to confirm our already strong suspicion the baby was posterior. Morgan was going to really have to work for this one! She got into McRoberts position (i.e. the position pretty flat on your back with your legs up by your ears that most folks think you never get into in a homebirth but sometimes is the best one for the baby to come out especially if posterior) and the baby started moving down more effectively. Soon after getting in that position the baby came around the curve of the birth canal and Morgan was able to feel "Frog's" head -- big brother Toby had named the baby Frog!

Zoe Indigo was born soon after weighing in at 7 lbs and indeed being born "sunny side up" or as my assistant Ana taught us it is called in Germany as a "stargazer". Thanks to Janeyne who was assisting me at this birth and complied with my excited request to get a picture of the baby and Morgan looking at each other when the head came out and Morgan was the amazing two-headed lady for a brief moment before she pushed out the rest of the body! And thanks for Morgan for being willing to share the pic!

Baby Zoe did the breast crawl and got a few good sucks in and some skin-to-skin time with mom and snuggles with daddy Keith (who was such a great support to Morgan throughout!) right after the birth which was so precious as that didn't happen in the hospital with her son. Big brother Toby slept the whole time but was very excited and a big overwhelmed to find out he had a sister when he woke!

Congratulations!

Welcome Cal Arthur...an early arrival!

Belinda wasn't due until Christmas eve so I was very surprised when I heard from her and Eric early in the morning of December 4th! But after an hour it was clear this wasn't warm-up later as her surges were coming every 3-4 minutes and getting stronger! When I arrived Belinda was working hard but doing a beautiful job relaxing with the contractions. Eric got the tub ready and she found some relief during transition in the warm water.

Belinda was strong and steady as she moved from the tub to the birth stool to her side in bed as she breathed her baby down and out. 7lb 5 oz Cal Arthur's head emerged after a slow gentle crowning while Belinda smiled from ear to ear with joy and relief!

His body slipped out with the next contraction and much to all of our delight this sweet little boy did the breast crawl and started nursing on his own minutes after the birth! Big brother Sam slept through the whole labor but joined his family soon after to welcome baby Cal. Congratulations to this great family!