BIRTH STORIES AND LOVE LETTERS

Midwifery: The profession or practice of assisting women in childbirth.
Throughout the course of my pregnancy people commented on my choice to use a midwife a lot. Typically it was people who were curious about the practice and how midwifery differed from an OB. Occasionally people excitedly shared their experience delivering with a midwife and praised my choice. Often I got worrisome looks and had to entertain all the “what if” scenarios that came to their minds.

The concerns came from a good place out of concern for me and my baby, but I truly believe it also came from a place of fear and misunderstanding. I did my due diligence when choosing a provider; I researched the practice, the different levels of education, questioned the methods and read the studies. I chose not to live in the land of fear and what if, and instead I trusted my body to do what it was made to do. I want to make one thing I believe very clear: the choice that each woman makes is hers, and there is no wrong choice. Midwife, OB, witchdoctor… whatever. Every woman should be able to choose what she is most comfortable with and be supported on her journey. Childbirth is a feat no matter the method; with the aid of drugs or not, vaginally or via cesarean, in the hospital or at home.

In the United States midwifery is on the rise, slowly. According to the National Center for Health Statistics, certified nurse-midwives (CNMs) and certified midwives (CMs) attended 332,107 births in 2014. This accounts for only 8.3% of births nationwide that year. The majority of these births occurred in hospitals, with only 3% of those births occurring in a birthing center, and 2.7% occurring at home. Why are so few babies born in the care of a midwife? A couple hundred years ago, when births were transitioning from the home to a hospital setting, smear campaigns were launched against midwives labeling the practice as dangerous. Later midwifery was banned altogether in the United States, but returned in the 1960’s. In the UK midwives attend 68% of all births, and their maternal mortality rate is nearly 1/3 of that of the US. A 2014 study conducted by the UK National Institute for Health and Care Excellence determined that healthy women with low risk pregnancies were safer giving birth with the assistance of a midwife than they were with a doctor. In 2015 another study found that per every 100,000 live births in the United States, 26.4 women died of complications of pregnancy or childbirth. Compare that to the UK, where for every 100,000 live births only 9.2 women die.

Last year, on the evening of Christmas Eve 2016, two (very faint) pink lines changed life for my husband and I instantly. We had been “trying” for all of 19 days when that positive pregnancy test surprised us. I was excited right away, and started researching OBs. Being faced with a list of doctors I was unfamiliar with was overwhelming. So many thoughts and concerns ran through my mind while sifting through their names, pictures and medical backgrounds. Most of the OB’s operate on a call rotation for deliveries, so the chance that my doctor would deliver my baby was low. Who would deliver my precious baby girl? Would I feel comfortable with him/her? Would they honor my wishes and care about my experience? There were so many unknowns associated with this list, how was I supposed to choose?

I started asking around and got some great advice about the local doctors, but I still wasn’t enthused, mainly because of the above-stated concerns. Then one friend told me all about her experience at the Wenatchee Midwife Service & Childbirth Center. I couldn’t help but notice her smile and glow when she spoke of the midwives and her experience there. I needed to know more, so she directed me to check out their website and to watch a documentary called “The Business of Being Born”. I called my husband and told him all about this idea I had – to have a natural delivery in an out-of-hospital setting with a midwife. He wasn’t crazy about the idea, so when I got home we watched the documentary that had been recommended and decided that we’d schedule a consultation with the midwife center. Ben’s first order of business was finding out how they’d handle a situation that went south. The practice is committed to the health and safety of mother and baby, and any cause for concern is handled quickly and efficiently. I felt confident in their abilities to care for me and the baby; Ben had his reservations at first but supported me in my choice. He warmed up to it pretty quickly and later thanked me for talking him into it.

The Wenatchee Midwife Service & Childbirth Center is founded and owned by Laurie Braunstein. She began her journey in 1985 assisting women during home births and her practice has since grown into a clinic and community of women assisting and empowering families through the stages of pregnancy, birth, and postpartum. Laurie, Eva and Danelle are the midwives you’ll meet if you ever wander in to this magical place. Laurie is no longer delivering babies, but can be seen in the clinic on most days spreading cheer, and when absent her presence is still felt.

Eva and Danelle share patients throughout pregnancy, and as an expectant mother you will spend equal time with each midwife during prenatal appointments. Appointments last about an hour each and the midwife is with you through the duration of that appointment and performs all care herself. During labor and childbirth, either Eva or Danelle is present and supportive throughout the whole process, and each midwife has a birth attendant who is NRP (Neonatal Resuscitation Program) certified and present for active labor and delivery. All the same newborn screening and vaccinations offered at the hospital are offered through the midwife center, but here you get to be present and involved in the process instead of having your baby swept away and brought back an hour later. After childbirth is over, moms typically stay for 4- 8 hours, and if baby is born late at night you are welcome to stay the night if you wish. The day following delivery, your midwife will perform a home visit to ensure things are going well, and at this time will recheck weight, do the 24 hour newborn screenings, and address any concerns the new parents may have. The midwife who delivers will then take on postpartum care for mother and baby for 6 weeks and is also reachable by phone at all times.

My journey at WMS began January 23, 2017 and will soon come to an end. My experience thus far has been nothing short of amazing. My first appointment was with Eva, and while waiting for it to start Ben and I sat in the lobby and read all the names of babies who’d been born recently. They have a long roll of paper that serves as a running tally for all the babies they’ve delivered.

I really looked forward to visiting with Eva or Danelle each prenatal appointment, we always began by discussing my pregnancy and slowly formulating a birth plan, but almost always ended up joking and laughing about other things. I absolutely love Danelle’s sense of humor, and I could listen to Eva talk all day, she has the most soothing and angelic voice I’ve ever heard. Twice during pregnancy I had concerns and called in, both times I had a midwife on the phone in 5 minutes or less. The first time I had kidney stones, the second I had elevated blood pressure. With both of these issues I felt their genuine concern and care. Toward the end of pregnancy after a routine appointment Ben told me “I am so happy you chose the midwife center. You have two women caring for you who love what they do and really care about you.” It’s true, I felt love from these women, and I love them too.

Around 38 weeks I was just plain sick of being pregnant. I walked in for my weekly checkup and begged Eva to get things moving. She granted me my wish and did her best to convince Sunny it was time to start moving out. Danelle did the same for me a week later. Friday September first, 40 weeks pregnant, I lay in bed mentally preparing myself to take castor oil. Suddenly I heard a faint popping sound and that was it, my misery was coming to an end; my water had broken. I contacted Eva to let her know and the beginning of the end commenced.

Ben and I were so excited as we quickly ate breakfast, grabbed the labor bags, and stopped by Tyson’s school so I could hug him as my only child one last time (insert emotional hormonal momma ugly cry here).  We headed to the birthing center to meet Eva. Once we arrived she checked my vital signs, listened to Sunny’s heart rate and did a couple of other things. When she was done she encouraged me to walk to regulate contractions. We happily set off down the alley, this was one of Ben’s favorite parts of the birthing center; the freedom we had to walk around outside. We enjoyed our time together with the comfort of knowing that Eva was accessible to us at all times. I felt like Shamu walking up and down the street with one foot on the sidewalk and one foot off and knew that I was a sight for sore eyes as the cars passed by.

After a couple hours of walking Eva recommended a series of yoga like positions called the Miles Circuit that was intended to progress labor. She knows her stuff, the circuit kicked contractions into high gear. Once active labor began I was offered the birthing tub, a giant Jacuzzi tub, which was one of the few items on my birth plan. When I got into the tub I remember breathing a sigh of relief as my body instantly relaxed. The birthing tub is as good as a milligram of morphine. I stayed there for the remainder of labor and Ben helped me through every single contraction by applying counter pressure to my hips, which was good for another milligram of morphine. For the last couple of hours I was surrounded by Ben, Eva and her birth assistant Danielle, and our birth photographer, Andrea, who is also one of my most loved friends. I felt more love and compassion in that room than I can remember at any other point in life. Sunny was born at 4:04 in the afternoon after about 9 hours of labor.

Natural childbirth can only be described as primal. I felt like an animal in the sense that even though this task required a huge amount of mental strength, my mind really was absent for the last couple hours and my body kicked in and instinct took over. All I could do was move forward one contraction at a time, one push at a time, until it was over. The moment Eva guided Sunny out and laid her on me is all a blur and I will be forever grateful to Andrea for capturing those moments. There is so much detail in the photos that I have no recollection of. In one photo I saw myself reaching for Sunny as Eva handed her to me, but I don’t remember reaching at all. In other photos I see the pain written in my expressions and I realize it really is true that a mother forgets almost instantly the pain of labor once they lay eyes on their child for the first time. I cannot put enough emphasis on the value of having these memories in the form of photos.

The whole midwifery experience was so special to me that it is difficult to put into words. From the very beginning Eva and Danelle were diligent in explaining each and every step and option to me and Ben. They put the knowledge into our hands and let us choose what felt right. In formulating a birth plan we started early, and they asked us things like who they should expect to show up when it was time for Sunny to be born. They made a list of those names and promised no one else would make it through the door should they find out I was in labor. They discussed different tests, treatments and vaccinations with us and asked us which ones we wanted. They never pushed anything on us, and if they disagreed with any of our choices they didn’t let on. During the labor process Eva was there for everything, but for much of it she remained in the shadows unless we wanted her to be front and center. When her birth assistant arrived any conversation between the two was hushed and minimal in an effort to respect the intimacy of our experience. There were no strangers, just friends. Eva checked me for dilation one time during the process, before I got into the bathtub to make sure I was far enough along in the labor process. Otherwise she was a quiet observer, monitoring my blood pressure and the baby’s heart rate. I remember asking her at one point if she needed to check dilation to know how close I was to pushing. She told me that my body would start to push on its own and at that point she’d begin to coach me through. I was not a pin cushion, nor was my body invaded regularly, and I was not hooked up to any uncomfortable monitors or machines. My body began to push on its own just like Eva had said it would. Once Sunny was born and she was given to me she was not taken away. Everything Eva needed to do and check was done while I held her.

When it was time to get out of the bathtub I passed Sunny off to Ben and walked to bed with Eva’s help. The placenta had a hard time coming out and the cord was weak so it couldn’t be guided. It ended up requiring more effort and support than I thought it would. While Eva worked on that Ben supported me and Andrea took care of Sunny, another huge bonus to having a friend present. Once it came out I got to snuggle up in a very comfortable bed with soft purple sheets – a stark contrast to the rough white sheets smattered with questionable stains on them at the hospital. We worked on breastfeeding and Ben and I relaxed and snuggled our new babe. After Sunny successfully latched Eva administered her Vitamin K shot. When she was done nursing Ben and Eva weighed her together and Eva gave her a good once over to ensure everything looked good. Once I ate and was able to pee we were free to go.  At 8pm we were out the door. Eva checked our car seat, walked us out, gave us hugs and off we went. She came to see Sunny the next day at our home and that was so fun. Never did we have to enter a sterile, foreign environment throughout this process. Everything was warm, cozy, inviting and safe. No strangers, no wailing from the room next door. We went in for an office visit for Sunny’s one week appointment. It was so fun to see her name on the list of babies born.

The best way I can describe the relationship that we had with Eva is to compare it to a healthy relationship. There is love, commitment and empathy, and a sense of freedom to be whom and what you are. We very consciously built this relationship together. Ben loved the involvement we had in the whole process, and the support and commitment we received from our midwives. My body was allowed to do what it was made to do, in its own way and on its own time. There were zero interventions, minimal prodding and poking, and maximum amount of compassion. Where else can you find a provider who will sit on the floor next to you for hours and provide silent support? I would choose this over and over. I whole heartedly believe Ben and I chose the best start to life we could give our daughter. If you are in search of a provider to assist you through pregnancy I strongly encourage you consider a midwife.

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Whitney