Thursday, October 29, 2015

A New Home

Hello All!
I am happy to share some big news with everyone. I am moving to new home and expanding my social media presence. Please check out my new website at as well as my new Facebook page at 'A Midwife on the Path' I look forward to seeing and hearing from everyone there!

Sunday, October 25, 2015

A Language Revolution

Language matters. Words, when spoken, have weight and a certain power. As birth workers we know this; the birthing person delivers the baby NOT the provider, midwives "catch" babies. The difference between "my care provider supported me through my VBAC" versus "my care provider allowed me to VBAC" is a very important one. As long as I have been involved in birth, I have felt very uneasy with the phrase "out of hospital birth". In my mind, it makes the hospital the norm and centralizes the focus on the hospital as the standard location for birth. This is wrong! If we plan to take back birth from the dominant physician based paradigm then we must move the focus from the hospital and put it back on the birthing family as the center of the process.

Recently, I attended the 2015 MANA Conference in Albuquerque, NM. One night, I attended a benefit dinner for FAM and I heard a phrase that struck a powerful cord within my heart and soul. This phrase has continued to grow in my subconscious and is taking root. I think that we need to start a language revolution and begin to use this phrase in place of "out of hospital birth". The history and philosophy of midwifery is based in the community; midwives view pregnancy and birth as a normal part of the life cycle. We see the Mother-Baby unit as a whole being in the context of their holistic framework. These things cannot be separated from the community; the entire family and the support circles that surround that family.

I work at a free standing birth center and as such my clients and midwives are often inadvertently left out of the conversation. Our current culture uses "home birth" and "hospital birth" and of course the above mentioned "out of hospital birth"...which often is only associated with homebirth. All of these terms fail to recognize birth center birth and maintain a marginalization of all the options. So, what is this phrase?....
Community Birthing
Community Birthing can encompass all the options that families may choose outside of the hospital. It does not utilize the hospital as the focus and therefor the norm. I plan to start using this term exclusively when referring to any birth that happens outside the hospital. No more "out of hospital" birth for me! What do you think? Care to join on this language revolution?....

Thursday, October 8, 2015

Why I Love Being a CNM.

Let me start off by saying that I am first and foremost a Midwife and I have learned that life often takes us to places we may never had anticipated. When I first decided to commit to this journey and become a midwife, I was absolutely going to become a CPM. I had zero interest in working in a hospital and never wanted to become a nurse.

Then I started to look for a preceptor and quickly became acquainted with this well known struggle! Eventually, I found an experienced homebirth midwife who would consider taking on an apprentice. However, I quickly realized that we had diametrically opposed philosophies, and that a relationship would not work. While I re-started the search for another apprenticeship opportunity, it also became clear that as a single mother to a young child keeping the schedule of an apprentice midwife would be nearly impossible. These factors caused me too look at other options. I started nursing pre-requisites at a local community college; reasoning that I would learn good information on A&P, microbiology, etc that could be useful as either a CPM or a CNM. I kept up the search for an apprenticeship and become involved in the local childbirth community. I still hoped, prayed and worked toward becoming a CPM. Then seemingly before I knew it, I was done with the pre-reqs and had to choose whether or not to apply to nursing school. I begrudgingly filled out the nursing school application. In my area of the country, in 2002, it was nearly impossible to get into a nursing program and it was common to spend a couple years on a wait list. I assumed that if I even got in, it would be on one of these wait lists.  To my complete shock and awe, I was accepted on the first try! After some serious contemplation, I decided to take this as a sign, made a HUGE leap of faith and went to nursing school.

Fast forward many years, trials, tribulations, a new marriage, joys and sorrows, a new baby, a few more years and I came out re-birthed as a Certified Nurse Midwife. In hindsight, which is of course always 20/20, everything worked out perfectly and as it needed to. I am thankful for everything that being a nurse taught me and I am proud to be able to call myself one. When I started this path, I had starry, rose colored glasses and was high on the idea of birth and babies. I had no idea how much I would also fall in love with full scope women's health care. I appreciate that, in many years, when the realities of being on call will become difficult I can choose to still serve women, just in a different capacity. Additionally, the security of being able to practice in any state or even internationally is comforting.  The past few weeks, and these cases, have exemplified why I love being a CNM and why I love working in a free standing birth center;
  • A sweet first time pregnant person at term calls to report that she thinks her water broke. A couple hours later I have her come in to the center and confirm that, indeed, the bag of waters has broken. We do an US to confirm that baby is cephalic (yes, I also did Leopolds and knew that babe was head down, but in these cases we also use the US) this way I did not do an internal, cervical exam. Because she is not in labor, we also do a Non-Stress Test or NST and the baby looks gorgeous. After a good discussion on all the risks and benefits and answering all their questions, she and her husband go home with some herbs to try and encourage labor to start. Several hours later, they call in a great labor pattern. When they arrive to the center, it is clear that she is in active labor and is entering transition, I do not do an internal cervical exam. We labor. A little while later, while in the birth pool she begins to spontaneously push and shortly thereafter gives birth to a beautiful baby. She never, during the entire course of her pregnancy, labor or birth had an internal cervical exam and I love that! 
  • Recently, one of my midwife sisters had a client in for a Well-Woman exam who wanted a photograph of her cervix. We were excited and made that happen, it didn't even phase us.
  • I have collected a pap smear while a toddler was latched and nursing and placed an IUD with the entire family present.
  • A few weeks ago, I had a couple come in for a Preconception Counseling visit. The client has a long and difficult history with some past drug use and mental health issues. She has felt judged and mistreated, "labeled", in traditional medical systems and practices. I was able to sit with her, spend a lot time and make her feel safe and comfortable. It was very likely her first ever positive experience with a health care provider. And she is now on track to plan a healthy and much wanted pregnancy.
  • A little while back, we had a client present for an annual well woman exam. Her physical exam lead us to do some blood tests to assess her thyroid function. These came back abnormal and we referred to a specialist. She was quickly diagnosed with thyroid cancer and had surgery to remove her thyroid, luckily the cancer had been caught early and there was no spreading of it to other organs or systems. She is now home and healthy with her sweet family.
  • There were two families at the center who had given birth and there were two families at the center in labor. The midwife on call received a phone call; a serious family emergency with one of her own children. I immediately sent her out to go to the hospital to be with her family. The other midwives in our group quickly stepped in and provided care to these families. This process was seamless and incredibly quick, the families did not even realize what had happened.
  • I have provided care to a woman who had never been sexually active, then met a wonderful man and counseled her on contraception and safe sex practices. Before their wedding I placed an IUD as they no longer needed to consider "safe sex" but contraception only. Then after they had been married and were ready to start a family, counseled them on preconception planning and removed her IUD. They then came to our center for their pregnancy and birth.
  • For the past year and a half, I have been providing care to a client with a significant history of abuse. She desires children some day. With time, care and the absence of any type of pressure we have worked up from our first meeting which had to take place out of the clinic to her being able to come into an exam room and have a partial physical exam. With the same care and patience, I have faith that we will be able to work up to a full exam.
All of these stories and many more make me grateful that my path took unexpected twists and turns, leading me to my current position. I truly appreciate every stage and aspect of being with all the ways that women need me.

Wednesday, September 16, 2015


I am a midwife and that is how I introduce myself. However, I am also a nurse and am a Certified Nurse Midwife. Here I am with two of my "doctor" stethoscopes, one for Mom and one for Baby. Not pictured here are my fetoscope and Pinard horn.

Sunday, September 13, 2015

A Poem for New Midwives

A dear colleague of mine is starting on the path of becoming a midwife. Last night, some midwife-sisters gathered to wish her well and share encouragement. I quickly jotted down some words; through my sleep and today, they have expanded and I share them here with her but also with all folks who are starting on this road.

Births will be glorious.
Births will be ferocious.

Babies will be welcomed through joy, laughter, gratitude and prayer.
Babies will be welcomed through weeping, sorrow, heartbreak and prayer.

Families will be wondrous.
Families will be tumultuous.

There will be unfathomable beauty. 
There will also be blood, urine, amniotic fluid, mucous, poop, sweat and tears.

Being 'with woman' is all engrossing; it requires tenacity, intellect, passion and grace.
Be mindful and feed your soul as well, do not become consumed.

Being 'with woman' is all rewarding; it will give you peace, community, strength and pride.
Be humble and remain rooted, do not become boastful.

Remember that you are not alone.
There is a history of ancestral knowledge behind you.
There is a circle of support around you in the now.
There is a place for you at the table in the future...and the view is glorious!

This post was recently republished on Birth Wisdom, a resource for maternal health advocates by Birth Institute. Want to become a midwife? Check out the Birth Institute Holistic Midwifery program

Sunday, August 9, 2015

Obstetric Violence (trigger warning)

We sat at her kitchen table drinking coffee. The sky was a clear blue with a gentle breeze. As often happens, when women hear that I am midwife, she wanted to share her birth stories with me. When this happens, I try to listen attentively and remain open to their sharing. Her children are 50 and 51, yes born very close together, 11 months apart to be exact. As she tells her stories, she becomes visibly upset and even agitated. For her, these things happened yesterday. In my experience, this is a crucial part of dealing with birth trauma; it always feels so current, the pain is often just below the surface. She is angry and confused, still not understanding the things that happened to her. She remembers very little, just snapshots really. She was "drugged" and felt out of her body, something "cold and hard" was placed inside her to "pull" out her children. She was treated "like an animal" there was no compassion. The next day, she had bruises and abrasions on her wrists. For years afterwards, she would wake in the night terrified and feeling as though she were dying.  She still deals with pain "down there" all these decades later. She asks me; "Do you know what happened to me?"
Do I tell her? Do I tell her about 'Twilight Sleep', women being strapped down to tables, episiotomies and forceps and the assembly line that was a labor and delivery unit? I ask her; "Do you want to hear my answers?" She responds that she does. So, I tell her, I tell her everything that likely happened to her. She is calm and quiet for a time, occasionally nodding to herself. Eventually she says, "Now at least I finally know that I am not crazy."  We two women looked at each other with silent tears on our cheeks and finished our coffee.

This is the truth behind the history of obstetrics in this country. This is the reality of what the knowledge is based upon. This is where "they are coming from" and we can never forget. Have we struggled, fought and toiled to make great strides to improve the care given to women during birth? Yes! Are we done? Hell No! This is why we must continue. Just because things are much better now does not mean that the work is done. I share this story so that we don't forget, so that the new advocates and activists remember the history, know the past and never forget where they came from.

Tuesday, May 12, 2015

#LifeOfAMidwife: Birth Happens

Birth Happens! Sometimes it happens so quickly that you barely have time to catch the sweet baby, let alone make it all the way inside the birth center! This handsome babe kept his parents in suspense, with a couple trips to the center with "false" alarms but then when he decided to make his move for real we didn't even get through the front door and only made it to the top of the stairwell. Both baby and Mama were fantastic and healthy, the baby was even born en caul. We quickly moved inside after the birth and they had a lovely postpartum recovery. This is a picture that I took later of the "aftermath" of the quick, beautiful birth. Then I had A LOT of scrubbing to do.