By: Alyssa Johns, LM, CPM
Midwives are a special breed and the care they provide is vastly different than the style of care typical in the western world. Here are some things that set us apart:
1. We believe your birth is normal until proven otherwise.
Pregnancy and birth are natural functions of the body, they are not illnesses or medical conditions. Yes, of course there are times that medical intervention is needed and times when complications arise. We are so thankful for the many things other providers can do when needed to keep us and our babies safe. Midwives are experts in what is normal in birth, and our job is to recognize when things are not in the range of normal and act from there. As long as you and baby are doing well through pregnancy and birth, there is no reason for us to do anything. We have seen that when we give you ample time and support that the process will work the majority of the time.
2. We believe in your ability to birth your baby.We have seen women do incredible things. We have seen their strength displayed time and time again. This knowledge gives us an unquestionable belief in your power. We know that whatever course your birth takes, you will display a depth of strength you never knew you had.
3.We care about the emotional aspects of your pregnancy, birth, and postpartum, not just the physical.
There is much more to pregnancy, birth, and postpartum than vital signs. Who you are and how you feel is incredibly important to us. We know that the emotional state you are in will affect your pregnancy, birth, and postpartum period. Our appointments with you reflect this belief as we offer long appointments so we can discuss your wishes, your life, your struggles, and your fears. We are close by throughout your labor to support you. We see you often in your postpartum period and make sure you are supported, coping with changes, and are feeling well emotionally.
4. We believe a relationship with you makes your birth safer and more comfortable.We work to make sure you feel comfortable and safe with us. We understand that having a strong sense of trust allows you to let go and labor more freely. Women do not tend to labor well when they are on guard. They labor well when they feel safe and supported.
5.We support your informed choices.Your body, your baby, your birth. We are here to inform you, support you, and keep you safe. We do everything we can to make sure you know what your options are, to inform you of the risks and benefits of the options available, and then allow you to choose what you feel is best for you.
6. We want you to feel respected and empowered. Our first priority is to keep you safe, but we also want you to have a great birth. It’s important to us that you feel respected throughout your labor, that you feel informed, and that you feel empowered to make the choices that are right for you. We want you to know that giving birth was done by your power, not ours. Birth is something you do, not something that should happen to you. We find that when our mothers feel respected and empowered, they feel positively about their birth experience no matter what turns it may take.
This quote from the Tao Te Ching says it best: ‘You are a midwife, You are helping at someone else's birth. Do good without show or fuss. Facilitate what is happening rather than what you think ought to be happening. If you must lead, lead so the woman is helped, yet still free and in charge. When the baby is born, the woman will rightly say,"We did it ourselves."
7. Our support doesn’t end at the birth.The Midwives Alliance of North America’s latest statistics say that 97% of women in the care of midwives are still breastfeeding at 6 weeks. We offer you support after your baby comes with caring for yourself, newborn care, and breastfeeding. If you go home and support is cut off 2-3 days postpartum, it is very hard to feel successful at these things. We are here to make sure you have resources and the support needed to have the best postpartum period possible.
8. We practice patience. A midwife’s motto is often “I sit on my hands.” We consciously choose not to act as long as all is well. We avoid the temptation to try to guide what’s happening if that is not needed. Labor can take time and when we are patient and allow the time needed, the body usually works things out. Pregnancy can take time too, so as long as you and baby are doing well, we don’t send you for induction before 42 weeks. When induction is out of the picture and we aren’t trying to rush the process, it usually goes much smoother.
By Alyssa Johns, LM, CPM
I’m a midwife. I thought I knew things. Pregnant with my second baby, I was sure breastfeeding was going to be easier than with my first, because I have learned things as a midwife that I didn’t know when my son was born. Breastfeeding him felt like breastfeeding an angry piranha. He chomped, screamed, but would not suck. After two weeks of my six week maternity leave had passed, I was marked with cracked and bleeding nipples and the feeling of defeat. I decided I was done spending my short leave crying and stressing over breastfeeding and I decided to just pump for as long as I could before switching to formula. That was 7 years ago. Since then, I have become a doula, a HypnoBirthing instructor, and a midwife. I have seen so much in the breastfeeding world. This time, I was sure I would be able to bypass the difficulties I faced with my son because of the experience I had.
Right after my baby girl was born, she latched on and ate and I felt elated at the thought that this time it was going to be smooth sailing. But 36 hours later, my nipples were damaged and flattened after every feeding. No problem, I thought, I have resources and support. So I called them in. I took her to see a consultant at three days old to have her tongue tie revised. It turned out she also had a lip tie and a cheek tie which I had never even heard of. So much for me knowing things! She was tiny, at 6lbs 4oz and those restrictions were making it so hard for her to open her already small mouth wide enough to eat. I had all three ties lasered and she latched on beautifully immediately after the procedure. I felt that relief and elation again. It lasted until the next day, when suddenly she wouldn’t latch at all, instead just screaming at me. Turns out some babies really take a long time to recover from those revisions. All of her muscles were now working differently and she was too sore and weak to breastfeed.
That was the beginning of a five-week journey involving chiropractic appointments, lactation consultant appointments, pumping, bottles, and tears. Why was breastfeeding so hard?! Every feeding involved my latching her and nursing her for as long as she could handle, then bottle feeding her and pumping. I felt like I was on a rollercoaster, with some days taking two steps forward and the next day one step back. It was practically impossible to go anywhere, it was hard to handle visitors with all of that feeding business, and I was quickly beginning to struggle mentally and emotionally with this challenge. The first consultant I saw who revised the tongue tie gave me a very interesting thought to ponder when I asked her why so many babies struggle to breastfeed and have tongue ties. She said she had read some research that suggested that formula, bottles, and pumps have kept alive many babies that would not have survived in the past due to their struggles to eat. As a result, these poor little eaters have survived and passed on their genetics. For the first time I stopped cursing my breast pump and gave thanks for it and for the formula that had kept my babies alive.
I had many days where I felt ready to give up. I grew so frustrated at the idea that I was a midwife that couldn’t get breastfeeding to work. My husband reassured me time and time again and reminded me not to put that extra pressure on myself to breastfeed just because of my job. Either way, I just couldn’t give up when I was always telling women not to give up! Working in the field that I do, I had many knowledgeable women checking on me, supporting me, and encouraging me. I had a wonderful, compassionate lactation consultant friend reminding me that it wasn’t me doing anything wrong and that it would eventually come together. One particularly low day, where I was really struggling and trying to decide how long to keep trying, I posted on my facebook page that I was struggling and asked for success stories. So many women posted about the similar struggles they had of having to pump, spoon feed, syringe feed, or supplement while facing issues like bad latches, tongue ties, and supply issues.
I realized that breastfeeding struggles are so incredibly common. These women had stuck it out and they said to give it six weeks. If they could do it, I knew I could too. So that day I decided that as long as I was seeing forward progress, no matter how slow, I would stick with it for at least six weeks. People encouraged me, but also reminded me the importance of my sanity. They reminded me that fed is best and that whatever happened, it wouldn’t make me any less of a mom if I decided to stop and switch to formula. Breastfeeding problems can feel so big when you are already exhausted, overwhelmed, and unsure. My friends wanted to make sure I knew that my mental and physical health mattered too.
At the end of week four, I noticed that my baby was starting to take more gulps and breastfeed for longer periods. I slowly started letting her just nurse and started weaning off the bottles. By the middle of the fifth week, she was eating exclusively by breastfeeding and my heart was soaring.
The ease of breastfeeding without having to worry about pumping, bottles, and carting around so much gear was astounding to me. I had never had the experience of being able to just pack myself and my baby and a couple of diapers and know that we were set not matter what rolled our way. The struggle we had to go through to get there was rought and I do not ever fault a single mom for giving up during that struggle. Our sanity is important and thanks to our modern times, our babies can be fed in many ways. But support is out there. Every mom I talked to that had successfully breastfed had words of wisdom and support for me. They had empathy for my struggle. There is so much lost breastfeeding wisdom that we are slowly regaining. I don’t know how many times I tearfully said I wanted to give up. It would have been ok if I had, but I am so glad I didn’t.
For the mothers out there struggling, if you want to breastfeed, reach out. If I hadn’t, I am confident I would have quit. There are caring consultants, support groups, and mothers that have been there and can help. I still don’t know why breastfeeding can be so complex and difficult, but I also know that leaning on the support from others made all the difference for me and my little one.
For many years, women either didn’t know much about choices and options in childbirth, or by virtue of location, didn’t have many options. The world for birthing choices has never been wider. But how do you choose what is right for you?
What is the evidence behind the safety of freestanding birth centers? The American Association of Birthing Centers has published a study on the safety of birthing centers for low risk women.
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