Midwifery

Welcome, Ava McDonald our Spring Semester Student Intern!

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Birthstream is welcoming Ava McDonald to intern with us this semester. We have never offered this opportunity to anyone before, but Ava is a unique applicant….we know her family well! She has already witnessed home and hospital births. We hope to offer her the opportunity to observe some prenatal and postpartum care as well as the behind the scenes midwifery work…and maybe a birth or two!

“My name is Ava MacDonald and I am a junior at Da Vinci Charter Academy in Davis and a part of the Da Vinci internship program. My two youngest siblings were born at home with the help of Birthstream Midwives, and now I have the ability to be a part of that. I am very excited to learn more about the Midwifery Model of care and to be able to experience it first hand. I hope that this internship will lead to clarity on my future plans as well as getting to see lots of cute babies!”

Please join us in welcoming her to Birthstream! We know that she will be ready for this adventure!

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Welcome Student Midwife, Rachel Schwartz!

Starting August 2018, Birthstream will have a new student!  She has already volunteered at the 2018 Whole Earth Festival midwife booth...even before she was an official student!  We are looking forward to beginning this journey with her.

Rachel at the 2018 Whole Earth Festival.  Flowers by @flowermama

Rachel at the 2018 Whole Earth Festival.  Flowers by @flowermama

Hi I'm Rachel Schwartz and I was born and raised in Davis. I'm about to start my journey as a student midwife with Birthstream.but before realizing the calling of Midwifery I was baking pies at the Collins Farm, helping out on organic farms, and working with kids.

Apprenticing with Birthstream is a dream coming into reality for me. I am so grateful to have this group of wise women initiate me into the art of midwifery.

I have felt drawn to some form of healing arts practice for years: I've practiced as a massage therapist, enjoy yoga and meditation, and love incorporating into my life other tools that enhance my well-being.

I also feel at home in the role of a space holder and support person. In the past two years I've discovered how much I enjoy offering those skills in the space of birth. While living in Missoula, MT in 2015 I took a doula training with Birth Mama Doula. Then in Davis in 2016 I joined the volunteer doula program at Sutter Davis Hospital and began attending and assisting at births. Every time I am present at a birth I feel humbled by its sacredness and awed at the strength and vulnerability of the person in labor.

I now feel called to offer more through the holistic and collaborative form of care that midwifery provides. I love that midwifery creates the space for relationships of real trust to be built between care providers and clients.

It's clear to me that births are shaped by the people who attend them, the environment, and the level of safety and respect the laboring person feels. I love that midwifery care in a home birth setting is uniquely sensitive to these aspects of birth.

I am so excited for this immersion into a midwifery practice that is offering our community something so important! I'm equally excited to meet many amazing families along the way!

Aprons: A Midwife's Love Story

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by Tosi Marceline, LM, CPM

Arriving in our very best party clothes is always surprising to the families when we come to a birth. But if they notice, it may give the birth a special feel, as they realize we came from a wedding, or a party to assist them.  We sometimes have the foresight to put an extra set of clothes in our car, but not always.  Even when we do, we don’t always have time to change! 

We have gone to births at all times of day and from all sorts of places. I remember being out shopping in Sacramento with my young daughter and got a call on my pager (yes, it was more than 20 years ago) and had to find a phone booth to call Amy Morgan, my midwife partner, to let her know the birth was happening fast. She left her children with a friend at the public swimming pool, throwing on her dress over the wet bathing suit and arrived just in time to put on an apron and help catch the baby!

So early in my life as a midwife, I found wearing an apron was practical for many reasons.  For a start, it protects your clothes somewhat. We have all had skirts get soaking wet with "birth fluid", but more often we find our clothes as clean as when we arrived which is helpful when you have a day of appointments after the birth and no time to change.  But more important for you...it is washed, ironed, and cleaner than whatever the midwife is wearing that day!

Our aprons are modest too, and cover us up to our necklines, so that our décolletage is not revealed as we lean over a birth tub to listen to the baby’s heartbeat!

Our deep apron pockets can carry much of what we need to have immediately on hand if the birth is very quick or in a small space. At one birth, the mother escaped her crowd of relatives by hiding in the toilet room (you know what I mean, the room that has only a toilet in it!) Well, with one midwife sitting on the toilet with the laboring woman on her lap, like a birth stool, and me on the floor in front of her with her husband kneeling beside me, there wasn’t a lot of room for much equipment and the pockets in my apron came in handy. This mother was able to push her baby out quickly in a safe and private space...with next birth, she invited fewer people!

Our first aprons were fashioned after Japanese Kappogi Aprons which had elbow length sleeves, as we did not do water births in the 1980’s. Several of our clients traded their sewing skills for part of their birth fee in order to make two aprons for each midwife.

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We need more than two aprons available in case of back to back births, so we supplemented with aprons from the cooking department of our local hardware store, but nothing was quite what we wanted or needed, until I came across an old apron a friend’s grandmother had given me in 1970. I traced a pattern from it onto newspaper, made the neckline higher, the hem lower, and the pockets more capacious.

After we added water birth to our practice, we needed aprons without sleeves, and so I turned to my mother, who offered to sew three aprons for each midwife! Now as I was growing up, my mother made much of our clothing (including matching Christmas and Easter outfits for our dolls.) She is a skilled seamstress, as was her mother and grandparents, who were tailors. It has been a great blessing to be able to wear something handmade by my own mother!

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We like wearing aprons for more than just their aesthetic or functional properties. Traditionally, they were made in the home and were often made by women to give as holiday gifts to their friends and relatives. Aprons are most frequently worn in the home or by people providing a service to others and we are a home birth midwifery service! Lastly, they are not scrubs!  We also wear aprons because it conveys a sense of comfort and nourishment.  We know that something good is coming when you see someone wearing an apron...maybe cookies or maybe a baby :)

Aprons have recently made a comeback in the craft and sewing world. I have collected a number of aprons to use in my own home, as time for actual sewing has been limited by births. These aprons, gathered from thrift and second-hand stores, are remarkably diverse, beautiful, and creative. They remind us of each woman’s need to express herself in her work at all levels: in their homes, in their families, in their communities, and in the world. They pay homage to the women’s work we all share.

We always need new aprons, as bleach and wear destroy them eventually.  Last year, my mother passed me the pattern we had developed together and said that it was my turn now. It seems that since I will be going to fewer births as time goes on, I will have more time for another type of creativity as the apron crafter.  Know that each apron will be a gift to midwifery and the families we serve and each stitch will be made with the same tender care we offer to birthing families and new babies.  So next time you see our aprons at a birth, you will know they hold within their fibers the love from generations of women before you and may that give you strength and courage during your transition into motherhood.

 
Tosi and her mom, Betsy.

Tosi and her mom, Betsy.

 

See more photos of us in our aprons on Instagram #midwivesinaprons

Midwife Musings: Listening to Birth Stories With an Open Heart

By Rachel Kiene, LM, CPM

The birth of a baby creates a story. Every mother has one for each of her children. In the age of Facebook, many birth stories become public, or at least are shared among a wide circle of friends and acquaintances. Most often, they elicit “likes” and supportive comments from readers. But occasionally, reading a birth narrative in a public forum seems an invitation to offer our perspective, or even criticism of others’ choices.

When I was learning to be a doula, I would hear stories from women who had cesareans or difficult births and immediately think, “What would I have done differently?” The thought was natural. I sought a deeper understanding of the birth process and of how to support women. By identifying avoidable interventions and how they contributed to unwanted outcomes, I hoped to be able to guide my clients more confidently through the challenges of labor and birth. If I could see where things “went wrong”, I might offer thoughts about how things might have been different in a different setting or with a different care provider. But I quickly learned that many women did not welcome the idea that their baby’s birth could have been better.

When we hear or read a birth story, we have a responsibility. How we listen and respond does matter. When we jump to give feedback or to share our own stories, the mother may feel judged or misunderstood. When we listen patiently and choose our responses carefully, we honor the mother’s own healing and learning process.

Each mother’s birth story is a sacred part of her journey into motherhood. The work of bringing her baby into the world affects her identity as a mother. A woman who believes that her baby’s life was saved by surgery or technology has found a way to understand what may have been a negative or even traumatic experience in a positive light. If her friend, trying to be supportive, says, “You didn’t need surgery. You could have birthed your baby if you had been at home with a midwife,” she may hear, “You made the wrong decisions (about place of birth, care provider, when to go to the hospital, etc.) and therefore you caused unnecessary problems for yourself and your baby.” The idea that an epidural or other pain medication may have contributed to birth complications is especially sensitive. The mother may hear, “Your weakness and selfishness caused your baby’s distress/cesarean/vacuum birth/breastfeeding problems/etc.” Since women often share their birth stories in the early days and weeks, these responses may come at a time when she is especially vulnerable and trying to make sense of her experience.

It is very common for women to question the events of their own births. Even a woman who sees her birth as positive may have mixed feelings about some aspects of her experience. As friends, midwives, and doulas, what can we do?

·         DO listen respectfully as she expresses her own thoughts and feelings about her birth.

·         DON’T assume she is dissatisfied with her birth just because it doesn’t meet your ideal.

·         DO answer her questions sensitively and soon return to listening rather than analyzing.

·         DON’T offer your own assessment of “what went wrong”.

·         DO continue to offer friendship and be available when she wants to talk about her birth.

·         DON’T dismiss her feelings of guilt or disappointment, but help her see how she was strong and made the best choices for her baby given the circumstances and the information she had.

·         DO refer her to resources such as the International Cesarean Awareness Network (ICAN), which connect women who have faced similar challenges.

·         DO encourage her to see a trusted care provider or professional counselor if she is experiencing depression or post-traumatic stress disorder (PTSD).  Postpartum Support International has many online resources including "Chat with an Expert" and local resources.

As midwives, we support many women who come to home birth and midwifery care because their previous births were unsatisfying, disappointing, negative, or traumatic. For some of them, the decision to approach birth differently came after months or years of processing. This is an ongoing journey. With a little sensitivity, we can give the mother space to grow into her own wisdom.

Originally Published in Birthstream Newsletter Spring 2015

Midwife Musings: Chickens and their Eggs

By Lesley Nelson, LM, CPM

I have four chickens. And they lay the most beautiful eggs – every single day I get three or four little brown, bundled-up, nutritious gifts for myself and family. It's the sweetest thing: going out to the little red coop my daughter and I built (mainly my daughter -she's kinda' awesome), and opening the nest door and finding these perfect presents in a small bed of hay from our happy, hopeful hens. It's such a joy!

I have always felt, since my days as a childbirth educator when I often talked about nutrition for pregnant women, that the egg was the perfect food: inexpensive and chock-full of vitamins, mineral and protien. An average egg has 7 grams of protein, vitamin D, B6, B12, fat soluable vitamins, A, D, and E, and minerals such ass zinc, iron and copper with about 75 calories total. But most recently, eggs are also designated as the number one source of choline, a relatively newly discovered nutrient (1998), which has been found to be especially important for pregnant and nursing mothers as it is essential for normal neural tube formation and brain development. The recommended adequate intake (AI) for choline has been set at 425 mg for women, 450 for pregnant women and 550 for lactating mothers. With one egg containing 125mg of choline and figuring most women get around 300 mg according to the National Institutes of Health they conclude that adding an egg to the diet each day would increase the number of pregnant women meeting the AI from 10% to more than 50%. In addition, choline is found to be key in preventing liver disease, heart disease, and possibly neurological disorders among adults. For women, diets high in choline have recently been associated with a decreased risk for breast cancer.

            So my chickens leave me these delicious,  nutritious packages daily and I gratefully hard-boil, poach, and scramble them and include them with other good-quality ingredients to try to do justice by them.  Organic tomatoes, fresh broccoli, steamed spinach and co-op made sausage goes very well with them, along with a big green salad and greens mixed in for a lovely quiche. Eggs are our go-to for breakfast or dinner. Fresh, clean water, organic chicken feed, sunshine, and dirt or a compost pile to scratch in daily are all that my hens require and in return my family is well-fed – what more can one ask for? I hope that however you go about getting them, that you consider eating eggs daily as part of taking good care of yourself and your family.  And remember to thank the chickens!

Previously Published in Birthstream Newletter Spring 2016

Midwife Musings: Birthstream 2016 Year in Review!

Birthstream families (and midwives) were busy in 2016 growing their families!  As the year came to a close we reflected on all the births we attended and all the new feet we met!  Let's look back on our year...the firsts, the lasts and all the in-betweens.

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There were 59 Birthstream Babies:  Girls 30, Boys 29

First babies: 15

Sixth, seventh, eighth...or 10th baby: 7

Second generation home birther:  9  with 3 of those families having both parents born at home!

Smallest baby was 6 lbs 13 oz and the biggest baby was 10 lbs 3 oz!

  • 6 lbs+ 6 babies

  • 7 lbs+ 19 babies

  • 8 lbs+ 20 babies

  • 9 lbs+ 12 babies

  • 10 lbs+ 2 babies

  • with 25% of all babies over 4000 grams (8 lbs 14 oz)!

Vaginal birth after cesarean:  1

Cesarean:  1  = rate of 1.6%

Baby born vaginally when both parents born by c-sec:  1

Breech births:  2, both vaginal and precipitous (very fast)...1 at home, 1 at hospital

Thank you all for sharing your year with us!  We are grateful to be part of those moments as you welcomed new little people into your home.

We look forward to a New Year with Joy and Gratitude...and more babies!

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Midwife Musings: What It Takes to Be a Midwife by Tosi

Midwife-in-training

Midwife-in-training

By Tosi Marceline, LM, CPM

Yes, I became a midwife because I felt called to it by my community. I, like so many midwives of the 1970s and 1980s had to recreate a model of care that was based in what families needed and what we as birthing mothers wanted for ourselves. We needed passion for our work and compassion and understanding for the women we served. But in order to continue to work as a midwife past the first few years, you needed more than idealism. So, for all the potential midwives among you and those who want a glimpse into the life of a midwife….I hope you enjoy my humorous, yet true (at least for me) view of what it takes to be a midwife with a long career.
What you really need to qualify as a midwife, according to my personal experiences:

1. Can eat anything and have an iron stomach. Must know how to squirrel away non-perishable food in her car for emergencies, or to eat to keep her awake while driving home after a long birth. Additionally, it would be helpful to be able to go long periods of time without any food, as the birthing family forgot to stock up on food for the midwives, or the appointment schedule is so tight that there is no time for lunch.

2. Can sleep anywhere, anytime, anyplace, and function well on little sleep. The floor may sometimes be more comfortable than the couch. You must keep a blanket and pillows in her car for short naps. Must scout out shady parks where naps are possible in hot weather. A park should not have too many ducks, especially if you are sleeping on the grass.

A book is helpful so that the sleeping midwife can put it over her face while she sleeps and needs to avoid looking like a homeless person. Hint: put your car keys in your bra, and don’t try to sleep in your car with the air conditioner running. It also helps to arrive at a social function after a nap so you don’t fall asleep among the non-midwife friends you still might know.

3. Have the bladder of a camel, especially if there is only one bathroom and the lady in labor is using it frequently. Control your drinking and save the coffee until after the birth! Out in rural areas, may need to know how to pee outside.

4. Need a good sense of direction. (Not as big a deal now that we have GPS, but what happens when they don’t work right? Don’t you hate it when they lose the signal?) We don’t want to get lost on the way to a birth or in a large apartment complex where the GPS is of no use.

5. Need a great family support system. Sometimes this means making your child believe that her birthday REALLY moved to Monday. “Honey, I was at a birth yesterday, so it couldn’t have been YOUR birthday. Your birthday must be tomorrow!”

It also helps to have someone who doesn’t think about saying, “Oh, I remember you!” when you call home. Oh, and you need a family that can tune out while you talk about bodily functions on the phone, put on a Thanksgiving dinner for 20 people without you, and put up with placentas in the freezer (or if they fall out on the family members ~ RFT)

6. Need a hefty dose of patience and tolerance. The man who used to greet my midwifery partner, Jan, and I as “Here comes Jam and Toasty!” no longer gets this newsletter so will be unlikely to read this. People DO say the darndest things. Can help a baby be born with a toddler on her lap, can do a prenatal in the middle of a group of small children and/ or household pets. Will allow a kindergartener to give you a new hair-do and be able to explain all the equipment in the prenatal bag to small children. Always must have a retractable measuring tape dedicated to the amusement of 2 year-olds.

7. Be physically fit, able to kneel on hard surfaces, bend for hours doing back massage, able to support or lift women larger than you are during labor, able to contort into impossible positions in small places to catch a baby. Imperative to have a great chiropractor and massage therapist!

8. Be conscious of clothing choices every time you leave your home. Be aware you may be sleeping in these clothes for the next two nights. You might need to go straight to a birth in the clothes you are wearing to your best friend’s wedding, or go to your best friend’s wedding in the clothes you just wore to a birth. Hint: flowered skirts do not show blood as easily as blue jeans and are more appropriate at social functions. Wear clothes that don’t wrinkle too much, keep extra clothes in your car, and remember, a washcloth works pretty well for cleaning your teeth if you forgot to carry a toothbrush in your car.

9. Drink some form of caffeine. This works so much better than Braille driving to get home after a long birth. I used to tell people I could never be a midwife where there weren’t any bumps on the lines in the road to help me get home, but then I discovered coffee! I really don’t know how Mormon midwives do it.☺

Previously Published in Birthstream Newsletter 2013 and in Childbirth Professionals International