Labor and Delivery

I am an expert in normal childbearing with a focus on promoting the natural progression of labor and delivery. I positively guide mothers through childbirth to help women achieve their goals for delivery, concluding in the most positive, safe birthing outcome as possible for both mother and baby. I will be present with the birthing woman from the time you are admitted in active labor, during the delivery of your baby, and during the first 2 hours post-partum.  During the process of labor, I look after the mother and baby's health and provide individualized emotional and physical support in a warm and positive environment. I will support the mother’s wishes and birth plan throughout labor and delivery within the realm of safety.  I help integrate the supportive family members and/or doulas into the support given if that is what the birthing mom desires.

During your care I will continually and vigilantly monitor the birthing process to ensure safety, help your baby get into the optimal position for birth if it is not yet in the right position, and maintain and support an environment in which you will feel safe, trusting, private, and intimate.  I become the guardian of your birthing space, and maintain it to optimize your state of relaxation and decrease your stress. The same environment in which babies are made is the same environment in which normal, physiological labor can unfold most naturally, without the need for intervention.  (Both prcocesses are mediated by the same hormone, oxcytocin, sometimes referred to as "the love hormone!")

I am very good at supporting and helping the normal processes of labor and birth with minimal intervention, unless such intervention is clearly indicated. There are no routine "preps," shaves, or enemas. If you are low risk and the initial evaluation upon admission shows fetal-well-being, there is no need for continuous fetal monitoring (being hooked up to a machine); I use the standards set forth by ACOG for intermittent monitoring of the baby.  Intermittent monitoring is not only safer for low risk births, but allows for more freedom of movement and walking during labor which helps both to cope with labor sensations and to encourage your baby to birth more easily.  Women who are low risk should be allowed to eat lightly and drink during labor. Because I am present throughout your labor, I can diagnose and reposition a baby in the wrong position by using specialized midwifery maneuvers.  I will assist your baby to descend more easily and naturally by suggesting alternative laboring and birthing positions and with the help of birthing balls, stools, rebozzo techniques, and squatting bars. I often encourage the use of water in the bathtub or shower for coping and comfort during labor.  I utilize massage, visualizations and aromatherapy to help promote relaxation during labor.   I support physiological pushing instead of directive pushing.  I am trained to help keep a woman’s perineal tissues as intact as possible during birth.  Although I can perform and repair episiotomies if they are medically necessary, my episiotomy rate is extremely low. I am trained to repair most spontaneous lacerations that may occur during birth.

In addition to supporting the patient’s choices for her pregnancy and birth as long as it is safe for mother and baby, there may be some clinical scenarios where I would need to use medical technology, even if it was not initially planned for, to assure a safe outcome for mother and baby. This may include continuous fetal monitoring, the use of medications, IV hydration, augmentation or induction of labor, or the use of an epidural. This can occur seamlessly in the hospital environment without the need for transfer to another facility.

I am expertly trained to recognize the signs of problems during pregnancy, labor, birth, and postpartum, and will consult the physician without hesitation if I detect any problems arising during labor that are out of the scope of midwifery practice to address. I always inform my back up physicians anyway if there are any deviations from normal so they are aware of your status.  If a Cesarean section becomes necessary I would accompany you and your partner into the operating room and continue to advocate for you to bond, touch and be with your baby as much as is clinically safe and appropriate during the surgery, and accompany you through your recovery period to preserve the parts of your birth that can still be normal, like breastfeeding, bonding and taking care of your baby.  I, as your midwife, would continue my care for you through the birth, the in-hospital post-partum period, and through the six week post-partum period that follows, as I would for any birth.

(See Hallmarks of My Care)