They did It!!

12:57pm today I received a heavenly text..our application was accepted, our license was granted!

Babymoon Inn is now officially the first free standing birth centre to open in Arizona that is owned and operated by independent midwives. There have been and are other birth centres of course, but they were/are attached to hospitals and run by CNM's.

This is the first time that women here in Arizona have the option to birth outside their home, yet away from the hospital. Birth centres have been identified in the literature, time and time again, as being as safe a place to birth as the hospital. More so, given the chances of having a natural birth are dramatically reduced the moment you set foot in a hospital.


Shell Walker, L.M. and Julia Hall have forged a way through the Arizona Health Department, that will enable not only mothers to birth where they choose, but also setting a precedent that will help other midwives set up there own birth centres. This is important in a city 6M large and roughly 80miles across.


I am so honoured to part of this project. WOW! what an experience.

I have the privilege of working with Shell, her former student, now partner Mani Canaday, L.M.!!! (Yay Mani!) and their business partner and pillar of strength and support Julia Hall.

Julia is an absolutely amazing woman, who serves mothers on such a deep level. Julia makes things better, taking everything to the next level, never having to be asked.

If it isn't bringing in muffins, fruit and her special lemon/lime water on clinic days, it is staying up all night with the autoclave, making sure it can pass the test!

She has done so much for this process, has been there through all the good and bad times and triumphed over all adversity. She is an inspiration and this means so much to her. It is a blessing to be in her presence.


Mani. Mani is a special soul. Kind and gentle. Always understanding and impartial. My voice of unjudging reason. Always has an ear for me when i need it, a hug and a kiss. Always a laugh and the ability to communicate with me without the use of words. I can not say enough of about Mani and I so look forward to working with her over the next years.

Where do I even begin with Shell. The universe brought me here, it connected me to her years ago and even though I traveled far, I never lost touch. Shell was constant. "I'll be here if you come". I doubt she thought I ever would, but then a year ago I showed up, having pretty much no knowledge, other than the confidence within me that this is what I am meant to do.

When I first caught wind that she was opening a birth centre I was trapped in Gangtok, Sikkim, India. I was losing my mind, depressed. I went to a cafe and there was a message from Shell, letting me know her plans. She was in Phoenix and was opening a birth centre. What was I waiting for. It's not like I was lost, I knew what I wanted, but I was delaying it. I immediately found a spot on a helicopter that was flying people out of Gangtok (the roads had been shut down due to protesters...i WAS trapped!). I got on a helicopter, took a train 50 hours and switched my plane ticket.

Even from there it took me a year to get here, but I made it.

I am looking forward to the next years with excitement and eagerness.


Congrats Babymoon Inn on your Birthday!

xoxo

mind bending and evolving

so considering changing the name of this blog.

this is my chosen procrastination right now.

I have begun my program at Birthwise Midwifery School in Maine. I am headed up to Maine, gaining reprieve from the heat, in less than a week and I have a lot more studying and assignments that I need to complete. Suppose I am almost on top of the assignments, aside from a wee paper .. that I have to do, find someone to recount a birth experience pre-1959.

I'm thinking i should change the title of this blog to "The Adventures of a (struggling) Student Midwife"?

I'm not really struggling, but being thrown into this whole school thing again is a rapid jolt to my reality.


Thank you, thank you that I have been blessed with this apprenticeship for the last year and that I actually learned and retained some important information in the process. I feel a bit ahead of the game in that regards, but trying to actually read all that I have to, while maintaining by duties as a student apprentice, especially to a midwife trying to open a birth centre! oh my the balancing I am trying to do.

Not to mention the fact I've had to move and am somewhat displaced, but I finally have almost all my belongings with me at the same time for the first time in 3 years! WOW. Really! and it all fits into this tiny room of mine. Not bad.

You should see the piles of books that surrounds me.

But I love it. I love that I have a client that calls me, that we have clients that befriend on on facebook and that are genuinely happy to see me.

I love being asked if I will be at their birth! Nothing would stop me...well, nothing aside from school now, sigh got to accept that one.

So, yes. That is what I am going to do.


Changing the title..maybe it will be the misadventures....

Second Catch

So this evening I caught my second baby. From S's view point. Mine is one and a half. L really did all the work, guiding her baby from her body.

I caught MK's little G. the situation under pressure. but my ignorance allowed me not to be afraid. S had fear, i didn't know how much until later. but she had fear as she remained calm, prepared for what was coming, and put me in the position to catch. MK is strong and capable of pushing out babies.

we lost hear tones as MK was beginning to push, 10 min earlier it was a healthy 130 bpm. She was a flexible 5cm. the baby began to bulge. S routinely checked HT with the doppler, as MK laboured on her side on the futon in her living room. gentle music played in the background. The two older boys were in the front room with their aunt. playing and running through the house, every once in awhile checking in on the birth.

I think we were there 20 min before baby was born. I arrived before S and sat with MK through a few surges. Checked her BP and pulse. both healthy. S arrived and I checked HTs with the fetascope.

When I arrived the surges were just beginning to overlap, becoming stronger and regular. I visited MK a few hours earlier to see how she was doing. She was entering early labour and was managing beautifully. I suggested she go for a walk and may be bake a birthday cake for her new baby. I thought the walk would get things really going.

It worked! Three and a half hours later we got the call it was time. As a third time mom, her body responded quickly to the powerful surges. Often when a baby is this low in the pelvis heart tones can be difficult to get. S checked MK and saw the scalp was white. Emergency mode instantly kicked in and she told L to call 911. It wasn't a complete shock to me, I was aware that S wasn't finding HTs, she probably was checking for 2-3min before she made the call. I was already in position to catch. S told MK to get into hands and knees position and that we had to get this baby out.

the ambulance arrived a few minutes after the birth. MK pushed like a warrior. The baby began to crown and within two pushes the head was out. S said to me "get that baby out". I slide my index and middle fingers down the babies neck and scooped the the right shoulder so she slide smoothly out.

The source of the panic was the umbilical cord...all 4ft of it! OK maybe i'm exaggerating. but it was amazing the length of that cord, and with that length had wound itself around the babies abdomen, shoulders and neck...but with that much slack it wasn't compressing any vitals until the surges began to intensify. I quickly unwound the cord and laid her on the bed, S suctioned and little G snorted and cleared her pathways and let out a healthy cry. with a bit of rubbing she began to pink up. we could hear the sirens.

The first responders came in and quickly found for themselves all was fine. The ambulance arrived and 7 young men found themselves in a living room, where a new baby had just entered into this world. One kept remarking how alert and smiley she was! over and over. it was endearing. only three of them were any where near the birth. One taken information, the second checking vitals and the third one, who was so amazed. The rest remained in the back ground surveying everything. confident everything was under control.

5 min apgar 9.

It was all so very exciting.

MK was very grateful to me. I don't feel like I did very much, but she was so appreciative. so kind in her words, encouraging me that I had indeed found my calling.


yeah pretty much the best job possible!

Happy Birthday MK and Little G!!!


02/15/2010

beautiful life

01/25/10

One of the most beautiful and peaceful births I’ve attended. I don’t know why. She was so beautiful as she sunk into the tub let the warm water relax her. Arms intertwined with her husband. As the surges came her voice rose to an operatic crescendo. I was waiting for her to break out in song. In a way she was.

We arrived at the house at 2am to find her in her bed. The poor soul was sick on top of being in labour. Listening to her hypnobirthing tapes she was in silent meditation. 6/7 cm, fully effaced, 0 station.

She rose from her bed and went to the tub. Within a few hours she was gently pushing her baby out as the little one rotated herself down and through her mothers pelvis. As she descended, K’s vagina slowly began to open, almost as if she were letting in the light to help guide her baby through the door, helping her to emerge into this bright world.

I sat silently in the corner. Watching. Listening. The sounds of her breathe. The moans rising in intensity as her baby was coming closer. She knew what to do. Though frightened briefly she strayed only once from the pain, until she embraced it and pushed her baby out in two surges.

Quietly the little baby came into being on her mother’s belly. Eyes open and alert, silently watching and taking in all that was around her. All those familiar voices were taking on new shapes. She felt safe and unafraid in her new environment. Still hanging on to her watery cocoon a single leg was immersed in the water.

She was placed on her father’s chest and wrapped to keep warm as her mother than birthed the home she had spent the last 40 weeks in. After mother was washed and tucked into bed, she was handed her new baby girl who latched on readily and ate until satiation.

The newborn exam done in the mother’s arms and then weighed and evaluated in front of the expanding family as they nourished themselves.

I am so blessed to be part of these experiences. One of the most intimate and important moments in a persons life, and I am privileged enough to share it with them.

Thank you.

International Midwifery

October 17, 2009

Should start keeping track of the date.

So new horizons forced by unfortunate occurrences have brought me back to the UK and to Manchester. I quite sad to have left Shell and her (our) mommas, but I hope that when I return I'll be able to support them throughout their labour and birth. I always cry.

I've been seeking connections with midwives here, joined the forums and been in contact with some local women involved in maternity care. It has been a slow start, but I'm still adjusting to my new time zone which has been harder than usual to do. Last night was a wonderful break through. I was connected with a women from AIMS (Association for the Improvement of Maternity Services) by a local NHS midwife (independent at heart). Both are great contacts to make.

I suppose my position and interest here has changed or expanded a bit to research international maternity services. I'm being given this wonderful opportunity to experience first hand how midwifery is practiced in very different settings.

My first experience of course was in The Gambia. Quite a shocking one at that. Whether that was typical or not, I'm not sure, But I have a feeling that an on-call midwife is the way it goes. The hospital itself did not have a midwife on staff, but it seemed as though there was a repository from which they could draw. I believe most women gave birth in the local clinics at home, and if they were anything like the birth I witnessed, they included the use of induction (and in my opinion completely needlessly and purely to speed up labour rather than to get it going - but what do I know? It was by first birth and I was sent out of the room to get towels when the drugs were administered).

Then there were the hospital births at home which occurred without access to midwives. One a planned c-section the other a super-fast hypnobirthing mom, who laboured all by herself beautifully, showing up at the hospital fully dialated. Need to take a step back from those. The fact that there was no access to midwifery care in these instances is what is important.

My first real experience with midwives and to me initiation into the birthing "profession" was in Phoenix. While both in Regina and Phoenix there is a strong birthing and natural parenting community, there are significantly more midwives in Phoenix. Of course, we have the population difference. There are Certified Nurse Midwives (CNM) and Certified Professional Midwives (CPM) work somewhat laterally with each other. I can not say together, although a new partnership is in the works which will do wonders for bridging that gap and hopefully dissolving that hierarchy.

The CNM is the direction Canada is going and represent the majority of the NHS system here in the UK. This is where we must look to if we want to understand the pros and cons of community practices run by a group (ranging in size from 5-6 to more commonly 10-11 CNM's). Based on the forums I've been reading and the discussion I had last night, the concept of normal birth is being dissolved. Many midwives no longer facilitate unmedicated noninterventive births, due to volume and policy. This begs the question of malpractice insurance for midwives and how that changes their practice (a topic for another post).

Returning the community practices and the number of midwives that consequently are involved with a single woman's pregnancy continuity of care is sacrificed. This single factor alone is what sets a women up for a successful birth and what should define midwifery itself. If we've lost one-on-one care then are midwives any different than OB's? If you can not promise a women that you will be at her birth, how can she trust that she will be supported? A women should be able to chose her caregiver. This sentiment is lost. After the conversation last night, I discovered that although women do have the right to chose a midwife to care for her from within a community practice that right is not exercised, usually do to not being informed of that right.

What I have gotten out of my short time here so far is that the NHS model of midwifery is not one for the rest of the world to base themselves upon. They are fast moving away from evidence based care and traditional midwifery is being threatened.

My questions have expanded to include woman's thoughts on birth, their preferences and their experiences. Also included in this is the care providers perspectives, their beliefs, their practice and their restrictions.

I'm blessed with support on this path from new friends. Lets see where I am taken.

x