When it came time for Whitney Zoubeck to decide how to have her second and third children, she decided to take a different route.
“I wanted to go as far as I could and do it myself. I feel like I was able to accomplish that. I made me feel very empowered. I really had a high from it for a long time,” Ms. Zoubeck says. “...just knowing that I did it on my own and knowing it is possible and it can be a very positive experience, it was empowering.”
Ms. Zoubeck is one of a growing number of women who are choosing to use a midwife during pregnancy, labor and delivery. In 2013, midwives attended almost 321,000 births nationwide, a slight increase from previous years. A majority of midwives practice in hospitals, while a small percent help mothers deliver in birth centers or in the home.
“I think it’s definitely becoming more common or more well known,” says Bryant Sarensen, certified professional midwife and owner of Kansas City-based Hullo Baby Midwifery. “... but, generally, there are some misconceptions about it, definitely.”
One of the biggest misconceptions about midwifery is that midwives only do home births, says Casey Wagner, certified nurse midwife with Mosaic Life Care.
“A lot of people think, when they hear I’m a midwife or my kid says ‘My mommy’s a midwife,’ they say ‘Oh, does your mom deliver babies at home?’ That’s the biggest misconception,” she says. “A lot of people don’t understand that we do gynecological care, too. We take care of women throughout their life. It’s not just during their pregnancy and during their delivery.”
Ms. Wagner was a labor and delivery nurse for five years before she returned to school to become a certified nurse midwife. She was one of the first certified nurse midwives to work at Mosaic, and is now one of three. They work with women without health complications such as hypertension or diabetes that may require further medical treatment.
“Midwifery is different in the fact that I don’t have a busy schedule,” Ms. Wagner says. “I typically do take care of women as they are going through their pregnancy, and I have a little bit more time to spend with them, give them an education, form a relationship with them. I try to deliver most of my patients, too.”
Patients get the same prenatal care with a certified nurse midwife, including gestational screenings and blood work, Ms. Wagner says. Most of her patients chose to have as little medical intervention as possible, she says, which the midwifery model of care can provide.
“A lot of them stay at home as long as possible,” she says. “As long as their water hasn’t broke or their contractions aren’t too close together, I encourage them to stay home and eat and drink and be comfortable for as long as possible until they feel the need to come in.”
Not all women who use a midwife chose to have low-intervention births and certified nurse midwives are able to administer epidurals and other medications if desired, Ms. Wagner says.
Ms. Wagner was Ms. Zoubeck’s midwife during the delivery of her second two children, now almost three and 17 months old. After a negative experience during her first birth, choosing a midwife was a positive change, Ms. Zoubeck says.
“(With a midwife), it’s about what I wanted to do, what we could do together and ‘how this is going to go right?’” Ms. Zoubeck says. “It was a good thing. It was totally different.”
While it is a smaller population, some midwives do assist in home births, including 24-year-old Bryant Sarensen, owner of Hullo Baby Midwifery. She has attended more than 150 home births since she began in 2012. After completing an apprenticeship and academic training, she interned at a clinic in the Philippines for five months before returning to start her own practice.
“When I was 13 or 14, I knew that I wanted to be a midwife,” Ms. Sarensen says. “I’m not really sure what prompted that, but I thought, if there was something that I could do to serve moms and help them realize their own strength and serve them in a way that really helps their bodies and promote health and wellness and be able to encourage them in that way, that would be great.”
The home birth process begins with a consultation with expectant mothers to determine if it is right for them, Ms. Sarensen says. She works with low-risk patients and sees them on a routine schedule during pregnancy, offering nutritional counseling, lab work and water birth options. Around week 36 of a client’s pregnancy, she performs a home visit to help prepare for labor and delivery.
“We talk about an emergency transfer plan if we do need to transfer (to a hospital). Anyone who is going to be at the birth, I like them to be there at the home visit so they can meet me and ask me any questions they have,” she says. “The moms can tell us what they envision for the birth.”
Each labor is different, Ms. Sarensen says, and she encourages mothers to feel empowered and stay in charge of the process.
“I just want to be available to the moms. I go to their homes when they are ready, with an assistant midwife. I stay there and monitor them one-on-one until they give birth,” she says. “... (after delivery), I give them some bonding time. I watch unobtrusively from the background and make sure everything is going well.”
She typically stays for two to three hours after delivery to make sure the mother and baby are healthy. She also does several postpartum checkups at the client’s home, and later at her office.
During the labor and delivery process, she focuses on providing a peaceful environment for labor and delivery, including having low lights and using calm voices.
“I want to be holistic, in terms of looking at the whole person, in terms of body, soul and mind so that you are looking at not just physical issues, but emotional things that might affect labor and birth,” Ms. Sarensen says. “I want labor and birth to be peaceful and calm so they look back on their birth experience feeling very empowered by that and not stressed.”
Both in the hospital and at home, empowerment and being in control of the situation is a key, the women say.
“I think getting letters from moms, handwritten letters, a couple of weeks after birth and they say ‘I didn’t think I could do it, but I did it,’ that’s really encouraging to me,” she says. “They say there isn’t anything I would change ... seeing them completely happy with their birth experience, that is very, very encouraging to me.”