The Wild Heart Midwifery Project

What are your passions in life?

What gets your heart racing with excitement?

Here are a few things that do it for me:

  • Starting a new knitting project with yummy yarn.

  • Rock climbing at a new place & looking up at a route with wonder and excitement.

  • Traveling anywhere with my husband and we are each other's sole focus.

  • Love snuggles with my kiddos where I can't hold them tight enough to my heart.

  • Sitting around a fire or living room belly laughing with good friends.

  • The moment of birth where the mom holds her baby for the first time with exhilaration and admiration and the rawest form of love.

And another thing has gotten my heart pumping lately...a new project! For years, I have wanted to study traditional birth practices around the world. I studied anthropology in college and fell in love with ethnography - the study of living cultures.  Now I want to record the home birth culture. I am passionate about preserving the WILD HEART of home birth midwifery while showing the world (or whoever ends up on the blog) how home birth midwives practice in various places. And what a better place to start than my own home town!

So, I have started a new blog where I will be posting pictures and stories of home birth midwives. It is called The Wild Heart Midwifery Project. It will start out simple with the goal to highlight and celebrate home birth midwives. I feel like it will take on a life of its own, growing through the years. So, if you are interested, head on over to....

THE WILD HEART MIDWIFERY PROJECT

Reflections on Being a Home Birth Midwife

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It’s been about 1 year and 10 months since I was licensed as a home birth midwife. I am finally settling into a rhythm of providing midwifery care and managing my small independent practice. I am finally recovering physically and emotionally from a busy three-year apprenticeship. And I recently asked myself why am I doing this? I have enjoyed each family that has trusted me with one the most precious times in their lives. I have felt accomplished in finally becoming a midwife. I have loved contributing financially to our family. I have felt proud to be self-employed. But why have I chosen a profession that gives me sleep deprivation? Why have I chosen a profession where my phone is a vital appendage to my body? Why have I chosen a professions that upends and puts on hold my personal life for an undetermined amount of time at a moments notice to answer frantic calls from clients or go to a birth? Why have I chosen a profession that is mostly not accepted by the community at large and medical colleagues as valid or safe? Why have I chosen a profession that brings on the tremendous stress of monitoring a person and fetus, then a newborn and postpartum person for health and well-being? Why have I chosen a profession where my connection with my clients is so deep and forever, yet I can only sustainably hold them and stay close for about a year? Did I mention the tremendous emotional and physical stress midwifery brings?

This is why…

Yesterday, I attended the birth of a client. There was a moment about 2 minutes after her baby was born that she looked at her baby and cried. She cried, because her labor was so hard. She cried, because she was in awe that she was finally holding her new baby. She cried, because she gave birth in water just like she wanted. She cried, because she was overwhelmed with love for this new being. She cried because she was so immensely happy.

This is why I am a home birth midwife.

I tear up just thinking about her face at that exact moment. Imagine the love her baby was feeling at that moment. Imagine the love the mom was feeling at that moment. It was perfect. Today, I feel immense gratitude that I get to help people and babies feel this moment. And this moment may not come right at birth. This moment may be prenatally when the pregnant person hears their baby’s heartbeat for the first time. This moment may be in labor when the pregnant person realizes their birth is not going to look like what they imagined but know they will be loved and supported throughout. This moment may be during the postpartum period when they feel empowered to parent an infant. It doesn’t matter when it happens, but it happens…each and every time, with each and every client.

This is why I am a home birth midwife.

South Austin Midwife Office

Guess What?!?! I am so excited! I have a new office at Pure Light Chiropractic near Manchaca & Ben White (1711 Fortview Rd). The owner of Pure Light Chiropractic is Laine Morales. She is an OH-SO-AWEOME chiropractor & I am so excited to be part of the Pure Light Family!! Laine does an amazing job with with pregnant mamas and babies, so it is the PERFECT fit! There are THREE chiropractors, TWO massage therapists, THREE midwives, an acupuncturist, and a cranio-sacral therapist. There are multiple classes on the weekends offering various types of education, including childbirth education, newborn care and breastfeeding support.

The office is so beautiful and relaxing. We will meet for the first time for your FREE initial consultation and then for your ONE HOUR long prenatal visits and final six week postpartum visit. Many of my clients have scheduled their other wellness visits with other practitioners in the office on the same day making SELF-CARE convenient and easy.

Being in Central Austin near Hwy 290, getting to the office is easy from anywhere in Austin and the surrounding areas.

Call me today for your FREE consultation and come check out my new location!

I am still seeing clients at my home office in Manchaca/Buda. Call me for more details.

Why Choose Home Birth?

"Why Choose Home Birth?"

This is a question that I get frequently from my family members, friends and acquaintances. Even my financial planner asked me this last week! So, why would a woman choose a home birth and midwife? There are plenty of OBs and hospitals in the Austin area, so what is the benefit of midwifery care and home birth? Well, of course, I know the answer to this, so I thought an excellent post would be filled with all of the different reasons that families I have served chose home birth. And then miraculously an awesome blog post came across my Facebook feed! It is written by a home birth mama on an evidence based look at why women choose home birth...PERFECT! I am a firm supporter of not reinventing the wheel, so here is Danielle's post. She has a whole slew of excellent posts, so go over to her site and check it out: Keeper of the Yolk.

An Evidence Based Look at Why We Chose Home Birth

Posted on November 23, 2015 by keeperoftheyolk

The decision to have Isla at home was not taken lightly. I researched like crazy for about a year before we were even pregnant, following the data and letting the evidence speak for itself. In my previous post, I discuss why I didn’t want to be in the hospital. On the other side of the same coin, here are the reasons why I did want to be at home.

1) Home birth is safe. Studies can be found hereherehereherehere and you get the point. One study actual found that home birth has better outcomes than hospital. There are of course studies that suggest the opposite, but every one that I have seen looks at all out of hospital births and lump them into the ‘home birth’ category. That means unplanned out of hospital births like delivering in the car on the way to the hospital or intentional unassisted (no midwife) homebirth are included within the data. This skews the results because there is big difference between a planned, conscious homebirth with trained professional midwifes and a road-side accidental delivery. The ones I have posted here looked only at planned home birth unless otherwise noted. These studies found no negative risks with planned home birth in comparison to hospital birth.

2) The hospital didn’t feel safe to me. After all the research I had done, I did not trust that the hospital was the best place for a low-risk, natural birth. I love my baby more than anything in the world and would only give birth in the place I felt was safest for her. There is good reason for needing to feel safe as well.   Ina May Gaskin is one of the most highly respected home birth midwives in the world. Her book Ina May’s Guide to Childbirth talks in depth about the need for safe surroundings. You hear it all the time: “I got to the hospital and my labor stopped.” Bright lights, unfamiliar people, needing to be checked for labor to be verified- these among many other factors all increase adrenaline in the body. Adrenaline is the opposite of oxytocin. Oxytocin is what causes contractions and dilation. When adrenaline starts to take over oxytocin, labor can stall. Ina May even cites cases where dilation has reversed when women enter the hospital. She goes on to discuss how humans, as mammals, have the same instincts in labor as any other mammal does. She refers to a cat or dog in labor going to find a dark, safe place where external threats are the least present. We are no different. I felt safest at home where I could control my environment.

3) I didn’t want a c-section. Let me first say that I am thankful that c-sections exist. They are necessary and it is absolutely amazing that they can be done so quickly and relatively easily to save a baby or mother’s life. The World Health Organization recommends a community’s rate of Cesarean deliveries not exceed 15% yet the cesarean rates in the US are hovering right around 33%. This means that just walking into a hospital in labor gives the mother a 1 of out 3 chance to being given a c-section. A study conducted by the Midwives Alliance found that the rate of home birth transfers ending in c-section in nearly 17,000 women was only 5.2%. When only 5% of woman needed a c-section at home and over 30% need them in hospital, what’s happening to make the hospital rates so high?

4) Enter the “the cascade of intervention.” I wanted to avoid it as much as possible. This is the term given to the domino affect interventions can cause during labor. Here’s an example:

A woman checks into the hospital in labor. She immediately gets an IV and continual electronic fetal monitoring, which I discuss here because it is standard of care in the majority of hospitals. She isn’t able to get up, change position to something other than lying, or walk around to naturally cope because of the machines she’s connected to. She gets an epidural. The epidural slows down labor so she gets Pitocin to induce stronger contractions. More pain meds to help with the now unnaturally intense contractions and more Pitocin to help with the deceleration of contractions caused by the pain meds. Baby’s heart rate drops because baby cannot handle the stress from the Pitocin. An emergency c-section is performed.

Obviously, this is just an example of what can happen and not every c-section is caused by this or any other cascade. C-sections will be necessary. But every intervention from not being allowed to eat in labor to receiving an epidural can lead down this path. In the home birth setting, most of these interventions do not exist. Midwives periodically check the baby’s heartrate with a Doppler and are constantly observing, charting and analyzing, but for the most part, they let mama do her thing. They step in as needed, but Pitocin will never be given to augment labor, an epidural will never be placed and they will allow and encourage the mother to change into whatever position she feels the best in.

5) I didn’t want cervical checks unless medically indicated. Cervical or vaginal exams during labor (and pregnancy) carry a small but real risk of infection and accidental artificial rapture of membranes (when they break your water by accident). In fact, the Cochran Report has stated that…

“We identified no convincing evidence to support, or reject, the use of routine vaginal examinations in labor, yet this is common practice throughout the world. More research is needed to find out if vaginal examinations are a useful measure of both normal and abnormal labor progress.”

Aside from there being no evidence to support checks, I didn’t want to know how far long I was. I didn’t want to become discouraged or have my confidence diminished if I wasn’t progressing fast enough. During my daughter’s birth, there was indication that I should be checked, and that was completely okay with me. I was informed and consented to the procedure. That was probably 30-ish hours into labor though and I was only at 8 centimeters. I was so disappointed! I may have given up my quest for a natural birth had I been checked 24 hours in and only been at 4 or 5 centimeters.

6) I knew I could do it without pain meds. I wasn’t afraid of the sensations of labor. I believe that women are taught from day 1 that birth is excruciating. Every TV birth scene is an emergency where the women scream out in pain, begging for the epidural and cursing their partners for knocking them up in the first place. Horrific birth stories are passed around at baby showers like appetizer and expecting mothers are left scared of giving birth. I refused to listen to it. I empowered myself my reading real, positive birth stories at Positive Birth Stories and Birth Without Fear and avoided conversations with women who I knew had negative things to say. I tried to forget ever being told that childbirth was painful and focused on envisioning a painless experience.

7) I knew that as a first time mom I was going to be a risk for “failure to progress”. As I mentioned in my previous post, woman are often held to a timetable where their dilatation needs to be completed within a set number of hours. This is called the Friedman Curve. By these standards, a first time mom would need to go from 0 to fully dilated in 14 hours. The finding by Dr. Freidman have been debunked since the time his work was published, yet many practitioners still expect these results from laboring mothers. When dilation is slower than this curve, the mother is labeled as Failure to Progress (FTP). So what’s the problem with this? The label of FTP leads to interventions like induction with Pitocin and in 1/3 of all cases, cesarean delivery.   My midwives alluded to the fact that 24+ hours would be totally normal and expected for my labor and that even 30+ hours would not be out of question. Even the Mayo Clinic says that labor for a first time mom can take as much as 20 hours. When actual FTP arises, (I was probably coming up on it), interventions are a blessing. But all too often, by Freidman or other hospital standards, this label causes unnecessary disruption of the natural labor process.

8) I could eat, drink and do whatever else I wanted at home. The reason for not being allowed to eat during labor comes from the risk of aspiration while under general anesthesia in the event of an emergency c-section. This was first reported back in the 40s. Since then, general anesthesia is no longer the standard of care and techniques have greatly improved. Now, there has been found to be no medical indication why food and drink should be restricted. And you know what? Giving birth is hard work. It’s physically and emotionally tolling. How could any woman be expected to make it through 8 hours let alone 12 or 20+ hours of labor without being allowed to eat or drink anything but ice chips? Eating helps to prevent exhaustion by sustaining the body. This is important because exhaustion can lead to the medically indicate use of interventions like epidurals to provide the mother with a break or Pitocin, if labor has slowed.

9) I wanted my husband to be part of our daughter’s birth. I pull so much strength from him and he is an absolute rock. I knew before going into labor that he would be my greatest support. At home, I could be sure that he would be included and considered. He had a comfy couch and a bed at home, more to eat than jello and crappy hospital food and it would have been almost impossible for him to miss anything. He could (and did) work with my midwives to help them give me the best care possible and advise them on my preferences when I was in the zone. In a very literal sense, I could not picture him being able to help me in these ways in a hospital setting.

10) I wanted to snuggle and bond with tiny new babe in my own bed with my husband immediately following birth. I can pretty much guarantee that this is on every home birther’s ‘pro’ list when considering bringing birth home, and let me tell you, it was so, so amazing. Plus, there is a ton of evidence that supports the benefits of skin to skin bonding after birth for both mother and baby. This practice is especially valuable for establishing breastfeeding which was incredibly important to me, regardless of the type of birth we had.

The other thing I took into heavy consideration is that our house is less than a block away from an ambulance station. It’s also important to note that midwives come prepared for emergency situations. They carry Pitocin and other medicines like Cytotec to control postpartum hemorrhage, resuscitation equipment like oxygen and masks, IVs and tubing and other medical materials like catheters. They can resuscitate a baby and manage blood loss the same way a hospital would. The only thing they don’t have is blood for a transfusion and the capability to perform a Cesarean. They are constantly observing though and will transfer a mother to the hospital in a heartbeat if there is any indication that mamma or baby needs additional help. One of the best things about home birth is that you can transfer to the hospital whenever you want.

Home birth is not for everybody though and while I do wish more women would research and consider it, I do truly believe that all women should give birth wherever they believe is safest. That is in my opinion truly the most important thing.

So, great, right? Another reason why I personally chose home births for my two kids was GERMS! I did not want to expose myself, my uterus or my newborn to any germs other than our own or what my body was used to in my own home. I have seen one doula client come home from the hospital with a nasty staph infection in her breast that her newborn son also got...eek! 

Making the decision to have a home, birth center or hospital birth is an important one. It is also a very personal decision. My goal is for every woman to have all of the information she needs to make an informed choice about her own body, birth and baby. 

Let’s talk more about home birth! Contact me to set up a FREE initial consultation.

Source: https://keeperoftheyolk.wordpress.com/2015...

Attracting Perfect Clients

I am so grateful for this transition time from being an apprentice midwife to having my solo home birth midwifery practice. It has been a time of deep reflection and clear intention.

I picked up a book a couple years ago...Attracting Perfect Customers: The Power of Strategic Synchronicity by Stacey Hall & Jan Brogniez. What a great book to visit while building my new practice, right? I love the idea of attracting perfect clients! Every client I have had has been perfect for me in their own unique way (even the not-so-perfect ones!). I have learned something from every pregnancy, birth and postpartum time. It is one of the aspects I love most about midwifery...the women, the babies, the relationships. I am honored each time a family hires me to be a participant during one of the most precious times in their lives. I honor my role, whatever that may look like. So, the idea of starting off my new practice by attracting more perfect clients sounds, well...perfect!

One of the exercises this book encourages is listing out all of the traits of a perfect client. The idea is to revisit this list daily to attract these type of clients to you. I found that all of these traits are qualities that I admire in someone, and in order to attract these type of clients to me, I must possess them myself. So, not only has this book helped me have a clear intention on the type of women I would like to work with, it has also helped me reflect on which qualities I need to work on myself. I have written all of these down and posted them where I can see them daily. And now to post them to the world...

healthy     spiritual     calm     open     self-aware     loving     grateful
mothering     conscientious     natural     smart     well-supported     researcher     clean     honest     good communicator     funny
able to manage stress     happy     realistic     nice     giving
community-centered     active     respectful     strong in mind & heart
intuitive     accountable     responsible     decisive     collaborative

Awesome, right? This list grows each day as I interact with different people and notice more positive qualities in each of them.

Another exercise from this book is to list what I choose for my perfect clients to expect from me...

  • provide clear choices and information

  • monitor health & well-being of mother and baby from pregnancy through 6 weeks postpartum

  • be honest

  • be organized

  • be prepared

  • answer emails & calls in a timely manner during office hours

  • be on call 24/7 two weeks before due date

  • provide most up-to-date safe evidences based practices

  • collaborate with other midwives

  • respect the mother's decision for herself & her baby

  • listen, support & validate

  • be nonjudgemental 

  • be loving

  • be emotionally & physically healthy

  • support family members

  • charge a fair fee

  • keep licenses current

  • be stable, trustworthy & decisive

  • provide excellent back up & assistant midwives

  • be reliable

Again, this list continues to grow as I practice and continue to build my client community. The book goes on to give 21 daily tips to build long and satisfying relationships with all of your clients. Being a midwife, the relationships I share with my clients is one of the most important aspects of my work. A long and satisfying relationship is essential in keeping midwifery safe and effective, so hopefully these activities and tips will strengthen my relationships and continue to attract the perfect clients to me!

Photo by  Kayla Gonzales

How I Got Here

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I have been thinking about what my first blog should be, and it finally occurred to me...ME! Why don't I start off this new blog with a snapshot of how I got to be a home birth midwife in Austin, TX? This way, you will get to know me and where I am coming from.

So, it all started here...

April 9, 1974 in Flagstaff, Arizona...my mom searched out a doctor that would allow her to give birth to me naturally after being put completely asleep with my brother 4 years earlier. My mom has always told the story how happy she was to see me immediately after my birth.

The years went on...we moved to Austin when I was three and then to Marble Falls when I was 11. My mom is a Registered Nurse, and throughout high school she ran a clinic in Llano providing prenatal care to Medicaid women.

I swore I would NEVER become a nurse like her, so I went to Texas State University (then, Southwest Texas State University) to study Physical Therapy, then Engineering, and eventually earned a degree in Anthropology with minors in Spanish and Mathematics in 1997.

Midwife with baby in Austin

Soon after, I met the love of my life and got pregnant. There was no doubt in my mind that I would have a home birth with Ann Dignan, CNM. Being due on Y2K, January 1, 2000, we took extra precautions to have our baby at my parents' house where there was a generator and well water just in case the world as we knew it came to an end. So as New Year's Eve came and went without a single computer getting confused by the date, we went back to our home in Austin to welcome our son, Samuel, into this world. It was such a powerful and empowering experience. My life was forever changed, and my soul knew that midwifery would be part of my future.

After a move to Baltimore, I got pregnant again and searched out a new home birth midwife. In 2001, home birth was illegal in Maryland, so it took a bit of work to find Kathy Slone, CNM. Our daughter's birth ended up in the hospital at the very last minute (everything ended up being just fine) which was just perfect, and my love for midwifery care and home birth intensified.

Six years later and back in the Austin area, I started training to be a doula. I was all of a sudden supporting lots of women giving birth, mainly in the hospital (here is the link to my old doula blog with lots of great articles...Beautiful Births). In 2010, I ran into a home birth midwife in the hospital, and we quickly became good friends. It felt natural to start apprenticing with her to become a midwife's assistant. After a year, I started to feel the strain of the midwifery lifestyle with small children, so I decided to take a break from apprenticing and continue my doula work. In 2013, after a quick thought to start apprenticing again and a simple text to a friend, I got the opportunity to train under Julia Bower, CNM and Honeydue Homebirth. When my mom passed on her blood pressure cuff and stethoscope to me, I immediately felt this sigh of relief...this is what I was supposed to do all along...be a nurse like her (well, sort of).

Midwife with her own baby

After three years with Honeydue Homebirth, 100 births (194 including doula work), lots of hard work, studying and good times, I became a Certified Professional Midwife and Licensed Midwife in the state of Texas in June of 2016. Which brings me to this first blog post!

Now that I am a home birth midwife, my passion to assist women, their babies and families experience a gentle home birth is realized. I LOVE to empower women to follow their hearts and intuitions in making the best decisions for themselves and their babies during pregnancy, birth and postpartum.

My vision for this blog is to pass on lots of interesting information to you related to home birth. I love new research on evidenced based midwifery practices, so I will share what I come across, as well as, sharing local resources for Austin area families.

So that's me in a nutshell! Thank you for joining me on the next chapter of my life!

Love,
Erica

This was my last birth as an apprentice with Julia Bower, CNM. So bittersweet! I tear up every time I look at it!

This was my last birth as an apprentice with Julia Bower, CNM. So bittersweet! I tear up every time I look at it!