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midwifery

WHAT TO DO WHEN YOUR BABY IS BREECH OR TRANSVERSE

WHAT TO DO WHEN YOUR BABY IS BREECH OR TRANSVERSE

Art by Catie Atkinson @spiritysol

How To Build A Successful Midwifery Practice

 

What I Didn't Learn In Midwifery School

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As midwives, we go through years of college and post graduate education and clinical training. We learn a lot about women’s bodies and supporting the natural processes of puberty through menopause, of everything childbearing and breastfeeding. We learn to provide excellent midwifery care - the science and the art of it. We learn prevention and management of complications and emergencies, and to collaborate or refer to a physician, when we are presented with situations beyond our broad scope of practice.

Doulas take a short course to learn how to provide labor and postpartum support, what is needed to mother the mother during this special journey. These things are obviously necessary to a successful midwifery or doula practice. But how to run a thriving midwifery or doula business is not really included in our training. Unless you’re going to be working in a setting where you’re purely an employee with no administrative or marketing role, there are some key elements missing to our education.

For those of us who are called to accompany families through the incredible journey of nurturing and birthing new life into this world, there is no greater honor than when a momma tells us, “I choose you.”

Even after helping moms to give birth to over 1,000 babies, every time I am hired to provide holistic maternity care I am so grateful and so delighted. I know that I will be a part of a powerful experience for that family. Returning power to women, encouraging them to feel their vitality, live in joy and love their birth are some of the hallmarks of my successful midwifery practice, as are my holistic approaches to health and healing.

However, I didn’t earn the opportunity to support the successful births of so many beautiful babies or empower so many inspiring mommas by education alone.

Having a successful midwifery practice of 21 plus years has provided me with many resources and a lot of lessons that I wish I would have known when I first started.

After my education and training, I felt skilled as a doula, childbirth educator, and a midwife. I could help people heal and transform psychic pain with Clarity Breathwork; I could teach yoga for pregnancy, labor and postpartum, and for life. With much experience and ongoing deeper work, I knew I had what it takes to help mommas love their birth experience and I created an online course to share my local practice with the global community. Professionals around the world also take it, to help them help the mommas they serve. Eventually I could write #1 international best selling books on natural holistic birthing and healing emotional pain, trauma and stress so prevalent in the modern world!

On the other hand, I had no clue how to build a successful, thriving practice. I spent a lot of money and time taking many workshops and continuing education. I embarked on my own self-study to master and refine my skills as not only a midwife, but also as an owner of a private practice and its administrator. And I made A LOT of mistakes along the way.

Below are the key things I wish I knew before I embarked on my doula, and my midwifery journey.

10 skills you need to learn (even if you outsource) for a successful midwifery practice

1) Bookkeeping. Billing, collections, taxes, accounts payable. If you don’t have financial systems in place from the start, things can get pretty messy.

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2) Dealing with insurance. If you plan to accept medical insurance, there’s a whole world of claims, codes, and coverage that you need to understand.

3) Online Marketing. Between the ever-changing social media platforms, chat rooms and websites, online marketing can feel overwhelming. It’s important to learn how to stand out on the over-crowded internet.

4) Client paperwork. Making needed practice forms, legal documents, and informative handouts for clients is a must in every practice.

5) Charting. The most efficient chart forms vary from practice to practice. And charting challenging cases can be well...challenging.

6) Professional communications. As you grow your practice, there will be a variety of situations that call for written communications to other health care professionals. These include networking and forming collaborative relationships, thank you notes for excellent supportive care, and summarizing cases for consultations or referrals.

7) External Communications. These are letters written to individuals outside the health care team on behalf of expectant mothers as their obstetric care provider. For example, disability claims, approval for gym membership, dental work, or travel, insurance exemptions, as well as payments and appeals.

8) Team Management. As my practice grew, it became increasingly necessary to have clarity about the roles of other members in my practice. Birth assistants and administrative team members need clear protocols for things like handling emergencies and maintaining certain skill sets.

9) Supply Management. This may seem simple, but not having the right supplies for a care visit or a birth can be a real nuisance. Not to mention embarrassing!

10) Self-care. Setting boundaries in your practice for your own personal health and self-care is key to being the best you can be for everyone in your life - family, clients, and self.

Want to learn how I did all this and more (like how I consistently earn six figures)?

Whether you’re considering a career as a midwife or doula, getting your practice started, or an experienced birth professional looking to take your practice to the next level, my programs will get you where you need to be.

You can have a successful midwifery or doula practice, and I’m here to help.

 

What's a Doula and Why I Recommend One

Art by Amanda Greavette

Art by Amanda Greavette

Happy WorldDoulaWeek! This is a week initiated by a doula in Israel to empower and support doulas around the world to improve the emotional and social health of birthing and postpartum women and their families; this is so needed in modern times, with the breakdown of community and resulting lack of sisterhood mothering, along with the prevalent fear and lack of exposure to birth, and the medicalization of childbirth. Says Dr. John H. Kennel MD, "If a #doula were a drug, it would be unethical not to use it."  When I think of the many #doulas I have been blessed to work with, I am reminded of strong, beautiful, kind, passionate, dedicated, fun-loving women who have found their calling supporting other women - these women rise by lifting others. Hug your doula this week; and if you don't have one, find one to hug, and research the many proven benefits of having a doula, especially if you are giving birth for the first time. 

I do love my vintage office bumper sticker.

I do love my vintage office bumper sticker.

What is a doula is and why do I recommend one when you don't have that kind of support around you?

A doula or a labor support person like a doula is must - someone calm and nurturing to mother you, who knows how to help mamas in labor, birth and postpartum and trusts the process. Women were surrounded by homebirth and supported other women in labor through history and around many parts of the world still today. In the US and many parts of the modern world today, many mamas don't have this, and it negatively impacts their birth and postpartum. My transfer rate is ~ 7% and it's mostly first time moms with prolonged labors, exhaustion and with a common theme - they did not set themselves up with doula or doula like labor support, despite what I said, now documented by solid research. I want mamas to optimize their chances of having an empowered, deeply positive and healthy birth experience. See if your midwife knows great doulas with a sliding scale. An awesome one is worth every penny.

I could talk for hours about this, but here are the main reasons I believe pregnant moms, especially first timers, those planning to VBAC, and those who have an obstetrician as their provider, should hire a doula. Doulas and midwives compliment one another even in out of hospital birth settings, and preserve rather than interfere with partner & family support & privacy.  Often dads are grateful they do not have to learn to be a labor coach.

In many cultures today, and throughout history, until relatively recently, when birth was moved into the hospitals in the 1920s to 1940s, and people dispersed away from their villages, women supported women through childbirth and postpartum. Doulas fill this void, and are trained to provide emotional support, comfort measures, reassurance, encouragement, empowerment, advocacy, and basically mother the laboring and postpartum mother. Most doulas go through a short training and certification process, although many take continuing education and serve childbearing families in other ways such as facilitating pregnancy and postpartum support circles, doing birth photography, creating mother blessing ceremonies, encapsulating placentas, and becoming childbirth educators to teach childbirth classes. Doulas are not medical providers like midwives and obstetricians, responsible for the actual maternity and newborn care - although midwives are more likely to provide doula like care which is integral to authentic midwifery, that is not their main role.

There is an impressive body of research on the many benefits without risks, of the continuous support of an experienced doula during labor, such as improved coping, self confidence, esteem and empowerment, enhanced satisfaction and positive feelings about their childbirth, shorter and easier labors, an easier time adapting to motherhood with enhanced skills, longer breastfeeding, more positive feelings towards their baby and even improved relationship with their partner! Scientific evidence from gold standard medical studies also reveals less pain and fear, less childbirth interventions including cesarean, vacuum and forceps deliveries, less episiotomies, medication for pain and stimulating labor, less babies in poor condition needing intensive care and longer hospital stays, and all the associated risks to of above interventions, and less postpartum depression. This is HUGE! It's having a personal coach so that you have the most healthiest, wonderful experience possible. All successful professional athletes, performers and most leading businesses and entrepreneurs have a coach of some sort.

Photo by Julia Sywers.

Photo by Julia Sywers.

This is doula love, given by my amazing birth assistant, doula and childbirth educator, to a superhero mama having her second homebirth. "The wisdom and compassion a woman intuitively experiences in childbirth can make her a source of healing and understanding for other women." - said the beloved Steve Gaskin. I want to honor all doulas this happy world doula week, and all superhero mamas who have given birth anyhow, anywhere.  Photo by Julia Sywers.

For personal questions and need for individual guidance you can schedule an online consultation with me- this is one of passions and areas of expertise. Many mamas ask to consult with me about their personal fears and concerns and what to do about them. I love helping mamas in person, and now with this global IG community, via Skype or phone conversation. You can also take my unique online ROCK and LOVE YOUR BIRTH course, which basically guides you through your pregnancy to birth and postpartum journey, as I guide the families in my midwifery practice - without the hands on care, to prepare and plan for an experience of their dreams.

Do you need supplements for preconception and pregnancy? Here are some of my favorite I recommend to mamas in my practice, along with my favorite herbal tea recipe for your journey. 

Flora

Make your Red Raspberry Leaf and Nettle herbal infusion.....rich in needed nutrients and specifically nourishing for pregnancy, birth and postpartum. Place 1 oz of dried red raspberry leaf, 1 oz of dried nettle leaf in a quart-sized glass canning jar with strainer, fill it with boiling water, cover and steep for at least 2 -4 hours at room temperature. Strain and place in a covered pitcher. You can make it in larger quantities and store in the fridge. For taste, dilute with water or steep for less time (but no less than half an hour), add lemon or lime juice, mint leaves or a teaspoon of honey. Drink 1-4 cups daily hot or cold.

I am passionate about changing lives. This 44-day course is changing lives. Vital Mind Reset is a program that will hold your hand and help you heal your life without a prescription. It will also introduce you to a community of people just like you – all working to transform their lives and revive their power and joy. Be a part of this community. Be a part of something greater and get yourself back! This course is a must, by renowned holistic psychiatrist Dr. Kelly Brogan, author of NY Times best seller 'A Mind Of Your Own', a dear friend and trusted colleague I can vouch for personally and support whole heartedly.  

Get a 10% discount on your Sleepod purchases at askrembla.com -use the code SWEETHOME to get your discount. 

Get a 10% discount on your Sleepod purchases ataskrembla.com-use the code SWEETHOME to get your discount. 

Below are some supplies to help you Rock your birthing experience! For more details check a recent  blog I specifically devoted to my recommended top 10 must haves for your birth - to make it easier and so much more wonderful.

The Strength of A Woman

@mikalacatherine

@mikalacatherine

"Today, along with every day since this day, I am so proud to be a woman and a mom." wrote inspired mama @mikalacatherine. "I had the incredible opportunity and privilege to carry my little boy for almost 41 weeks. But what I am most proud of is the fact that I was able to give birth to him. It's something I think about literally every day. I did it. Women every day do it. It blows my mind because the frequency of births makes it seem common. But let me tell you, it is not common. It is quite literally the worst and best thing I have ever done. Having given birth has made me so proud of all moms because now I know what each and every mom has had to go through with pregnancy, delivery, and postpartum. None are easy. All are important and meaningful. I know I risk seeming conceded with this post, but I am so dang proud of myself for doing it. Some days I am in awe of that fact. So today, I am so proud to be a woman and to stand with other women. With all mommies and caretakers. With all moms whether they have carried their babies physically or in their hearts instead. I am honored."

I honor of the billions of strong women who have found their strength and birthed (majority at home, naturally) since the beginning of time. Billions. Something to remember in labor, to encourage and empower. 

I saw the exam table and thought what a great place for warrior - because women are warriors, period - no matter where and how they birthed, whether they had babies or not.  In all these years I have met so many amazing women, women who have faced and dealt with a range of serious life challenges, many many women who grow, birth, feed and raise little humans, and those who were unable to even get pregnant or carry their pregnancies. The warrior pose is in honor of all women who find their strength at times when it seems impossible - and those are the women I have been blessed to know and learn from. 

Warriors are not born and they are not made…Warriors create themselves through trial and error, mistakes and limitations, pain and suffering, being upside down, wide open and vulnerable – and that is strength. Warriors get up and try again in spite of all of it. “Strength doesn’t come from what you can do. It comes from overcoming the things you thought you couldn’t.” Ashley Greene. We women are stronger than we know, and we find that out when we have too. And once we tap into that power, we birth our babies, we handle the challenges, we birth ourselves...each and every day, with the little hardships and the mountains that seem impossible to climb...until we do.

Art by Catie Atkinson @spiritysol.

Art by Catie Atkinson @spiritysol.

"Behind every man stands no woman. There is no greater man than the man that can acknowledge the woman standing right next to him." ~ Rachel Wolchin. Women rock! Mothers rock! We are strong because we had to be, wiser because we learned through our powerful experiences, always doing our best with what we know, have and are faced with at the time; we are admirable warriors of honor because we stayed the course, did not give up despite the challenges and struggles, and had the courage to plow forward irregardless of fears. Our blessings are that we have a fan club - the little ones we grow within us, birth, nurture and take care of, who adore us without caring about the mess, the laundry, our to-do lists. They are the little ones we adopt or foster. They are the people we deeply care for who are not our babies. We are beautiful to them no matter how we look or dress; we are perfect to them even when we make mistakes. They want our time and loving attention more than any material gift. I would love women to be treated and to treat themselves like the goddesses they are.

Photo by Megan Hancock Photography

Photo by Megan Hancock Photography

Let Me Help You Create The Happiest Birth Experience Of Your Life...

Whether you're a first time or experienced momma,

Or a midwife, doula, or birth professional guiding mommas..

Regardless if you are planning a birth at home, a hospital, a birth center or need a cesarean section, or if you are taking another childbirth education class…

You Really Can Create The Delivery Of Your Dreams.

And have a blissful birth wherever you are.

More Precious Than A Wedding...A Birth Should Be A Celebration!

Let me show you how to…

  • Understand the sensations of your body and connect your intuition with how your body is communicating and leading you towards what to do during labor
  • Tap into your inner calm to deeply relax yourself,letting go of busy, stressful and fearful thoughts on demand for the health of baby
  • Speak your truth from your heart in a way that deepens your relationships, sets clear boundaries, and has people listen to you and support you before, during and after pregnancy
  • Trust yourself, connect with your body wisdom andcommunicate with baby in belly
  • Connect with natural time and sync your body and mind up with your unique biological clock for ease from pregnancy to postpartum
  • Reprogram negative patterns, stories, and beliefs that undermine your confidence, strength and self trust so you can rock your birth

Physicians and midwives around the world recommend my teachings to their pregnant clients and many Doulas across the country learn the secrets of blissful birthing from me to supplement their Doula Training & Certification process!

To learn more, visit:  LOVE YOUR BIRTH Online Childbirth Course!

It is based on my years of experience, as a midwife and yoga teacher, helping thousands of women tap into their calm and live and birth from a place of grounded relaxation and joy. 

Educate and inspire yourself, ready your body, ready your mind, ready your heart with my list of TOP BOOKS of every category you can imagine listed  - with links on where to get them as books, listen on audio, or read them on kindle. The better prepared we are for a situation, the better the outcome will be. I feel passionate about empowering and educating women to get the most out of their womanhood, pregnancy, birth, postpartum, breastfeeding, mama, yoga and life journeys!

I am excited about this course is by a best selling author whose personal story, insights and life changes after recovery from terminal cancer and a near death experience are beyond inspiring and riveting. Not only is it such a testimony to her strength, I feel it can help moms with many of the physical, emotional and psychological challenges associated with pregnancy, postpartum and beyond, also help all women and the professionals who serve them, and really every human being....to find their strength that is already within them.

“Dying to be Me” by Anita Moorjani emphasizes the importance of YOU. She discusses positive ways you can radically alter beliefs about yourself, your purpose on earth, your health, your relationships, and your life. These lessons may help you in recognizing and dealing with the various challenges you face, and may aid as a tool or a resource to be used for you to learn about YOU and reconnect to the best parts of you – Featuring lessons in Loving Authentically, From Surviving to Thriving, From Fear To Freedom, Finding My Purpose and Creating a Magnificent Life with special dear guest Wayne Dyer. Anita will also inspire you to radically alter your current beliefs about yourself, your purpose on earth, your health, your relationships, and your life;  and she can help you transform your life by living more authentically, discovering your greatest passions, transcending your deepest fears, and living from a place of pure joy. 

Birth: Expect The Unexpected

Certified Nurse Midwife Anne Margolis discussed what happens when labor does not go as planned. She talked about the importance of understanding what a cesarean section is and why it's important to know what happens in case of an emergency.

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When it comes to birth, oftentimes things don’t go as planned. Sometimes this means a woman never makes it to the birthing tub she prepared, filled up and dreamt about birthing in, because in the moment of giving birth, she found her groove and prefers to stay on the squatting stool or her labor progresses quickly, and she needs to push before the tub is filled with water. Sometimes this means certain family members or friends aren’t present for the birth like originally intended because for example a mama is not laboring well with her kids present, they want to leave, or her best friend is sick and could not come to help.

Other times, when things don’t go as planned, this means a woman might need medical or surgical intervention. A common example: a mama is experiencing a hard back labor at home or free standing birth center, her baby persists in the posterior position, she is not progressing for hours despite trying everything and is exhausted; she is transferred to the hospital for Pitocin to augment her labor and the compassionate use of an epidural. A less common example is baby is not tolerating the labor, and is showing signs of worsening distress in any birth setting, and a cesarean is needed to save baby’s life.

Photo by Mary Elliott O'Haire

Photo by Mary Elliott O'Haire

Overall, we must surrender to the process of labor and birth and know that we are being guided and well cared for. To avoid needless suffering, we must embrace what comes our way that is not in our control, as what is meant to happen – because it is happening or did happen; and we can raise to the level of being grateful that we were given exactly what we needed for our benefit, what we each needed on our own journey as a soul temporarily living in a body, even if we do not understand the whys. I am not apologetic about my spiritual perspective and my firm belief that the infinite all powerful being, Spirit or G-d of our own understanding is pure goodness and love for each and everyone one of us.

I’d like to address a question I get asked frequently.

Art by Catie Atkinson @spiritysol

Art by Catie Atkinson @spiritysol

Why do I mention cesareans in my online posts?

Cesareans can be both planned and unplanned for serious complications or illness. In both cases, they are indeed a birth. They are a birth for baby, a birth for mom, a birth for dad, and a birth of a new family unit.

I want all women to feel lovingly supported and cared for however they birthed and that includes a cesarean.

Art by Catie Atkinson of @spiritysol.

Art by Catie Atkinson of @spiritysol.

I like to post information on what I refer to as a gentle cesarean. It’s still using a home birth model of care, with the principle of restoring humanity to maternity and newborn care – especially in the operating room. A gentle cesarean would include possibly pulling the curtain down, allowing the baby to birth itself gently through the incision, encouraging mom to receive her baby directly from the surgeon, hold her baby skin to skin, delayed cord clamping and early breastfeeding; it can also include allowing her partner, doula and anyone else she needs in the OR by her side.

I want to offer support to all women, and especially women who feel their birth did not go as planned. Although it’s rare for normal births to lead to complications or emergencies requiring life saving medical and surgical interventions, most births don’t go as initially planned.

Photo Credit: @albanydoula

What do I do when things don’t go as planned?

In general, healthy mamas with healthy pregnancies have healthy births. The stats on homebirth  and free standing birth center outcomes are excellent when there is a trained experienced midwife in attendance.

My transfer rate from home to hospital in labor is 7% and that is comparable to those of my colleagues. The vast majority of transfers are non-urgent. In most cases, it’s usually first time vaginal birthers whose labor stops progressing with exhaustion despite us trying every one of our "tricks" to remedy the situation. The need to call 911 and have an urgent ambulance transfer has been a handful of times in 20 years.

The midwife is of course there as a lifeguard - as rarely emergencies do occur. I bring the same emergency equipment and medications that any free-standing birth center has. Most of the time I don't use it and all is well. But when I need it, I have saved lives, as any seasoned midwife can say.

I saw much more catastrophic events when I was an OB nurse in the hospital. I have never lost a mother, but our country's maternal mortality rates are among the highest compared to most modernized countries, and this is largely from risky hospital interventions, which are not happening at home.

I have had to resuscitate significantly less babies at home – we have a screened healthy low risk population, are watching closely and WITH the mama in active labor. We do not intervene unless medically necessary and do not cut the umbilical cord until it stops pulsing or placenta is birthed, unless there is a problem or a request for lotus birth.

In 20 plus years of homebirth midwifery practice I have had to transfer 3 babies to the hospital who did not respond to resuscitation and needed intensive care due to unrelated complications, and this is significantly less than our country's high newborn morbidity and mortality rates.

Yes, we need to be prepared for and have to manage a rare shoulder dystocia (stuck shoulders) but it happens less as our mamas are laboring and birthing in positions that use gravity and maximize the diameter of the pelvis. Yes we have had to treat postpartum hemorrhage not responsive to natural remedies, with medication and IV fluids.

Not to offend animal lovers and vegans, but this moose provided a perfect home "IV pole" for a mama who needed intravenous fluids during her homebirth. Homebirth midwives must be creative.

Not to offend animal lovers and vegans, but this moose provided a perfect home "IV pole" for a mama who needed intravenous fluids during her homebirth. Homebirth midwives must be creative.

I do not convince anyone to have a homebirth as it needs to be each mama's decision. I do provide information so she can make an informed one. She needs to birth where she feels safe or she won't labor well. 

It is one of my passions and areas of expertise to help mama's with these sorts of questions. I offer online consulting for mama's just like you, whether a one hour discussion or a package of consultations and email access from pregnancy through postpartum – which is great for mamas who want and need more personal attention and guidance to a holistic midwife as they have no access to one in their area.

To really best help a mama make a decision unique to her situation - I recommend a conversation. This is not something simply answered on social media, without discussion.

If you want to schedule an online consultation, please go to my website:  - I look forward to connecting more and answering your personal questions.

Photo by Megan Hancock Photography

Photo by Megan Hancock Photography

Let Me Help You Create The Happiest Birth Experience Of Your Life...

Whether you're a first time or experienced momma,

Or a midwife, doula, or birth professional guiding mommas..

Regardless if you are planning a birth at home, a hospital, a birth center or need a cesarean section, or if you are taking another childbirth education class…

You Really Can Create The Delivery Of Your Dreams.

And have a blissful birth wherever you are.

More Precious Than A Wedding...A Birth Should Be A Celebration!

Let me show you how to…

  • Understand the sensations of your body and connect your intuition with how your body is communicating and leading you towards what to do during labor

  • Tap into your inner calm to deeply relax yourself,letting go of busy, stressful and fearful thoughts on demand for the health of baby

  • Speak your truth from your heart in a way that deepens your relationships, sets clear boundaries, and has people listen to you and support you before, during and after pregnancy

  • Trust yourself, connect with your body wisdom andcommunicate with baby in belly

  • Connect with natural time and sync your body and mind up with your unique biological clock for ease from pregnancy to postpartum

  • Reprogram negative patterns, stories, and beliefs that undermine your confidence, strength and self trust so you can rock your birth

Physicians and midwives around the world recommend my teachings to their pregnant clients and many Doulas across the country learn the secrets of blissful birthing from me to supplement their Doula Training & Certification process!

To learn more, visit:  LOVE YOUR BIRTH Online Childbirth Course!

It is based on my years of experience, as a midwife and yoga teacher, helping thousands of women tap into their calm and live and birth from a place of grounded relaxation and joy. 

Check out my pregnancy herbal tonic recipe and some of my favorite supplements I recommend below, to augment a wholesome healthy diet, so you can meet the increased needs of your body and your growing baby.

 

Do you need supplements? Here are some of my favorite I recommend to mamas in my practice.

Make your Red Raspberry Leaf and Nettle herbal infusion.....rich in needed nutrients and specifically nourishing for pregnancy, birth and postpartum. Place 1 oz of dried red raspberry leaf, 1 oz of dried nettle leaf in a quart-sized glass canning jar with strainer, fill it with boiling water, cover and steep for at least 2 -4 hours at room temperature. Strain and place in a covered pitcher. You can make it in larger quantities and store in the fridge. For taste, dilute with water or steep for less time (but no less than half an hour), add lemon or lime juice, mint leaves or a teaspoon of honey. Drink 1-4 cups daily hot or cold.