- I ride motorcycles. My current ride is a BMW F650 GS.
- I love to bake and am actually quite good at it.
- The only time in my life I did not have a cat was during college. I couldn't have one in the dorm, or my first apartment.
- I grew up in Kansas.
- I am the oldest, I have two younger sisters.
- I do not like onions, to the point of picking them out of my food no matter how small they are cut.
- My house is decorated with raccoons. Several came with my hubby and we have added to the collection through the years.
- I did not learn to read until I was in 2nd grade. I am so thankful for the teacher who made me stay in during recess until I finally learned.
- I enjoy curling up with a good book, a cat on my lap, and a nice cup of tea.
- And finally, I get to serve the most amazing clients and families as a midwife!
We like getting to know people, learning where they are from, what things they like, what hobbies they have and so on. I often see social media posts with lists of things you can select from to let friends know more about you such as if you have ever had a broken bone, or traveled overseas. In the spirit of those social media posts, I'm sharing a few facts about myself to let you get to know me better.
Torie Bowie was an athlete. She wasn't just any athlete, she won multiple medals including the gold medal at the 2016 Olympics. This was a woman who was incredibly fit. She was found dead at 8 months pregnant due to eclampsia. The takeaway is that even the healthiest of mothers can have health issues that are a direct result of pregnancy, and that maternity care providers must do better for mothers in their care.
It grieves me to learn of stories where normal maternity care should have caught something. It grieves me to hear of mothers who aren't listened to, whose concerns are dismissed and who do not feel heard and respected. It appalls me that mothers aren't educated about nutrition, appropriate weight gain and normal changes in pregnancy. It scares me that mothers aren't educated about symptoms of concerning health conditions during pregnancy.
In my midwifery practice, I partner with my clients in providing care. I want my clients to understand what is normal and what may be concerning. I want my clients to know what symptoms to watch for that means we need to do some testing, or additional checks. I want my clients to know that I hear them and I take what they say seriously. I want my clients to know I will not dismiss their concerns, observations and complaints. I want my clients to know I care!
It's so hard for me to wrap my mind around how this nation can spend so much money on health care and yet have higher percentages of poor outcomes compared to other countries, including those we consider developing. I don't think more interventions, medications or treatments are going to solve the maternity crisis in America. Listening to women, and trusting them are the things we can do to improve care dramatically and quickly in my opinion. We can't continue doing the same old things and hoping for different results. We must make big changes, and make them now. Increasing access to midwifery care is a simple, effective way to reduce maternal mortality. I'm proud to be a midwife who is making a difference one birth at a time!
Since I became a CPM, I have discovered the "just a CPM" world. It's on social media, and sometimes in personal interactions I've had. I personally find "just a CPM" demeaning of my education, skills and what I do.
There are differences between a CPM, a CNM, and an OB-GYN. Those differences include the education required, the philosophy of practice, and the clients we each serve. I know I'm not trained, or equipped to handle the situations an OB-GYN does, and the same goes for CNMs. I value the skills and education they have, and am thankful they are able to help clients when they need more than I can offer. Each provider has their own skill set, and is best suited to serve particular needs.
OB-GYNs are absolutely the experts to go to when a mother has conditions or indications of a condition that puts her life or baby's life at risk. A mother who is a smoker, who has high blood pressure, who has a history of blood clotting issues; a baby who is not growing, whose ultrasound shows a possible congenital issue, who isn't tolerating labor well will benefit from the care an OB-GYN can provide. A mother who wants the care of a midwife as well as the options a hospital has such as an epidural will benefit from the care of a CNM. For the mother who is healthy, and having a low risk pregnancy that wants to have baby in the comfort and security of her home, a CPM has the skills and training to support her well. Each type of provider has a niche, or particular women they would serve well.
There are differences in skills, training and expertise among types of providers. Since I support births at home, that is what my training emphasized. That is why I was required to attend at least 55 births (I attended a lot more), with 45 of those in the home setting. OB-GYNs and CNMs are not required to attend any home births but they do have to attend hospital births as part of their training since they will be working in the hospital. With the differences in training and skills, if all the providers can work together when different skills are needed, both babies and mothers will benefit from the wide range of expertise.
To refer to me as "just a CPM" is belittling, in the same way as saying "she's just a stay at home mom". It implies that there is less value in being a CPM instead of recognizing that each type of provider has unique skills and understanding that makes them valuable in their own right.
Being a midwife can be challenging, and it requires many skills. One of the skills I have had to hone as a midwife is juggling....
Being a midwife means being an expert in calendar juggling. Scheduled commitments and activities may get canceled at the very last minute, or rearranged a few times depending on when babies decide to come. Being a midwife means being dependable for clients, occasionally at the expense of your friends and family. Sometimes you have to put the needs and desires of your family second. Yay for flexible families and friends who understand this and support the midwife wholeheartedly!
Sometimes being a midwife means juggling vehicles. In my life, we have an older car which is fun to drive but isn't the car you want to drive for longer distances. If the hubby needs to travel, we have a discussion about where my clients are located to decide which car he's taking. Sometimes he may come and switch out cars while I'm at a birth.
Being a midwife means you may juggle your own needs so you can support a client in labor. I've been at many births where my needs for sleep, eating or drinking were shifted or delayed so I could be available to support a client in labor.
Being a midwife means trying to juggle the expectations you have of yourself, the expectations your clients have, and expectations others who are invited into the birth may have. Trying to juggle expectations means I am forever second guessing myself. I always wonder if I have missed something, if I am understanding what I can see, feel and observe correctly. I am not perfect and know I will make mistakes, but I keep chasing after perfection.
Don't misunderstand me, I am not complaining. I chose to be a midwife. I have impressed myself at times with the juggling that is part of midwifery. Maybe one day I'll even learn to juggle balls or fruit!
How much time does the average prenatal appointment with an obstetrician last? 15 minutes.
How long is the obstetrician with you during labor and birth? They may come in for 5 minutes or less to check on you a few times before birth, and then they come in shortly before the baby is born and leave as soon as they are done with any suturing you may need. Based on the hospital births I've attended, you might see the doctor for up to an hour total.
How many postpartum appointments do you have with an obstetrician? 1 at 6 weeks is typical. In 2018 ACOG recommended that OB's have contact with patients starting at 3 weeks. Given that it takes 17 years on average for a new recommendation to become mainstream practice, not every doctor will have implemented the new guidelines. In just the past 30 days I attended a hospital birth. That patient's postpartum visit is scheduled for 6 weeks, with nothing before then.
How long is the average postpartum appointment with an obstetrician? 15 minutes, perhaps a little longer if the patient is having a cervical check such as pap smear.
Who decided that 15 minutes is enough time to assess how well pregnancy is progressing, how well Mom and baby are doing? It seems that Medicare prompted it in 1992 and the health insurance industry followed suit. There was no research into how long an appointment should last. The decision was made as a monetary decision, not a health care decision. In the years since that decision, time for actual care has decreased to about 8 minutes.
How much time does the average prenatal appointment with me last? One hour. Why? I feel that fifteen minutes is not nearly enough time to assess how well Mom and baby are doing. I do more than just taking blood pressure, and listening to the baby's heartbeat. I take the time to understand how Mom is feeling, how she is adjusting to the changes that come with pregnancy and how well she is preparing for birth and postpartum. I want to have plenty of time to answer questions, discuss changes and what to expect. I want to know more than how my client is doing physically, I want to know how she is doing emotionally. I want to take the time to make sure she understands the risks and benefits of procedures and tests and what her options are. I want to take the time to discuss what to expect at the birth. I want to be sure my client knows what to expect in the postpartum period and has help lined up for the first few weeks. I want to know my client well enough to recognize when something is starting to creep outside of normal. In my midwifery practice, I focus on my clients, and I take the time to provide the best possible care I can. I do not focus on the clock.