Aaaaand we’re back! I know it took me a little longer than usual to get this one up. Birth workers are busy! Today, it’s my pleasure to introduce the team down at Community Midwifery Services in Norman.
I’m doing this blog in a little different format than usual, because an interview with five people just doesn’t translate well into a straight up transcript. This summary is super compact though, so I really encourage you to give the video a listen though, to really get to know these lovely ladies and hear their full comments. For a good chunk of this interview, I didn’t even ask questions, just sat back and watched them riff off each other.
The team at CMS has been together for a long time. Michelle has been a midwife for 25 years, and Gail has been doing it for 35. In 2003, Michelle took on her first partnership, and the second one was Gail in 2004, and they’ve grown from there. The rest of the team has been around for a long time too…. so long, that they’ve become fantastically sympatico. They’re more like a family than a group of co-workers.
Hannah became interested in birth work when her mom delivered her younger sister (Michelle was the midwife!) when Hannah was 4 years old. She got to witness several more births after that, and it sparked the birth work fire in her heart. I identify with this hardcore. I saw my little sister being born when I was 7, and have tried my best to be at all my sibling births since then. After midwifery school, Hannah worked in the Philippines for two years, before reconnecting with the midwives who had inspired her at CMS, where she’s been for the last three years.
As for Michelle, she had a midwife at the birth of her daughter in 1986, and began looking into midwifery shortly after that. “The door to midwifery opened up, and I fell in,” she says with a laugh. She started her training in 1991 in Nevada, then opened her practice in Oklahoma in 1993, and the birth center in 1995.
Gail says the first time she heard of a woman having a home birth, back in 1980, she was amazed that the mama thought she could do such a thing. Was it even legal? But that birth planted the seed in Gail. “I’ve never respected a woman more,” she says. So she studied for four years, and then began practicing, first with Ruth Cobb, and then with Michelle. She’s also been an EMT, worked in an Amish community, and studied pretty much every related topic she could. “I’m so thankful that my life has been spent in midwifery,” she says.
Like Hannah, Nikki was introduced to midwifery by the birth of her siblings, and (surprise!) Gail was her mom’s midwife. At 15, she attended her first home water birth (VBAC) and she got the bug. She came to CMS about ten years ago and asked for training. After working as a birth doula, she became a practicing midwife.
The newest member of the team, intern midwife Chelsea, came to birth work after the birth of her second child. She met Gail and Michelle in 2010, and they were impressed with her work ethic and invited her to lunch and recruited her to the team.
“Everyone in our team is someone that we choose,” Gail tells me. “I think most midwives feel that way… it’s really important to have someone that you respect and trust.”
“We midwife our clients and we midwife each other,” Michelle agrees. “We certainly want to be that ‘with woman’ that allows each of us to practice the trade that we love… it’s really great to have a full tribe to make sure this work gets done well, and also that we are well.”
Nikki also interjects to praise the CMS assistants, who aren’t in the video, but do help carry the load. “There are some days where we’re like, ‘how did we do anything before we had this many assistants?”
How has midwifery changed over time
We talked at length about the changes these ladies have seen in midwifery over the years. Gail and Michelle especially, began practicing when midwifery was not common, and midwives didn’t have access to things like labs, ultrasounds, and genetic screenings. In the intervening time, and in large part thanks to the work of these ladies and others across the state, midwifery practice has transformed into full-spectrum care that includes all the labs, screenings, and partnerships with health departments and physicians to make sure that women have all the best choices available to them, and are still able to birth where and how they choose.
“We all feel like pioneers,” Gail told me. “It has been our goal since the beginning to expand the choices that women might have, that choose to have a baby in a way that’s not necessarily in the box,” Michelle added.
Questions About Out-of-Hospital Births
One fortunate side of midwifery care is that midwives generally care for already healthy women. They often refer to themselves as “guardians of normal.” Since hospitals see a much higher percentage of high-risk pregnancies than midwives typically do, most births are not risky.
“The most important thing,” Michelle said, “is that we are not cavalier about what we do. We know it’s not like it’s no big deal. It is a big deal. A whole person is coming into the world, and that’s great. A mother is being born, and that’s great as well.” She emphasized that they take this duty seriously, and make sure that women who need hospital care receive it, and that the appropriate screenings are done at the outset, to make sure that if a mom would be better served by hospital care, that’s what she’ll get.
Gail added that the CMS midwives are happy to educate grandma’s and dads and any other family members who might be concerned. “We do have so many options and safety is our priority,” she said. “You think of a midwife as boiling chicken bones in the back yard,” she laughed, but that’s not what it’s like.
“We work toward family-centered care,” Michelle agreed. They go out of their way to make sure family understands what’s happening during prenatal screenings and at the birth. “It’s really important to us that the family members feel like they can be heard.”
Tell me about some special birth experiences
Gail looked surprised when I asked this question. “Gosh, every one has something special!” she said.
Chelsea brought us all to tears by telling me a story about a recent mom who was adopted, and had never known any of her biological family. When her baby was born, the sweet mama said to to her, “you are the first person I’ve ever met that I’m related to.”
“That’s an honor to be a witness to that,” Chelsea said. “She became a mother in so many ways at that time…. you don’t know what each birth means to each family, but that was a transformative moment.”
“Don’t you think that that is one of those defining moments as a midwife?” Michelle asked. This prompted a beautiful discussion as the ladies talked about their role in each birth, and reminded each other that while their role is a big one, they are most importantly witnesses to someone else’s defining moments.
“Walking along with them through that is just such a privilege,” Hannah said. “It’s such an honor and blessing.”
Why does your practice model work?
“Every birth you walk in that door, you have no idea what you’re walking into,” Gail said. “You have to leave your problems at the door.” The ladies agreed that having a group practice can make this easier on everyone. Using their model, they’re able to care for each other, and make sure that there’s always a well-rested available midwife for each birth.
“We get to fill our cup in between,” Michelle said. She added that the group perspective and familiarity with each of their clients provides really robust care.
“And we get to pull on each other’s wisdom,” Hannah said. “Any question I have, I can call anybody… we have all of these minds, and we use them all, and we use them all collectively.”
What do you offer clients?
CMS offers both home birth and birth center experiences, based on the client’s preference. They will receive prenatal care either at the Norman office, the Satellite office in Shawnee, or the satellite office in OKC. CMS provides complete comprehensive care including any screenings they’d receive elsewhere, but it’s laid out like a menu: the client chooses the options they want.
Each visit is an hour, and during these visits, they’ll get to talk through all the information needed to make the choices about screenings and tests, birth preferences, and concerns, as well as physical exams (measuring the baby, blood pressure, etc.). CMS also does a lot of nutritional counseling (“We look at food as medicine first,”) so throughout the pregnancy, mom and CMS staff will be exploring the best nutritional options, looking at deficiencies, and adjusting as they go.
Michelle added that the team works to have 2 – 3 members available for every birth to ensure the best care and the ability to focus on mom’s needs.
“We look at every birth plan like a road map,” Michelle said. “It’s our job to understand what’s important to the family… so that we can tailor any kind of comfort measures that we can around that.”
The birthing center includes two birthing suites with tubs, and CMS is equipped with birthing pools for home births as well. They make sure that bonding time with baby is a high priority before doing weights and measures, and discuss preferences for things like that during client consultations.
“We offer really extensive postpartum care,” Hannah said. This includes a 24-hour home visit, where they check the baby’s vitals and do a pulse oximetry screening, a 3-day home visit to address breastfeeding concerns and answer any questions, and then visits at 2 weeks, 6 weeks, 9 weeks, and 12 weeks. All these visits include hearing and metabolic screenings for the baby, and are tailored to the family’s needs. They also offer additional breastfeeding support as needed, and check all babies for tongue ties and lip ties.
Tips for moms to stay healthy during pregnancy
Nikki: Body care is really important prenatally as well as postpartum. This includes chiropractic care, craniosacral therapy, exercise, and acupuncture. “You don’t have to be miserable in your pregnancy. You can feel vital, and healthy, and energetic, and vibrant, so take care of your whole body and your whole structure.”
Chelsea: Emotional self-care. That can be taking a bath, or just taking five minutes by yourself, taking a 20-minute walk with your partner for exercise and one-on-one time… you need that bonding time and good, open communication.
Gail: Birth is a physical experience, but the emotional and spiritual part is super important too. Nutrition and general wellbeing: If you’re sick initially and you can’t eat due to nausea, we want to reassure the first-time mom about the way her body is providing nutrition for her little one. Reassurance of the things they can do, however small it is, mentally, physically, and spiritually.
Michelle: A good food-based vitamin. Making sure they’re taking a supplement that works for pregnancy that’s right for them. And then knowing which foods to choose from, when it comes to organic, GMO, etc.
Hannah: So many moms get really focused on the birth and prepare and plan, but postpartum falls by the wayside. Plan for postpartum. Have people in place ahead of time to help you with food, laundry, or whatever you need. Ask people if they’re willing to be part of that, so that you can thrive postpartum.