Haiti 2015: How Can You Help?

Glen and I will be leaving for Haiti in 7 short weeks, and are in need of your support! Our trip to Haiti is one we look forward to but seems to financially add up so quickly for us...the snacks, medical supplies, airfare, the cost of checking our baggage and the cost of volunteer accommodations with Midwives for Haiti. It is something we are able to do, but not without challenge.

So we ask...

Are you able to help? In the next few weeks we will have various ways we will ask for your help and support. 

One of my favorite gifts to take to Haiti has become what I call "Newborn Gift Packs." The packs are ziplock freezer bags which typically consist of a newborn onesie, pair of socks, hat, light blanket, cloth diaper, and cloth pad for Mom. (Note: The cloth diaper and cloth pad do not need to be anything expensive, but even just a thick, absorbent fabric such as cotton or flannel.)
These gift packs have been handed out at mobile clinics throughout Haiti as a way to encourage moms to keep returning for prenatal care. Glen and I have also kept some on hand when we work shifts at the hospital. Inevitably, there are moms who have no clean sheet to deliver on, nor anything for their new babies. 

If you are interested in making some "Newborn Gift Packs," please message me. We will be collecting them, as well as additional supplies, up until September 16th. 

Items do not need to be brand new, but simply in clean, like-new condition. 

If you are interested in purchasing clothing items to be put into gift packs, all L'oved Baby clothing items which are purchased for this cause will be 50% off at Betula Baby (the baby boutique located inside Integrated Women's Wellness & Center for Birth). Simply let us know that your purchase will be donated to our Haiti 2015 trip, and all clothing items purchased for the trip will be 50% off. This would be a great and EASY way to help. If you do not have supplies or the time to put together gift packs, you can purchase items from Betula Baby that we will then put into gift packs and take with us to Haiti. 

Thank you, for whatever support you can give!

[Be sure to follow along our journey by checking the blog, our facebook pages, and @tara_elrod and @thecenterforbirth on Instagram.]

#lifeofamidwife: To Teach

Perhaps one of the most oxymoronic aspects of my career as a midwife is my role as a preceptor. It is challenging- outright maddening quite often- but also a source of great inner learning and reward. I try to keep this in mind on the particularly rough, frustrating days when I feel as though I am barreling down a one-way street called Give.

I'm a midwife yet very rarely do I catch a baby. My hands are often not the first hands to touch a fresh new life- they guide and meld the hands of two student midwives as they create and hone their own skill. 

We had a mom recovering from delivery in one birth room, when another mom came in. This patient was a repeat patient of mine, who had had her first baby under mine and Glen's care. When her baby was crowning, I switched places with Mary, moving from between the patient's legs, taking the Doppler in my hand, and switching to the role of monitoring baby. Mary moved in to "catch."

The baby's head is at a full crown and mom's perineum at a full stretch. The student is nervously touching the baby's head, as if giving a head massage, obviously feeling the need to do something with her hands. We (midwives) often speak of the importance of "sitting on our hands." It's easier said than done for some. 

"Stop," I quietly say, nearly inaudible. 

She is oblivious to me. 

The baby's head delivers, direct OA. The student midwife starts to apply pressure to the baby, gently downward on the baby's head as if to facilitate delivery. 

"Don’t do that," I gently and discreetly say. 

She reminds me of the many physicians (and  yes, even midwives), I have witnessed who apply traction immediately after the delivery of the head, expediting delivery even long before the woman has the next contraction. So many practitioners do this as a means to actively manage (the threat of) a shoulder dystocia, but what it inevitably ends up doing is the opposite. Facilitating delivery prematurely only increases the likelihood of an impaction, as the baby's Cardinal Movements and specific, intricate movements to maneuver through the pelvis are not allowed to be completed, with the baby being brought down into a non-ideal position. Further, it's common for downward traction to be applied while verbally instructing the mother to push even in the absence of a contraction, which is not nearly as powerful as when she pushes with a contraction. 

I see the student in her I-feel-like-I-should-be-doing-something nervousness, and I think of this. I briefly make eye contact with the other student and she cocks an eyebrow at me. We can read each other's minds without saying a word. "What in the world is she doing?" I know exactly what she is wondering. 

"Stop touching the baby." I outright, very matter-of-factly say. She catches herself and retracts her hands as if she has laid hands on fire. 

The baby restitutes to the maternal left leg, and with the next contraction, is born. 

These women are legit. It takes a special person to be a student midwife, yet an even more special one to work under Glen and myself. Our expectations are incredibly high, we don't allow room for excuses, and we don't hesitate to say what could be and should be better. If they stick with it, these women have the potential to be two of the very best midwives. 

Later we debrief from the birth- how it went, how we did, what could have been done differently...and we teasingly make fun of the shenanigans. She’s good sport. Before we know it, these student midwives will be licensed and catching babies as midwives. I'm thankful that so far neither of them have flushed a placenta down a toilet or flooded a birth room. I can't think of any student midwife that would do that. ;-) [Reminiscing back to my apprenticeship...]

I think and laugh to myself that an apprenticeship is a special sort of hazing. 

Haiti 2015

It's official! Glen and I have set the date for our third trip to Haiti, in support of Midwives for Haiti. We will be in Haiti September 19th-26th.

As with our previous two trips, we need and value the support of our family, friends, and community. We appreciate all forms of support- encouraging words, prayer, monetary gifts to help purchase supplies, gifts of comfort items for ourselves to use while volunteering (hand sanitizer, snacks), medical supplies, and basic baby items made into gift packs to hand out during mobile clinic (well as for the families who come to the hospital with nothing) including: a onesie, hat, pair of socks, baby blanket, and cloth diaper.


The single most important factor in ensuring a safe birth for both mother and baby is having a access to care with a skilled birth attendant. While we struggle here in the United States with decreasing the rate of (unnecessary) intervention, there are women and babies dying due to that they do not have the most basic of intervention- a skilled birth attendant.

Please support us as we support Midwives for Haiti in their work to end preventable maternal and infant mortality. All donations may be brought to Integrated Women's Wellness & Center for Birth, now through September 14th. A list of specific needs will be posted and kept updated on a separate blog entry.

With Thankfulness,

Tara Elrod

Humility

Last night after a birth- like after most births I attend- my husband sent me a text that read, "Good job." We had just had a calm, gentle waterbirth, and welcomed a new baby boy.

I'm not sure if my husband's words of praise are a thoughtful effort on his part to lift me or encourage me (no matter how 'easy,' uncomplicated, normal, or short a birth may be, the demands of what it is to be a midwife never change), but he makes sure to share this small praise with me often.

"I didn't do anything," I responded. Truly, this woman required very little of me. I was with her in my simple presence of just Being. My work included monitoring her baby and ensuring the normalcy of what was already naturally occurring.

A conversation stemming from his "good job" ensued. 

"You obviously did do something.  She got there at a great time in her labor, she had a good birth, no complications...You obviously had some part in orchestrating that." Yes, yes I did. But I know that we both already know that. And I recognize who did the most important work (not I). Should I be boastful? Should I be prideful? There is a difference with having pride and being prideful.

I drove home at 2:30 am, the Alaskan sky still glowing with light like the smoldering hot embers of a campfire that continues to persist. I marveled in the beauty of  "summer birth" in Alaska, how easy it is compared to the dead darkness of the desolate winter. Tiredness doesn't cohabitate with Alaskan Summer, and at 2:30 am, it might as well have been 2:30 in the afternoon. I drove marveling over Pioneer Peak, while mulling over the value of Humility. When I got home, I quietly crept into my house, still light from the Midnight Sun and without need of turning on a light, devoured two cold pieces of pizza right out of the box that had sat there all afternoon and night. I crawled into bed beside my sleeping husband and baby, and further contemplated humility; what it means to be humble.

"Humility has nothing to do with depreciating ourselves and our gifts in ways we know to be untrue. Even 'humble' attitudes can be masks of pride. Humility is that freedom from our self which enables us to be in positions in which we have neither recognition nor importance, neither power nor visibility, and even experience deprivation, and yet have joy and delight. It is the freedom of knowing that we are not in the center of the universe, not even in the center of our own private universe." -David Wells

This speaks to midwifery and what I value in my heart. 

Miss Perception

When we first broke ground on our new office and birth center, we were called several times by people in what seemed to be going toward a community uproar. Why? Because we were building an abortion clinic, that's why. Or so, that was the word on the street. People in our neighborhood called our office. The church across the street called our office. Another midwife in our community was approached about us by inquiring minds in her own church. 

The interesting thing with living in a small community, is that we are all connected. This, for the most part, is a strength and why I love living in a small community. I go on to have repeat clients and help them welcome all of their babies, I take care of friends and family members of previous clients, and we all continue to be further enriched by being deeply and strongly interweaved. However, sometimes- as in the case of the abortion clinic- living in a small community turns comparable to a bad case of The Telephone Game: information is shared, misconstrued, added, subtracted, twisted, contorted, misinterpreted, and passed on as factual truth. 

In the case of the abortion clinic, the truth was: we were- and are- anything but. We take care of women. We help families become families. 

Fast forward to today and on a completely different topic, our office received a phone call from a very upset, and not-so-nice woman. Her phone call really upset one of our receptionists. The woman felt the need to randomly call and speak of "things she had heard." In speaking with our employees about the incident, I contemplated the idea of calling this anonymous woman back to address her statements and provide her with accurate, factual information. Would it do any good? Would it be welcomed? Would it/could it make a difference to this apparent raging-mad woman? Would it just upset me? One of our employees pointed out: if I didn't call- if I just left it as it was- this woman would remain with her inaccurate misunderstandings. Thankfully for caller ID and a thoughtful receptionist, I had her phone number. 

I picked up the phone and called this woman, not knowing what to expect but knowing that my heart was open and I was coming from a place where I wanted to rectify any misinformation. 

The Telephone Game teaches us the power of perception and individual interpretation...stories morph as they go from individual to individual, each unique in perception and interpretation. 

For the anonymous caller, I hope our talk helped- and put this lesson into perspective. 

The Birth Center Option

Every week it seems we get more and more calls and emails inquiring about what our care consists of and what exactly a birth center can offer. It is wonderful to see more and more women and families actively researching and wanting to know more about this option. So, I got to thinking I should write a little bit about what we offer and why we are the best. Here goes...


In a time when healthcare consumers are becoming more and more involved in their care and decision-making, an increasing number of families are choosing to give birth not in the hospital, but rather, within a birth center- a homelike facility that revolves around the wellness model of pregnancy and birth.

The increasing number of families choosing to deliver at birth centers may largely be attributed to the increasing number of women desiring to have a natural, unmedicated birth, free of unnecessary intervention. Rather than policies of routine intervention, birth centers are guided by principles of support and prevention.

So you know you want a natural birth? Maybe you don't even know that for sure and are bordering on thinking that it is a wild and crazy idea! The best thing you can do- for yourself and your baby- is to know your options and learn more about what a birth center can offer. As we say around Integrated Women's Wellness...if you don't know your options, then you have none!


Here is what you can expect from a birth center birth with us:


Us

We are a small, intimate practice whose primary focus is providing evidence-based, family-centered care, and truly getting to know each individual person. Unless planned well in advance, you know you will have the same care providers you have seen throughout your pregnancy attending you at your birth. Our patients have the benefit of an integrated model of care, which marries the personalized, wellness model that is midwifery care, with the science of obstetrics.

Tara Elrod, CDM

Glen Elrod, OB/Gyn

Our Rooms

We have two beautiful rooms that we specifically designed to be a cross between the comfort of home and the relaxing space of a luxury hotel. Both birth rooms showcase the scenic photographic art of our local Alaska surroundings (done by a local photographer, Calvin Hall), though each with different decor and its own distinct 'feel.' Both rooms offer a queen-sized family bed, an open-concept shower, and a large tub- both for hydrotherapy as well as the option for waterbirth.
There is no separation from partner, the barricade of a bed rail on a hospital bed, nor a hospital bed that gets "broken down" for a lithotomy-positioned turtle-back delivery.

Support People

Our model of care is that of evidence-based, family-centered care. There is no limit on the number of people allowed to be with you as you give birth or how involved they can be. It is entirely up to the patient. Family members, doulas, and siblings are welcome, as mom so chooses. Siblings and dads are welcomed and encouraged to be active participants in the birth. Also, at Integrated Women's Wellness & Center for Birth, we have two Apprentice Midwives who are also both Certified Doulas, who are able to provide wonderful additional support.

Shelby Larson, Apprentice Midwife and Doula

Mary Yanagawa, Apprentice Midwife and Doula

IVs and Medication

While birth centers are guided by principles of prevention and only appropriate medical intervention, some interventions are available, when indicated. At The Center for Birth, most women do not need to be hooked up to an IV, as they are low-risk and able to eat and drink freely. IVs are available as needed- for hydration, antibiotic administration for GBS, and for blood loss management. While IV pain medications are not available, antibiotics, Pitocin, Methergine, and Cytotec (for the management of a retained placenta or postpartum hemorrhage) are readily available and given as needed. If there is a laceration that needs to be repaired, lidocaine is able to be used for numbing.


Pain Management and Relaxation

Due to possible side effects for mom and baby, analgesic drugs (like IV pain medications) aren't given at The Center for Birth. However, the best kind of pain management comes from the encouragement and freedom of movement, aromatherapy, physical and emotional support, musical therapy, the supportive and calming surroundings, and the use of hydrotherapy in our large walk-in showers, and large tubs. Nearly 90% of the births with Integrated Women's Wellness and Center for Birth are waterbirths, and 99% of moms use water as a means of pain management and relaxation at some point during labor.

A Higher Level of Care (Hospital)

Emergencies are not expected but always anticipated and prepared for. Every clinical person- providers as well as support people- are trained and certified in Neonatal Resuscitation, the treatment of postpartum hemorrhage is possible, and we are located less than one mile from Mat-Su Regional Medical Center, should a hospital transport be necessary.


The birth of a baby- a new life- is a sacred event and a momentous occasion for a family. Consider having your baby in a welcoming, family-centered, and safe environment- our birth center!

AKbirth.com

A Record Holder

A wonderful part about being a midwife is creating long-term relationships with people. Maybe not the kind of relationship in which I see past patients often or even keep in touch on a daily or weekly or monthly basis, but the kind of relationship that perseveres through time, with meaning that does not diminish as years go by or as people move away. I speak of a relationship that very often consists of keeping in touch to hear about birthdays and milestones, and mostly, simply remembering. Most anyone who has had a midwife that they loved during their pregnancy and birth will never forget that midwife. Most midwives who have had a patient who they have connected with, gotten to know well, or served in a particularly meaningful way will never forget that patient...or that birth.


Today I received this message from a past patient who has since moved away:

"Hey Tara! Our sweet Asher turned one today and we are reminded of your (and Dr. Elrods )help and support during this special day. We made a mad dash and nearly had him in our car, but you were my voice of reason and strength on the phone. I can not even express to you the comfort you brought me and that I much needed on that drive over. You guys make a great team! Thank you for being a part of our special day!"

I read this short message and it brought a smile to my face. I won't ever forget Ginni's labor. It was fast and furious! She had called me in labor, letting me know that she was contracting every 2 minutes. I told her to head to the birth center. I won't ever forget literally running out the front door of my house- which I do often, but not quite like this- yelling behind at Glen to come with me and HURRY UP!

Minutes later Ginni called to let me know that her water had just broke on her way out the door in heading to the birth center. I asked her the usual questions, assessing that everything was 'normal'  and well. I told her not to panic but to simply get in the car and get to the birth center. I hung up the phone and as I was driving said to Glen, "She is going to call back in a couple minutes and tell me that she's pushing." Two minutes later my phone rings and it's Ginni- in control but scared- telling me that she was pushing. I'm on the phone, holding it with one hand and conservatively  navigating the precarious roads with my left hand on the steering wheel. Ginni is crying. The roads are crisp white, blanketed in freshly fallen snow. There is no such thing as driving fast and rushing in the Alaskan winter of gentle snowfall. Ginni is trying not to push and doesn't know what to do. I tell her that it's ok. If she has to push, then don't panic...just relax and let your body push if you need to. I tell her to have her husband turn the heat on to get the car warm and to get something ready to wrap the baby in. I tell her, calmly but yet firmly to tell her husband to NOT STOP. "Tell him that if you are pushing or if the baby starts to come, do not stop driving. Do not pull over. Keep driving to the birth center, no matter what." A baby born inside a car certainly wasn't ideal for anyone, but a baby born in a stationary car on the side of the road was even worse.

We stayed on the phone together- her driving one direction and me driving another, both toward the birth center from equal distances. As she was pushing something dawned on me..."Ginni, do you have your pants on?" I envisioned a baby crowning into pants.   Yes, she said. "If you are going to push then you have to pull your pants down. The baby can't be born in your pants." In such a situation, this is not at the forefront of anyone's mind.

We were just a couple minutes from the birth center. "Oh heck," I thought, "But what if the baby isn't born yet when we arrive to the birth center? Then she will have to get into the birth center with no pants on." It's amazing how even when things are happening relatively furiously and your brain is firing a million times at once, one is still capable of having long, detailed thought processes. I wasn't sure which was worse, the baby being born in her pants, or having to get her from the van to the birth center with no pants on.

We pulled up to the birth center at the same time. As we were pulling in, Glen took off his seat belt, in preparation of jumping out to help. He flew out one way and I the other- him to assist Ginni's husband in helping her and I to unlock the birth center door. We got into the birth center, pulled down the bed coverings, and 2 minutes after arrival, a beautiful, healthy baby boy was born.

To this day, Ginni holds the record for shortest time from arrival to birth. I won't ever forget the birth of Asher, nor will I forget how strong Ginni was while being within the eye of the storm!

Happy Birth Day to the both of you, Ginni and Asher.