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.

Another Day

My day began shortly after 6:00am. A call from a patient in labor. The answering service patched her through and the voice on the end is a long, steady moan, which trails along for a full minute. I look at the clock to register what time it is: 6:05, my phone says. "Let's meet at the birth center at 7:00. That will allow me time to get there before you and set up," I tell her. We hang up and I call our two apprentices. They will be on their way.

I get up and as I'm getting dressed, Glen gets Callen changed, dressed, and ready to go along with me. Baby Callen and I head to the birth center. 

As I pull up I see the laboring mom standing outside. I told her 7:00 and yet she's there early. She's standing outside at the birth center entrance, laboring in the crisp Alaska cold. Thankfully it's a mild morning at 40 degrees. 

I jump out of the car, apologize that she beat me there (hey, I did say 7!), grab Callen in the carseat and run to the door to let us in. I punch in the code. The door doesn't unlock. I punch it in again. It doesn't unlock. I enter the code yet again, this time slow and methodical. No luck. I try a few more times for good measure and to make sure I'm not losing my mind. Nope. 

I run to the car and put Callen back in. 40 degrees may be mild but it is cold for a baby. I run to the front of the building- mom laboring, leaning against her car- and enter the code on the front door. It doesn't unlock. I try again. Still, it doesn't unlock. I call Glen as I run back around to the birth center door, I'm sure waking him from a dead sleep. "Where the heck are the apprentices?! I can't get in! Why isn't the door working?! Can you call Vivint right now?!" I don't even give the poor man a second to answer any of it and I'm pretty sure I hang up on him. I go back to the side door to try again. I'm contemplating in my mind which stone I'm going to pick up and whether it will be best to break the glass on the door or the window. 

I enter the code again, making sure- again- that I'm getting it right. It should be unlocking the damn door and it's not. The definition of insanity crosses me mind. "I'm doing the same thing over and over again, expecting a different result." I enter it again, one final try before I shatter some glass and crawl through a window. And it works. We're in. 

Thankfully the rest of the birth is unlike our entrance and goes smoothly- a first time mom has a beautiful, calm, unmedicated birth, and meets her baby girl. 

The relationships I form with my clients vary widely in their degree, depth, and meaning. Most clients I bond with, but some more than others- with a handful developing into relationships I know I will have and treasure for years to come. Birth unfolds a new level of understanding that wasn't present prior. It's one thing to see and know a woman during pregnancy, spending 30 minutes, sometimes an hour, with her. It's another to be with her during birth. 

I looked at this mom today and had such a better, deeper understanding of her and for her. 

You get to know someone on a different level when you see them outside of their normal comfort zone- whether it be within the parameters of pain, anxiety, excitement, or anticipation that you witness.

During the postpartum course, I figure I can wear Callen. Shantel and I attempt to configure Callen in a side-carry using the Ergo, since I can't find my ring sling. I say configure because that's what it felt like...along with some guestimation. I walk into the birth room looking ridiculous and one of the apprentices, Shelby, takes one look at me and we bust up laughing. I’m informed by the other apprentice, Mary, me that I should probably refrain from posting my picture on the Babywearers Page because I'm in the midst of a baby wearing fail.  Shelby takes Callen and wears him while I do vitals. 

The new mom and her family oooh and ahhh over Callen. Mom is amazed that her baby will likely be about Callen's size in a mere 7 weeks. Oh, the time flies with these sweet babes. 

The feeling in the room is happy...happy and proud. 

I'm proud of this mom- not just for accomplishing Birth, but for being such a beautiful, positive person even with some not-ideal circumstances. I'm proud to now know her that much deeper and I'm proud to be her midwife. 

It's a good day. 

The Birth of Callen Grey

Birth for me is very vulnerable...though, vulnerable not in the sense of being broken down and susceptible, exposed and weak (because in labor and birth I know and feel I am anything but these things). Birth for me is feeling vulnerable to the world...vulnerable in cognizance and coherence of how fragile life is, how powerful yet also how delicate the body is, and, perhaps the most physically, emotionally, and mentally possessive- the awareness of how very little control we truly have.

I knew going into this birth that my support people mattered very much to me. I knew I likely wouldn't need much from them, only their presence and perhaps reassuring words, but that these two things mattered greatly to me. We planned to have our midwife, Peggy, our doula, Mary (who is also our student midwife that works alongside us), and my cousin, Melissa, as support.

Melissa flew in from California and planned to stay two weeks. When she arrived I was 39+2 weeks. Having had Aubrey at 38 weeks, Ethan at 39, and Adria at 40+4, the running joke was that I would likely continue this trend and go slightly longer with this pregnancy. Of course, labor and birth are unpredictable, so we surely didn't know for certain. Just over 39 weeks seemed like a safe time for her to arrive- unlikely that I would deliver before then, and unlikely that two weeks later- at 41+2 weeks- I would still be pregnant.

No surprise to any though, my due date came and went...and the days ticked by, with Melissa and Glen getting more anxious. I felt so good and so not as if my body were ready (literally no signs of anything), I began wondering if my dates were correct. Ha! Perhaps a bit of "nearing-41-week-denial!"

On the Sunday before 41 weeks (40+6) we awoke to a beautiful day. The air was cool with just a slight Autumn crisp to it, the sky was a perfect blue and sparred of the presence of even the slightest speckle of cloud. This beautiful day could not go unused- and so we set off for a day trip to Talkeetna.

We ate at the local brewery, perused the small, eclectic gift shops, and made our way to the river bank, where Denali was clearly exposed, in all her glory. There remained not a cloud in the sky, and both Glen and I repeatedly marveled and remarked at how we had never before seen Denali so clear and unobscured. Even with our repetitious awe, I am not quite sure Melissa understood what a rare presence we had. The world around us was glorious.

As the next day I would officially be 41 weeks, on the way home from Talkeetna we stopped at the office and did an NST and an AFI. All was well. With Melissa set to leave on Wednesday, both her and Glen were getting anxious. But, it was what it was- I felt great, and baby was active and still doing well.

The next day, we met with our midwife, Peggy, for a prenatal appointment. I am not one for vaginal exams (and am quite a baby when it comes to them, apparently), but I felt it wouldn't be unreasonable to have Peggy check me, and if possible, "strip my membranes" to see if it  would help to get things going. She checked me at the end of our appointment and I was 3cm, 50% effaced, and -2 station. She was able to strip my membranes and then left, knowing that she might be hearing from me later that night. Or...it could do nothing.

The kids went to bed, and then Melissa went to bed...both not without being adamant that I was to wake them up should anything start happening.

10:30pm and my contractions were regular but not very close together. As I would advise any of my own patients to do- I ignored them as best as I could and didn't time them. If I had to guess, I would say they were about 10 minutes apart. Glen and I laid there for nearly 2 hours- just together in the quiet, dark room, side-lying together with him holding me from behind. I remember whispering to him how much I liked laboring with him, quietly, just the two of us. No fuss, no noise, just us.

A little after midnight, I needed a change of position. The contractions still were spaced out but when they were happening, they were much stronger. I got in the shower for a bit. Not long after that, at about 12:30am, I told Glen that though it might be on the early side, he should text Mary (our doula) and tell her to head over. She too had been adamant about me not waiting until the last minute to call her (for fear that she would miss the birth), and so I was taking this into consideration. It dawned on me that we hadn't even mentioned to Peggy that I was in labor. I all of a sudden had my midwife hat on, thinking of how much I would not like it if a patient of mine was in communication with her birth team but not keeping me in the loop as well. I verbalized this to Glen and told him he should text Peggy and tell her that maybe she should head over too. I then changed my mind and said nevermind- I didn't want her to come over and just be sitting at the house for hours. "Maybe you should check me first." He had already sent her a text by this point but went ahead and checked me. I was 5cm, 90% effaced, and 0 station. "It's too early to have her come. Tell her nevermind, we'll call her when I'm closer." He went to tell her nevermind but she was already on her way. "Ok," I said, "Then she can just get comfortable on the couch and get some sleep until I'm further along." I was so worried about her being here for hours and hours unnecessarily. I felt bad thinking that she would be at our house for hours in the middle of the night.

Mary arrived, Peggy arrived, and we let Melissa get her beauty rest. I got out of the shower and went downstairs to walk around. My contractions were still quite spaced apart, but again, when they happened, they were certainly getting my attention. Peggy sat on the living room sofa and I walked around the kitchen island, taking big, wide steps and swaying my hips. Eventually my feet were hurting from standing in the shower and the numerous kitchen island laps. I told Peggy and Mary, "I don't know what I should do- keep moving to get these contractions going, or go lay down and rest." Mary started laughing and said, "I know what you would tell a patient." "Yeah? What's that," I asked? "Keep moving," she said! "Nah...I think I would say 'listen to your body.'" With that, I decided to go upstairs to rest. Laying down wasn't an option, so I sat on the birth ball and leaned over on pillows on the bed, as Mary rubbed my back. Glen laid a couple feet away on his side of the bed still sleeping. Eventually I became less aware of his obnoxious snoring and began to float in and out of sleep as Mary caressed my back. There was no sense of time for how long I stayed that way, but 30 minutes would be my guess. My contractions did indeed pick up, now feeling as if they were 2 minutes apart. The next memory I have is the shower being turned on for me and me now on my hands and knees, beside my bed. Mary walks in and asks loudly, "Are you having ANOTHER contraction?!" I think to myself, "ARE YOU REALLY ASKING THIS?! A little bit of observation goes a long way." I kept the thought to myself and kept my mouth shut. I got up and got back in the shower. At some point, Melissa woke up on her own and joined us.

I would intermittently try to sit on the toilet. That wasn't comfortable. I would stand for a contraction. That wasn't comfortable. I would sit back down, stand back up, sit back down. I would literally go up and down throughout my contraction, and this repetitive motion was a coping mechanism in itself.

I look at Mary and ask her, "Will you say some bible verses?" She says the first one that comes to mind:

"Fear not, for I am with you."

I nod. That's a good one.

Mary goes and gets her phone and searches for more applicable bible verses, as she seems to be stumped. She comes back reading them. I look at Melissa and matter-of-factly say, "Tell Mary her bible versus aren't very good."

We laugh at it now but at the time I was dead serious. Her bible versus weren't good enough.

Transition at its finest.

I get in the tub. My contractions were now 2 minutes apart and strong, transition contractions. It was quiet- myself included. Shortly thereafter I was getting the urge to push and began bearing down, silently, at the peak of each contraction. I never announced it to the room and I remember thinking to myself, "I wonder if they can tell that I'm pushing?" At this point the pain was intense and there were three things that made it better: silence, swaying my head, and having Glen close. I ask him if he would get in the tub with me. I needed the comfort of having him there, beside me. It is amazing how you can be in such intense pain that you are incapable of verbalizing, but yet your mind is still sharply aware and processing. I remember assessing, thinking of how I was so quiet and also thinking to myself how I was certain everyone in the room thought I looked like a crazy person, with my head swaying back and forth and my eyes rolling in the back of my head. I remember thinking, "If I had the energy to laugh, I would laugh at myself."
I would continue pushing for nearly 40 minutes, and at some point in the midst of that I had the realization that what I was doing was not working. Callen felt bigger than Adria and I felt like I was trying to push a 10 lb. brick out of my rear that was not budging, despite my best efforts. The midwife in me told me that I needed to change positions, get out of the tub, and go sit on the toilet. Oh, but everyone hates the toilet. The mom in me adamantly said hell no, that is going to hurt more. And so, true to the ways of being human, I stayed where I was. Eventually, probably 5 minutes before birth, I had a come-to-Jesus moment where I thought to myself, "Enough of this. You have got to just push and push HARD, as hard as you can, and get this baby OUT." I started pushing like I had never before in my life done, with any of my other babies, and for the first time in my labor, became vocal. For the first time ever, I felt the "ring of fire"- the burning sensation of my perineum stretching as the baby's head was crowning.

"It burns," I said.
"You're doing great," someone said. "Keep pushing."

I continue pushing, long, strong, as hard as I think is possible...

"Is his head out," I ask?

"No...keep pushing...," I'm told.

RAWWWWRRRR!!!!! I'm pushing like a multip shouldn't have to push...

"You're to his eyebrows, keep pushing..."

I roar and keep pushing, as hard as I can. I picture what usually happens with a multip, pushing this hard- the baby usually flies out. WHY IS THIS KID NOT FLYING OUT?!

"Top of the ears...keep going..." someone says.

"RAWWWRRR!!!!!!" Pushing as hard as I can...

"To his nose now..."

"Is his chin out," I ask?

"Keep going, give another push." It's Glen that says this.

I am pushing so hard...

Callen's head comes out. I have relief knowing that I'm almost done. Glen sees that Callen doesn't restitute and tells me to push to get the rest of him delivered. I give one last, long push and Callen is born into his Dad's hands. Peggy says, "Reach down and get your baby" and I reach down and lift Callen out of the water, onto me. It's 5:19am on September 30th, 2014.

I thank and praise The Lord, "Thank you Lord, thank you Lord, thank you Lord..." this is all I'm verbalizing, but in my heart and mind I know what I am saying...Thank you for giving me the capability, thank you for giving me the strength, and thank you for blessing me with this life.

It feels good to be done and to have my baby in my arms.

I get out of the tub, walk to my bed, and get tucked in with our new baby. The newborn exam is done with all of us watching, and Callen Grey weighs in at 9 lbs. 8 oz.

At 2 hours postpartum, Glen gets called in for another mom who would have her baby shortly thereafter, and Peggy stays for another hour, leaving Melissa, and Callen & I tucked in bed. Nicole, our nanny, arrives as Peggy is leaving, and I nap all morning off and on, with the big kids playing happily and excitedly downstairs.

Glen arrives home, happy to be back home with his wife, kids, and new son, and basking in how wonderful it feels to have also helped another family welcome their own son on the same day.


We are so blessed.

If These Walls Could Talk

If these walls could talk, perhaps they'd be speechless anyhow
they'd say it's sometimes all for nothing
the nods and smiles and pretense of love,
sometimes he's just bluffing

Growing bellies equate to growing life and not just cell division
tides changing, life enveloping
it's not all that was envisioned

If these walls could talk, they'd share of disintegrated love gushing out of red-rimmed eyes,
a life-full belly pushed against an empty heart,
a liar, a cheater, a leaver
his mind and body miles apart

If these walls could talk, they'd rejoice in happiness and victory,
victorious, glorious, ecstatic
not just a baby born, but a mother
oxytocin drenched, wholly climactic

If these walls could talk, what is it that they'd say
would they tell these stories justly
the excitement, the fear, the love, the betray?

Oh the stories...

Veins of flowing heroin, waking up beside death,
the sun shined bright but she was always in the dark
in the darkness of addiction
she was the prey, and the predator had its mark

A two vessel cord and a fall down the stairs
life is oh so fragile
living on our prayers

Warm midwife hands and a smile to the soul
These walls could tell of our laughs and our cries
You'll be ok...
don't you know?

If these walls could talk perhaps they'd imitate guttural moans in the night
grasping swaying rocking,
bone on bone in the dark, the most challenging mental fight

If these walls could talk, what is it that they'd say?
They'd share the life of a midwife- LIFE-
excitement, fear, love, and betray.

The Waterbirth of Riley Dawn

I often speak of the importance of a strong and trusting patient-provider relationship- what it entails, what it means, and why it is absolutely necessary. Specifically, I often speak of how it's even more so pertinent to our Out-Of-Hospital birth patients.

Out-Of-Hospital birth is an entirely different beast than hospital birth. For the patient, the family, and the providers alike. There are no epidurals, no pain medications- not even the comfort of having it as an easily accessible, immediate option. To do Out-Of-Hospital birth means to have a strong desire and a determined commitment- again, not just for the woman and her family, but her care providers as well. And trust...trust is the cornerstone. To have trust in each other is to know that everything is out on the table- concerns, fears, desires, expectations- and that we can mutually work together through it and for it. Trust is when the shit hits the fan and you think you may very well be dying because you are in the thick of it, but we look at you with guidance and reassurance and well, you ARE reassured that yes, it's ok, and yes, you CAN do this.

This morning was a perfect example of trust and commitment and how the patient-provider relationship carries that.

I helped support a family in welcoming their 3rd baby; not only their first Out-Of-Hospital birth, but their first unmedicated birth. I didn't see them at all throughout their pregnancy and therefore didn't (and don't) really know them in the way that I know my own patients. But what made them special is that they have been long-time patients of Glen's.

I remember first meeting Randi- at a childbirth class I taught at the office. Afterward we stood and chatted briefly. She hadn't previously considered a birth center birth, but after learning of her options and wanting the same doctor- her doctor- she changed her plans for birth. She looked at me and said, very matter-of-factly, "We've had two babies with Dr. Elrod. I'm not having a baby without him. If I need to have a birth center birth to guarantee that he'll be there, then I'm having my baby here. I'll go wherever he is."

I remember going home and being amazed, repeating those words to Glen. Yes, a relationship and trust are very strong things.

Just like any woman experiencing natural childbirth- there were a few- but brief- intense moments. It may have been her 3rd baby, but Randi had never felt THIS before. In the small birth room, in the corner tub, surrounded by the decor I myself love and deliberately selected, with her husband by the side of the tub, and Glen and myself kneeling in front, with the urge to push and not knowing what to do she exclaimed, "Dr. Elrod, please help me!"

The room was dimly lit by the sconces that light up on each side of the bed. The same sconces we have in our home. The wood headboard that was made locally. A room that not only has what is needed to practice evidence-based care and safely have a baby, but that also feels like the kind of environment that is conducive to a family actively working together and welcoming their new baby.

Glen looked at her and reassured her that her baby's head was right there. She pushed 3 times and the baby's head was out. She looked at me- directly and intentionally- and said entirely calm and collected, yet every bit as intense as the words she spoke,

"Tara, I'm scared. I'm so scared."

Her eyes were wide and intensely locked on mine.

"You're ok. It's just your baby's head. Everything is ok, " I reassured her.

And with that, one more push and she delivered her baby girl- into the water, into Glen's hands and then immediately up to her chest. Even though she was admittedly scared, she was strong, and SHE DID IT!

Riley Dawn was born today- an uncomplicated, unmedicated, beautiful waterbirth. Mom and baby are doing great, and Dr. Elrod is pretty proud too!