“EVERYONE IS so VERY PASSIONATE ABOUT PROVIDING THE BEST CARE TO EVERY PERSON THAT WALKS THROUGH OUR DOORS. IT’S PRETTY SPECIAL to be a part of such an amazing team! So I would like to start by saying thank you to everyone I work with; the doctors I consult with, the nurses I work with at Providence Hospital, the birth assistants at my clinic, and my wonderful staff. I have amazing people surrounding me and I want to show them all how much I appreciate them. ”
What exactly is a midwife?
A midwife is typically a woman who cares for women during pregnancy, birth, and postpartum. A midwife focuses on being with a woman during her pregnancy and birth.
How long have you been practicing and how many births have you attended?
I have been practicing as a Certified Nurse Midwife (CNM) since 2005. I was a labor and delivery nurse at Providence Medical Center in Anchorage, Alaska for about five and a half years prior to becoming a CNM. Collectively I have attended more than 1,000 births as an L&D nurse and CNM, however I have caught just over 500 myself.
I became an owner of Midwifery and Women’s Health Care at Geneva Woods in 2006 and we opened the Anchorage Birth Center in 2015. Within our practice we have five midwives, a lactation consultant, a licensed counselor, and birthing assistants. Our staff and providers are absolutely amazing!
We offer birthing and lactation classes, nutrition counseling, and lots of postpartum support. Breastfeeding in my opinion is one of the biggest challenges beyond just giving birth. With a lactation consultant in our practice, we are able to support new mothers with breastfeeding as well as support them through the postpartum period through the care of our other providers. As a CNM, we are very passionate about postpartum care and emphasize postnatal care during the first year after giving birth. It absolutely breaks my heart when I see a mother for her annual exam years later and she is still struggling to come through the fog of postpartum when her baby is already 2 or 3 years old.
What is the role of a midwife during labor?
The role of a midwife during labor depends on the woman that is in labor. I ultimately assess the safety of the situation and ensure that the mother and baby are safe during the birthing process. My approach as a provider is to offer support, however that may be. It is so different for each woman in labor. Some women need support from their partner and their families, and only need me for a little guidance. Some women need me to be rubbing their backs and giving them encouraging words. If the mother and her partner need more space and privacy, then I step back. I am present but I am not physically right there. If they need something more hands on, then I step in.
What led you to become a midwife?
Well, I started taking my general education courses in college and I wasn’t exactly sure what I wanted to do yet. I took a gap year after completing my general education courses and took the time to travel the world. I spent some time in Mexico, Guatemala, Belize, and Australia before coming back to the USA. Then my significant other and I bought a Volkswagon van and began to road trip around the Lower 48.
While we were traveling around in our van, we got pregnant. I thought to myself, we will just have this baby wherever we land. About halfway through my pregnancy I was like HOLY MOLY, we should probably go home! We need to have family around to support us. So at that point we came home to Alaska and I ended up in the care of midwives. My son came early, so I risked out of their care and were transferred into the care of an OBGYN. I decided after giving birth that I really wanted to be a midwife. The intimacy of the relationship that I had established with my midwife was something I had never experienced before. I loved that the midwives actually wanted to know me personally. The differences between obstetric and midwifery care stood out to me and I wanted the opportunity to help women transition into mothers.
I always knew that I wanted to go back to school to get my bachelors degree, so I decided to go back and get my bachelors in nursing. I became a labor and delivery nurse with the intentions of continuing onto midwifery a couple of years later, but you as I mentioned earlier, I worked quite a bit longer as a L&D nurse before going back to school. While I was working as an L&D nurse, a CNM reminded me that the reason I went to nursing school was because I wanted to be a midwife. She really encouraged me to continue on to pursue my dream. My husband also encouraged me to go back to school because he knew midwifery was my passion.
I saw all sorts of reasons to become a midwife. I myself was fearful of the process of my own birth and was scared of what the birthing process would be like, just as many women are. Women should be better informed of the birthing process. They should be surrounded by people they know during their birth, not just a person they met here and there.
What advice would you give to an expecting mother on how to find or choose a midwife?
One of the amazing and unique things about our community of midwives is that many of them offer consultations. At our practice, if you have questions about midwifery or want to come into our practice and get a feel for it, then you are invited to schedule a free 30 minute initial consultation. We encourage mothers to schedule a free consultation with a midwife to ask any and all questions they might have.
I encourage expecting mothers to explore their options and see what feels best. You will walk into some places and say ‘oh this feels like home’. The most important thing’s is that you feel connected to the person or people providing your care. We have many great options in our community and we are so very fortunate to have a variety of choices. Ask your friends and family. Ask those you love and respect and trust. Not everyone is like-minded, but word of mouth is huge. Choose what feels comfortable to you and to your partner.
What are the benefits of having a midwife?
There are a lot of statistics available regarding the benefits of midwifery and positive birth outcomes with the care of a midwife. Women often feel more supported by midwives during labor because of the bond and relationship that has grown over the course of the pregnancy. We have longer visits because we really focus on the women and ensure that all of their questions are answered before they leave the clinic.
As a Certified Nurse Midwife (CNM), I provide women’s healthcare in general, not just prenatal care. Our annual well woman exams are very in depth, covering everything from general medical history and family medical history to what the patient’s diet is, how much sleep they get, and how much they exercise. We discuss whether or not they eat or don’t eat things for religious reasons or if they have allergies or if they are following a specific diet. We talk about their dental health and whether or not they brush and floss their teeth? I ask clients: how do you cope with your stress? Are you surrounded by people who support you? Do you wear your seatbelt? How many partners do you have? Do you drink caffeine; coffee or energy drinks? Do you have pain with sex? How are you feeling emotionally?
I’d like to say that your annual exam shouldn’t just be about your breasts and cervix, there is so much more to caring for women. I am always so fascinated with women who have been receiving care elsewhere and transfer their care to our clinic. Midwives look at the WHOLE person. It’s important to look at how the woman interacts with her community and who her community is. There are so many different components to a person, so it’s important that the visit is thorough and comprehensive.
How does prenatal care differ with a midwife?
The biggest difference with midwifery care is the quality time spent with the client. Our initial appointment is about an hour and a half. During our first appointment, there is a lot of information exchange happening. The goal is to offer frequent opportunities to provide care and to get to know the mother. I love having the opportunity to get to know my clients and my clients having the opportunity to get to know me. This relationship building is the foundation to trust which is important when you’re trying to help clients navigate the decision making process of health care.
My goal is to offer information based on current research and experience. For some, more is better and for others, less is better, but the overall goal is to have an informed client. During prenatal appointments, we discuss the birthing process. We discuss the pros and cons of medications and breaking the water. We discuss positioning during labor and how to stimulate the contractions with water. The patient trusts the provider to keep them safe.
What are some common misconceptions about midwifery and how would you address those?
So I immediately thought of this couple that I got to know during their pregnancy. The wife grew up in a rural community and leaned more towards midwifery due to her family upbringing. The husband grew up in a bit more conservative household and was not at all familiar with midwifery. You could tell he was a bit concerned throughout our initial appointment. After a long appointment of chatting and getting to know each other, I did a comprehensive physical exam on the wife. As I was moving to put the blood pressure cuff on her arm, the husband let out a big sigh of relief. He thought that midwifery care was completely hands off. He later told me that he thought I was just going to watch when the baby arrives. Little did he know, midwifery care can be completely hands on!
We are not just hippies, birthing babies under trees while wearing Birkenstocks and flowing skirts… although I do love wearing skirts and Birks. We are attentive and respond to the needs of moms and babies. I commonly hear that midwives do not intervene, when in fact we do intervene appropriately. Some clients think that you cant have an ultrasound or genetic testing with midwives, however we can order similar things as obstetricians if a client desires.
During the prenatal appointments, we talk about the misconceptions and any skepticisms that the client’s may have. I provide information to the mothers about what to expect under the care of a midwife right out of the gate.
What is the best part of what you do?
I am so fortunate because I have the best staff and clients ever. My practice is a place to grow and be supported whether you work there or come see us for care. We aim to provide a place of support, to learn more about ourselves and others. People come from all walks of life and all lifestyles. I love that I have the opportunity to get to know different people from our community, each with a different story.
I absolutely love the look on the families faces when a baby comes into the world. The shock and surreal look of oh my gosh! Look at what I did!! No matter how many births I attend, I will always love seeing the families with their new babies. It makes me teary just talking about it because its so exciting.
Recently, a friend brought to my attention that a client had had a professional video edited of their family this past fall from over the year. They welcomed a new baby earlier this year. I provided their prenatal care and they had a cesarean delivery, which I also attended. The video opens from the delivery room. I am laughing and completely full of joy. They had a clear drape so that the mother could see her baby during the birth. The OBGYN brought the baby up to the clear drape and you could hear me in the background saying “It’s your baby!! Look at your baby!! Its your baby!! Your baby is looking at you!!”
I have this same level of enthusiasm at every birth. I learn something from each and every person that I meet. Every mother has something to teach me. I believe that each person has so many words of wisdom and has something to share. I recognize that I am not an expert on all things, but I look at each person and know that they are the expert of themselves. This may sound pretty cheesy, but it is pretty neat to get to know people.
Where do your births take place?
Our births take place at the Anchorage Birth Center and Providence Alaska Medical Center. I would say its about 50/50. Our name, Midwifery and Women’s Health Care at Geneva Woods is a bit of a mouthful. We are located in the Geneva Woods Medical Center in the Geneva Woods neighborhood. We opened the Anchorage Birth Center in 2015 and is exclusively utilized by the midwives at Midwifery and Women’s Healthcare.
Laura Gore, CDM, CPM, and I own Midwifery and Women’s Health Care at Geneva Woods, where we have the ability to provide true midwifery care. We have a “no guilt policy” and encourage our clients to give birth where they feel comfortable and safe. If they prefer to be in a hospital, then we go with them and we provide the same care that they would receive at the birth center. When my clients call and tell me they’re in labor, I am so excited to assist them no matter where they deliver!
Can patients bill insurance?
We are in network with all insurance companies. When you come in for your first prenatal visit, we provide you with a packet of information as well as a financial worksheet. The financial worksheet is more like a script to follow. You call your insurance company and ask them the very specific questions outlined on the financial worksheet. For example, do they cover both direct entry midwives and certified nurse midwives? Do they cover out-of-hospital births (birth centers) and hospital-births? Once completed, the client returns the worksheet to our medical biller and we will give them an estimate on how much it will cost to have a baby. We strive to help families become savvy healthcare consumers and navigate the financials of healthcare.