The Difference A Homebirth Midwife Makes: Part 1 Pregnancy Update


As some of you may remember, I posted this picture of my fifth son on HFFG’s Facebook page in December of 2012:

Along with this caption:

The pregnancy with #5 had the most intervention with not only an ob/gyn but also a maternal/fetal medicine specialist (perinatologist). Not coincidentally, it also had the worst outcome.

There were many reasons for this, including the doctor’s failure to respect my requests for doing hemoglobin checks (resulting in a missed case of anemia as well as hospital-induced anemia from so many blood draws), our family’s financial hardship at the time (having to get free food from a local church), and too much unnecessary medical intervention/procedures (like frequent exams and ultrasounds at every appointment), all adding up to a difficult and scary pregnancy with an outcome much worse than my other pregnancies that had much less medical intervention.

Consequently, I want to invite each of you onto a personal, candid journey with me in my 6th pregnancy to see what a difference the care of a homebirth midwife and the research from my nutrition counseling education can make. This is our chance to see together what traditional wisdom and good nutrition can make from one pregnancy to the next.

So is it making a difference? To show that it is, I’d like to detail the stark contrast between this pregnancy and the last at the 32-week mark:

Pregnancy #5:

26 weeks:

Prenatal care completely switched to perinatologist (ob specialist) (at this point it had been half and half between providers) at request of regular obstetrician due to being dilated to 1. (Keep in mind, this was my FIFTH pregnancy.) At this point, no regular attention/care had been given to hemoglobin levels, nutrition, or pre-existing risk factors for preterm labor (despite history of baby #4 being born at 35 weeks).

30 weeks:

Admitted to hospital in preterm labor. After 3 or 4 days in hospital and having multiple blood draws, perinatologist recommends blood transfusion as a result of severe anemia (HGB somewhere around 7). Because neither doctor had previously been monitoring my iron levels (they each assumed the other doctor was doing it), we are unsure whether my anemia was pre-existing prior to my hospital stay or if it was hospital-induced. It would stand to reason that if it was severe anemia that existed before hospitalization, one of the many blood draws would have picked up on this. However, it may have been a combination of both factors.

(Hospital-acquired anemia is very common. This study found that 2/3 of all patients who were hospitalized that had adequate hemoglobin levels at the beginning of their hospital stay became anemic during their hospitalization: http://www.ncbi.nlm.nih.gov/pubmed/16583583 Other studies cite frequent and unnecessary blood draws as the main cause of hospital-acquired anemia. )

After the perinatologist assured me that I could not bring up my iron levels by way of nutrition/supplements, I naively consented to blood transfusion. (See below for how quickly I was able to raise my hemoglobin through nutritional/supplement measures the next time around!) Preterm labor seemed to halted for the time being so I was discharged after 5 days. No advice was given regarding preterm labor causes/remedies.

30-34 weeks:

Contractions/preterm labor symptoms continued (and were possibly worsened with each weekly perinatologist appointment due to level 3 ultrasounds at each one. One study found that when women at risk of giving birth preterm were examined once a week to determine the state of their cervix, just over half (52%) of those who were examined using ultrasound went on to have a preterm birth compared to a quarter (25%) of those given a manual pelvic examination.[1] Twice as many women had preterm birth as a result of ultrasound over those who had a manual pelvic exam! (And I wonder how much lower that rate is for women who have no ultrasound or manual exam intervention at all!!)

Labor was full-force at 34 weeks and there was no stopping baby. Cord was clamped early despite my requests to delay it, causing baby to turn blue and need a ventilator as soon as cord was clamped. Baby spent 3 weeks in NICU under mom and dad’s constant watch. Praise God that he is now an extremely healthy, strong, independent unvaccinated 3-year old that was breastfed until age 2 1/2 (when I got pregnant with #6).

Pregnancy #6:

Prior to pregnancy and up until 26 weeks:

All prenatal care exclusively with homebirth, aka “lay” midwife, trained with traditional wisdom, nutritional and herbal knowledge, as well as an understanding of the root causes of complications during pregnancy and how to prevent them. Before we even knew that I was pregnant, we did some testing on my vitamin and mineral levels. We discovered that my mineral levels were extremely low (largely in part due to drinking reverse osmosis water for the last 5 years which, by the way, removes all minerals in addition to removing the bad stuff like chlorine and fluoride). My midwife explained that this could very well have been a large factor in my preterm contractions/labor symptoms from previous pregnancy as the muscles need magnesium to relax, as well as other reasons why minerals are important.

So in addition to my Personal Prenatal Regimen described in this post here, I also incorporated mineral supplementation. The main way I did this was to add mineral drops to our filtered drinking water. I use this:

And this:

Prior to becoming pregnant, I studied to become a Certified Nutrition Consultant, so I was able to walk into this pregnancy with nutritional knowledge from myself as well. Armed with this information, my midwife and I spent the first two trimesters addressing nutritional needs and getting my vitamin/mineral levels to where they should be. This included frequent testing and monitoring of those levels, as well as the purchase of many supplements!

($400 worth of supplements as of 32 weeks to be exact, not counting the costs of blood and hair tests for nutritional levels. Yes, it has been expensive but only a fraction of the cost of 3 weeks in the NICU!! And in my opinion, it is worth it to try and avoid having another preterm baby as that time in the NICU can be very challenging for the whole family!)

28 weeks:

Despite having monitored hemoglobin levels, we discover at this point that they suddenly got too low (about 9). (This is a recurring problem in my extended family but only tends to be a problem with me during pregnancies.) My midwife and I created a plan to increase the levels naturally via food and supplements by my next appointment at 30 weeks. In addition to the things I was already doing (as seen in my Personal Prenatal Regimen), the plan was:

For some people, this list would include eliminating some/all grains, especially wheat, as those can block absorption of iron. Other foods that can cause anemia are caffeine (coffee) and pasteurized milk. (This is why so many infants, especially those who are formula-fed, are anemic.) Since I was already gluten-free and did not consume caffeine or pasteurized milk, these things were not a factor for me.

(I would like to note that while I refused the traditional 28-week glucose test for GD (ya’ll know how I feel about consuming refined sugar anyway!!), awesome midwives like mine test their patients’ urine at every appointment for sugar levels, thereby monitoring it the ENTIRE pregnancy!)

30 Weeks:

Prenatal appointment with midwife displayed that our plan was very effective! Hemoglobin was increased to 10.5 in just two weeks (will continue until levels remain steady over 11), thereby avoiding IV iron treatment! As you remember from pregnancy #5, I was also admitted to the hospital in pre-term labor at this point before. This time, I feel GREAT!! Only small, sporadic Braxton Hick contractions. pH levels are back up to 7.0 (they had fallen very low previously in the pregnancy due to stressful family times), and everything else looks wonderful. Midwife says to keep up all of the hard work and good nutrition!

(For others experiencing problems with preterm labor, I would like to note just a few of the things that can cause it which can often be easily remedied but because conventional doctors are not trained in this area of knowledge, they simply give moms drugs to help strengthen babies lungs and prefer for preterm delivery. Some of the things that are overlooked are:

    • Dehydration–One of the most common reasons for hospital admissions during pregnancy and preterm labor. It’s not enough to just drink water–expectant moms must drink a lot (at least 3 quarts/day) and that water should not be void of minerals (as stated above). It’s also important to remember that caffeine causes the body to lose water faster than it can often take those things in, so eliminating coffee and soda is very important.
    • Position of baby–My midwife told me the story of a pregnant mom who, after having a slight fall, began experiencing regular contractions that indicated the possible onset of preterm labor. After receiving chiropractic and/or craniosacral therapy, her contractions abruptly stopped. As she explained, anything that may put the baby into an awkward position can cause the uterus to contract. Chiropractic and/or craniosacral therapy has the benefit of helping keep mom and baby aligned.
    • Nutritional deficiencies–Anemia is just one of many examples of nutritional deficiencies that can cause preterm labor. When a baby in utero is not getting the nutrition he/she needs, they instinctively vacate the premises in hopes that they will get it elsewhere. Deep, underlying nutritional deficiencies can also prevent a woman from conceiving in the first place.Addressing nutritional deficiencies is my specialty, whether in pregnancy, before pregnancy, or any other time of life, this is what I do with my clients. If you are interested in receiving a personal nutritional consultation with me to examine and address any nutritional deficiencies you may have that are causing health complications in your life, please check out the information on my services.
    • Hormonal Imbalances–We live in an age where more women in America suffer from hormonal imbalance than those who don’t. Namely, estrogen dominance (an overabundance of estrogen resulting in a deficiency of progesterone and other necessary hormones) is rampant and causes multiple health problems that prevent conception and can cause miscarriage/preterm labor. I have helped many clients address this imbalance through nutritional and environmental changes, but it is best addressed before pregnancy. Please check out this link for more information on my services.
    • Overabundance of Unnecessary Intervention–As we can see from the link above regarding regular ultrasounds doubling a woman’s risk of having preterm labor, there are many overlooked factors in conventional prenatal care that increases preterm labor rates. We can see how these are more easily avoided with the care of a homebirth midwife.There are, of course, many other factors to be considered in the cause of preterm labor. Some of them, such as pre-eclampsia and other complications, can easily be addressed with nutritional counseling and dietary changes. Of course, obstetricians are not trained in this important area of health so most women are not told of the amazing difference that proper nutrition makes. And if you look at the cost of services from someone such as myself for proper nutritional counseling and/or the cost of the care of a traditional midwife trained in nutrition, it pales in comparison to the costs of conventional prenatal care and hospital birth!
    • Infection–Bacterial and/or yeast infections are a very commonly-overlooked cause of preterm labor, as well as miscarriage and complications in the infant after birth. This is an extremely important area to watch, especially in the days of things that destroy the necessary balance of the microbiome such as antibiotics (in prescription drugs as well as our food), chlorine, sugar, etc.–See my full post on gut destroyers here.)As the following article explains:

      The microbes of the human vagina are paramount to our survival; and in this era of burgeoning research on the human microbiome generally, we need to pay more attention to them.

      Vaginosis increases the risk of contracting secondary infections, from herpes to HIV. But even on its own, the microbial shift may prompt low-grade inflammation that can derail reproduction. It can prevent fertilization in would-be mothers, prompt spontaneous abortion in pregnant women, and increase the risk of preterm birth later in pregnancy…If the vaginal microbiome were suddenly to shift across the entire human population, it’s not unreasonable to predict that humanity would go extinct.

      One study as described in the article found that vaginosis MORE THAN QUINTUPLED the risk of early preterm birth. Vaginosis-related microbes have been implicated in roughly one-quarter of all preterm births. For the most vulnerable group of children, those born extremely preterm, or before 25 weeks, the number perhaps doubles.

      This is not an article you want to miss! Read it here: http://www.slate.com/articles/health_and_science/medical_examiner/2013/01/microbial_balance_in_vagina_miscarriage_infertility_pre_term_birth_linked.single.html

Anyway, that appointment was two weeks ago, so we are now heading into week 32 of pregnancy #6. I wanted to update you as follow up of my invitation last December to come along with me on this journey to see if having a traditional homebirth midwife makes a difference, even over an obstetric specialist. (Note: I understand all care providers are different and some may experience a different model of care than what I experienced from various providers.)

While we still have a ways to go, and we are not out of the woods yet, I am excited at the differences thus far! I will continue to keep all my awesome HFFG facebook friends updated as we go. Praying that we make it to at least 37 weeks so we can have not only a full-term baby but the homebirth we are dreaming of! Thank you all for your amazing encouragement and your prayers! Please keep them coming!

Me at 28 weeks pregnant with baby #6

[1] Lancet 1992;340:1229-303

If you are still unsure about the difference a care a traditional/homebirth midwife can make, I encourage you to further your research. Here are some good articles on the topic:

Home Births May Be Safer Than Hospital Births

A new Cochrane Library review revealed that all countries should think about setting up proper home birth services. Medical interventions are common in childbirth, but are starting to become a concern. Interventions can lead to other unintended results. For example, routine electronic monitoring can cause more women to have artificial rupture of membranes, which can result in even more complications.

Read the full article here: http://www.medicalnewstoday.com/articles/250452.php

Home birth complications ‘less common’ than hospital

Planned home births are less risky than planned hospital births, particularly for second-time mothers, says research in the British Medical Journal. A large Dutch study found the risk of severe complications to be twice as high in hospital births than homebirths.
http://www.bbc.co.uk/news/health-22888411

The Case For Homebirth In The United States

the focus within the midwifery model of care is on a “preventive, holistic model, a more personal relationship with clientele, and a philosophy of care that recognizes the importance of parental responsibility and choice within the birth process” (Barith, pamphlet). Midwifery care is individualized to address each woman and family’s physical, emotional, and spiritual needs. Midwives generally spend more time with clients during pregnancy and labor. They join their clients early in labor and provide continuous care throughout the entire process. The average prenatal visit with a midwife lasts 30-60 minutes. The average prenatal with an obstetrician lasts 6 minutes. By the time a woman reaches term, a midwife would have had 65-130 times more interaction with her than her doctor. Midwives are also able to help most women avoid the use of routine obstetric intervention such as labor induction, IVs, anesthetics, and episiotomies. In various studies considering methodological differences between midwives and obstetricians, midwives valued nutrition, education, counseling, women’s comfort and convenience, and joint decision-making more than obstetricians (Goer, 296).

http://www.ourrealvillage.com/parenting-link/pregnancy-a-childbirth/137-the-case-for-homebirth-in-the-united-states

As we can see, nutritional counseling makes an incredible difference in not only pregnancy but in overall health. In 2010, a medical review (found here http://www.ncbi.nlm.nih.gov/pubmed/20974412 ) tries to once again remind prenatal health providers of the importance of nutritional counseling and focus for better outcomes during pregnancy. Unfortunately, this is not a very strong area in conventional obstetrics. For those who do not/can not seek the care of a nutritionally-trained care provider during their pregnancy, I am working to fill the void in that important area of health care by providing prenatal/conception nutrition counseling services. For more information on my services, including how affordable they are and how they can be done online, please go here.

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