Deaconess Women’s Clinic: Part 2
By Tine Reese
March 3, 2010
Deaconess Women's Clinic midwives Lauren Armstrong, Kathleen Bentley and Catherine Shields.
How is the care you provide different from an OB?
CS: “I’m so grateful that Deaconess will allow us to have the kind of schedule that we do, so that we can practice the midwifery model. We are with the mother from the time she goes into labor until the time the baby comes. Therefore, we’re not the kind of midwives that have to leave the office and leave everybody unattended to run to the hospital for a birth. We always have one midwife in the clinic, one midwife on call catching babies and the third is off duty. We just rotate. If you work for an obstetrician’s office, you usually don’t have that option—at least, I’ve never seen it in this community. I think we have a really unique practice where, as nurse midwives, we practice independently in our own clinic and collaborate with obstetricians if necessary.
We can offer patients the time, the education and our presence, not only when they’re in the clinic but also when labor begins.
“We can offer patients the time, the education and our presence, not only when they’re in the clinic but also when labor begins. It offers them a familiar face, something they can’t be guaranteed by most OB practices. I don’t want to slam their medical model. They provide many other services for women: surgeries and taking care of complicated problems that nurse-midwives do not. That’s what they’re there for. We believe that we’re specialists in the normal.”
What do you do to prevent medical intervention?
CS: “I promise to honor what our patient’s want and do the best I can to prevent intervention. Actually, I wouldn’t even consider doing it if we didn’t see that it was necessary. There are times when it does become necessary, but before we do anything we have a discussion. And because we’re with our patients the whole time we don’t try to plant seeds of intervention or caesarean section, but we just keep them aware of what’s going on—from the beginning to the end—so that they’re informed. It may be a disappointment, but it’s not a total surprise.”
What is the birth culture like at Deaconess?
CS: “We do what you say. We don’t tell you what to do. The nurses have seen us sit down at the bedside, and explain in detail what is happening, exploring options instead of saying “you definitely need an epidural because you’ve been in labor too long.” No matter what, even it I don’t feel like they are many viable options, I try to lay as many on the table as possible so that parents don’t feel stuck in a box with no choices.
The birth plan is part of the registration process. When you come in as a patient the nurses want to see your birth plan. I just love that! The parent’s present their birth plan, the nurses go, ‘This is what she wants. Catherine’s on her way.’ And they just hang with it.”
How safe are your methods?
CS: “There’s a competency about the way we do our practice, which I like to flaunt: we’ve never had any poor outcomes in the over 5,000 births that we’ve had at Deaconess Hospital. I think that has a lot to do with our presence at the bedside. Things don’t happen—they don’t go to pot—without us knowing about it, dealing with it and getting help as we see fit.”
How does your practice holistically support women?
CS: “I have had mothers, grandmothers, sisters, neighbors, best friends and cousins in tears. Not even maybe at the birth, but at the prenatal visit because they realize, ‘Oh my God, is that the way it could be? Is that the way it really is? No one ever told me any of that.’
We talk about more than just how the baby was and how the heart rate sounded, but really address the well-being of the mother.
One time, a intensive care nurse came to help out temporarily at our clinic and was so amazed at the environment, the comfortableness of it. We sit down at the bedside of the mother and introduce ourselves to the whole family. We talk about more than just how the baby was and how the heart rate sounded, but really address the well-being of the mother—how things were going at home, how things were going with the toddler, how you’re doing with daddy gone to war or on the job out of town, with grandma being sick. It’s an encompassing attitude and energy that we put into a mother-to-be because we consider it to be the most important event in a human beings life.
Why is it important for women to really experience birth?
CS: “It has so much to do with how you move into the future as a parent, as a wife, a mother—a breastfeeding mother. It’s something that a mother who goes through birth, where she feels like she’s heard, her questions are answered and that her concerns are concerned about, she can move forward in her life always being able to call on that experience. She can say, “Oh my God. I did that! And if I can do that, then I can do this.” And it doesn’t matter whether it’s a sick toddler, a 16-year-old that’s going out with the car for the first time, saying goodbye to your teenager as they go to college or as your children are giving birth themselves.
I wish that every woman could have that experience [of being present during birth] because their whole life would be so enlarged.
It’s an experience unlike anything we do every day as humans. You know, we pay the bills, go to work, fill up the car with gas, scrub out the toilet. I wish that every woman could have that experience [of being present during birth] because their whole life would be so enlarged. The bigger picture would seem easier had they had the strength to call on what they did during birth and to appreciate and honor their body for what it does. It’s huge.”
What is the biggest misconception about nurse-midwives?
CS: “I had a new patient yesterday who said, ‘I have a friend who is leery of me going to midwives because they don’t give you any medicine. You have to go totally natural.’ And that’s probably the hugest myth or misconception about nurse-midwives who work in hospitals. The bottom line is it’s not about us and our desires. It’s about the mother and her goals and wishes.
They can be like you [Tine] and sit on the birth ball, labor in the bathtub and walk around the whole time which we totally love. They can receive any medication that we have to offer should they desire or need that.”
What happens when a patient does need a c-section?
CS: “We’ll never leave our patients no matter what happens. If they have to go to the OR for a caesarean section, we’re right there.”
What’s the biggest obstacle to women trying to have a natural birth at Deaconess?
CS: “I think its the societal view that women can’t do it without drugs. You spend your whole life hearing that you need medication and interventions because it’s the safe way to do it. There are attitudes that say if you don’t give women medication that you’re being cruel. I was criticized by a doctor one time who said, ‘Give her what she wants. She doesn’t have to be a martyr for you, Catherine.’ It was horrible. It was just a slap in the face. But it’s easier for doctors to do their work when the patient has anesthesia.
We try to do nothing. Because we know we don’t have to and if we leave it alone it will unfold. It’s really an awesome process. If a woman’s attitude is ‘I need an epidural,’ then that is exactly what they’ll get. I’m not there to talk them into something. I’m there to honor what they want. We try to inform them, but sometimes they are defensive about it. They don’t want to hear it.”
Why are nurse-midwives a good choice for women pursuing natural birth?
CS: “Our specialty is being able to sit by the bedside, the rocking chair or the bath tub and help the mother through it. And not be afraid of her sounds or her pain. And encourage them to know that they’re doing an awseome job, their bodies are working fine, their baby is safe and that it won’t be long. It won’t be long.”
As we covered this topic, student midwife Tonia Baker who is in training at Deaconess shared a recent experience of sitting in a rocking chair in the labor room while a mother was laboring in the bath tub. The patient could see her in the chair, just sitting there listening to her. She said, “The mother was using HypnoBirthing techniques. She said she could see me sitting in the other room, wathcing and listening to her. When she began faltering during transition, thinking she couldn’t do it, my presence was enough to make her say to herself, ‘OK. I can do this.’ And she did. She did beautifully.”
CS: “It is so important to be with them. We walk in the door and see our patients sigh with relief. They may be in the middle of a contraction, but there’s that peace that comes to them when a familiar face walks in the room. That’s what makes the stress and the long hours of our job worthwhile. It’s physical. It’s emotional. It’s spiritual. It’s everything! There just could not be anything more rewarding than the art and skill of being a midwife.”
If you missed it, read Deaconess Women’s Clinic: Part 1.
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Comments
Beautiful Tine–thank you!
Thank you for the wonderful article about the Deaconess Women’s Clinic! All the midwives at DWC are an inspiration to me and as a current Frontier midwifery student, I am looking forward to my clinical rotation with them. My husband & I will be moving to Rwanda Africa to run a women’s clinic. I knew after catching my first baby there, I would become a midwife just like my big sister, Catherine. She is so supportive of the midwifery model, she traveled all the way to Rwanda just to see what we are doing and help us plan our future there. Just like her patients, she supports and encourages me in my vision of women birthing naturally and safely. I am forever grateful to all the midwife pioneers in this community who have supported and encouraged women. I wouldn’t be who I am today without my big sister and mentor, Catherine! I love you, Mae Mae xo
These articles are as wonderful as these 3 dedicated, professional and compassionate midwives are. You captured their unending spirit of bringing a positive birth experince to every pregnant woman.
I love and miss them all. Shirley Keith,RN, Former Manager, Deaconess Women’s Clinic.
Thank you so much for that lovely interview! What an inspiration you are Catherine!!! I am a physical therapist who has just applied to midwifery school as it is my dream to become a midwife. Catherine, would you be willing to let me buy you a cup of tea and just talk with me some time? From what I have read in this article, you and I have some very similar experiences and I would love to “pick your brain” a little if you were willing. Thank you!