700 Babies

700 Babies
Image by monetnicole.com

700 Babies, born in the water, welcomed in the hospital, born on the land, welcomed in the community setting.

Rooted in the soil

Reaching through the milky stars

A midwife stands guard

The soul cracks and grows

The water swirls and supports

The eyes glow with grace

Strong hands open wide

A brow furrowed in love

A midwife stands guard

700 Babies
Image by andrearaephotography.mypixieset

700 Babies and counting, I have been on this journey for well over a decade. I started as a nurse in 2005 and was a witness and supporter to countless births in that role and they are near and dear to my heart. Then, as a midwife in 2010 with these 700 births. From my first birth through to now, I have always kept a record of each one. Records of the ‘soft’ data: the words spoken, the feelings shared, the time spent. And the ‘hard’ data: the calculations and the outcomes. Both encompass the art and science of Midwifery. The labor we expend, the love we share, the spaces we guard. Both are necessary and valid. I have made a tradition of sharing these data and will continue to do so as long as I am attending births. For me, knowing these numbers helps to ensure that I am providing safe, appropriate care. In looking back, I can learn and grow as a practitioner, I can keep myself honest so to speak. Sharing these numbers also takes some bravery as every time I do so, I open myself up to opinions and scrutiny. I am always open to respectful thoughts, questions and discussion but will not engage in negative attacks.

When I started my career in 2010, I worked exclusively in the community setting at a free standing birth center. Then in 2017, I transitioned to a new role as I built and developed a new birth center. This one with the support of a physician group and so I have hospital privileges now and attend births in both a birth center and a hospital. This shift is of course reflected in my statistics.

Image by lindseyedenphotography.com

Disclaimers: these are my personal numbers and not those of the groups I work within. If some percentages do not add up exactly, that is due to the fact that my early births may not have included all the data points I am sharing here.

  • Cesarean Birth Rate = 4.3%, of course as a midwife I am not a surgeon. However, since 2017, I have been certified as a First Assist in the operating room so I have been able to follow my families through this process. Curious about what a First Assist is? Read more here.
  • Waterbirth = 25.1%, sadly, the hospital in which I also attend births does not offer waterbirth so this number has gone down.
  • Postpartum Hemorrhage (PPH) Rate = 4.5%. PPH rates have been and are notoriously under-reported as most providers and facilities use “estimated” blood loss (EBL). For years, I have utilized “quantified” blood loss (QBL), meaning that I weigh all the materials that have been used to catch the blood. When doing QBL’s you will have a seemingly higher PPH rate but this is misleading as you are truly calculating the loos and not simply eye-balling it. And we as humans are not that great at eye-balling blood loss and will subconsciously under guess. You can read more about this concept here.
  • Epidural Rate = 19.9%, in 2017, when I started at my new practice, I started attending hospital births. From 2017-2019 most of these were planned hospital births where the birthing person had been planning an epidural before the onset of labor. Currently, I only attend hospital births with families who had been planning a community birth without an epidural but may change these plans when a transfer is necessary.
  • Induction of Labor (IOL) = 6.6% Primarily, these were all for medical reasons such as prolonged rupture of membranes, hypertensive disorders or cholestasis or pregnancy. However, I have done a small handful of these for “social” reasons such as partner who is the military and is being deployed or a partner who had a serious medical condition affect their life expectancy and wanting them to be able to meet the baby.
  • Neonatal Intensive Care Unit (NICU) Admission: 2.4% Each of these babies has made a full recovery, most were admitted for minor respiratory issues and some have been related to congenital anomalies.
  • Fetal Monitoring: Intermittent Auscultation (IA) = 72%, Continuous Electronic Fetal Monitoring (CEFM) = 16% and Fetal Scalp Electrode (FSE) = 1.3%
  • Artificial Rupture of Membranes (AROM) = 16.9%
  • Birth Position: Hands and Knees = 24.7%, Semi-reclined = 21.5, Birth Stool = 12.2%, McRoberts = 11.2%, Side Lying = 7.7%, Squatting = 7.2%, Standing = 3.9% and Semi-fowlers = 0.6%
  • Perineal Integrity: Intact = 28.3%, First degree laceration = 16.3%, Second degree laceration = 28.5%, Third degree laceration = 3.1%, Fourth degree laceration= 0.9%, Episiotomy = 1.7% and Peri-urethral lacerations = 1.1%
  • Group Beta Strep (GBS) Positive Rate = 18.7%
  • Retained Placenta = 1.6%, in 12 years of practice, I have had 2 clients with unknown placenta accreta for which there were no risk factors or cause apparent.
  • En Caul Births = 3.1%
  • Cord Avulsion = 1.4%
  • True Knots in the Umbilical Cord = 5 total
  • Youngest Birthing Person = 15
  • Oldest Birthing Person = 45
  • Biggest Full Term Baby = 10lbs 12oz
  • Smallest Full Term Baby = 5lbs 3oz
700 Babies
Image by monetnicole.com

Walking this path has been rewarding, exhausting and inspiring. I am constantly in awe of the birthing people and families that choose to invite into their most private space. As I continue to walk this path, hopefully, for years to come I often feel the flow of the waters carrying me, calming me, giving me strength and soothing me. I believe that birth is a deeply elemental process and for me, the element that I feel most often is that of water. It is powerful and soft, loud and gentle, it fills and takes the shape of each individual space.

Image by A Midwife On The Path

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