Many of you know the story of my call to midwifery-of my first birth experience with midwives at a freestanding birth center in Pittsburgh (BirthPlace-an old Victorian home on Baum Blvd, which has since evolved into the Midwife Center for Birth and Women’s Health in a new location), and how when we moved to Cleveland when I was 6 months pregnant with Claudia, I asked where the local birth center was. People looked at me like I was speaking a language they didn’t understand. There wasn’t one, and few people understood why I was in search of one. That was twenty-two years ago. I spent the next two decades raising children and steadily pursuing midwifery by first becoming a doula and a childbirth educator, then by going back to college to get a nursing degree so I could eventually get a masters degree in nursing/midwifery. It’s been a long road. It’s twenty-two years later and I’m still wondering where the local birth center is. The laws and culture around birth and midwifery in Ohio just haven’t budged, making it challenging if not impossible for me to practice in a way that is in true alignment with my head and my heart. My experience with Mt. Eaton Midwifery and the Amish and Mennonite communities is as close as I’ve come to that, and has been an amazing experience that I will always cherish. Maybe the laws will eventually change-once again there is legislation pushing for independent practice, but for now it is what it is, and changing a law doesn’t quickly change a culture.
In the span of the last month or so, I interviewed for and received an offer for a position with a private midwifery practice in Buffalo, where the laws around the practice of midwifery are completely different than they are in Ohio. In New York state, midwives licensed by the state practice independently (New York state passed the Midwifery Modernization Act in 2010). This unique practice encompasses full-scope midwifery in all birth settings (home, birth center, hospital), with the majority of clients choosing out of hospital birth. Due to challenges on multiple levels, this model simply doesn’t exist in the state of Ohio. I had a weekend-long whirlwind of an interview a few weekends ago (while Dave explored the city, which he loved) and met a whole lot of of supportive and amazing people from the Buffalo birth community (midwives, RN homebirth assistants, doulas, labor & delivery staff, etc) including a role model of mine who is the founder of the Birthing Center of Buffalo, where I will have privileges, and who will be my consulting physician/sponsor for hospital privileges at Oishei Children's Hospital. And so, with lots of support from loved ones (for which I feel incredibly lucky and grateful), I have accepted the position and will officially be starting January 1st.
Here is a link to the practice, which recently bought a historical home (the oldest house in Buffalo!) where the practice will be based (and babies will be born!) beginning in January. https://www.fikamidwifery.com/
All that we know (or think we know) as "normal" comes from our environments, our lived experiences and exposures, and let's face it, our media feeds. While midwifery has been mainstream in my mind for decades, it's still not mainstream for the majority and I've had a good reminder of that since launching the Rise Midwifery and Wellness website. I've had a lot of, "too bad I'm all done having babies" responses, and while I'd love to be your midwife for that, the truth is I can be your midwife for so many other things too. Here are a few (but not an exhaustive list of) examples:
Time for your annual exam? There's a midwife for that. Certified nurse midwives (CNMs) provide primary health care services for women from adolescence to beyond menopause. We offer cervical cancer and HPV (the virus responsible for cervical cancer) screenings (Pap tests) at recommended intervals and order lab tests and screenings based on recommendations and individual symptoms. Annual exams do not have to include a pelvic exam. "No search without probable cause" is my motto.
Think you might want to start or switch birth control methods? There's a midwife for that. CNMs have full prescriptive authority in Ohio as a part of their licensure and can help you decide what methods might be best for you based on your health history, preferences, and other factors. Natural family planning and the fertility awareness method are a specialty of many midwives because we tend to get nerdy about things like hormonal health and cycles.
Having pain when you pee or other symptoms of a possible urinary tract infection? There's a midwife for that. I can do a urinalysis, call in a prescription and send a urine culture to the lab to make sure you're being treated appropriately. We can also talk about strategies for preventing future infections.
Vaginal or vulvar itching, burning, or unusual discharge? There's a midwife for that. You can do a self-swab at your visit (or I can do it for you, if that's your preference) and I will take a look at it under a microscope (I'll encourage you to look too!) to help determine the cause of your symptoms. We will talk about options for treatment and I can call in a prescription if that's appropriate and what you want or we can talk about natural methods to clear things up. I can also test for and treat sexually transmitted infections if that's what's suspected. Again, prevention will always be a part of our discussion.
Period problems or tricky peri-menopause or menopause symptoms? There's a midwife for that. CNMs deal with menstrual irregularities and menopause symptoms on the regular! We will discuss possible causes and explore options for addressing issues including natural and prescription hormonal options.
International Day of the Midwife is coming up on May 5th and is a great opportunity to shout the benefits of midwifery care for women in all stages from the rooftops! This year's theme highlights the vital role that midwives play not only in ensuring women and their newborns navigate pregnancy and childbirth safely, but also receive excellent, relationship-based healthcare both before and beyond the childbirth continuum, creating a lifetime of good health and well being. There's a midwife for that, and that's something to celebrate!