In this episode Deb speaks to renowned Midwife Deborah Flowers R.N., C.P.M. Deborah has 30 years of experience at The Farm Midwifery Center in training and service attending over 1,000 births. In addition to working at the farm Deborah served as the lab director and director of midwifery and childbirth education at Plenty International. She has served on the board of Midwife International and regularly leads trainings for midwives specializing in IV therapy and neonatal resuscitation.
As a special treat for our listeners and to help clarify any questions you might have Deborah has included her show notes:
How did you and the other Farm Midwives hone your skills when the Farm was first forming?
-
- The first births were attended by women who were pregnant themselves. So one day they might be attending a birth as the midwife and the next day be in labor and receiving care. This made it so they really knew how it felt to be on the receiving end of care, what works, what made them feel good and what didn’t.
- For the medical side of things, we read OB text books, we learned from doctors, and we learned from experience.
Were you well received or was there any backlash from the OBs or people in the area?
-
- There are Amish in the area and they had their babies at home and a very well respected local doctor who delivered some of the Amish in their homes took us under his wing and that helped a lot.
-
- But some of the nurses in the hospital were not very friendly at first
- Now that has changed
Can you explain the difference between the Midwifery model of care and that of a traditional, pathological model. More specifically, the Farm Midwifery model of care?
-
- We try to involve women in the decision making about their care
-
- We are more likely to wait for your body to go into labor on its own as opposed to scheduling the day that you will be induced!
- We let your water release when it is ready most of the time
-
- There will not be people you have never met coming in unannounced at any moment
-
- We allow women to have long labors, we don’t follow any kind of dilation curve
-
- We don’t hook women up to an external fetal monitor. We use a Doppler or fetascope to listen intermittently to the babies heart beat
-
- We allow women to walk and move around in labor, get in a birth tub if they want, etc.
-
- I think you have to individualize your care for each woman. During prenatal care we get to know each other and talk about what she would like to do at her birth. That is different than a birth plan, because you also have to see what works in the moment and be open to the fact that it may not go like you thought it would and be flexible.
- We believe in delayed cord clamping
I have read the latest birth statistics you have online- it looks like from 1970-2010- there was roughly 3000 birth on The Farm, with a 2% cesarean rate, a 96% successful VBAC rate and 1.7% of postpartum hemorrhage rate. These are just some of the significant statistics that caught eye-there are more for people who want to review all of them. I recognize these are all low risk women, but even among low risk women, these statistics do not reflect the birthing trend in the US. These statistics are just amazing- do you think it is just the woman centered birth approach that produces such healthy births?
-
- We spend a lot of time with women during their prenatal exams, sometimes 2 hours or more,
-
- We have someone with her whenever she feels like she needs someone there
-
- We encourage the woman and her partner to spend time being affectionate with each other to get the oxytocin going
-
- If it is early labor we might encourage her to go for a walk, a change of scenery really can be helpful
- We will consult with friendly doctors if we have any concerns, that might include getting a non-stress test or a BPP
What would risk a woman out of using your services?
-
- Insulin dependent diabetic
-
- More than 2 previous cesareans
-
- Right now we usually don’t take someone having a breech first baby who is not already in our care. Same with twins.
-
- Blood clotting disorder
- Age alone does not risk someone out
I saw that your transfer rate is about 5%, what are the reasons someone usually needs to be transferred?
-
- If the FHTs are not good and we can’t get them to improve – rare
-
- If the water breaks and there is a lot of blood in with the water, or too much bleeding at any time. – also rare
-
- Failure to progress
-
- Malposition of the baby that we can’t change
-
- Hypertension
-
- Prematurity
-
- VBAC with S& S of rupture or Failure to progress
- Prolapsed cord
How would a woman go about using the services of the Farm?
- Start by writing or calling us
Do you have any tips or advice looking to have a physiological birth?
-
- Trust your inner knowing
-
- Find a midwife and /or doula that is like minded
-
- During your pregnancy, surround yourself with people who speak about birth in a positive way
-
- Take good care of yourself during your pregnancy
-
- Exercise, diet, etc.
-
- Learn about what makes oxytocin and endorphins flow
-
- You want to be in a place and with the people who make you feel safe
-
- Know that it may be the hardest thing you have ever done, but embrace that, believe in yourself. You were born knowing how to give birth. You are the direct descendant of women who successfully gave birth all the way back to the beginning of time.
-
- It is Ok to get primal!
-
- Move in labor, dance, walk, sway
-
- Contraction, expansion
-
- Dim the lights, play music, have some privacy, no or little talking
-
- I’ve seen women change in labor “oh let it hurt!”
- I’ve see women have orgasmic birth
To learn more about Deborah please visit: http://farmmidwife.com
For trainings with Deborah: http://midwiferyworkshops.org
Facebook: https://www.facebook.com/DeborahFlowersFarmMidwife?ref=bookmarks
Youtube: https://www.youtube.com/watch?v=CbURfzKM-jM&feature=youtu.be
Email: debrncpm@gmail.com
