Wasatch Midwifery & Wellness

When I was pregnant with my second baby, I opted to see a midwife and have him at a freestanding birth center instead of a hospital. I was low-risk and it ended up being far and away a better experience than when I had my first baby in a hospital four years prior.

One of the midwives I saw on a regular basis was Adrienne Brown. She was warm, friendly, straightforward, and she made me feel completely at ease while at the same time, I felt completely confident that my baby and I were very well taken care of. She hails from the realm of “you know your body and your baby best, I’m just here to support you.” What more could a woman ask for, right??

A few years ago she opened her own freestanding birth center and practice and I was honored to be able to create rack cards for her birth center. She had a logo already and some beautiful photos, so I created a few layouts and this was the final result. It’s honestly an easy job when there are such beautiful photos!

Check out her site! Wasatch Midwifery + Wellness

I love how they turned out!

My Birth Center Experience

Even before I became pregnant with my second baby, I knew I wanted to go a different route when it came to my prenatal care and birth support team. While my experience with my OB and a hospital in 2009 wasn't awful, I felt I got very lucky with supportive nurses when it came to wanting a drug and intervention-free hospital birth for my first son. 

Disclaimer: I FULLY understand that there are many aspects to childbirth that are outside of my control, but I am also educated in how the U.S. healthcare system notoriously treats pregnant individuals. I am fully aware of my privilege in that that I had more options when it came to my prenatal team that many in this country. I also fully understand that a birth plan is just that: a plan… not set in stone. Just guidelines on my wishes assuming my body and my baby cooperated.

Prenatal care with my OB was fairly typical for the U.S. maternity system. I often waited thirty minutes to an hour after my scheduled appointment time before seeing my OB for a rushed visit. My weight and blood pressure were scrutinized by a nurse and I had only five to ten minutes with my OB each appointment. She never talked to me about nutrition or exercise, and she relied on me to ask questions to spark any conversations about what she recommended. Thankfully, as I became more and more educated, I came to each appointment prepared with questions, but I often felt like my asking questions was an inconvenience for her.

Also, there were five OBs in the practice. I met with all of them at least one time throughout the course of my pregnancy and learned that only three of them were actually going to be supportive of my leave-me-alone-to-labor-without-intervention birth plans. 

I distinctly remember the prenatal visit when I was 34 weeks and we presented our birth plan to my OB (the one I saw most often). My husband joked that it felt like we were watching a teacher grade a test in front of us. :::eye roll::::

She pushed back on a few of the items on our birth plan, but we were prepared for some resistance; especially on me moving freely throughout labor, eating and drinking to maintain my blood sugar and hydration, and preferring intermittent fetal monitoring vs continuous monitoring. We compromised on a few things and I verbally agreed to a couple of things I had no intention of actually following through with.

Some of the things she said about my birth plan should have been red flags: 

"I won't let you suffer in agony for hours without pain medication"

“After your water breaks, I don't want you walking around in case the umbilical cord tries to come out first." 

When I stated I would prefer to tear than to receive an episiotomy she said, "Well, I'm going to cut your perineum if I think you're about to tear up top, by your urethra." Despite those comments, I was naively confident that we would be fine. That OB was on vacation when I went into labor anyway.

The nurses at the hospital were WAY more supportive and never once asked me if I wanted pain meds. They actually took the time to read my birth plan, dimmed the lights, brought me some cranberry juice, and pretty much left my husband and me alone to do our slow-dancing-labor thing. Immediate skin-to-skin bonding for mama and baby was standard practice too. 

When we moved to Utah a few years later and were trying for baby #2, I was afraid we wouldn't get as lucky the second time around. Not wanting to have to interview OBs and research hospitals, or potentially have to find a new OB midway through my pregnancy, I searched for freestanding birth centers in the area. Luckily there was one just twenty minutes from us and that's where our second son, M was born.

It was a completely different experience with my second pregnancy. I have listed some of the biggest and most noticeable differences.

Prenatal Care:

- At my first appointment I sat and chatted with the midwife for almost two hours going over my history; both of us asking questions and getting to know each other. She wanted to know about my pregnancy and birth with TJ and I wanted to know what the criteria would be if complications came up and I "risked out" and had to transfer to an OB. She answered all of my questions thoroughly and never made me feel like she was in a hurry to get to the next patient.

- I turned 35 a few weeks before my first prenatal visit. My midwife noticed and made a point to tell me that I wasn't automatically "high risk" just because I was 35.

- I was due for a pap smear around then too. Given that I'd never had an abnormal pap, my midwife shrugged and said we could wait and do it at my 6-week postpartum visit. My OB insisted I get one when I was 9 weeks pregnant with my first son and it was not pleasant.

- There are toys in the main meeting room at the birth center and there are also a few toys in a drawer of all the exam rooms to keep little ones occupied. When TJ had a random question, my midwife answered him with complete seriousness and even gave the stuffed dog an exam once too. Toward the end of my pregnancy, it was standard procedure for him to get the doppler and measuring tape out of the drawer for her. Once, she even showed him how to find his little brother's heartbeat with a fetoscope. 

- At every appointment, I weighed myself, checked my own blood pressure, and I did my own urine test. It became routine that my son helped me into the blood pressure cuff and pushed the button to start the machine. It made him feel like a part of the process and I liked getting to do all of this on my own. When it was time to test for Group B Strep, I did the swab myself too.

- All blood draws were done by the midwife. I never had to go to a separate lab. With my first pregnancy, the lab was down the street from the OB's office and I always had to wait at least thirty minutes before I was seen, even the few times I had an appointment. I can't imagine having to do that with my antsy preschooler with me. 

- For my glucose test I didn't have to drink the icky, syrupy drink if I didn't want to. I had a list of options that included an Odwalla mango smoothie or a choice of candy bars. Win!

- Nutrition was discussed a lot. The midwives at my birth center truly believe that good nutrition can help stave off a lot of common pregnancy complications. Taking probiotics was also recommended to me to prevent developing a UTI; a pregnancy complication I had during my first pregnancy that landed me in the hospital. I really believe they worked. I never even caught a cold with my second pregnancy, despite it being cold and flu season AND my oldest starting preschool!

- Prenatal visits were thorough and never, ever rushed. Even when I didn't have any questions to ask and the exam went quickly, my appointments still lasted well over an hour with me chatting about a random aspect of pregnancy or childbirth with my midwife.

Labor and Delivery:

- The birthing room at the birth center didn't look or feel anything like a hospital room even though I know hospital-like equipment was hiding behind cabinet doors if it was needed. The room had a regular bed, an awesome bathroom with a walk-in shower, and a fantastic, big bathtub. I know they had a birthing chair, a hammock to hang from and probably more fun labor-assisting contraptions. The room looked more like a hotel suite than a birthing room. A little part of me wishes my labor was longer so I could have used more of the room.

- While in labor I could wear whatever I wanted. I could walk around and do pretty much whatever felt most comfortable to me. I could be in whatever position I wanted when it was time to push. I only had one cervical exam, and it was done gently and with my consent. I was free to eat and drink as I pleased. My older son was welcome to be present and participate as much as he was comfortable with so long as we had another adult there to supervise him if needed. 

- After my baby was born, I didn't have to stay for a mandatory 24-48 hours like I did in the hospital. If I didn't have some postpartum complications, we would have been home within a few hours after birth ready to snuggle with our newborn in our own bed. 

Postpartum Care:

· My midwife was prepared for the postpartum hemorrhage I had. A saline IV was started and I was given a couple of drugs to help my uterus stop bleeding. When they weren't working, an ambulance was called and we transferred to the hospital. All of this was done before it became a scary emergency. My midwife came with us to the hospital and stayed well into the morning; even though she didn't have privileges there. She was constantly talking to me, answering my questions, and making sure I understood what was going on and that my mind was at ease.

· My midwife noticed my son had a tongue tie and an upper lip tie within an hour of his birth. She clipped them both the next day and he went on to be a champion nursling with almost zero breastfeeding issues. I learned a lot about tongue ties from her and we discovered that both my older son and I had tongue ties that were never diagnosed. My heart ached a little bit thinking back to how incredibly painful nursing was for me in the early newborn weeks with my oldest.

· I saw my midwife two days postpartum for our first checkup. She did my son's newborn screening and hearing test along with a thorough follow-up for me. We saw her again one week and then two weeks postpartum for more follow-up to make sure that breastfeeding was going well and M's jaundice was under control (it wasn't, long story). In between appointments, she called me to check in and ask how things were going. 

· If I had needed it, a home visit with an IBCLC was included in my care. With my first pregnancy, they did the newborn stuff in the hospital and then I didn't see my OB again until six weeks postpartum. She had no idea about our breastfeeding struggles or TJ's jaundice and she probably didn't care. Newborn stuff was for the pediatrician and breastfeeding issues were for a lactation consultant or the pediatrician. Our pediatrician back then never asked how breastfeeding was going either, he only cared that my baby was gaining weight. At my birth center this time, all of it was under my midwife's scope of care and she strived to make sure BOTH of us were doing well.

· At my six-week postpartum check, Eva (birth assistant & office manager) was happy to snuggle with my baby while I had my exam with the midwife. With my OB, my husband had to take a morning off work to come to the appointment with me so he could hold our son while I was examined.

In conclusion, my experience with a midwife at a birth center compared to a hospital with an OB was so vastly different that I will never go back to an OB and a hospital if I have any more babies so long as my pregnancies remain low risk. 

Not all women experience their prenatal care the same way I did. I know there are some truly respectful and supportive obstetricians out there. And I'm sure there are some not-so-nice midwives too. 

I have learned that the whole attitude of midwifery care is much more to my liking. Midwives tend to treat pregnancies as low risk and normal unless something changes, and they do their best to teach preventative care to mamas to help keep them that way. Most obstetricians don't see pregnancy and childbirth the same way. They tend to see all pregnancies as high risk until proven otherwise.

The second time around, I truly felt cared for and that the health of my baby and myself were the most important things… not what was hospital policy, not the convenience of a doctor, not the wishes of an insurance company. It made my birth experience even more empowering to know this. 

Even when I had to transfer to the hospital shortly after my son's birth, my midwife stayed with us and was there to answer my many, many questions. They know and understand the value of psychological healing when things don't go as planned. I can't recommend these wonderful midwives enough!

M's Birth Story

Image by Jessica Kay Photography

Since I went into labor with my first baby at 37.5 weeks, I wasn’t sure what to expect with my second. Both my husband and I had it in our heads that Easter weekend was going to be when this little guy decided to make his appearance… for no reason other than intuition.

37 and 38 weeks came and went and I found myself in uncharted territory. I was uncomfortable, none of my maternity clothes really fit anymore, my body ached and I was really getting tired. I finally understood what it meant to be “done” with pregnancy… a feeling I’d never experienced with my first. My loving husband bought me a gift certificate for a couple of prenatal massages and they really helped me get through those feelings at the end of my pregnancy. Seriously, all mamas should have at least one in the third trimester!

Saturday morning (38w, 5d, the day before Easter) I woke up to some contractions that were significantly different than any of the Braxton Hicks contractions I’d been having. They were incredibly low in my abdomen and in my lower back. They were uncomfortable, and only occasionally painful. I knew this could be it, but I just went about my morning as chill as I could. My husband was at a sharpshooting match that morning and politely requested I hold off any labor until he got home. My son TJ, who’s 4.5, requested that I not have his little brother on Easter because he was going to be “busy looking for eggs” that day. I laughed at both of them.

Image by Cari Hollis Photography

These new contractions were about 20-30 seconds long and ranged from 5 to 15 minutes apart. By lunchtime they fizzled out and I was only having one every half an hour or so. I ate lunch, drank some water and I took a nap when TJ napped and I didn’t have any contractions then.

After our naps and after my husband came home, the contractions picked up again. I let him know what was happening, but that I really wasn’t sure if this was it. I took a long shower and drank more water. Before dinner, contractions were 5 to 7 minutes apart, but still only 30-40 seconds long, and the majority of them were very manageable. I sent text messages to my midwife and birth photographer to let them know what was going on. My husband got our truck packed and the infant car seat installed. He thought this was go-time, even though I wasn’t convinced.

After dinner, my mother-in-law put our 4.5 year old son to bed while my husband and I went for a walk around the block. The contractions had started to space out again and I hoped the walk would kick things into gear. We walked for about 25 minutes when I got tired and decided I was just going to go to bed. The walk didn’t work and contractions were now 20 to 30 minutes apart and getting weaker.

I was discouraged and sent text messages to my midwife and photographer telling them I was going to bed and that I’d let them know if anything changed.

We all went to bed and I fully expected to wake up in the morning to a new day, an Easter egg hunt with TJ, and maybe some more contractions. I fell asleep as soon as my head hit the pillow.

About two hours later (about 1:45 am) I woke up to go pee and had a super strong contraction while walking to the bathroom. While sitting on the toilet I continued to have contractions that were only a couple of minutes apart and lasting well over a minute. I had to focus and concentrate on my breathing through them all.

After a few of them, I felt a small pop and some fluid trickling. I immediately knew that my water had broken. It wasn’t a huge gush, but a trickle every time I had a contraction.

My husband came into the bathroom to check on me and I told him that we needed to call the midwife and get going right now. This was the real deal and I had no idea how quick this was going to be.

He went downstairs to wake up TJ and his mom and get them dressed and into the truck while I tried my damnedest to get my butt off the toilet. It took a lot of willpower to get up, get some clothes on and physically get myself into the truck with contractions only a couple of minutes apart. My husband followed me down the stairs with his hands on my lower back the whole way.

The 15 minute drive to The Birth Center sucked, but I was thankful to have a few minutes between contractions. I can tell you exactly which bumps in the road made me swear under my breath while my 4.5 year old was happily chatting behind me. He was so excited that this was happening in the middle of the night, something he’d requested.

During the drive, I was texting my birth photographer to let her know we were on our way and we debated having her meet us there or wait until I’d had a cervical exam to come. Waiting until my cervix was checked made the most sense to me, so I told her we’d text her after I was checked. Yeah, I regret that decision.

We pulled into the birth center just as my midwife and assistant arrived. She rushed upstairs to get things ready while I slowly got myself out of the truck. I had a contraction that almost brought me to my knees right there in the parking lot but my husband held on to me and kept me focused.

I got into the birthing room, stripped off my skirt and undies and worked my way onto the bed so my midwife could check my cervix. The second midwife arrived a minute later and I heard someone turn on the water to start filling up the tub. I had one powerful contraction while laying down before she could examine me, then she was super quick with her exam. I was 9cm!

As soon as that registered in my head I asked my husband to text the photographer. Before he could hit Send, the next contraction started and I quickly shouted for my husband and the birth assistant to help me up onto my hands and knees; I couldn’t handle another contraction while laying on the bed.

That contraction literally rocked me and my body was pushing. I shouted that I felt “pushy” and I put my hand between my legs in some sort of futile effort to stop the pushing. I felt my son’s head crown almost immediately and it took every ounce of strength I had to slow down that push so his head didn’t come out too fast. I was literally gasping for breath to gain a tiny bit of control over my body as both midwives and the assistant were looking for a mirror and a flashlight to see what was going on. I really, really didn’t want to tear! My husband had his arm around me and I buried my face into his shoulder, willing my body to slow down.

I was somehow able to ease my son’s head out slowly when the contraction finally ended and I had a moment of relief. I felt the next contraction begin and warned everyone that it was coming. His shoulders eased out and the rest of him followed. I picked him up and brought his slimy, squirmy body right to my chest and I’m pretty sure I looked up at everyone and said, “wow!”

Image by Earthside Photography

With some help, I took off the tank top I had been wearing, rocked back onto the bed and snuggled with my brand new son. TJ came over to check out his baby brother and I asked him what he thought; he had watched the whole thing from across the room. He said it was pretty cool.

From the time we arrived at the birth center to the time M was born was approximately 15 minutes!

A couple of minutes later our photographer arrived. I felt SO bad that she missed his fast and furious birth. If only I had told her to just come when we first arrived!

Image by Earthside Photography

We all snuggled together while she shot some photos, I delivered my placenta and my husband cut the umbilical cord. And happily, no tearing!

Image by Earthside Photography

After about two hours, my midwife was getting a little concerned that my uterus was taking its sweet time to clamp down and she was keeping a close eye on my blood loss. She said my placenta had come out backward and she was concerned that a couple of pieces were still in my uterus… something that can happen when the placenta comes out that way. Some poking and prodding wasn’t helping so she started a saline IV and gave me a shot of Pitocin in the leg to see if that helped. It didn’t really, so I was given a dose of Misoprostol orally as well. Misoprostol is also known as Cytotec and is often used for hospital inductions. It’s pretty well known for it’s use to help stop postpartum hemorrhaging, too.

It had been about two and a half hours since my son had been born and my body was still bleeding at a steady trickle.

Image by Earthside Photography

We had a decision to make. My midwife could try to manually extract clots or retained placenta from my uterus and see if that did the trick. It’s a very painful procedure, and she really didn’t think anyone should go through it without pain medication. I wasn’t hemorrhaging terribly, but it was getting to the point where we didn’t want this to turn into an emergency situation.

The other option would be to transfer to the local hospital via ambulance, have an ultrasound to see what was going on and go from there. The OB could do a manual extraction of any clots or retained placenta with pain meds for me. And if a D&C or a blood transfusion was needed, we’d already be there to get it going.

As much as it pained me to admit, transferring to the hospital was really the best option. M was quickly weighed and measured and a quick newborn exam was done while an ambulance was called for me and we got the process going. Since I wasn’t hemorrhaging profusely, lights and sirens weren’t needed, much to my older son’s chagrin.

In the ER I was given another bag of fluids along with some more Pitocin and the on-call OB came down to do an ultrasound. She saw that there were some big clots in the lower part of my uterus and she was confident that she could extract them manually. If the bleeding stopped then I’d be able to avoid a D&C and hopefully go home later that day.

And, thankfully, that’s exactly what happened.

We transferred to L&D, I was given a dose of Fentanyl and she manually extracted some clots from my uterus. It was not pleasant at all, but she worked very quickly and I was feeling a LOT better about 20 minutes later. I was very grateful that my body was handling the blood loss really well. I was very pale and a little shaky (also a side effect of the Misoprostol), but I never felt dizzy or lightheaded or had a drop in my blood pressure. I even got up to use the bathroom a few times and didn’t pass out. After all was said and done, I had lost over a liter of blood.

My blood loss was monitored for a few hours along with any signs of infection, and by 3pm that same day, I was discharged and heading home.

The folks at the hospital were really wonderful and every time a new resident, nurse or doctor introduced themselves, they apologized that I had to be there at all; understanding that the whole point of delivering at a birth center was to skip the hospital all together.

In hindsight, I will admit I felt like I was robbed from part of the peaceful birth experience I had hoped for because of the hospital transfer. My son’s birth was incredible and exhilarating and I am so grateful that we are both healthy. I know that I had no control over what happened afterward, and in reality, I had the best possible outcome after a severe postpartum bleed. And at no time did I wish I had just given birth in a hospital.

But a little part of me grieved for the moments I wanted to experience during that blissful postpartum period. I was hoping to take an herbal bath with both of my sons after M’s birth, something my older son was really looking forward to in the birth center’s big bathtub. Even though he totally understood why it didn’t happen, he was still sad, and it broke my heart a little bit when I had to explain to him why we couldn’t do that.

My amazing birth photographer Ginger, made some arrangements with my birth center and almost two weeks after my son’s birth, we finally got to take that postpartum herbal bath that I had hoped for (and take some photos!). We didn’t tell TJ about it until we actually got there since there was always the possibility that we couldn’t if a laboring mom needed the room. But we did and he was so happy. We soaked in the tub and snuggled skin-to-skin, letting the herbs heal our tired bodies.

Image by Earthside Photography

Image by Earthside Photography

Image by Earthside Photography

After a hectic two weeks of almost daily heel pricks to check M’s bilirubin, doctor visits, and two hospital stays (my transfer plus two nights with M for jaundice), I finally felt like I had some peaceful closure to what was very likely my last journey with pregnancy and childbirth.

Image by Earthside Photography