On Motherhood and Midwifery

When my second son was born in December 2009, I transitioned from midwifery into a more supportive role at Special Beginnings. Since then, I have managed our social media platforms, taught baby care, sibling preparation and the occasional breastfeeding classes. I have continued to attend births in the nurse’s assisting role. I love being a midwife, it is the joy and purpose of my life…second only to being a mother! I gave birth to a daughter in 2012 and I am incredibly fortunate to be a mostly-at-home mom while continuing to support family centered, beautiful birth center births.

The bittersweet milestones of our children’s lives bring them ever nearer to their independence. It’s the juxtaposition of our jobs as parents to prepare them while we cherish their smallness, their unfolding. My youngest will enter kindergarten in the fall. My big guy just turned ten and my little guy is in first grade. My kids are nowhere near moving out and moving on! However, my days of nursing babies and toddlers and diapering and existing as the center of their universes have developed into days of cheering on their endeavors and marveling at the thoughts they think. I still kiss ouchies and hold hands, and now, we read bedtime stories to each other. I create boundaries and keep them safe. But I no longer smell like breast milk, nor do I follow the kids around the playground.

And so, it is with great pleasure and contentment that I return to the role of Certified Nurse Midwife with the practice at Special Beginnings in a part- time position. I love getting to know our clients and families during prenatal appointments again. It makes birth all the more precious to me when my hands have tracked your baby’s growth and we have sat together and envisioned your baby’s birthday.

I am thrilled to return to gynecological care. I like to solve problems, like a woman’s health Nancy Drew, and I love the stories that women have to tell. The strength and persistence of women is the story of the earth itself. I look forward to working with you.

Melissa Youssi, CNM

 

Our Laurel Flies South

laurel

There is no doubt at all that Laurel loves babies.

Laurel Naff, RN, IBCLC, came to Special Beginnings in 2002 as a LPN and birth assistant. In the 14 yrs since, she has become an International Board Certified Lactation Consultant and a Registered Nurse. She took on the role of Director of Nursing. After hundreds and hundreds of births, so many sweet new babies assessed and kept warm, so many nursing mamas helped through struggles, so many strong birthing mamas and the loving families that surround them, so much traveling from Easton to Pykesville to Takoma Park to Lutherville and everywhere in between for postpartum home visits…  Laurel is leaving the birth center and moving to Naples, Florida. Though it breaks our hearts to say good-bye, we know that the mothers and babies down south will be as blessed as our birth center families have been to have the benefits of Laurel’s smile, skill and caring touch.

Safe journeys to Laurel and Chuck as they sail south. She will be sorely missed. Feel free to leave comments and notes to Laurel below to express your own gratitude for how she impacted your pregnancy, birth and postpartum experiences.

 

 

Newly Appointed Director of Midwifery

Myra DeLuca, CNM092013_lifes_journey__2

As Director of Midwifery, my goals for Special Beginnings include: to continue to provide the high quality of health care that our clients expect with renewed energy and passion; also, our craft of midwifery will focus on the needs of our “Village.”

For more than a dozen years, I worked to obtain my midwifery degree with determination and personal sacrifice for myself and my family. I feel truly privileged to be able to provide midwifery care. It is my purpose. Being a midwife is my life.

I have been instrumental in the implementation of our new electronic medical records (EMR) system which gives every client access to her own chart at any time. We now have nitrous oxide for laboring women as an effective choice for pain management and I developed the protocols for its use the training therein. I envision many more exciting things to come for the Special Beginnings community!

 

 

Join Us For Our 17th Birthday Party On May 9th, From 5:00 PM to 7PM

15th Birthday PartySpecial Beginnings Birth & Women’s Center will host our annual birthday party celebrating 17 years since our opening in 1997. Come out and say hello, meet some new midwives and catch up with the familiar ones. There will be snacks and cake, a moon bounce and other activities for children. We look forward to seeing you and your growing kids!

Meet Pamela Barone, CNM

 

Pam Barone, CNM
Pam Barone, CNM

 

Pam joins the team of midwives at Special Beginnings in a temporary position. She is originally from the Towson area, but relocated to South Florida for a few years. Pam and her family have recently returned to the Baltimore area. She and her husband have four children, ages 15 to 24. Here, she shares the story of how her first son’s birth and his journey transformed her life. This is Pam’s call to midwifery, in her own words:

 

 

It has been nearly 25 years since my first child was born on the day that changed my life forever. The delivery room was completely quiet, except for the cry of my baby. Something was wrong. He was scooped away, over to a corner where the doctor and nurses surrounded his tiny body. I desperately wanted to see him. The physician was empathetic and warm. My mom was calm and unnerved. And I was devastated.

But the nurse was incredibly special. She was there for all of us. She laid my baby in my arms, showing me where he was missing four fingers, commenting on his beautiful eyes and hair. His leg looked deformed and I worried about all the invisible things that may be wrong with him. But the nurse was soothing and hopeful. She made the difference. She created special moments for me. It’s difficult to describe: it’s the little things she did and didn’t do, the things she said and didn’t say.

I can’t remember every detail of that day, but I remember the moments. A single moment can be a lifelong gift. Some of them rise above the rest. I fell in love with my son the moment I saw him. The moment he looked at me, I vowed to never leave his side.

The moment I left the delivery room, I knew my calling. What a defining moment! I was 17 years old. Events from my childhood, my birth experience, my nurse, and being a teen mom all inspired me to pursue a career in nursing. I became a nursing assistant first and went to school, class by class. I graduated nursing school in 1995 and began working in Labor and Delivery right away. A year later, I became certified as a doula. Next, I obtained my Bachelor of Science in Nursing. One step at a time, I climbed toward my dreams and in 2002, the midwife in me was born.

Twelve years later, I still feel deeply that to practice midwifery is an honor and a privilege. I love what I do and I can’t imagine doing anything else. Beyond birthing babies, I enjoy witnessing the birth of a mother and her family. Midwifery is an expression of who I am on the inside. It is so rewarding to protect both the fragility and strength of women, to advocate, teach, empower and nurture. It’s about heart and hands and mind, and the ability to touch a life in a way that neither of us will ever forget. This is the art of midwifery to me and my life is richer and more meaningful because of the experiences… because of the moments.

Pam & family
Pam & family

Thank You, David Paad, CNM

Since the doors of Special Beginnings Birth and Women’s Center opened on May 10, 1997, the gentle hands and reassuring presence of David Paad, CNM, have been unwavering and constant. Families with initial trepidation about a male midwife became his greatest proponents in time. Perhaps you, reader, are one of those.

His hands received hundreds of babies, his smile greeted countless families at the doors to the birth center or on the Labor and Delivery floor of Anne Arundel Medical Center. He guided student midwives through clinical experiences with teaching skill and expertise. He oriented new midwives as they took their first wobbling steps into independent practice.

During quiet, miraculous births in water, in emergencies requiring urgent medical intervention, in the day to day business of midwifery care, belly measurements and well woman exams, David Paad is a Certified Nurse Midwife of grace and professionalism. He has served the birth center and AAMC communities with dedication and loyalty for over 16 years. On Friday, June 28, 2013, David leaves Special Beginnings and takes with him the deepest of gratitude from the birth center staff and so many families whose lives he touched profoundly with exceptional care and blessed hands. Thank you, David.

David, Emily and Maggie
David with Emily and her second VBAC baby, Maggie. David was also with her for her first VBAC of Henry.

 

Closed on Tuesday, Oct 30

The conditions that will be hitting our area and environs throughout the night being unpredictable and given that the state has issued warnings against cars on the road, we will also be closed tomorrow, Tuesday, October 30th. Again, page the midwife for any emergent medical situations or labor. At this time, all laboring families will be met at Anne Arundel Medical Center to ensure absolute safety. Thank you!

“Overdue” for birth announcements?

Please accept our apologies if you are here looking for the family photo at the birth center. We are currently backed up on a very busy couple of months with several staff vacations. Do check back in 2 to 3 weeks to see your loved ones!

Rowan’s Birth in the Quiet House by Christine Doran


There we were, my 2 ½ year old son and I, one afternoon in November, two weeks and two days before my due date. The Kid was up from his nap and we were lolling on the sofa having some “side” (his word for nursing). And suddenly, “flub,” went something wetly in my pants.

I told The Kid that something had happened and it meant the baby was going to come soon, probably today or tonight. Then I got up and did the same pointless flapping around looking for a pad and a large towel to sit on that I’d done the previous time. I gave my husband a call and mentioned that he might want to pack up and come home and tell them he wouldn’t be back for two weeks or so. I called the birth center and the midwife said to wait until I was contracting five minutes apart for a minute each and then ring again.

I repaired to the sofa. The Kid was looking worried and was ominously quiet. I asked him was he okay and he said, “Giant coming.” He’d been having nightmares about giants lately and I think it was his psyche manifesting the prospect of the baby as something big and scary. I tried to comfort him and sound as normal as possible. I didn’t really want to nurse him much more in case it made the contractions come too fast but I did nurse him a bit.

The Husband came home and made tea or whatever one does in these situations and I had some cereal and drank some water and made sure everything was in my bag and went to bed for a couple of hours. I didn’t sleep and the contractions started coming slowly but surely. I didn’t want them to go away entirely, so I got up after a while. I languished on the sofa and leafed through my Ina May Gaskin book to get me into the right frame of mind. I wanted to try and string things out until after The Kid’s bedtime, if possible. I told a bunch of strangers on the Internet that I was in labour but hardly anyone in real life.

Everything, amazingly, went to plan. The Kid’s bedtime came with as much normality as possible and no big promises of a baby tomorrow morning; though we did tell him that Alice might be here when he woke up. Our wonderful friend Alice arrived at 9 pm with her daughter asleep over a shoulder and we rang the birth center to say we were on our way.

It’s a 30 minute drive and by the time we arrived, the contractions were weaker. The midwife chatted to us, got our info and then said frankly that I didn’t look as if I was working all that hard and maybe we’d have to go home and come back in the morning. I resolved that the baby was just going to have to hurry itself up and get the show on the road. The midwife said we’d give it an hour or so and sat down to do some paperwork. The Husband installed himself in the kitchen with a fresh paperback. And I started walking the corridors of the empty birth center, weaving in and out of the rooms, rubbing my nipples shamelessly and thinking good thoughts about wide tunnels and open and down. Every time a contraction came, I tried to loosen my jaw and not clench anything, and think the baby down.

After maybe ten minutes, the contractions really did start to get long and painful. I’d lean over the bedstead or against the wall (where the midwife could see me so she’d know what was going on and banish any more silly notions of sending us away), and I began to wonder how I could possibly have suggested that my sister-in-law, newly pregnant, should attempt a drug-free labour. I decided I needed to go to the bathroom and was pleased to see that my body was getting everything out of the way in preparation for the big push.

I was still sitting there on the loo and I realised that I was still pushing even though I’d finished what I thought I’d come there to do. And I couldn’t stop it. And it hurt like the bejaysus.

I yelled in a strangulated sort of way for the midwife. The Husband came and hovered outside the door. I said “Come in” and “Get Megan” and saw that she was walking calmly by and putting on some latex gloves. Since my waters had broken, she hadn’t checked me when I arrived as that would make me susceptible to infection.

“I’m pushing!” I finally wailed as it really seemed that this was not transition but the actual real deal. This time both The Husband and Megan looked down and there was a head, crowning.

“Scoot forward,” said Megan, holding out her hands. I managed to move myself so that our baby wasn’t born straight into the porcelain and with one almighty push she came out. Megan said “Lift up your shirt”–so much for the clothes I’d brought to “labour in” and the nightdresses I’d brought “for delivery”–I was still wearing the tracksuit bottoms and red shirt I’d shown up in, and I believe I still had my knickers round my ankles. She put a pinky-grey, writhing, alive, slippy, tiny baby on my tummy. “I think it’s a girl,” said The Husband. “Is it a girl, really?” I asked. Megan confirmed that it was.

I walked (well, hobbled) from the bathroom to the bed holding my daughter to me, umbilical cord still attached and we nursed. After a while, The Husband got to cut the cord and my placenta was delivered with a little yank on the cord and a little push from me. They rubbed the vernix into the baby’s soft, soft skin and put on the obligatory hat.

We went home the same night, as per birth center policy. I had no tearing (hooray!) and my bleeding was very manageable and the baby was just perfect. We turfed poor Alice out of our bed, climbed in and The Kid got to wake up the next morning to find a new baby sister had sneaked in overnight.

The birth center experience was wonderful for me–certainly helped by my ridiculously quick delivery. The memory I’ll always keep of my daughter’s birth is that of the quiet house, with just us three in it, the calmness surrounding me as I worked on the contractions and how lovely it was afterwards in contrast to the hustle and bustle of a hospital.

Luke’s Birth and Sarah’s Gold Star

I knew rather quickly after Sam’s birth that I would not be able to endure that type of medical management again. It was only 3 months into Sam’s life when I started researching other options. I saw a facebook post about a waterbirth and was intrigued. Where did she have this opportunity that I wanted so desperately? I found out she went to Special Beginnings Birth and Women’s Center. From that moment, I dreamed of going there and delivering my own child.

Luke’s pregnancy was uncomplicated and peaceful, except for slight tension between Johnny [husband] and I regarding prenatal care. He was not sold on the idea of using a midwife in an out of hospital setting for reasons of safety. His concern was real and I did not discount his fears of losing me or the baby. However, I read a lot during this pregnancy and throughout my readings, the safety of non-hospital births with a midwife for a low risk pregnancy was reiterated over and over. Never in my entire life have I ever felt more validated through reading than I did during this pregnancy. I was amazed at how often I would read the exact reassuring words I needed to hear at that particular moment.

Johnny attended the first couple appointments at the birth center with me. However, we both agreed that I should make appointments on a separate day from our family day. The tension between us regarding the birth center started to dissipate after we implemented this plan. My mom or sister came to my appointments with me to help out with Sam. During the summer, my mom, Sam and I had a wonderful time on our day trips to Annapolis – something I will cherish forever.

From the moment we decided to travel an hour and 40 minutes for prenatal care, I prayed that there would be a clear sign that labor was starting. With Sam, there was no clear sign; I was comfortable walking around at 4-5 cm dilated. During this pregnancy, I feared that without a clear sign, I would be left to deliver my baby at the local hospital, instead of the preferred birth center.

The “clear sign” (no pun intended) came when my water broke in the bathroom at home. I was trying to help Sam sit on his little potty and as I bent over, the water gushed, quite relieving the extreme pressure in my lower abdomen. Sam’s precious comment as I stood there in slight shock: “mama, mess.”

Contractions stalled just past Easton. When we arrived at the birth center, I was contracting infrequently and frustrated. Johnny and I walked. I took stairs two at a time. I sat on the birthing ball. Nothing worked. Two hours after we got to the birth center, we did a non-stress test that was non-reactive due to lack of heart rate changes in response to a contraction. Fetal movement was minimal. All of this added up to a transfer to the hospital. It was 11pm. I was disappointed. I felt, however, that if we were supposed to birth in the hospital, then something would happen to encourage us in that direction. This was our sign and I had to be okay with that.

I avoided the question posed to me by the nurse regarding whether or not my bag of waters had ruptured [even though I was sure it was on my transfer papers]. I didn’t want to be placed on a time limit; especially in a hospital. After expressing my fears to Niki, I felt comforted to know that I was not on a time limit and that gave me freedom to relax.

I consented to intravenous fluids with the hopes that the baby’s heart rate and lack of movement were due to dehydration. It worked. I drank a lot of cranberry juice mixed with ginger ale. I questioned whether or not I could be released from the hospital. My contractions weren’t regular at this point and the vital signs for the baby and me were good. Allowing me to leave the hospital that night was certainly the most pivotal moment. I’m so grateful Niki realized the importance of the natural birth experience for me in the birth center setting.

A Super 8 next door looked really good at 4am. I slept so soundly between contractions that I would never have realized they were continuing at regular 10 minute intervals if I hadn’t been tapping the start/stop button on my phone. At 5:45am, the contractions were so strong that I had to sit up. I sat on the edge of the bed and rocked my hips back and forth and in circles to try and lessen the discomfort. I focused on my breathing in an instinctual way; not a learned technique. Almost immediately the contractions progressed to every 5 minutes for >1 minute each. The shower was wonderful and I stayed in there for about 30 minutes. It was very hard to get out, knowing that I had to finish getting ready, all while still having contractions. They were now 3 minutes apart for >1 minute each. Little did I know, but that was about as close to a waterbirth as I was going to get.

Laboring is hard work. And with little sleep and no food, I started to feel as if I was going to pass out. In one of those moments where you wonder how all the pieces came together, we found cranberry juice that we unknowingly brought from the hospital. I drank it, but all I could think about was a smoothie from Starbucks; a lot of calories and easy to get down. The last reason I was going to be sent back to the hospital was for low blood sugar, so we hurried to leave and stopped at a Starbucks a few doors down from the birth center.

It’s about 7:30am and I’m dying; or so I think. Looking back, I should have known this was transition, but there were very few clear thoughts being processed at this point. Johnny was inside Starbucks and I was inside the car, trying to stretch out in the front seat. I couldn’t fathom why people would want to park right next to us – didn’t they know I was going to have a baby? It was probably my only irrational thought during this whole process and every laboring women is allowed at least one. I called David again but couldn’t speak to him during the 2 minute contraction I was having, and I remember just holding the phone in the air. David said he’d be there in 10 minutes. Okay, I can do this for 10 minutes.

We got to the birth center parking lot and looking back, I wonder why we parked away from the entrance. But we did. I had to get out of the car immediately. And once I did, I realized that the baby was coming out. I could feel the “ring of fire.” A grounds crew worker was using a loud machine on the nearby grass and my oh-so-quiet-and-chill husband sternly told him to turn it off. I remember thinking it was “funny.” I told Johnny that the baby was coming and he said, “if David isn’t here in the next 2 minutes, I’m calling an ambulance.” I had a sense that David would be there on time and I didn’t panic. I did reach down to see if I could feel his head. I couldn’t, thank goodness.

In my most dramatic labor and delivery moment, Johnny and David carried me [“off the football field” style] into the birth center. I felt silly, but the baby’s head was so low, that I could not walk. I made sure I requested the purple room. It was the room I envisioned and I wasn’t going to let that vision go, even with the head coming out. I also remember asking if we could have a waterbirth. David turned on the water, but he didn’t think we would have time. Johnny undressed me and I got into the quadruped position on the bed. I remember thinking that this was absolutely the best position, especially since Luke liked to face anterior for most of my pregnancy. I had difficulty holding myself up. Johnny knelt on the bed and I let him have my full weight.

With lots of “ow, ow, ow’s,” Luke was born within 5 minutes of arriving at the birth center. David placed him face up under me and I scooped him up and propped myself up at the head of the bed.

I did it! I am super woman! I CAN do anything! Hands down the best feeling of my life. Complete euphoria. This is what it’s supposed to be like!

I held him close for 4-5 minutes before Johnny said: “Don’t you want to know if it’s a boy or a girl?” Oh yeah, I forgot about that. Quick check, and it’s a boy.  I turned to Johnny and said “Luke?” and he nodded. I had my Luke Henry. A name I was proud to use, as it represents both grandfathers.

David stitched up minor tears on both labia, but I had no perineal tearing! That might have been the worst part of it all! Johnny returned and we rested in the bed together. I actually fell asleep briefly and felt very refreshed. It was so calm and peaceful – exactly as I imagined and hoped for.

Niki, the midwife from the hospital, knocked and came into the room. We shared a nice hug that, for me, said a million things without ever speaking.

Later I showered and dressed in a black cotton dress with nursing tank top – I felt beautiful. I delivered a baby. I wanted to tell everyone. I was amazed at what I had just done hours earlier. Johnny was so proud, and that made the whole experience complete. My gratitude for the way we were able to work through this conflict is unending. My dream and vision for birth came full circle.

An obstetrician once told me that there was no “gold star” at the end of labor/delivery if I did it all natural. I would like to tell her that for me, there is a “gold star.” It’s called empowerment. And I’m so glad I can claim it.

David, Sarah, Johnny and Luke