This is the seventh post in a series of blog posts based on interviews I’m doing with midwives who serve Utah County.

In this post, I’ll introduce you to the wonderful Melissa Chappell, owner of Songbird Maternity and co-owner of Utah Birth Suites, alongside Seasons Warner. She attends births at their beautiful new birth center in Provo, as well as home births in Utah County.

Twenty-six years ago, when Melissa was pregnant with her first child, she took a Bradley Method birth class and had a great first birth experience, even though her labor was very long. After that birth, she wanted to teach others to help them prepare for awesome birth experiences, so she became a childbirth educator. Later, she became a doula, then a doula trainer, and then a midwife, which she has been doing since 2015! She attended The Community School of Midwifery and completed the North American Registry of Midwives (NARM) Portfolio Evaluation Process and earned her CPM and Utah State Licensure (LDEM) credentials in 2018. Now, she also enjoys teaching potential midwives! Over the 25 years she’s served the birth community, she has touched the lives of hundreds of birthing families.

During our interview, I asked Melissa if she would talk with me about pushing, or the second stage of labor. If you’ve ever watched a TV birth scene, you likely imagine many people standing around, chanting, “Push! Push!” or counting from 1 to 10 as the mother bears down, purple-faced and out of breath. But, as Melissa can attest, birthing your baby doesn’t have to be this way!

In fact, that’s not how it goes at all at the births that Melissa attends. “Most of the time, if you just let a mom follow her body, she’s going to be able to push on her own,” she says. Melissa mentions that some people say they’ve given birth to multiple babies and never really felt the urge to push. “A lot of times that comes from people not really being given the time for their bodies to get to that point where they’re ready to push,” Melissa explains. “I mean, no one’s just going to sit there with a baby inside them forever! Their bodies are eventually going to help them know how to push the babies out.”

Sometimes, you may reach full dilation (10 cm), and still not feel, instinctually, that it’s time to push. Your contractions may even slow down for a while and give you a little break. When that happens, Melissa calls it the “rest and be thankful” stage. As you take some time for a little break before birthing your baby, your baby descends further into your pelvis, until you may notice that you’re grunting a little at the top of each contraction. When Melissa hears that little grunt, she gets excited—the baby is almost here!

Once the second stage of labor (pushing phase) starts, the length of time until baby is born varies greatly. On average, Melissa’s clients push for under an hour, but some push for a couple of hours, and every now and then, up to four hours! Recent research indicates that this is safe as long as both the mother and her baby’s vital signs look good and she is making progress in moving the baby down.

In a first birth, Melissa will sometimes offer gentle coaching or direction if her clients would like more guidance about how to push. One way she may do this is by gently placing her finger inside the bottom of the vagina (in the perineal space) to offer direction about where to push. Of course, Melissa never does this without the explicit consent or request of her clients!
For many clients, though, Melissa doesn’t give any direction or coaching. She just gives them time and space to listen to their bodies.

And what about cervical exams? Melissa says she rarely does them. (Although with first time moms, she does them a little more frequently, to help them assess where they are in their labor progression when they first arrive at the birth center.) “As a midwife, after doing this for years and years, you get to a point where you can tell without doing a cervical check, if someone is almost ready to push.” She listens to the sounds her clients are making (like that little grunt at the top of each contraction), and she watches the pattern of their labor: the length, frequency, and intensity of their contractions. By closely watching and listening, Melissa says that cervical exams to ensure complete dilation before pushing begins are rarely needed. Melissa further explains, “If you’re really, really empowering a laboring person to listen to their body and not push unless she feels that overwhelming urge, you’re not going to have people pushing on cervixes that are not ready to be pushed on.”
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Melissa is not alone in the way she empowers and encourages her clients to listen to their bodies and instinctively push during labor—there are many other fabulous midwives across Utah County who offer that same sort of care! I’m grateful that Melissa took the time to discuss this important topic with me, and for the individualized and empowering care she gives to her clients. She has a vibrant personality and lots of enthusiasm for the incredible work she does. Head on over to her website to learn more!

This is the sixth post in a series of blog posts based on interviews I’m doing with midwives who serve Utah County.

Today’s post is based on a conversation with Amy Ihrig. Amy owns Joyful Birth Midwifery Services. She has been in the birth community for 15 years (starting out as a doula), and has been a midwife for about five years. She graduated from Midwives College of Utah and is a Certified Professional Midwife (CPM). Amy attends home births in northern Utah County. Amy is passionate about learning and teaching, and it shows with the wide ranges of classes and services she offers! In addition to being a midwife, Amy is also a Bradley Method Childbirth educator. The Bradley method focuses on how husbands can support their wives during labor and birth. She also teaches infant massage classes for new parents, as well as comfort measures classes, which she calls “doula dad” courses. And she teachers mother/daughter maturation classes using the Maidens by His Design curriculum, a Christian-based program to help mothers and daughters understand and communicate about their incredible bodies.

As you can surely tell from that impressive list, Amy believes in the power of education and the wonder of birth. She truly believes that birth can and should be a joyful experience. Amy is a holistic care provider; rather than just considering her clients’ medical well-being, she looks at the whole picture of their overall wellness as part of her care.

Like many midwives I’ve interviewed, Amy began her journey to midwifery as a doula. She decided to become a doula after her awesome second birth experience (an accidental home birth—keep reading for the details!) After nearly a decade as a doula, she felt called to expand her scope of practice to be able to provide fullness of care—medical and beyond—to her clients.

Since I’ve noticed this doula-->midwife pattern in several conversations with midwives I’ve interviewed,  and I’m currently riding the doula-->midwife trajectory after having a transformatively awesome birth, I joked with Amy that having an amazing birth is a “gateway drug” for aspiring birth professionals.

Give a woman an amazing birth, and she’ll want to become a doula. When she becomes a doula, she’ll love it and realize the importance of education along the pregnancy and birth journey. She’ll decide to become a childbirth educator. When she becomes a childbirth educator, she’ll realize that she could expand her circle of influence even more by becoming a midwife. When she becomes a midwife, she’ll continue to seek opportunities for learning and growth to better serve her clients and invite them to have amazing births. And when her clients have amazing births…

(Now that’s a version of If You Give a Mouse a Cookie, or, rather, If You Give a Woman an Amazing Birth that I can get behind! Give me that kind of ripple effect any day!)

Back to Amy’s journey from amazing birth to doula to midwife.

Before becoming a doula, Amy was staunchly opposed to home birth. Then, she had an accidental home birth. Her labor moved along much more rapidly than she expected, so she birthed her baby in her bedroom with baffled paramedics as her birth attendants. The birth was smooth and beautiful, and something in Amy shifted. Her next birth was a planned home birth, and the rest is history.

Now, Amy is a strong proponent of home birth and the opportunity it affords for an intimate birthing experience. She loves supporting her clients as they make informed decisions in the peace of their own home. “My ideal client,” Amy says, “is someone who takes responsibility for their own choices. They will listen to the education that I’m providing them, and they will pursue further research in helping themselves to stay healthy and low-risk.”

​Having a joyful home birth is not a fictional fantasy. Amy’s passion and work is to make the dream of a joyful home birth a reality for her clients. Preparing for a home birth requires research and work, and a supportive and experienced midwife. We are lucky, here in Utah County, to have so many such options! And we’re fortunate that Amy Ihrig is among them.

​​This is the fifth post in a series of blog posts based on interviews I’m doing with midwives who serve Utah County and the surrounding areas.

Today, I’m honored to introduce you to Katia L’Ecuyer. Katia owns Innate Midwifery with birth centers in Holladay and West Jordan, UT. She also attends home births in Salt Lake County and north Utah County. She is a Certified Professional Midwife (CPM), a Licensed Direct Entry Midwife (LDEM), and a graduate of Midwives College of Utah. She also holds a bachelor’s degree in biology with a minor in chemistry from Utah Valley University. As a midwife for over 10 years, she has attended over 500 births in both Utah and Costa Rica. Katia is also a midwifery preceptor and enjoys mentoring student midwives.

This is the fourth post in a series of blog posts based on interviews I’m doing with midwives who serve Utah County.

This week, I’m spotlighting Seasons Warner (CPM, LDEM), owner of Four Seasons Midwifery. Seasons has been practicing as a midwife since 2014 and attends home births in the greater Utah County area (especially south of Utah county, extending into Juab, San Pete, and Sevier counties). Fun fact: if you see a car with a Utah license plate the reads MIDWIFE, you’re tailgating Seasons. So give her some space if it seems like she’s in a hurry to get to a birth!

Alongside Melissa Chappell, Seasons also co-owns Utah Birth Suites: a beautiful birth center with locations in Orem and Provo. Both locations are beautifully and thoughtfully designed to give expectant families a feeling of homey comfort with all of the medical tools needed for pregnancy visits and birth. They’re also just minutes from local hospitals, in case a transfer of care is needed.

I spoke with Seasons about the postpartum care she gives her clients. In the US medical model of maternity care, new mothers are typically discharged from the hospital 48 hours after giving birth and then not seen by their care provider until six weeks postpartum. This large gap in care, which comes after weekly prenatal visits at the end of the third trimester, can feel jarring and isolating to new parents who are physically recovering from giving birth and adjusting to caring for a (very sweet and cuddly but very needy!) newborn. Midwives, like Seasons, work to make sure that their clients continue to be monitored and well-cared for in the hours, days, and weeks shortly after birth.

After Seasons’ clients give birth, she closely monitors them and their babies for a few hours to ensure that baby is eating and there are no pressing medical needs. Then, she packs up and leaves them to settle in as a family (if the birth was at home) or sends them on their way home (if they birthed at one of the Utah Birth Suites locations). Within 24-48 hours after the birth, Seasons visits her clients in their home (whether they birthed at home or at the birth center).

Seasons again checks in with her clients via text every couple of days during the first two weeks after birth, and then they come to the birth center for appointments at two, four, and six weeks postpartum. This way, she’s regularly in touch with her clients as they recover from birth, and she’s able to offer ongoing newborn screenings and care. As a midwife, Seasons is licensed to offer well-baby care during the first six weeks of life. If any needs arise for mom or baby in the weeks after birth, Seasons is able to spot the need and care for it—or make recommendations for further care—before it becomes a larger issue.

At her postpartum visits, Seasons offers standard postpartum care. She checks in on how breastfeeding and sleeping are going, bathroom needs, stitches and perineal healing, and cracked or sore nipples. She notes baby’s weight and growth, umbilical cord stump, and does a heart and lung check-up. She provides newborn metabolic screening (PKU) tests. After her check-ups, she’ll refer her clients to other medical care providers if anything looks abnormal.

Another important service Seasons offers is repeated mental health screenings. Seasons asks her clients about how they’re feeling, who’s in their support system, and what their daily habits are. (Are they getting enough to eat and drink? Are they getting dressed, able to do some daily activities, and feeling like themselves?) This sort of screening is especially important at the four- and six-week postpartum visits, when lingering emotional or mental health concerns are an indication that her clients are in need of further care from a mental health professional.

Throughout the days and weeks after birth, Seasons is always available through text or phone call if her clients have questions or needs along the way. She’s also well-connected with a local network of lactation consultants, pelvic floor physical therapists, chiropractors, pediatricians, obstetricians, mental health providers, and other specialists. Utah County has a village of postpartum care specialists, and Seasons connects her clients with the village when they have a specific need!

As we concluded our conversation, Seasons reflected, “I think the thing that sets midwifery apart, really, in the postpartum period—not even just the frequency of our visits—is just the level of intimacy and care that you have with a midwife.” Those who are able to have this sort of connection and care with Seasons certainly count themselves blessed.

​This is the third post in a series of blog posts based on interviews I’m doing with midwives who serve Utah County.

For this post, I was honored to interview Amber Adams (DEM) and Teryl Stay (CPM, LDEM), who attend home births in northern Utah County and southern Salt Lake county. Together with student midwife Kirsten, Amber and Teryl are Birth Mind Body, midwifery care that “brings back the village” to care for new parents. Both Amber and Teryl attend all prenatal visits and births together and work as a team.
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Teryl and Amber each became midwives after first working as doulas. I loved talking with them about their journeys to midwifery, as my goal is to become a midwife as well! (I’m hoping to attend Vanderbilt’s CNM program. Fingers crossed!) Teryl became a doula at a friend’s suggestion and fell in love with community birth. She started attending Midwives College of Utah when her then-youngest child started kindergarten. For Amber, a series of random events led her to choosing midwifery care for her own first pregnancy and learning more about pregnancy and birth. After three people separately told her that she ought to be a midwife, Amber accepted the call to midwifery and also enrolled at Midwives College of Utah. Both Teryl and Amber had a baby (or two) while in midwifery school, and have personally experienced a range of birth experiences. They agree that the variety among their own births is an invaluable resource they drawn on as they support their clients. “I really believe that every midwifery journey gives you a different perspective to be able to help a client down the road,” Amber reflects.

The main topic I chatted with Teryl and Amber about was how they support their clients through decision-making. Throughout the conversation, they both emphasized that they view their relationship with their clients as a partnership, and that they expect their clients to be involved, active participants in their care.

Whenever their clients are making choices, their role is to teach their clients about benefits and risks of each of their options and respect their informed decisions as they move forward. Anytime screenings, tests, or interventions (such as glucose screening, Strep B testing, etc.) are offered, they provide an informed decision-making document with information about the possible benefits and risks of each option. Together with their clients, they talk through all of the information on the document and offer the chance to discuss any further questions they may have. The document also points them towards other resources they can consult as they make their own informed decisions.

“A lot of it is based on trust,” Amber says. It’s important that their clients trust their midwives to give them the information they need to make decisions about their care, and that they trust themselves enough to confidently make decisions.

Of course, there are times when, as medical care providers, Amber and Teryl sometimes need to hold firm on certain guidelines. They insist that all clients have an ultrasound to determine the placenta’s location during pregnancy, as placenta previa (when the placenta covers the cervix) is a serious complication that needs a higher level of care.

​If other complications arise during birth, trust is again key. Teryl explains, “It’s also so important to talk about this prenatally, and even during the interview, that these things can come up… We want to make sure that you have enough trust in us that if we’re telling you, ‘you need to go to the hospital; there’s a higher level of care needed,’ that they will trust us.”
With this relationship of trust, Amber and Teryl strive to honor their client’s autonomy and provide safe, quality care throughout pregnancy, birth, and postpartum.

This is the first in a series of blog posts based on interviews I’m doing with midwives who serve Utah County. 

Today's interview is with Roxanna Maurer of Angel Baby Midwifery. Roxanna has been a midwife since she graduated from Utah School of Midwifery in 1998! She lives in Payson, Utah and attends home births in Utah County. Roxanna is a warm, loving, beautiful person—I hope this post captures some of that for you!

Last month, I chatted with Roxanna as she took a break in the shade from landscaping her backyard. She already has a thriving garden, and is expanding it with fruit trees and other plants. She shared her wisdom about the importance of good nutrition during pregnancy.

​When Roxanna takes on new clients, one of the questions she asks them is, Are you willing to take responsibility for yourself and your baby? Roxanna says, “I can talk to you till I'm blue in the face. But it's pointless if you go home and don't do anything about it.” This is especially important to Roxanna and her clients since all of her clients give birth at home. “Part of having home birth means I'm willing to take responsibility for myself,” she says. “That means you prepare for the marathon of birth.” And if you’re preparing for a marathon, you can’t be stocking up on candy bars and Diet Coke. Nutrition is critical.

So Roxanna shares a handy acronym to help her clients remember the critical nutrition components they need every day. The acronym was developed by her good friend and fellow midwife, Nikki Sasser. She says, “if you want to be a birthing queen, you need a WHOPPER every day.” And let me tell you, Nikki and Roxanna do not mean one from Burger King! (It’s also great advice for outside of pregnancy!)

W stands for whole grains. Roxanna’s disclaimer about whole grains? “I don't mean General Mills cereal that says whole grain on it because let's just be honest… it's not.” For those who are able to eat grains, she suggests oats, quinoa, millet, and brown rice as some delicious, nutritious options.

H stands for hydrate. Roxanna recommends drinking half of your weight in ounces of water. So if you weigh 160 pounds, drink 80 ounces of water every day. Coconut water is also a great source of natural electrolytes—like Gatorade, but “with all the good stuff and none of the junk.”

O is for omegas. Roxanna uses the acronym BACON to remember sources of healthy fat and omegas. Butter, Avocado, Coconut, Olive oil, and Nuts.

P stands for proteins. As your blood volume increases during pregnancy, it’s important to have adequate amounts of protein. Iron and B vitamins are also critical in promoting healthy blood quality during pregnancy and having the necessary stamina for labor, birth, and early parenting, Roxanna says. (Vegans or vegetarians may need to take a B-vitamin supplement, as B-vitamins are typically found in animal products.) What sources does Roxanna recommend for protein? Beef, chicken, fish, eggs, lentils, beans and rice, nuts and seeds, protein powder drinks.”Those are a variety of ways of getting proteins in your diet.”

The second P in the WHOPPER acronym is probiotics. Probiotics “colonize the gut and break down the food.” Roxanna recommends Standard Process’s Lactic Acid Yeast as a probiotic supplement.

E stands for enzymes. Probiotics help break down the food, and enzymes continue the process. “That's the purpose of enzymes, to help you digest your food effectively,” Roxanna says. A healthy diet only does you good if your body is able to adequately digest it! Multizyme from Standard Process and TerraZyme from doTerra are options for enzyme supplements.

Lastly, the R in WHOPPER stands for the Rainbow. Eating a rainbow of healthy foods invites lots of beneficial vitamins and minerals into your diet. Go through the rainbow, and try to incorporate foods of every color. Red berries and cherries or beets, orange pumpkin, yellow squash, green salads or smoothies, blueberries, and purple plums or grapes… you get the idea!

And there you have it! Roxanna’s WHOPPER for birthing queens! Changing habits and sticking to a healthy diet can feel overwhelming, but you can do it! Check out my Top 5 Tips for Healthy Eating During Pregnancy. And to encourage yourself, here’s Roxanna’s tip: “Take a picture of success that you've had in your life and hang it in your mind.” Keep going back to that success in your thoughts; refer back to it. As you recognize other successes you’re having, “bring that into your success gallery, and refer to that. I was strong here. I can be strong here. And if I'm strong here, what else can I do?”