Pregnancy Pathways

Hi from Pregnancy Pathways! We’ve been a bit quiet the past couple years as we focused on career changes and growing our own families. We graduated midwifery school, became Certified Nurse Midwives, and began our careers catching babies in the hospital and out-of-hospital setting. We even welcomed another baby into our mix, at home, supported by some of our favorite midwives, doulas, and MDs. We’re excited to announce some changes coming soon to Pregnancy Pathways! Stay tuned. Photo by @kelseygoodknight

Earlier this month, Willie spoke as the inaugural guest mentor at the UCLA Center for Reproductive Science, Health and Education @ucla_crshe . This incredible center is on a mission to support research and educational initiatives designed to improve human health, promote healthy families, and to advance the well-being of society. Her presentation was on doula and midwifery care and helped to illuminate other careers in the reproductive health and maternal and child health sphere. It was so special to talk with these incredible students and continue to educate people about the incredible work midwives do in the community.

Up until now, California Hospital Medical Center (CHMC) has been home to the largest full scope OBGYN/midwifery practice in LA for over 30 years. The Eisner nurse-midwives & Eisner OBs have since been the hospitalists, where every patient had an opportunity for midwifery care. The hospital served one of the largest birthing communities in LA, many of whom are low-income, Medicaid insured, immigrants, & families of color. The midwives also provided back up for the out of hospital birth community when families risked out of home or birth center births. As of this past month, the midwives sadly are no longer supporting birthing people in labor & catching babies due to a series of complex issues surrounding finances, bureaucracy, & politics, leaving a huge gap in the community for quality care, especially for families that need it most. This place has meant so much to us. We first experienced CHMC as doulas, then eventually as New Grad L&D nurses, & now most recently Clancy as a student nurse-midwife fulfilling her clinical rotation under the Eisner midwives. Willie even had one of the beloved midwives, Sarah Obermeyer, deliver her baby at home. Through these experiences we have seen firsthand the contribution the midwives have had on the birthing community providing essential collaborative care. They have also contributed immensely to the legacy of midwifery, serving as one of the largest training grounds for student nurse-midwives in LA. We’ve been so impacted by our experiences at CHMC, the nurses, & with the midwives. We are devastated by this loss and wish that all hospitals can offer midwifery care as the standard of care in their hospitals. This Monday, Nov. 6, the CHMC RNs (whom we also love dearly) will be holding a picket outside the hospital to bring attention to the need for improved safety measures including bringing midwives back to the hospital. The evidence is there that midwives are a solution to reducing disparities & poor outcomes in maternal health. #midwives #pregnancy #childbirth #nurse #midwife #eisnermidwives

Congratulations to @moxiebirth in the opening of the only OB & Midwife-owned and led birth center in LA! The partnership of midwife Sara Howard, LM, IBCLC and Dr. Bente Kaiser, OBGYN, along with Dr. Julia Ray, DO, is a testament to the power of true collaborative care at its finest. Shockingly, while only 10% of births in the U.S. are attended by midwives, studies show that collaborative care teams that include midwives and physicians are a necessary component to improving maternal health outcomes in the U.S. (including improved patient satisfaction, lowering costs, & reducing our very high c-section rate). More so, collaborative care needs to be true collaboration, with mutual respect for each other’s professions and diverse educational backgrounds in order to provide adequate and comprehensive patient-centered care. Moxie Birth Center offers an out of hospital option for birthing people and their families, while also providing access to a higher level of care. They also provide a seamless transfer, if needed, in the hospital. In addition Moxie Care offers full spectrum sexual / reproductive health care, and gynecological and obstetrical care with the option to birth in hospital. And fun stuff - Moxie Care is covered by insurance! We’ve had the wonderful privilege of attending a recent Moxie birth and can say how beautiful it is to see the partnership and commitment to their clients in real time. We are so excited for what it means for the future of sexual, reproductive, and maternal health care in Los Angeles. cc @moxiebirth @losangelesmidwife @kaiserbente @bujuyuguu #midwife #birthcenter References: Tekoa L. King, Russell K. Laros, Julian T. Parer, Interprofessional Collaborative Practice in Obstetrics and Midwifery, Obstetrics and Gynecology Clinics of North America, Volume 39, Issue 3, 2012, Pages 411-422, /10.1016/j.ogc.2012.05.009 Vedam, S., Stoll, K., MacDorman, M., Declercq, E., Cramer, R., Cheyney, M., Fisher, T., Butt, E., Yang, Y. T., & Powell Kennedy, H. (2018). Mapping integration of midwives across the United States: Impact on access, equity, and outcomes. PLOS ONE, 13(2). /10.1371/journal.pone.0192523

These are just a few of the incredible midwives we’ve had the privilege to witness in their caregiving. We are so grateful for their work providing care to our own community here in LA, and to us during our own personal journey through pregnancy, birth, and postpartum. Thank you for working tirelessly in hospital, in home, & in birth centers to support new families and to support us, baby midwives. Thank you (all of you midwives) for all that you do. Happy International Day of the Midwife. #midwife #birth #pregnancy #postpartum #pregancypathways #internationaldayofthemidwife

If you know anyone who has had an out of hospital birth on the east side of LA, Hayley Oaks (@hayleythemidwife ) was most likely their midwife. Hayley, LM, CPM, spent the majority of her midwifery career supporting moms and delivering babies at the original Del Mar Birth Center in Pasadena (now @moxiebirth ) before venturing into her own home birth career. Since starting her own family, she has mainly focused on providing consultative prenatal & postpartum care for those seeking an in-hospital birth. She has also partnered with the complimentary care company Akin (@with.akin ) to provide virtual integrative midwifery care to birthing people all over. Akin offers personalized collaborative care, specializing in fertility, pregnancy & postpartum with services ranging from acupuncture, mental health, pelvic floor therapy, nutrition, infant feeding & doula support (in person care offered in San Francisco and LA). What Hayley offers is special, unique and a creative way to integrate midwifery care into the current maternity system where the majority of people deliver in hospital with an OB. We’re happy to say that many of our #PregnancyPathways clients have been grateful for the complimentary support she has provided, and we’ve been grateful for her support and guidance as soon to-be baby midwives. #midwives #consultativecare #pregnancy #birth #doula #prenatal #postpartum #collaborativecare #midwife #homebirth #hospitalbirth

15 years ago, Ricki Lake & Abby Epstein launched “The Business of Being Born” a film that would shake up the maternity care system and the general public’s view on giving birth in America. For many - it was a first introduction to midwifery care and doula care and inspired a movement of birth justice and seeking out alternative birthing options, because, as we learned in the film, our healthcare system does not have the best interest of birthing families at heart…and in shockingly many cases, causes more harm than good. We are so grateful for the work of Ricki & Abby, for being part of the movement that inspired us to become midwives but also for being the original birth networkers! They were the first to dive deep within the birth worker communities, making some of the initial introductions (14 yrs ago!!) that have led us to our work today with Pregnancy Pathways - it was an honor to even be included in this incredible gathering of so many whom we admire! The film continues to be a must watch because unfortunately, while the message has reached so many, the healthcare system has yet to adapt to the model of care that will best serve birthing families. But the good news is that there is an exceptional group of people out there who have dedicated their lives to making sure you will be supported…and we’d love to introduce you to them! ♥️ #BOBB #maternalhealth #midwives #doulas #nurses #maternitycare #birth #pregnancy

Another Pregnancy Pathways birth story: At 40 weeks and 2 days, I decided to have my midwife @obermeyersarah do a membrane sweep and found out I was already 2 cm dilated and 80% effaced. Two days after that, at 12p, I drank the castor oil “Midwives Brew” and at 2p everything that was once in my intestines quickly left. I had my first very small crampy contraction at 4p and continued to watch tv, chat on the phone, and bounce on my birth ball. Things picked up and my mild contractions became more intense around 7:30p. I called @clancymccarty to come over and quickly called Sarah right after. Both of them arrived around 8p and I was maybe able to talk for the first two contractions they were there. After that things escalated quickly! Every contraction started to feel twice as intense as the last. I thought I would be able to regulate my breathing, or movement, or sounds better, but the reality is each contraction took me to a place that I just had to give up control and let my body do what it was going to do. Sarah suggested I sit on the toilet because I felt like pushing during contractions. She also asked if I wanted to reach down to check and see if I could feel the baby’s head. I could! We moved to the bed because everything was moving so quickly the birth tub was only halfway filled with water. After about 20 minutes of pushing Della was born. 7 hour labor from the first slight contraction to baby being born. So much faster and so much more intense than I could’ve ever imagined. What an absolutely transformative experience. My team was everything because while the birth was so rapid and intense, I felt so safe and supported. I’ll never forget looking at Clancy in between contractions in disbelief she did this a year ago. Thank you @losangelesmidwife for being the perfect second pair of #midwife hands! I will always look back at this experience with such immense gratitude for the midwifery model of care and the ability to assemble my absolute dream birth team. #homebirth

We met @obermeyersarah , CNM, WHNP, IBCLC while working our first job as new grad Labor & Delivery nurses at one of the few LA hospitals staffed by certified nurse-midwives. This hospital stands as a great example of collaborative care - with CNMs, OBs, and nurses working together in tandem to care for patients. Low-risk women and birthing people are typically seen by the #midwives, who work in collaboration with the OBs if a complication or high-risk status develops. While this hospital provides care to a primarily underserved and often high-risk population, it also receives many home birth and #birth center transfers because of the ease of the transfer of care to #midwives in the hospital. While Sarah devotes more of her time to the hospital and clinic, and her students (yes she is on faculty at our school too!) she will also graciously offer home birth to #nurses and midwives. The constant communication and care @willielarson has had throughout her #pregnancy has shown her first hand how special and different the midwifery model is. While this is something she has always known theoretically and seen through other people, being able to experience it first hand has only anchored her deeper in her love for this profession. Whatever birth story she ends up having, she is grateful to have received such respect and support.

Happy National Midwifery Week! We love you midwives & are so grateful for you. Pic of the incredible @naomidruckernursemidwife of @losangelesmidwives at a postpartum home visit #NationalMidwiferyWeek #Midwives #postpartum #birth #newborn

Is an unmedicated birth in a hospital possible? Is creating a home birth environment in a hospital possible? We obviously support pain medication if that’s what you know you want and/or need in #birth (yes it can be helpful). But if your plan is to have an #unmedicated hospital birth, or just to create a warm home birth environment, it often takes a lot of work, resources, as well as a dedicated team to make that possible. And often times, you’ll have an uphill battle to conquer to get what you want in addition to the uphill battle of #labor. We often hear people say that their provider has advised them not to hire a doula because they can set up a “home birth” for their clients in a hospital. Sadly, the odds of actually doing that are small & near impossible given the capacity the provider, nursing staff, and/or the hospital has in terms of resources, time, and education to make that possible. If your goal is to go without pain medication, it is crucial to have a team that will help secure the resources you need & advocate for your needs throughout the labor & birth (because yes, despite your preferences, you may be asked multiple times if you want pain meds). You will also need to invest in your education & own mindfulness practices to work through the labor, each contraction at a time, & each stage at a time. Can you hire a #doula? Can you find a nurse-midwife? Can you get a room with a tub? A shower? Can you get wireless monitors? A hep-lock? Can you eat throughout labor? Can you keep the lights off? Can you regulate who comes in and out of your room? Are you mentally & physically prepared to work through the pain? What are your options if finances are limited? These are some questions to consider, & some questions to ask your provider as you plan your unmedicated hospital birth. But it can happen, & we are here to help make that possible. And yes, these photos were taken in the hospital. #homebirth #hospital #labor #childbirth #midwives #nurses #pregnancy

Jessica is a boss home birth #midwife, #doula trainer and educator. She’s also provided a lot of guidance and mentorship to Willie and I as we set out on our own paths to becoming #midwives. So it makes sense that she’s launched @joincentered to provide a community of mentorship and support to doulas while also matching expectant parents to doula care. As we know, evidence shows continuous support during vulnerable times such as #pregnancy and #birth leads to more positive outcomes. And those providing support and caregiving also need a community to lean on. ♥️ @jessicaadiggs