Offering Free Prenatal Care: The Good and the Bad | Indie Birth

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Offering Free Prenatal Care: The Good and the Bad

March 29, 2018

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We're Maryn + Margo

We are mamas and birth workers who decided to do birth differently– and bring others along with us. We are kind, fun to work with, and great at (lovingly) calling people on their bullshit when necessary. With 11 children and 16 years of midwifery between us, we’ve learned a thing or two along the way, and Indie Birth is our space to share it all with you.

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Margo and I have been talking about and pondering a way to get true midwifery care to more women; even if these women aren’t planning home births. We believe that realizing one’s power in birth really rarely happens without finding a way to have a powerful pregnancy, and it is this belief that was the motivation behind finally creating our own version of a “free prenatal clinic” model. Certainly, the idea is not new and many women have benefitted from midwifery care and self-care models throughout time. What we DO think is unique is our focus on what we call “wise woman care”; we believe in providing all women that come to prenatal care (of any variety) with individualized discussion, testing options and recommendations no matter who they are seeing or what their birth plans are. Powerful women that are feeling loved and cared for during their pregnancies will surely create change! Not to mention when these women also feel that they have choices, and that there is support for their own decision making and “risk” assessment process. Powerful women are grown, and the pregnancy time provides such an amazing opportunity for growth!

We do plan to create a prototype of our clinic idea (which we are fondly calling “Midwifery for the People; a direct (or almost direct) tribute to Nahko, a musician we adore; while also obviously referencing the all-inclusiveness of this “program”) and offer this at our upcoming retreat and also online in the next few months for any midwife that wants to offer this in her community without reinventing the wheel. I thought I’d share just a couple of tidbits here, along with some photos (shared with permission) of the monthly Midwifery for the People clinic I’ve been offering here in Sedona.

The first code of ethics with this care (and any prenatal care) is: Listening. Unlike women that you get to know, these women are coming for just 45 minutes. There isn’t time to ask everything or cover everything. Being able to get the “right” information, while honing in on what THIS mama wants to discuss, ask or cover; this is the essence of prenatal care distilled right down. Many/most of these free appointments are truly spent in listening mode. Many women don’t know what they don’t know, so may not think to ask to cover certain things, like about nutrition for example. It’s all about a quick but hopefully accurate read on what will help her most; what can we say/do/encourage to ensure she leaves on top of the world? Years of prenatal care experience at work!

This “listening” component runs right into learning. Women that sign up for our free prenatal care program know that students observing and obtaining clinical practice is part of the deal (although we do say and mean that a woman CAN request a “midwife only” appointment as we do very value confidentiality and some people’s need for privacy). This is an amazing experience for students to have as they are learning one-on-one prenatal care. During the 3 clinics I have held so far, the students have gotten to observe run-downs of health histories, hear concise nutrition recommendations and see what it means to field what feel like random questions and complaints (and of course they aren’t “random”; we just are meeting these women for the first time!). Also, some of our midwifery students are getting clinical practice obtaining blood pressure, pulse, fetal heart tones while also hopefully pocketing the information about true informed choice; what do any of these clinical signs mean and why would we even want the information? Last month, we all got to humbly witness a brand new mama who had never experienced midwifery care. She started the appointment desiring the use of a doppler to hear the baby’s heartbeat. After some book recommendations and discussions around the alleged risks (and possible benefits, depending on her situation) of doppler, this mama proudly changed her mind and declined the doppler option. By the same token, another mama desired the use of this technology! It is life-changing (we think!) for students to observe true individualized care supported by information. In the end, none of the choices these mamas have to make are ours to decide. Learning and seeing that midwives truly can hold space and remain impartial is crucial if we really want women to be in charge of their own care. In addition, teaching the WOMEN (not just the students!) has been a fun part of inviting these mamas in. Nearly all of the pregnant mamas so far had NOT been taught, shown, encouraged to feel their own bodies; whether in palpating an early pregnancy uterus or learning to feel what a 28-week baby is up to, head, and parts and even hearing a heartbeat with a fetoscope. Showing women that they can (and should!) sit in the driver’s seat and seeing their reactions is one “selfish” reason for hosting these clinics. All of us; students, midwives, mamas all leave with an oxytocin high; there is no better feeling than showing women that they have everything they need within, and that a great midwife (in the average prenatal situation) is simply a guide, teacher and confidante.

Assessments of this manifesting idea are ongoing! Margo and I definitely love creating, so I see that this IS a working “model” and we are developing more of a system/paperwork/creativity around making it even better (more efficient, better reach in the community, etc.). We certainly would love to reach a more diverse group of women, whether that is income-status differences or even just women seeing other care providers, like hospital obstetricians or licensed midwives. We’d love to find more ways to get the word out in general, so that more people know. Another “snafu” has been organizing a scheduling system that allows for flexibility and this being a truly FREE service; while respecting our own time and what we are giving to this program given that sometimes free is not best and not valued. We really do want this to work, but we also need our communities to be willing to try it with us, and spread the word.

In the end, this we’d love to see this become a global movement: Midwifery for the People, everywhere! May the midwives provide and may the women come so that together we can effect change in not only pregnancy and birth outcomes, but in the way women view their own health, pregnancies and worth when they are moving through this time of life.

You can read more over at our page about this program; and, if you are in Northern Arizona you can also visit this page reserve a 45 minute time slot to be a recipient of one of these free prenatal care appointments.

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We are mamas and birth workers who decided to do birth differently– and bring others along with us. We are kind, fun to work with, and great at (lovingly) calling people on their bullshit when necessary. With 11 children and 16 years of midwifery between us, we’ve learned a thing or two along the way, and Indie Birth is our space to share it all with you.

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