While home, water, and birth center delivery is slowly rising amongst childbearing women, midwife assisted births are still a somewhat taboo subject. Deciding on the best prenatal and delivery method is a decision that all expecting mothers are faced with. Educating yourself on the steps involved in the various methods of bringing a new person into the world will ensure that you make the best decision for you and your baby. LaQuita Brazile shares her journey to midwifery, and defines their roles and capabilities.
Brazile comes from a family of educators -three generations of educators, to include her sibling, who was also an educator at sometime. She too became an educator, but something changed for her after stepping in to support a good friend throughout a pregnancy and childbirth. Shortly after the experience Brazile came to the realization that being just an educator was not the purpose she was meant to serve.
“I started really thinking about it and doing my research with the first birth that I did. But after the second birth, I started contemplating and was like, ‘This is it. I’m good. I’m not going back to teaching after this year.’ I decided to resign after my fifth year of teaching and just went for it,” she said.
A midwife is a licensed healthcare professional who takes care of the clinical aspect of prenatal care, labor, delivery, and after-birth care for healthy women. They may deliver babies at birthing centers or at home, but most can also deliver babies at a hospital. Midwives have assisted women with childbirth since the beginning of time. However, unlike physicians and doctors, there are no medical school and residency requirements necessary to become a midwife. But there are requirements; in the state of Texas, a person has to complete written and clinical requirements within a five year period to attain a license in midwifery.
Brazile completed her academic and clinical requirements in March of 2018 and attained her license in November of that year. And explained that she has primarily been a home birth midwife and is now a staff midwife at The Nest Birthing Center, located in Mansfield,Texas. She enjoys assisting her sister midwives in which she has developed a supportive and trusting relationships with.
“I hold my interviews there to give them an idea of what a birth center looks like -it’s a mutual place to meet if they don’t really know where they want to birth. They get to tour it, so they can have options; and if they want to have a birth center birth, this will be the place that they will have their baby if they decide to have me as their healthcare provider,” she said.
The natural progression of childbirth has been met with mainstream technology and practices, skyrocketing the number of (C-Section) cesarean section births in the U.S. (United States). CDC (Center of Disease Control) reports show that the percentage of C-Sections for first-time expecting mothers in the U.S. has risen from 20.8% in 1998 to a staggering 32% in 2018. And the number of low-risk pregnancies ending with C-Sections in the U.S. rose from 18.4% to 26% in the same twenty year time span.
Society’s push to “get the epidural” for painless deliveries, or to pick your baby’s birthday and “schedule that C-Section” is enticing and seemingly effortless for new moms, with overly busy lifestyles. But how many of those C-Sections are absolutely necessary? Unfortunately, many women lack the knowledge and are afraid to ask the questions necessary to fully understand the process of natural childbirth, and find themselves being fast-talked into the operating room.
“You have to trust in your health care provider and your health care provider has to trust in you. And you -in your body, as in, letting you know that your body can do this. I allow the person to be who they are. I have no judgment, whatever you prefer to do -as long as it’s within normal limits of your pregnancies. There is no judgment in your situation, your choice, your religion, your lifestyle. My concern is your whole well-being and baby’s well-being. If you’re going to have an out of hospital birth, you have to be low risk.”
A licensed midwife is trained to recognize the variations of the normal progress of labor, and understand how to deal with deviations from normal. They may intervene in high risk situations such as breech births, twin births, and births where the baby is in a posterior position, using non-invasive techniques.
Often times, the role of a midwife is confused with that of a doula, so Brazile explained, “A midwife and a doula. A midwife pretty much does the clinical side of things. Our job is to monitor the birthing persons pregnancy throughout, and, as well as, the labor and the delivery and the postpartum. So, instead of going to an OB (obstetrician) -go to your midwife,” she said.
“You will see your midwife just as often as you would see an OB. From early pregnancy to 28 weeks you’d go to your midwife every month, once a month. Then, when you hit 28 weeks to 36 weeks you see your midwife every other week. And then from 36 weeks to birth you see them every week; and we do the blood work.
Now a doula is pretty much your friend, your coach, your advocate and who helps you with your nutrition. They help coach you throughout labor -labor sit, and help you with different positions. They also get you and dad, if there’s a dad or partner in the picture, to understand the needs of the birthing person. Just, pretty much try to get the flow and the relationship going, and understanding of the process of birth. Some doulas only do labor and postpartum. Some doulas only do labor. You have doulas that do prenatal labor and postpartum. You may just have a postpartum doula. Bereavement doulas, abortion doulas. There are a lot of different doulas,” explained Brazile.
When a pregnant woman requires care beyond the midwife’s scope of practice, they are referred to an obstetrician, or primatologist -medical specialists in complications related to pregnancy and birth, including surgical and instrumental deliveries.
“So as I mentioned before, like a midwife, if you are seeking midwifery care outside of the hospital, you have to be low risk. But, if something does arise throughout the prenatal care and it can still be monitored and you can still have your baby outside of the hospital, but you still need an OB’s expertise in it, it will be like your co-caring with the doctor. If you don’t necessarily need an OB just stick with your midwife,” she said. “Now, OB is for high-risk. You know, say for instance if you have gestational diabetes that you need insulin or have preeclampsia or you have certain situations that will keep you from having a baby outside of the hospital. If you know that you may need a caesarian, your best bet is to be in the hospital. I’m not against hospitals at all because midwifery is not my last stop,” she said.
“So I would like to be a women’s health or family nurse practitioner someday as well as keeping my licensure as a midwife. I desire to serve underserved persons and families, especially pregnant incarcerated persons someday,” she said in closing. For more information about services and care options, Brazile can be reached via email at firstname.lastname@example.org