Category Archives: Birth

Exploring Your Options Series – Part 5

Deciding on a place of birth is simple for most women. Most women choose to give birth in a hospital. Women generally feel safe in a hospital. Are there any other safe options? Is it safe to give birth out of the hospital? YES! Studies show that out of hospital options, such as a birth center or at home, are safe for low risk women.

I would encourage you to consider and research the different options and their safety before coming to a conclusion about where to have your baby. The location of your birth will determine what other options are available to you. Some links to help with your research Science and Sensibility “Is Home Birth Reasonable Option?”Science and Sensibility “Birth Outcomes by Birth Location”Science and Sensibility “Flaws In Recent Home Birth Research”, Science and Sensibility – “Obstetricians Claim Homebirth is Unsafe…Again. Where’s The Evidence?”

Part of the decision making process should include weighing the pros and cons of each birth place. Previous decisions (ie: deciding on a care provider) will also have an influence on where you give birth. If you want a physician to attend your birth, having a home birth may not be an option. Not many physicians attend home births, but there are some. I am not sure there are any in Utah, though.

Below are some pros and cons I came up with. Because everyone is different and there is no one right answer for anyone, these things may not apply to your situation. Feel free to make your own pros and cons list to figure out what is the best option for you. Where you feel the most comfortable and safest will be the best place for you to give birth.

Most women in this area plan to have a hospital birth and never consider a birth center or home birth. I would encourage you to consider and research the different options and their safety before coming to a conclusion about where to have your baby. The location of your birth will determine what other options are available to you.

  • Hospital
    • Pros –
      • Specialized care for high-risk pregnancies and births.
      • Pain medication readily available
      • A nurse to take care of you and baby, meals brought to you
    • Cons –
      • Birth is seen as a medical crisis.
      • Mother and baby are often separated
      • Difficulties are often resolved with medications and high-tech procedures
      • Standardized care rather than individualized.
      • Often noisy, lack of privacy, strangers (the nurses are likely people you will not have met prior to your birth. Your particular doctor or midwife may not be the one to attend the birth)
      • Institutional feel.
      • Understaffed.
      • Higher risk of infection.
      • Have to pack and travel to birth place
  • Birth Center
    • Pros –
      • Less infection risk than hospital.
      • Midwifery Care Model
      • More home like than hospital
      • Most problems that arise can be dealt with on location.
      • Baby is never separated from the mother
      • Continuous support
    • Cons –
      • Have to pack and travel to birth place
      • Higher transfer rate than home birth.
      • Fewer pain medication options available
  • Home
    • Pros –
      • Your own space/Familiarity
      • Midwifery Care Model
      • Low-risk treatments used to resolve issues that may arise.
      • One-on-one care with your chosen birth attendant (although this isn’t always the case now. There are some homebirth midwives in the area that have a “practice” much like doctors)
      • Individualized care.
      • Continuous support
    • Cons –
      • Arrange for someone to take care of mom’s needs, the home, and other children.
      • No pain medications available
      • May need to transfer if difficulties arise.

Part 1 | Part 2 | Part 3 | Part 4

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Birth Photography – Capturing the Precious Journey


After having an amazing experience with the birth of my second girl, my love for all things birth grew substantially. I knew I wanted to be more involved in my birth community and it didn’t take long before I added this genre of photography to my portfolio. I remember the first birth I ever photographed and the high that remained in the weeks that followed. It was amazing! What an honor it is to me to be invited to witness, rejoice, and document one of the most wonderful things of life.


With birth photography gaining more recent attention, more and more couples are choosing to hire a professional birth photographer. But even with it’s growing popularity, there are still a great number of people who think that having your birth photographed is “gross”, “ugly” and “distasteful”. My goal for this article is to open your mind to the beauty of birth and show you some beautiful images as well.


Birth photography documents your experience from start to finish. It is your personal story that captures your labor, your partner’s/doulas support, the emotions, the moment you meet your baby for the first time, and so much more. The woman is a true goddess as she finds her inner strength to birth her baby. She is beautiful!


Someone who is not very familiar with birth photography may wonder why anyone would want such graphic images. But the truth is, unless a client requests a “graphic” image, everything is done very tastefully. A professional photographer will know exactly what to do with their camera to blur certain parts of a scene to ensure a mom’s modesty. Most moms are concerned about this anyway, and it’s something I discuss with them before the birth.


One reason some couples choose not to hire a photographer is because of the intimacy of such an experience and they prefer to keep it just between the two of them. While there is absolutely nothing wrong with that, your birth will most likely not be a two people only event. You have nurses, a doctor, and other medical staff going in and out of your room. This is where I believe who you hire to be your photographer matters greatly. Because of my small doula background and knowledge, and my own birth experiences, I have a high respect for the process of birth.


Your photographer should meet with you and get to know you, as well as keep in touch throughout your last few weeks of pregnancy. This helps to not feel like there is a stranger in the room. All that being said, my job is to be a fly on the wall. Never am I right up in a moms face invading her concentration. Just like with your doctor, you will build a relationship with your photographer also. If there is anything that you are concerned about, talk to her!


Another big reason they may forgo a photographer is because they think their partner can take the pictures. The partner is just as much a part of the birth as the mom and shouldn’t have to be held responsible for capturing some big moments. I learned that the hard way when I realized the photos my husband took made it look like he wasn’t even there! Some of the sweetest moments I capture are those of a partner caressing his sweet wife’s face, holding her hand, and focusing on each other. These are not pictures you’ll be able to treasure and remember if hubby is in charge of the camera. Leave it up to your photographer to include your partner in this experience and document how you welcomed your little bundle together!


There are so many beautiful pieces that make up a birth story; how you paced the hospital halls, how your partner rubbed your back and held your hand through every contraction, the encouraging words your doula said to you, yours and his first reaction, the tiny details of baby…it’s all beautiful! Your baby will only have one BIRTHday, and just like your wedding day, it is an event to be captured and remembered forever too.


Valery Bunnell is a photographer in Salt Lake City, Utah specializing in maternity, birth, and newborn photography. She attends births in hospitals, birth centers, and homes. To see more of her work, visit her website or Facebook page.

Check out our Facebook page later today for a giveaway from Valery Bunnell Photography!

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Exploring Your Options Series – Part 4

questions to ask a potential care provider

After you’ve setup interviews with doctors and/or midwives, you’re going to need some questions to ask them. For this post I want to talk about how to conduct an interview.

Hence Goer, author of Thinking Woman’s Guide to a Better Birthsuggest asking questions in a way that does not give away your opinion. If they know what your opinion is, they may tailor their response to your opinion instead of what their actual answer is. It is important to ask open-ended questions. Begin a question with “When do you usually recommend….?” Using the vision of your birth experience as a guide, ask questions about key elements of your birth vision. If you want to push in different positions than the traditional-hospital-position of laying on your back with legs in stirrups, ask your potential care provider about this. You could ask “What is your opinion of pushing in upright positions?” or “What is your approach to the pushing stage of labor?”

When the care provider answers the question vaguely, such as “I only do that when it is necessary”, follow up with more questions. If the answer they give is “I only do that when it is necessary”, ask “In what situation would it be necessary?” or “How often do you find it necessary?” If it is important to you not to have an episiotomy (when the care provider cuts your perineum), and the care provider says they find it necessary in every first time mom and about 80% of the rest of moms, then this is probably not the best care provider for the birth experience you want.

Is the care provider answering with feelings instead of facts? These types of answers can be very misleading. At first it seems like they care about your experience, when really they are trying to appeal to your emotion rather than using evidence based practices. If they answer with a feeling based answer, follow up with questions to get them to state specifics. In the situation of episiotomies, would you rather hear “Would you rather have a clean cut than a jagged tear?” or “I do them very rarely. It’s been about 3 years since the last time I did one. They are routinely done as part of a forceps delivery”.

Does the potential care provider seem comfortable with you asking them questions? If they seems irritated or impatient with your questions, they may not be the best care provider for you. If they are not comfortable with your interview questions, how would they react if you had a “dumb” question to ask. Think to yourself, “would I feel comfortable asking them a ‘dumb’ question?” There are times during pregnancy or birth that something doesn’t feel right or you unsure about what is going on with your body and you should feel comfortable talking to your care provider about these things without feeling stupid about it.

Here are specific questions to ask a potential care provider:

  • Are you board certified (physicians only)?
  •  Under what circumstances would you transfer my care to an obstetrician (midwives and family physicians only)?
  • Do the midwives attend births? (if you are interviewing at a practice that has both midwives and OBs)
  • What is the likelihood that you will attend my birth?
  • What are your dietary recommendations? How much weight should I gain?
  • What is your policy on ultrasounds?
  • Under what circumstances do you recommend inducing labor?
  • How do you handle slowly progressing labors?
  • What are your policies regarding monitoring the baby’s heart rate in labor, IVs, drinking or eating in labor, breaking the bag of waters (amniotomy), epidurals, episiotomies?
  • What are your reasons to do a cesarean? How often do you find it necessary? How do you try to avoid the need for cesarean?

The Thinking Woman’s Guide to a Better Birth, Henci Goer, p. 195-196


Henci Goers book has a lot of information about evidence based practices and I would recommend getting your hands on a copy. It may help you define your birth vision. In the particular section referenced about she also has “Red Flag Responses”. Great read!

Here are some links to help with questions to ask a potential care provider:

Read the previous posts in this series here: PART 1 | PART 2 | PART 3 | Part 5

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Exploring Your Options Series – Part 3

In my last post I talked about choosing a care provider being an important decision in your childbirth experience. In that article I mentioned interviewing several care providers. Today I would like to talk more about interviewing a care providers

The first step to choosing a care provider is to become clear about what type of birth you want. Think about the experience you want to have. What does the end result look like? How do you want to feel about your experience? Become really clear about what is important to you and your partner as you begin this life changing event. If you decide you want a medicated birth in a hospital, you can eliminate home birth midwives from your list of care providers to interview.

The next step to choosing a care provider is to find some care providers to research and interview. This can be accomplished in several ways; receive recommendations from friends and acquaintances, ask for recommendations on social media, ask your current care provider for referrals and recommendations, you can search the internet. When asking friends and acquaintances for recommendations on a care provider make sure to ask them about their childbirth experience. You will know their care provider would make a good match for you, if their childbirth experience is similar to the one you hope for. If they had a wonderful medicated birth in the hospital and you would like to have an unmedicated birth without medical interventions, their care provider may not be the right one for you. Ask them how their care provider made them feel. I have heard several women talk about their care providers who say they were really nice, but they didn’t feel like their questions were important or the care provider didn’t spend much time with them. These points are important to know when receiving recommendations from friends and acquaintances. Searching online for a care provider can be very helpful. Several sites online have a rating and feedback system. You can read about other’s experiences with a particular care provider and see their overall rating. This can help you narrow down your list of care providers to interview. Keep in mind when hearing or reading feedback about care providers that birth is an emotionally charged event which creates strong feelings (positive and negative) toward those involved. Many times when things do not go how the birthing family had planned the care provider is seen as responsible and the negative emotion is directed solely toward the care provider. It also happens in reverse, when a birthing family has a positive experience, the positive emotion can become directed at the care provider. This is why many women have strong positive emotions toward their care provider and you may hear many say “I LOVE my OB” or “I LOVE my midwife”. Make sure to ask them why! What did they do to earn such a strong emotion?

The next step to choosing a care provider is to compile a list of care providers to interview. After you have become clear on the childbirth experience you want to have and have asked for recommendations, you are ready to compile a list, narrow it down and setup interviews. Take the recommendations you have received and use the information you gathered to determine which care providers can help you accomplish the type of childbirth experience you want to have. Make a list of these care providers. I suggest having at least 3 different care providers (as well as different types) and not more than 5. If a natural birth in a hospital is part of your ideal childbirth experience, I would suggest speaking with at least one licensed home birth midwife. You may find you can have the best of both worlds with a greater chance of having the childbirth experience you want. Make sure to ask questions about the safety of home birth and what she does in the case of certain emergencies (get specific!).

The next step to choosing a care provider is to setup and conduct interviews. Some women wonder why in the world you would interview a care provider. For most it doesn’t make sense, because it is rarely done. We usually just go to whomever is covered by insurance or whoever our mom or best friend go to. However, the care provider that attends your birth is a very important element to the type of experience you will have. If you want to have a natural birth with few medical interventions in a hospital and the OBGYN you choose is not supportive of natural birth your likelihood of having the experience you want is very low. If you want to reduce the risks of having a cesarean section and your OBGYN has a high c-section rate, your risk of cesarean is increased just by the care provider you chose. Choose carefully! Take your time! And if the one you choose isn’t supportive of the experience you want to have, fire them! Go to a new care provider who is supportive. I have known women you have fired their care provider during labor. They work for you!

The final step is to conduct interviews. Call the care provider’s office and setup a “consult” appointment. Tell the receptionist you would like to discuss different birth options with the care provider. This will help them know how much time to give you for the appointment. On my next post I will discuss how to interview a care provider.

Read the previous posts in this series here: PART 1  PART 2

Image courtesy of photostock /

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I Am On A Mission…

I am on a mission to provide priceless information and support to empower birthing women to have a confident, respected, and intimate childbirth experience. – Marcie HunterI am on a mission

please do not copy or remove watermark. If you would like to share or post, please link back to my site.

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Exploring Your Options Series – Part 2

I first thing I want to talk about are 2 very important choices. These two choices will determine what other choices you have surrounding your birth. This week we will talk about the first important choice:

Care ProvidersMidwife, Suzanne Smith

When choosing a care provider, it is important not to make assumptions about the type of care or philosophy based on the sex or type of care provider. You cannot assume that a female care provider will be more caring, flexible and less likely to introduce interventions, than a male. You cannot assume that all midwives practice from the midwifery care model and that OBs or Family Doctors will not. There are some OBs that act as excellent “midwives” and some midwives that offer a more medicalized approach to pregnancy and birth. The pros and cons I will present are generalized. What may be a con to you, may be a pro for someone else and vice versa. It is important to interview several different care providers before choosing one. Ask lots of questions!

  • Obstetrician/Gynecologist or OB/GYN
    • Pros –
      • Skills and experience to diagnose and treat serious complications during pregnancy and birth
      • Rarely would require transfer of care
    • Cons –
      • Trained surgical specialist in the pathology of women’s reproductive organs. More medicalized care. Less naturally minded.
      • Low-risk women often seen as high-risk
      • Limited repertoire; no experience in other lower risk options
      • As someone put it “If you don’t want to get cut, don’t go to a surgeon.”
      • Limited to hospital
  • Family Doctor
    • Pros –
      • Tend to introduce fewer interventions than an OB.
      • All members of the family can see one doctor.
        • This creates better doctor/patient relationships and convenience.
    • Cons –
      • Pregnancy or birth complications may mean a transfer of care.
      • Still have a “high-risk” mentality of pregnancy and birth and introduce interventions more than a midwife.
      • Limited to hospital
  • Midwife

Most midwives practice under the Midwives Model of Care. This model of care is based on the fact that pregnancy and birth are normal life processes.

The Midwives Model of Care includes:

  • Monitoring the physical, psychological, and social well-being of the mother throughout the childbearing cycle
  • Providing the mother with individualized education, counseling, and prenatal care, continuous hands-on assistance during labor and delivery, and postpartum support
  • Minimizing technological interventions
  • Identifying and referring women who require obstetrical attention

The application of this woman-centered model of care has been proven to reduce the incidence of birth injury, trauma, and cesarean section.

  • Pros –
    • Offer flexible, individualized, supportive care rather than introducing medical interventions routinely.
    • More attentive to emotional issues during pregnancy and childbirth.
    • Offer many low-risk strategies for correcting problems that may arise during pregnancy and childbirth.
    • Midwife practices, procedures and tests come closer to the recommended guidelines of official physicians’ organizations, than those of a typical OB.
    • Many midwives offer well-woman care. This allows women to continue their care postpartum with the same care provider.
    • Midwives aren’t just limited to hospital care. They attend birth at freestanding birth centers and home births.
    • Cons –
      • Pregnancy and birth complications may mean a transfer of care to an OB.
    • Different Types of Midwives
        • There are three different types of midwives that can legally practice in Utah:
          • LDEM- Licensed Direct Entry Midwife. This is someone who went straight into midwifery and is licensed by the state. He or She is a CPM (Certified Professional Midwife), having met the requirements with NARM (North American Registry of Midwives). LDEMs are licensed with the State of Utah and can carry oxygen, lidocaine (for stitching up your perineum in the case of tears), Rhogam for Rh- mothers, pitocin for a hemorrhage, vitamin K for baby, eye ointment for baby, and with a physicians approval, IV’s if needed, more medications for hemorrhage, and certain antibiotics for labor. They are not under the supervision of a doctor but practice independently.
          • CPM or DEM- Certified Professional Midwife or Direct Entry Midwife. In Utah no certification or licensure is required to call oneself a midwife. Therefore it is up to you the consumer to determine the skill level and capability of anyone calling them self a midwife. Therefore this midwife may or may not have the CPM credential. Many midwives in this category are very skilled, but once again it is up to the consumer to determine the knowledge and skill level of this midwife. This midwife can carry oxygen, but cannot carry any other medications.
          • CNM- Certified Nurse Midwife. This midwife has gone through formal nurse’s training and certification as well as midwifery training. Most CNM’s work in the hospital, they can carry medications, and write prescriptions. They are under the supervision of a doctor.


The next important choice we will talk about next week is where you will give birth.

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Exploring Your Options Series

The focus of my doula business is to help birthing families know what their options are.

For this reason I’ve decided to write a series of posts about how to make informed decisions and what different options there are.

There was a study done in the 60s and 70s to evaluate the factors that influenced a woman’s level of satisfaction in her childbirth experience. In the study, women rated their level of satisfaction, filled out a questionnaire, and related their childbirth experience. Then home water birth, opiefoto.com15 to 20 years later the researchers followed up with these same women. What they found was that women remembered the details of their childbirth experiences very vividly and felt the same emotional intensity several years later. The research showed that the thing that made the difference in the level of satisfaction was whether a woman felt like she had a say in the care she received. Women who had a say in the decision making process reported to have the highest level of satisfaction in her childbirth experience. This is one reason why I believe women need to feel empowered and supported in making informed decisions for their care.

The first thing I would like to talk about is making decisions about your care. This formula is not just for pregnancy and birth. It can be applied to any situation where medical decisions need to be made. Think of the acronym “BRAIN”.


  • B – Benefits?
  • R – Risks?
  • A – Alternatives?
  • I – Intuition? (How do I feel about this?) Prayer.
  • N – Not now, but wait?

Take time to discuss. Ask your care provider and/or nurse to give you a moment to discuss your options. Very rarely do decisions need to be made so quickly that you do not have time to ask questions and discuss it privately. In the event of a time sensitive

Midwife - careprovideremergency ask for 1 minute alone to discuss it, if a minute is too long, ask for 30 seconds.  In a situation before the birth, you can get a second opinion. If you aren’t comfortable with what your care provider is telling you, you can change care providers. Don’t be afraid to fire your care provider. They work for you and you can find another one who you are more comfortable with and will honor your wishes. During your birth you can ask for another nurse, if you don’t feel supported by the one assigned to you.

More in depth questions you can ask your care provider:

As you ask questions about your care, you will become a responsible consumer and will gain greater satisfaction in your childbirth experience.


When a test is suggested:

  1. Why should I have the test? What problem are we looking for?
  2. What will the test tell us? How accurate are the results?
  3. What are the risks/side-effects of the test?
  4. If the test detects a problem, what will happen next?
  5. What is the cost of the test?

When a treatment or intervention is suggested:

  1. What is the problem? Why is it a problem? How serious is it? How urgent is it that we begin treatment?
  2. Describe the treatment: How is it done? How likely is it to detect or solve the problem?
  3. If it does not succeed, what are the next steps?
  4. What are the risks or side-effects to the treatment?
  5. Are there any alternatives (including waiting or doing nothing?)
  6. Ask questions b,c, and d about any alternatives.
  7. What is the cost?

–adapted by Kristi F. Ridd (originated by Penny Simkin)

Coming up we’ll talk about choosing a care provider, the pros and cons of different care providers, choosing a birth place, and a doula.

Photos take by opiefoto at the birth of my 3rd child.

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Planning to Have an Epidural? Bring Some Extra Tools

I learned something new at a birth yesterday. If you have low blood platelets, you cannot get an epidural. I don’t think low blood platelets is common, but what I learned was that sometimes a woman may not know she won’t have pain medication as an option until she goes into labor.

I believe it is important for all birthing women to be educated in the normal process of birth, basic comfort measures, and have trained birth support (and don’t count on the L&D nurse being able to provide this, they are busy and many of them do not have a lot of training or experience in natural birth). You never know when you won’t be able to have an epidural, they don’t always work, and sometimes you have to wait a significant amount of time before you can get one.

Epidurals can be a positive tool used during birth, just make sure you have other tools as well.

A doula has many tools, if you hire one it can make your birthing experience more positive, no matter what happens.

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Delayed Cord Clamping

Delayed Cord ClamingA common routine practice within hospitals is to immediately clamp and cut the umbilical cord following the birth of the baby. Although care providers (doctors and midwives) give many excuses for this practice there is no evidence to support it. In fact, there is much evidence to support delaying clamping of the cord.

Below is some of the evidence I’ve collected that shows the benefits of delayed cord clamping. As you read through and view this information you can learn about the benefits for yourself and make the best choice for you and your baby.

Science and Sensibility, a blog by Lamaze International, has gathered a plethora of information on delayed cord clamping. Here is a post in which they refute, with evidence, some of the common objections care providers use in regards to delayed cord clamping.

“In some cases this continued practice is due to a misunderstanding of placental physiology in the first few minutes after birth. In others, human nature plays a role: We are often reluctant to change the way we were taught to do things, even in the face of clear evidence that contradicts that teaching.”

Click HERE to read the full article.

To view all the articles they have on the subject of delayed cord clamping, click HERE. They have a really informative video series about delayed cord clamping given by Dr. Nicholas Fogelson, MD A.P. Department Obstetrics and Gynecology USC School of Medicine. To watch this series click HERE.

Dr. Judith Mercer, PhD, CNM, FACNM, a member of the faculty at the University Rhode Island, is the Principal Investigator on a randomized controlled trial at Women & Infants Hospital examining the effects of delayed cord clamping on outcomes of preterm, very low birth weight babies. She was interviewed over at Science and Sensibility blog. She relates an amazing experience she had at a homebirth in 1979 that helped to influence her decision to research delayed cord clamping.

“I had an epiphany at a home birth in 1979. An infant was born very rapidly with the cord 2 and 1/2 times around his neck. He was as pale as the white sheet his mother had on her bed and limp and breathless. I was very afraid that I would not be able to resuscitate him.  I placed him on the bed and immediately unwrapped the cord from around his neck and dried and stimulated him with no response. His heart rate was well over 100 and the cord was pulsating vigorously.  I noticed that his color was changing from the pale white to pink as his body gained the blood back into it. His heart rate was always over 100. In about 1 and 1/2 minutes, he flexed his extremities, opened his eyes and took a gentle breath.  He looked at us like “What is the fuss?” and never cried.  I tried as hard as I could to get him to cry as I believed at that time that he should do but I could not get him to.  He nursed very well and was a normal child at one year of age when I last saw him.

I knew that I had seen a miracle and one that I would never have seen in the hospital.  In the hospital, we would have cut the cord and taken the infant to a warmer to resuscitate him. In doing so, we would have denied him exactly what he needed – the opportunity for the blood squeezed out of him in the birth process due to the tight cord around his neck to flow back into his body.  This event marked the beginning of my research career.  I vowed that at some point in my life I would research what I had seen but did not fully understand.”

To read the rest of her interview, click HERE.

Below is a video where Penny Simkin talks about the amount of blood lost when we practice immediate cord clamping. She talks about the benefits of delayed cord clamping in a visual way that really helped me understand the way it works. Watch the video, it’s a really great way to spend 5 minutes and you’ll walk away with some beneficial information on this important birth option.

Along with all of the clinical benefits and researched evidence noted in the above links, a benefit that I have seen is the way delayed cord clamping slows down the birthing process. Sometimes in the hospital there is so much routine that is practiced by the doctor/midwife and nurses everything happens so quickly. I believe it is important to slow this process down. When the birth of a baby is slowed down the mother and her partner have the chance to savor the moment and the experience is etched into their memory. Slowing down the birth process is one way to improve and protect the memory of the birth.

As you consider your birth options and preferences, I hope you will research the information available on delayed cord clamping to make the best choice for you, your baby and your situation.

The midwives that I know of who attend home births regularly practice delayed cord clamping. It is important to talk to your care provider to find out their regular practices.

Picture above take by OpieFoto. Taken at the home birth of my 3rd child.

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Me and The Moms I’ve Supported

Pictures of me with some of the women I’ve supported during the births of their babies.




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