The Power of Presence
one midwife’s experience in collaborative care
In 2019, I was working part-time in a CNM-owned and led birth center and home birth practice. Though I had attended home births in the past, the past few years I had been providing care in a hospital setting. I decided to return to home births simply because I had always loved them so much.
Home births and birth centers create a very personalized experience. The midwives who attend out-of-hospital birth tend to trust the labor and birth process in a way that feels deeply meaningful and spiritual to me. Another benefit of home births and birth centers is more autonomy. Typically in a hospital, the birthing person is limited to 2 or 3 support people. These support people are the only ones allowed to be present in the labor room and witness the birth of the baby. At a home birth, the birthing person can choose who is present with them for the labor and birth process. Home birth midwives welcome family to be part of the process for emotional and physical support.
The midwives who attend out-of-hospital birth tend to trust the labor and birth process in a way that feels deeply meaningful and spiritual to me.
For your information
Birth centers and home births are not medically appropriate for every pregnant person. However, some hospitals have in-hospital birth centers attended by CNMs and OBs, which may be an option for those with higher risk.
I remember one home birth that I attended with a Certified Professional Midwife (CPM). She had attended many out-of-hospital births and was very well-known in and around Washington D.C., Maryland, and Virginia. The CPM and I partnered to care for a couple who had experienced a pregnancy loss in their previous pregnancy. The couple was very committed to birthing at home and had thoroughly prepared for a home birth. However, they had also expressed some anxiety and fear about the labor and birth process as a result of the trauma from the loss of their first pregnancy. We had talked with the couple about the emotions and fears they were feeling during the pregnancy. They were aware they could safely transfer to a hospital at any time and for any reason. Still, they both chose to give birth at home.
Labor and birth are intensely physical, spiritual, and emotional processes.
Labor and birth are intensely physical, spiritual, and emotional processes. They require a great deal of personal strength from the birthing person and lots of support and guidance from their birth team. When labor began, the client required support, prayer, encouragement, and physical presence to get through each contraction. At one point, they became tearful and very anxious. They began to doubt that they could continue to labor naturally and birth the baby. For a brief moment I, too, felt anxiety and doubt creep into my body. That is not the energy you want your birth team to bring into the room! But at that very moment, the CPM placed her hand on my shoulder and whispered in my ear that everything was going well. The baby would arrive soon.
For your information
Whether you’re laboring in a hospital or at home, always choose a team that makes you feel safe, respected, supported, and listened to.
The CPM provided the physical and emotional encouragement I needed to continue to be present and care for our laboring client. I placed my hand on the client’s chest and began to breathe and pray with them. Their breathing slowed down, and they were able to ground themselves and breathe through each contraction with intention. The anxiety and fear that had crept into the room steadily dissipated. Only 15 minutes later, a healthy baby was safely born into the couple's hands.
She recognized my anxiety and provided me with her support and encouragement at just the right time.
I was so grateful for the CPM in that moment. She recognized my anxiety and provided me with her support and encouragement at just the right time. I was also grateful to partner with a midwife who had more home birth experience than me. Her presence was greatly reassuring. I was able to attend two home births with that CPM, both of which were lovely births. Working together, we were able to provide two incredible birth experiences that wouldn’t have been the same without our joint efforts and expertise.
The CPM who attended this birth with me passed away in 2020 at the age 71. I am so grateful for her support and knowledge. I’m also grateful for all the families she served, especially the Black and Brown families that nobody else would care for. Thank you for all your great work.