Midwife Model of Care - Our Philosophies

Over the centuries, midwifery has evolved into a woman-centered model of care using philosophies that align with local cultures and scientific research. 

In the United States, the Midwife Model of Care views pregnancy and birth, not as something to fear, but as a normal life process that does not always require interventions or invasive practices.

Find out how the Cincinnati Birth Center handles topics such as:

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• Epidurals

• Natural Pain Management

• Breech Babies

• Hospital Transfers

The heart of midwifery lies in prioritizing the health of mother and baby while standing shoulder-to-shoulder with the mother in personalized approaches.

What Does the Midwife Model of Care Include?

The Midwife Model of Care is an approach that attends to the physical, psychological, and social well-being of the mother throughout pregnancy, childbirth, and postpartum.

This model is distinguished by several key practices:

1. Holistic Monitoring: Midwives continuously monitor the overall health of the mother, including her physical condition, emotional state, and social environment.

2. Individualized Support: Mothers receive personalized education, counseling, and prenatal care. During labor and delivery, midwives provide continuous, hands-on assistance, followed by supportive postpartum care.

3. Minimizing Interventions: Technological and medical interventions are minimized to help mothers achieve natural childbirth whenever possible while ensuring safety.

4. Timely Referrals: Midwives are trained to identify situations that require obstetrical intervention and make timely referrals when a pregnancy is no longer considered low-risk or a hospital transfer is needed.

The above key practices are shaped by the following philosophies:

• Midwives are considered the most suitable caregivers for women during childbirth, offering specialized and compassionate care.

• Midwife care promotes, protects, and supports women's health and rights, respecting ethnic and cultural diversity.

• This care model is continuous and holistic, addressing the social, emotional, cultural, spiritual, psychological, and physical experiences of women.

• Midwives build up the health and social status of women, empowering them through their ability to cope with childbirth.

• Midwives are respectful, personalized, continuous, and non-authoritarian, referring back to the philosophy of a woman-centered model of care.

• Midwife care is guided by ongoing education, scientific research, and the application of evidence, making sure that it is both ethical and competent.

History and Evolution of the Midwife Model of Care

The role of midwives in the United States has constantly evolved over the years. Historically, midwives were the primary providers of maternity care, particularly in rural and underserved areas. However, the rise of hospital-based obstetric care in the 20th century led to a decline in midwifery services. It wasn’t until the latter half of the century, amidst growing concerns over high intervention rates and a movement towards more personalized care, that midwifery began to experience a resurgence.

The establishment of professional organizations, such as the American College of Nurse-Midwives (ACNM) in 1955, played a role in professionalizing midwifery and integrating it into the broader healthcare system. Today, midwives are recognized as key providers in maternal healthcare, working in various settings including hospitals, birth centers, and home birth practices.

Midwifery Today

Today, the number of births attended by midwives in the U.S. is increasing as awareness grows and home birth myths are dispelled. Studies have proven that midwife care reduces the need for cesarean sections or medical interventions, and significantly lowers the rate of birth injury or trauma [1 , 2]. 

Despite the proven benefits, midwifery in the U.S. faces challenges such as:

• Varying state regulations

• Limited integration into some healthcare systems

• Public misconceptions concerning safety

We need to constantly advocate, educate, and address policy reforms to push our cause forward.

Looking ahead, integrating midwives into regular healthcare and increasing access will help meet the needs of diverse populations, reduce medical interventions, and lead to healthier outcomes for mothers and babies.

Midwifery Legislation in Ohio

Meghan speaking at the capitol

Midwife legislation has experienced a lot of evolution in the United States. Regulations vary across all 50 states depending on how each approaches healthcare, autonomy, and professional standards.

Ohio is currently a focal point with a bill in review which could open up midwife licensure and integration into healthcare. Our very own Meghan Nowland recently visited the state capitol and advocated for midwifery legislation, coinciding with the International Day of the Midwife on May 5, 2024!

Midwife Regulation in the US: CNMs vs CPMs

Midwifery is governed by a web of state-specific laws and regulations across the U.S. These laws typically distinguish between Certified Nurse-Midwives (CNMs) and Certified Professional Midwives (CPMs).

• CNMs generally enjoy broader practice privileges due to their nursing background and advanced education. CNMs are licensed in all 50 states and are usually authorized to practice in hospitals, birth centers, and home settings.

• CPMs, on the other hand, tend to work exclusively at home births and birth centers and face more restrictive licensing laws. Only 36 states have specific licensure pathways for CPMs, which leaves them advocating for their right to practice. 

Ohio Legislation - House Bills 496 & 545

In 2022, House Bill 496 was introduced which would allow midwives to become licensed and fully integrated into the healthcare system. 

Meghan with State Representatives Riordan McClain & Melanie Miller

As of May 2024, House Bill 545 was also introduced into the 135th General Assembly to further the cause of midwife regulation. 

The proposed legislation, backed by a coalition of midwifery advocacy groups, healthcare professionals, and lawmakers, seeks to create a regulatory framework that acknowledges the competencies of CPMs while ensuring safety and quality standards.

The bills have received substantial support from both the public and professional communities. Proponents argue that formal licensure will enhance access to midwifery services, particularly in underserved rural areas where traditional healthcare facilities are sparse. It will also integrate CPMs into the broader healthcare system, providing better collaboration and emergency care protocols.

Currently, we are facing a shortage of midwives due to restrictive regulations. The enactment of these bills will increase the number of those who can practice and will open up employment opportunities in Ohio.

To summarize, the formal licensure of CPMs would:

1. Enhance Access to Care: By providing a clear regulatory framework, the bills will likely increase the number of practicing CPMs, improving access to midwifery services, particularly in rural and underserved communities.

2. Integrate Midwifery into Healthcare: The bills will foster greater collaboration between midwives and other healthcare providers, promoting a more integrated and comprehensive approach to maternal and infant health.

3. Standardize Quality and Safety: By setting educational and practice standards, the bills aim to ensure high-quality care and enhance patient safety, addressing concerns about the variability in midwifery practices.

4. Improved Outcomes: This change could potentially improve maternal and infant outcomes by providing more birthing options and integrating midwifery more fully into prenatal and postnatal care frameworks.

When to Transfer to a Hospital During Home Birth

Most home births go smoothly without the need for any medical interventions or hospital transfers. Since a low-risk pregnancy is required to qualify for a home birth, any emergencies that occur can usually be handled by the midwife at home. 

Sometimes, despite careful planning and preparation, a hospital transfer might be necessary. The decision to transfer during labor is never taken lightly and is one your midwives will carefully consider with you, prioritizing the safety of both you and your baby. At the Cincinnati Birth Center, we average around 10% of our clients transferring during labor with a 6% cesarean section rate. Even with these low numbers, it is always best to be prepared. In the event of an emergency, what are some reasons a transfer might need to happen?

4 Reasons for a Hospital Transfer

1. Stalled / Slow Labor

Usually, slower labor isn’t something to be too concerned about, especially during the first part of labor or if you are a first-time mom. If nothing seems to be progressing or contractions are slowing down, you may want to try different ways to get things moving that don’t involve medical interventions:

• Try going for a walk to encourage the baby to descend.

• Change your surroundings if you are uncomfortable, feel closed in, or need more privacy.

• Switch up positions frequently - being stationary for too long can slow things down.

• Stimulate your nipples to produce oxytocin for contractions.

However, if labor is progressing too slowly during the second stage of labor, the mother may become exhausted and the baby could run the risk of fetal distress. Your midwife will work with you to make a judgment call if it’s time to move to a medical facility.

2. Postpartum Hemorrhage

At a home birth, midwives are equipped to handle most hemorrhages the same as a hospital doctor would, and there is very rarely any cause for concern. Most hemorrhages are mild and are easily managed. Sometimes postpartum hemorrhages happen after the first 24 hours post-birth, which is one reason why your midwife will conduct multiple postpartum visits to check on both you and baby.

In the rare event of a severe hemorrhage, an ambulance will be called while the midwife massages the uterus to stimulate a contraction, administer an oxytocic drug, and put up an IV if this does not stop the bleeding.

3. Infant Respiratory Problems

After the baby is born, his or her respiration is monitored and recorded until it has remained stable for two hours. If the baby is born in respiratory distress, the midwife will immediately perform resuscitation with her emergency equipment. However, a medical transfer will take place if the infant continues to show signs of respiratory distress or cyanosis (blue skin due to lack of oxygen).

4. Request for Epidural 

Sometimes mothers (especially first-time moms) change their minds and decide they want to transfer to a hospital for an epidural or help with accelerating labor. Before choosing a provider, it’s wise to consider whether you can commit to a birth without medical pain management. If you change your mind during labor, your midwife will respect your choice and transfer you to your chosen backup hospital.

Remember, a decision to transfer to a hospital is not a home birth “failure!” Your midwives are committed to ensuring the safety of you and your baby, and sometimes extra medical attention is needed. At the end of the day, what matters is that your baby is in your arms no matter where you are.

How Should I Plan for an Emergency Transfer?

Although most births proceed without complications, you will want to have a plan in place just in case of an emergency.

• Start by researching or asking your midwife reasons a transfer might be necessary to help you understand when and why it might need to happen. 

• If you have a written birth plan, include a “plan B” if you need to go to a hospital and make sure your preferred location is listed along with a phone number. Include a section specifically addressing the possibility of a transfer, detailing preferences for transportation, choice of hospital, and preferences for medical interventions if needed.  If you aren’t writing out a birth plan, keep the hospital’s address and contact information somewhere close by, such as hanging on the refrigerator.

• Discuss transportation options in advance and make arrangements if needed so that you have a reliable mode of transport to the hospital if needed.

• Even if you are planning on a home birth, you will still want to pack an emergency bag just in case you have an unexpected hospital stay. Include clothing, toiletries, personal documents, and any comfort items that can help make the transition smoother. Keep the bag nearby in case of a sudden transfer.

• Keep an emergency contact list close by of healthcare providers, family members, and anyone else who may need to be notified in case of a transfer.

How to Turn a Breech Baby

When your baby drops into position, usually they will assume the “head down” position ideal for childbirth. However, about 3-4% of full-term pregnancies experience a breech presentation where the baby’s buttocks, feet, or both are positioned to enter the pelvis first instead of the head [1].

Some breech babies can be delivered vaginally, but if the baby doesn’t turn before delivery, we recommend transferring to your preferred hospital in case of complications.

If you’ve found out your little one is breech - don’t panic! Around 30% of babies are breech at 30-32 weeks and only 3% are still breech at 37 weeks. Even if the baby is still breech at full-term, most of them will turn before labor begins, or even during labor. 

7 Ways to Turn Your Breech Baby 

Spinning Babies is an excellent resource to learn how to balance your body at home to get baby back into the proper position. They offer several easy activities to help turn your baby and get your body ready for birth. 

Some of the most effective ways to turn your breech baby are outlined below.

1. Forward Leaning Inversion

The forward leaning inversion is a commonly used technique that has seen great results for turning babies in breech and other unwanted positions. It untwists and lengthens ligaments in the uterus by using gravity to make room for a good fetal position. 

Download Spinning Babies’ Daily Essentials Video tutorial or read step-by-step instructions to learn the technique yourself.

2. Breech Tilt

The breech tilt, or pelvic tilt, creates an angle that encourages the baby to tuck their chin and flip. Many women use an ironing board and prop it at an angle and lie on it with their head toward the floor and feet in the air. Try lying on the board 20 minutes at a time 1-3 times a day often to help turn the baby.

3. The Webster Technique

Chiropractic care during pregnancy helps with all kinds of issues, from sciatica to reducing labor time. Did you know it can also help turn babies in poor positions? Known as the Webster Technique, this approach realigns the pelvis to create more space for the baby. 

Balance Chiropractic, located at our main office on 841 Lincoln Avenue, specializes in this technique along with further care for infants and mothers.

4. Acupuncture with Moxibustion

Moxibustion, used by Chinese medicine for thousands of years, is a form of acupuncture that uses “moxi sticks,” which contain the leaves of the mugwort plant. Moxibustion stimulates the BL57 acupuncture point and has been shown to be effective in turning breech babies and preventing c-sections [2].

5. Music

Try playing gentle music through headphones and placing them on the lower part of your belly. Sometimes the sound will encourage the baby to turn in the direction it is coming from, which can ease them into the proper position.

6. Heat and Cold

Babies like to stay warm, so one strategy to turn your breech baby is to place a warm pack at the bottom of your belly and a cold pack (such as a bag of frozen peas) at the top of your abdomen. This can encourage them to shift and turn to get more comfortable and closer to the heat.

7. Sleeping Positions

You’re probably already sleeping on your side, but if you haven’t tried this already, lie on your left side when you go to bed with a pillow between your legs. Keep your abdomen and upper leg in a forward position to give your baby more room to turn. At the very least, this may help alleviate some of your aches and pains!

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Sometimes, if nothing else has worked, we will schedule an external cephalic version (ECV) with a doctor when the baby is term. This is a short, but uncomfortable procedure where the doctor attempts to manipulate the baby’s position by pushing on your belly and abdomen. This does not always work and is not always recommended, but may be the best route if unable to naturally turn the baby.

If you have more questions or concerns about your baby’s position, your midwife will be more than happy to sit down and discuss a plan with you to help turn your baby! Most importantly, don’t stress - at the Cincinnati Birth Center, we’re here to walk you through each step of your pregnancy and tailor care specifically for you and your child.

Home Birth Safety - Myth vs. Reality

If you have had or are considering a home birth, you’ve probably heard responses ranging from excitement to surprise to not-so-subtle judgment. You’ve probably also gotten a lot of questions about the safety and practicality of home birth. 

Unfortunately, a lot of misinformation spreads around the topic of home birth - and misinformation provides a breeding ground for skepticism. Today, we’re going to debunk some of the top myths surrounding the safety of home birth.

Myth #1: Home births are riskier than hospital births

One of the most common myths about home births is that they are unsafe compared to hospital births. “What if you need a c-section?” or “What about hemorrhaging?” are common concerns people may have.

Research shows that home births of low-risk pregnancies attended by trained professionals are just as safe (if not more safe!) than hospital births.

In fact, according to a study published in the British Medical Journal, planned home births for low-risk women resulted in lower rates of interventions such as cesarean sections, epidurals, and episiotomies compared to hospital births, without compromising the safety of mothers or babies [1].

Myth #2: Home births are messy and unsanitary

It’s true, birth is a messy business. However, this doesn’t mean that you will need to tear out carpet or replace your mattress. 

Your midwives carefully plan and organize births, using waterproof coverings and pads so that surfaces are kept spotless. After the birth, midwives and/or doulas typically handle the cleanup so that there are no signs that a birth just took place in the room.

As far as sanitation goes - the midwives bring professional, sterile equipment, and the risk of infection is actually much lower at home than in a hospital [2].

Myth #3: Home births don’t have professional medical support

Home birth is not the same as “free birth,” which is when the mother gives birth without any health professionals present. A home birth is attended by certified midwives who are highly trained professionals equipped with medical supplies and emergency protocols. Plus, midwives build relationships with expecting families, offering personalized care throughout pregnancy, labor, and the postpartum period.

With the Cincinnati Birth Center, you can be confident that our midwives and assistants are experts in their field and will take care of you every step of the way.

Myth #4: Emergencies cannot be managed at home

In the last few decades, the philosophy behind birth has evolved from being thought of as a natural process into being considered a medical concern that “requires” hospital interventions. While emergencies do happen, and hospitals certainly are needed for some of these, not every emergency requires a location transfer.

Certified midwives are trained to recognize signs of complications and are equipped to handle many emergencies. They carry emergency medical supplies and constantly monitor both mother and baby. If a situation arises that must be addressed at a hospital, a transfer can quickly and easily take place. Otherwise, any other issues can likely be handled at home.

Myth #5: There are no pain relief options

When people think of birth pain management, their minds often jump straight to epidurals. Of course, epidurals are not an option at home, so many assume that having a home birth means having no pain relief options, making it intolerable for birthing mothers.

The truth is, there are many other natural pain management techniques that can be extremely effective without the side effects. These may include massage, water immersion, breathing exercises, and different positions to help labor progress. Some families choose to use alternative therapies such as acupuncture or hypnosis.

Myth #6: Home births are only for hippies

Another misconception is that home births are only for alternative lifestyles or for those with extreme birth ideologies. 

In reality, home birth is an amazing choice for anyone who simply wants a more intimate and personalized birth experience - it doesn’t necessarily have anything to do with lifestyle or beliefs. When choosing natural home birth, families get to have more control over their birth environment, reduce medical interventions, and make their own laboring choices.

Mushrooms - A Pregnancy Superfood

When you think of healthy foods to add to your diet during pregnancy, you’re probably not thinking about mushrooms. But did you know that medicinal mushrooms are packed with nutrients and bioactive compounds that support healthy immune function?

Beta Glucans: Healing Nutrients in Medicinal Mushrooms

Medicinal mushrooms are a group of mushrooms known for their health benefits and often consumed as a supplement for their therapeutic properties.

Some well-known medicinal mushrooms include:

• Reishi

• Chaga

• Shiitake

• Lion’s Mane

• Cordyceps

• Turkey Tail

One of the key components in medicinal mushrooms that make them particularly beneficial during pregnancy is beta-glucan. Beta glucan is a type of soluble fiber found in the cell walls of these mushrooms that has a wide range of health benefits such as boosting the immune system and improving cholesterol levels [1]. For pregnant women, beta-glucan’s immune boosting properties can be especially valuable for protecting both mother and baby from illness.

Beta-glucan has also been linked to an increase in milk supply for breastfeeding mothers. By stimulating the production of prolactin (the hormone responsible for lactation), beta-glucan can help provide nursing mothers with an ample supply of breast milk for their infants.

Reishi for Buddha Babies

The Reishi mushroom is known for promoting a sense of calm and relaxation. They have a long history of use in Traditional Chinese Medicine for their calming effects on the mind and body. 

Have you heard of the term “Reishi Babies?”

Herbalist Ron Teegaurden has observed over the years that mothers who include reishi mushrooms in their diet give birth to babies who are calm and zen, almost like “little Buddhas.” This calm and easygoing nature often follows them into childhood [2]. 

Not only does reishi bring a sense of peacefulness to babies, but their mothers also receive these benefits [3]: 

• Calmer during pregnancy, labor, and birth

• Balanced mind, body and spirit

• Stronger immune system and cardiovascular system

• Packed full of nutrients

• Anti-inflammatory properties

• May help balance blood sugar levels

• Better quality of sleep

Whether you’re looking to enhance immune function, increase milk supply, or create a sense of calm for yourself and your baby, medicinal mushrooms - particularly reishi mushrooms - are a valuable source of bioactive compounds that boost health during and after pregnancy.

Troubleshoot a Poor Latch for Breastfeeding Success

Breastfeeding is a beautiful connection between mother and child that not only nourishes with nutrients unique to YOUR child, but also helps build a strong bond. Most mothers want to be able to experience this and provide their baby with the best possible sustenance, but many are not prepared for when challenges arise. 

A poor latch is one of the most common breastfeeding obstacles that leaves women frustrated, in pain, and ready to give up.

Before you assume breastfeeding won’t work and decide to turn to a bottle, keep reading to see if you and your baby are experiencing a poor latch that can be resolved.

Signs of a Poor Latch

When a baby latches onto the breast correctly, they can effectively extract milk for adequate nutrition and stimulate milk production. Plus, a good latch helps prevent nipple pain and damage - a common concern for many breastfeeding mothers.

• Recognizing the signs of a poor latch is the first step towards addressing the issue:

• Nipple pain or discomfort lasting longer than a few seconds and persisting between feedings.

• Nipple damage, such as cracking, blistering, or bleeding.

• Baby's mouth is not fully covering the areola, instead only latching onto the nipple.

• Baby making clicking noises while nursing.

• Poor weight gain or inadequate diaper output.

Common Causes of Poor Latching

Experiencing any of the signs above? Now it’s time to identify what is causing the poor latch so that you can get to the root of the issue.

Some common causes of a poor latch include:

1. Inexperienced breastfeeding: For both mother and baby, breastfeeding is a learning process. In the early days, it may take time for both parties to figure out the best positioning and technique, especially as a first-time mother.

2. Engorgement: When the breasts are overly full and firm, it can be challenging for the baby to latch properly.

3. Flat or inverted nipples: These variations in nipple shape can make it difficult for the baby to latch effectively. You can definitely still breastfeed, but you want to be aware that you have one of these variations and learn techniques for latching with flat or inverted nipples.

4. Tongue tie or lip tie: Ankyloglossia (tongue tie) or a tight frenulum (lip tie) can restrict the baby's ability to latch deeply.

5. Latch-on technique: Improper positioning of the baby at the breast or incorrect latch technique can lead to a poor latch.

How to Resolve Latching Issues

Don't hesitate to reach out to a lactation consultant or breastfeeding support group for guidance. These professionals can provide valuable tips and support tailored to your specific situation. Your midwife knows you and your baby best, and can walk you through your latching issues and come up with a solution.

Experiment with different breastfeeding positions to find what works best for you and your baby. Common positions include the cradle hold, football hold, and side-lying position.

Check on your latch technique - find pictures so that you have a visual of what you should be seeing. Ensure that your baby's mouth is wide open with lips flanged outwards before bringing them to the breast. Aim to have the baby latch onto the entire areola, not just the nipple.

If you're experiencing nipple pain or damage, try using lanolin cream or hydrogel pads to soothe soreness and promote healing.

Take your baby to a chiropractor to ensure their neck, jaw, palate, and cranium are aligned for successful breastfeeding. Balance Chiropractic at Cincinnati Birth Center is experienced in helping resolve these kinds of issues for a healthier, happier baby.

If your baby has underlying issues such as a tongue tie or lip tie, talk with your midwife and/or pediatrician to discuss treatment options. 

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Above all, remember that breastfeeding requires patience and persistence. With the right support and resources, most challenges can be overcome. By prioritizing a proper latch and addressing any difficulties promptly, you can create a positive breastfeeding experience for both you and your baby.

Red Raspberry Leaf Tea Health Benefits

Red raspberry leaf tea uses dried leaves from the red raspberry plant - rich in several nutrients and compounds, including vitamins (such as vitamins C, E, and B), minerals (like calcium, iron, and magnesium), flavonoids, tannins, and powerful antioxidants that help protect against free radicals.

Benefits of Drinking Red Raspberry Leaf Tea

• 1. Uterine Tonic: Red raspberry leaf is hailed for its uterine toning properties, allowing more efficient contractions during labor. Studies show that it can increase blood flow to the uterus for strengthening, which helps with efficient contractions and can help prevent hemorrhage [1]. 

• 2. Nutrients for Pregnancy: Red raspberry leaf tea supports a healthy pregnancy by providing essential nutrients such as iron and magnesium. It is also rich in antioxidants such as ellagitannins, hydroxybenzoic acids, and anthocyanins.

• 3. Easing Labor: Studies suggest that regularly drinking red raspberry leaf tea during pregnancy may help shorten the duration of labor and reduce the need for medical interventions (cesarean sections, assisted deliveries, etc.) [2].

• 4. Postpartum Recovery: Red raspberry leaf tea also assists with postpartum recovery by promoting uterine involution (the return of the uterus to its pre-pregnancy state) and increasing lactation.

When Should I Start Drinking Red Raspberry Leaf Tea?

There is no one right answer for when you should start drinking red raspberry leaf tea. It’s generally safe to start drinking it around the 2nd trimester, and you can often drink it even earlier if your midwife gives the green light. If you have a history of fast labors or you feel uncomfortable drinking it earlier, you can wait until the 3rd trimester, keeping in mind that this might not allow enough time for it to have significant toning effects.

So how often should you drink red raspberry leaf tea? If you start drinking it early in pregnancy, try sticking with 1-2 cups a day (keep an eye out for any uterine cramping - if you experience this, cut back on your dosage and ask your midwife when you should try drinking it again). Later in pregnancy, you can increase your intake to 1-3 cups as part of your daily routine.

At Cincinnati Birth Center, we offer Potent Pregnancy Tea as a nourishing boost for expecting mothers. A blend of red raspberry leaf, nettles, alfalfa, oatstraw, and spearmint, this tea provides all the benefits of regular red raspberry leaf tea - plus extra!

Epidurals During Labor: Pros and Cons

The Epidural Through History

Using epidurals for pain relief during childbirth can be traced back to the early 20th century. In 1901, the use of anesthetics in the epidural space was first reported. Fidel Pagés was a pioneer of the epidural, promoting it for surgical purposes through his article published in 1921.

However, it wasn't until the 1970s that epidurals gained popularity for labor due to advancements in medical technology and improvements in technique. The development of the epidural catheter allowed for a continuous flow of anesthesia, enhancing control over pain relief during labor. This marked a new era in the history of childbirth, as more women began to consider epidurals as a viable option for managing labor pain.

Throughout the latter half of the 20th century and into modern years, the number of women using epidurals has continued to rise. Today, around 70% of laboring women use an epidural. As childbirth has shifted into hospitals and become more and more of a medical procedure, many women see the epidural as a non-negotiable and as the “normal” way to manage labor pain.

Pros and Cons of Epidurals

Pros:

• Pain Relief: Epidurals are very effective in easing pain, allowing mothers to get more rest during labor and feel less exhausted. For a mother anxious about childbirth pain, an epidural may look very appealing.

• Flexibility: Epidurals provide a more controlled and adjustable pain relief approach, with the ability to administer additional medication if necessary.

• Easier Medical Interventions: The pain relief provided by epidurals can facilitate medical interventions such as forceps or vacuum-assisted delivery if complications arise.

Cons:

• Reduced Mobility: Epidurals limit a woman's ability to move and change positions during labor, often slowing down natural progression. Walking, standing, and swaying are some of the best ways to speed up labor.

• Increased Risk of Medical Interventions: When labor is slowed down, there is a higher chance you will require medical interventions to help it progress. Pushing is sometimes more difficult with an epidural in place, so this can increase the risk of needing forceps, vacuum-assisted delivery, or a c-section.

• Potential Side Effects: Epidurals can lead to side effects such as low blood pressure, back pain, headache, and nausea - see next section for more information.

• Worse Postpartum Recovery: Many women complain of experiencing a worse recovery period due to their epidural. Epidurals can often increase the risk of tearing since a doctor has to guide you when to push and you aren’t able to listen to your body.

• Pain Medication in Baby’s System: A small amount of the epidural does cross over and enter the baby’s system, remaining there for at least the first 30 days of life.

• Possible Breastfeeding Issues: Exposure to pain medication often dulls a baby’s initial feeding behaviors. Epidurals also inhibit the mother’s release of natural oxytocin and can delay the milk coming in.

Common Epidural Side Effects

While epidurals are generally considered safe, women often experience side effects, including:

• Low Blood Pressure

• Headache

• Nausea and Vomiting

• Back Pain

• Perineal Tearing / Swelling

• Urination Problems

• Elevated Temperature

It’s true, epidurals are effective in reducing labor pain - but there are several natural pain management techniques to consider that allow you to avoid unwanted side effects and feel empowered by using your own strength. 

Anna’s Birth Stories with the CBC

Birth #1 - A Christmas Gift

I found out I was pregnant right in the middle of Covid in 2021. I had always assumed I would have a hospital birth, at least with my first, but all the rules surrounding the virus made me hesitate. Would we be exposed to the virus at a hospital? Would I be separated from my baby if I tested positive? Would family even be allowed to be with me?

I started to explore home birth as an option and started researching the best midwives in my area.

Enter Meghan, a calming presence whose knowledge about all things childbirth set me right at ease. Prenatal appointments at the Cincinnati Birth Center offered a serene, tranquil environment, and I was so happy with my decision to have a natural birth at home.

Fast forward a few months to Christmas Eve night when I thought I was feeling signs of early labor. When I woke up at 12am Christmas morning, I KNEW today was the day! My doula and mother-in-law came over right away to give their support and we worked through contractions together. 

After a couple hours of pacing, swaying, and using an exercise ball, I felt we should call Meghan - in my inexperience, I thought that these contractions were intense and meant baby was almost here! Meghan came over right away to check me out…  and I was disappointed to learn I was only 3cm dilated. 

Meghan left with instructions to call her when labor ramped up more and I tried to catch some sleep between contractions (easier said than done!). My husband never slept more than ten minutes during my whole labor - he massaged my back, helped me take a warm shower, and held my hand as the pain got worse.

Mid-morning marked the turning point as labor definitely progressed, prompting us to call Meghan again. This time she arrived with her birth assistant, India, and they immediately prepped for the delivery of my little girl. Reality started setting in! But I barely had time to process anything with contractions stealing my focus at only 1-2 minutes apart. I labored on the bed and tried different positions, but didn’t feel the urge to push yet.

At some point, I stood up to encourage the baby’s descent - and my water instantly broke. Two intense hours of pushing followed – and believe me, it’s nothing like in movies! It turns out that the baby was in a compound presentation, where her hand was next to her head in the birth canal. This caused some difficult pushing and delivery. But the moment my baby girl was placed in my arms, I just felt the relief and joy of holding Lily Renae, my little Christmas gift.

Birth #2 - Born in the Water

Two years after my first was born, I found out I was pregnant with my second little girl! I knew I wanted to have the midwives at CBC perform the delivery again, and called them up right away.

Since I had already experienced a home birth, I felt much more confident this time around and decided I wanted to experience water labor with this delivery.

Two weeks before my due date, I started having regular mild contractions that lasted all day - I was sure I was going into early labor and alerted Meghan. My in-laws picked up my toddler for a “sleepover” and I waited all day for the labor to progress. After a full day of mild contractions, they finally petered out that night. False alarm - I had been tricked by prodromal labor and baby girl didn’t have any plans of making an appearance yet.

The next two weeks seemed to drag on, but finally my due date came… and went. That night I ate the spiciest food I could handle and did lunges, stair walking, and bounced on an exercise ball. Did any of that induce labor? I’ll never know for sure, but the next morning at 6:45am I woke up with very real contractions.

They progressed quickly within the next hour, so after we got our toddler some breakfast and packed to go hang out with grandpa, I called Meghan knowing I would need assistance soon.

Around 10am, I knew things were going much faster than they had with my first birth. Meghan was already at another birth that morning, so India came over with her assistant. India is wonderful, and instantly put me at ease with her encouraging presence.

We got our birthing pool set up - unfortunately, it was defective out of the box and wanted to leak air. But it was nothing my husband, mother-in-law, and duct tape couldn’t handle! I couldn’t believe how RELAXING the water was, and I swore I’d never labor any other way in the future!

A couple of hours passed, and the contractions intensified much faster than I expected. When I saw India and her assistant sharing a nod, I knew we were almost at the finish line. Sure enough, I got a massive urge to push. A few minutes later and the baby was crowning and we could see her head! After a couple more pushes that didn’t do anything, India had me change positions to hands and knees, which instantly brought the baby down and out with the next push.

The relief post-birth was just as great as the first time, and it was just as magical having Evangeline Rose placed in my arms. Every birth is unique, but it was especially exciting to find out she was born “en caul”, meaning she had the amniotic sac still intact over her head - a rare event that only occurs every 1 in 80,000 births!

I couldn’t wait for her and her sister to meet later that day - my two home birth babies, a route I’ll always be so thankful I took.