March 2002

Spring 2002 Edition

Births Attended by Midwives on The Rise

Midwife attended births have been reported in birth certificate data since 1975. In 1975, certified nurse-midwives delivered 19,686 infants in hospitals which was 0.6 percent of all births that year in the United States. In 1989, the birth certificate form was altered to distinguish between different types of midwives. That year, CNMs attended the births of 132,286 infants or 3.2 percent of births. In the decade between 1989 and 1999, the number of CNM attended births increased by 117 percent!!! The 287,296 live births attended by CNMs in 1999 accounted for 7.2 percent of all births and 9.4 percent of all spontaneous vaginal deliveries.

The Birth of Alexander Evan

After delivering my first two sons with an OB/GYN, an epidural, and an episiotomy, I decided I needed to find something different before my next pregnancy. My sister, who is a labor and delivery nurse at Allegheny Valley Hospital, kept telling me what I needed was a midwife. I went online and was excited to find a group so close to my Greensburg home. I requested some information and was excited when I received the packet in the mail. The first thing I read was someoneís birth story in the newsletter. I loved the whole idea of the natural birth the woman had and her expressions of gratitude toward the midwife and the Family Birth Place. I did not much feel like thanking my OB after my first two births so this really intrigued me. After reading much of the information, I made my annual appointment with my new midwife. I was impressed immediately at the attention and care I received. My OB never explained what he was doing during my exams in the past, let alone ask my permission. I felt empowered. I knew my next pregnancy and delivery would be different. Almost one year after my first visit, I became pregnant. When I called, I stated I had gotten a positive home pregnancy test. Sueís first words were "Congratulations!" and I felt welcomed by her warm attitude. My children were invited to enjoy all aspects of my pregnancy and were allowed to help with the heartbeat and blood pressure. They always begged to go to my appointments and were disappointed when they could not.

My pregnancy was relatively uneventful until the last few weeks. My temperamental baby had decided he was not going to be happy head down and wanted to lay sideways. An ultrasound was scheduled for about 37 weeks to determine if he was still breech. Not only was he breech but he was found to have enlarged kidneys. I was so afraid when Sandy called to tell me I would need to see a specialist at West Penn. Sandy seemed as concerned as I was and really helped me keep things in perspective. My appointment was to be several days later at West Penn for a Level II sonogram and a version to turn the baby if everything seemed all right. I went to West Penn with my husband, my sister and the prayers of many friends and family. In the car on the way, I told my sister it felt that the baby had really moved. Sure enough, the ultrasound showed he was head
down and while being monitored there, I was having contractions every 10-15 minutes. Dr. Lippe came in and checked my babyís kidneys. He said they were enlarged, my blood pressure was up and my placenta was starting to calcify (which is normal at term). He felt I should be induced at Jeannette that day. I was nervous about the birth but much more anxious to have my baby checked out after he was born. I went to the midwife office, Gretchen checked me and said I was already 1 cm and effacing. With my previous pregnancies, I was always completely closed and had no effacement when I was induced. I was hopeful that things might go quicker than my previous 29 and 15 hours on pitocin for my first two boys. Gretchen and I talked about what I wanted and did not want and I was off to the Family Birth Place.

When I was admitted, I met the nurse I would have with me through delivery. Her name was Bonnie. I cannot begin to tell you how wonderful she was. She not only supplied me with the things I wanted or needed; she had ready the things I had not realized I needed yet. She was kind and lighthearted and very easy to laugh with. I appreciated her caring and professional personality. My pitocin was started around 3:00PM. I was fine for a few hours and walked the small circle around the nurseís station many times stopping mostly to have by blood pressure checked. I was unable to use the new labor tub because of the IV of pitocin but figured I would try some of the other things available. I rocked, walked, and tried the birth ball at different points of my labor. They were things I had never been able to try with my previous deliveries because of the epidural. Eventually, my water broke and things started to move. As I progressed, my mood changed and I had tremendous back pain. I felt as though someone had set my lower back on fire with each contraction. When Gretchen checked me, I was only 3cm and I felt I was going to be doing this for hours and hours. I lost concentration and felt I would not be able to go without the epidural again. I asked for pain medication to see if it would help take the edge off of the contractions. I was given Nubain but did not really feel any different. I began begging for an epidural with each contraction and yelling at everyone who spoke to me. Luckily, I had a good support system in my husband, my sister and Gretchen. They all knew I really did not want the epidural and helped me try other things. After stating I was going to remove all of my husband's teeth if he spoke again, Gretchen checked me. I was 4-5 cm but was very discouraged. I really did not realize how quickly things were actually going. At about 10:00PM, I was getting off the birth ball and back onto the bed when I felt the baby literally drop into my pelvis. I screamed "I have to push---no no no I don't!" Gretchen checked me and said I could push with the next contraction. There was no waiting for me. I pushed right away and my third baby boy was born at 10:10PM on January 14th, 2002 weighing 7lbs 9oz and measuring 19 inches long. I had a tiny tear but no episitomy, epidural or regrets. Alexander Evan Podolinski was beautiful, alert and nursing within the hour.

I recovered and healed quicker than ever before and felt wonderful that I had finally met my goal of not having an epidural. I want to thank Gretchen, Sandy and Nancy for all their caring and help during my pregnancy, labor and delivery. I also want to give a big thanks to Sue for always going out of her way to help as well. Alex is doing wonderfully and has seen a nephrolologist at Children's Hospital to assess his kidneys. He feels all is well now and he will not need any further treatment, as his kidneys are normal size now. I am so thankful for all of the prayers and support we received and that Alex is all right. My hope is that someone will get their packet of information from the Family Nurse Midwife Associates, read my story and find themselves intrigued enough to change their next pregnancy, labor and delivery by choosing this practice to care for them.

Leslie Podolinski, Greensburg We want to Thank all of our patients who were affected by our recent Baby Boom for all their understanding and patience as we had to reschedule many of your appointments and for waiting patiently in the office.