A Look into the Empowering World of Home Birth with a North Dakota Midwife, Part 1 | Dickinson Birth Photographer
An interview with Chelsea Smith, Midwife
This interview has been sitting in my files for quite awhile and as I read through it again, I was brought to tears by Chelsea’s clear passion for birth and holding space for individual families as they meet their babies on their own terms. I’m so, so grateful to Chelsea for taking the time to share such profound and articulate thoughts on home birth and her practice.
How long have you been a midwife and what got you into midwifery?
“It is a gift and honor to be invited into those intimate spaces between mothers and fathers in home and hearth, “where many souls are gathered”.”
Like so many other birth workers, I was attracted to women’s work from a very young age without really understanding why. I was not surrounded by many other children or pregnant women. For most of my life, my path through adolescence and early adulthood to walking with women was very unclear until I became much older and wiser.
When I became a mother, I was cared for by the very first midwife I ever met. I knew nothing of midwives. At that same time, I also had the unique opportunity to walk beside her in this work professionally. She nourished me professionally. She cared for me, my babies, and so many others with laughter, warmth, skill, and wisdom. She nurtured my soul when my child was stillborn; and again when my rainbow child came. She walked with me through the darkness and light, and she how I learned what a midwife could be.
The reason why I actually became a midwife was in full due to the spiritual rebirth I found myself navigating following the stillbirth of my first child. I was accepted into my midwifery program on what would have been her first birth~day. Had it been any other day - any other time - I would have said no. I will never be able to verbalize the gratitude and humility I feel underneath the guidance of those that have come and left before me. I am in love with my life. It is a gift and honor to be invited into those intimate spaces between mothers and fathers in home and hearth, “where many souls are gathered”.
Can you walk me through a typical homebirth, from the initial consultation to postpartum follow-up?
We offer free one hour consultation, either in person or over the phone, dependent upon location and availability. First and foremost, when you’re inviting someone into your home to share those intimate spaces, you need to feel safe and taken care of. We sit down and get to know each other a little bit better to make sure we are a good fit for one another. The beauty of this work and the community that we live in is that there is literally someone for everyone. I am passionate about helping people find their people, even if it isn’t with us.
Once our clients decide to come into care, we offer a prenatal schedule somewhat like you what you would receive in the clinic. Typically, prenatal visit start out every 4 to 6 weeks, and as the pregnancy progresses, the visits get closer together. At each visit, we talk about different goals and different aspects to our experiences, whether they are physical, emotional, or spiritual and nature. We honor each unique woman, and the amazing spaces their body has carried them through. We honor the humanness of our unique individual experiences – all of the emotions, even the intense ones. Our bodies and spirits work to serve and protect us, and they command love from within us all. We also talk about all of the things from lifestyle and nourishment, movement, herbs and homeopathies through all of the medical tools available to them to ensure they feel nourished in their bodies, hearts, and minds to make the those (sometimes difficult) decisions that are best for themselves and their families.
We offer 24-7 on-call services for all of our pregnant and postpartum clients. Following the birth of their baby, we continue close postpartum care for mom and baby. Within the first week postpartum, there are on average 2 to 3 visits for mom and baby. Our well-babies typically stay in care for the first 28 days of life, and then are transferred to their primary care provider or pediatrician thereafter. Our postpartum moms typically stay in care for 6 to 8 weeks, but that is sometimes extended based on the unique needs of the client. From there, though no visits are typically scheduled thereafter, all of our clients have access to our practice for any needs that may arise until their child’s first birthday.
How do you work with families to create a birth plan that is specific to their needs and preferences?
Our practice philosophy is as follows:
We believe women are the bedrock of healthy family and community units, born with the innate right to experience independence and support to safely exercise their fully informed free will.
Womanhood and childbirth are both natural, physiological, spiritual, and emotional human experiences with an immensely powerful transformative potential to produce well, caregiving individuals.
Each unique, individual woman deserves genuine compassion, care, respect, and dignity and accommodation to safe health and wellness care by skilled professionals who will hold space for them through their most vulnerable and precious experiences.
We believe in professional, ethical, and competent care that is supportive of all aspects of the human experience. When escalation of care is necessary, decisive, and prompt action will be taken to ensure the safety of the women and children in our care.
At each visit, we talk about different goals and different aspects to our experiences, whether they are physical, emotional, or spiritual and nature. We honor each unique woman, and the amazing spaces their body has carried them through. We honor the humanness of our unique individual experiences – all of the emotions, even the intense ones. Our bodies and spirits work to serve and protect us, and they command love from within us all. We also talk about all of the things from lifestyle and nourishment, movement, herbs and homeopathies through all of the medical tools available to them to ensure they feel nourished in their bodies, hearts, and minds to make the those (sometimes difficult) decisions that are best for themselves and their families.
What would you say to someone with a concern or fear about giving birth at home?
Fear often comes from the unknown, or intense experiences held and stored within us from trauma. We do a lot of work, honoring those sacred spaces. The ones where we don’t always feel strong enough or prepared enough to look into alone. Women create amazing spaces for everyone around them. As midwives, as wise women in the circle with women, we are here to walk with women through their relationship with their bodies, their relationship with their babies, and with those who surround them. We honor each unique woman, and the amazing spaces their body has carried them through. We honor the humanness of our unique individual experiences – all of the emotions that come with them, even the intense ones. Our bodies and spirits work to serve and protect us, and they command love from within us all. I highly recommend tools like ‘Ten Moons: The Inner Journey of Pregnancy’ by Jane Hardwicke Collings when beginning to emotionally and spiritually prepare for any childbirth experience.
“We do a lot of work, honoring those sacred spaces. The ones where we don’t always feel strong enough or prepared enough to look into alone. Women create amazing spaces for everyone around them. As midwives, as wise women in the circle with women, we are here to walk with women through their relationship with their bodies, their relationship with their babies, and with those who surround them. We honor each unique woman, and the amazing spaces their body has carried them through. We honor the humanness of our unique individual experiences – all of the emotions that come with them, even the intense ones. Our bodies and spirits work to serve and protect us, and they command love from within us all.”
Home birth is a safe option for low–risk, healthy women. Home birth midwives help create and hold space for safe birthing in your home while maintaining the home environment. The midwife carries equipment to the home, including but not limited to: tools that help listen to and monitor the wellbeing of mom and baby; oxygen, suctioning, and breathing supplies; select medications and intravenous support; and perineal repair tools. The midwife is trained and experienced in resuscitation. There are fewer unnecessary interventions at home, which ultimately invite fewer complications.
Midwifery care in the home setting includes rigorous and continuous screening processes for the duration of care. The safety of mother and baby are always the priority, though sometimes our experience may ultimately look different than we imagined and planned for.
When two individual beings – you and your child – are bound together in one experience, unforeseen events may arise despite our best precautions and efforts. This is true in any setting a woman births her child, be it at a hospital, birth center, or home. There are fewer diagnostic and therapeutic tools and resources available in the home than in a hospital. The home is not equivalent to hospital facilities that have equipment immediately available to address serious, life–threatening and catastrophic events.
Some experiences and emergencies are better managed in a hospital setting, and some births need physicians and surgeons to guard the safe passage of you and your baby. If the rare problem develops in which a hospital is needed, we will transfer promptly to the hospital of choice (if non emergent) or to the closest hospital (if emergent). Your midwife will stay with you to support you throughout the transfer and the birth of your baby, as permitted to do so. You midwife will resume your postpartum care when you return home.
Statistical data indicates that planned well home birth is as safe as hospital birth, though it is not appropriate for every pregnancy. When birth emergencies or poor outcomes happen in hospitals, the birthplace is seldom called into question. During home birth, if the same situation or outcome occurs, the choice of location is always called into question. No human being – including your midwife – can guarantee a “normal” birth or predict the birth outcome of mother and child. Acceptance as a client for home birth in no way constitutes any such guarantee. We offer the expertise to help you balance the inevitable and undeniable risks of childbirth, however small, including unexpected injury and death of mother or child. We use the skill, tools, resources, and teams at our disposal to reduce risk to mother and child as much as possible.
In our culture, midwives provide an option for families who believe that pregnancy, childbirth, and lactation can be natural, healthy, and fulfilling human experiences. Focusing on the normalcy does not mean that problems go unrecognized or unattended; rather, they are viewed as imbalances that need to be righted. They are not expected in every pregnancy, nor are they feared. If problems occur during the childbearing journey at home, family, friends, and professionals alike will invariably call the wisdom of your choice for home birth into question. I ask you to honestly project yourselves into the worst–case scenario and examine how you would feel about your original choice for home birth after the fact. Then, please feel free to discuss this with me so that you and I can work to build an intimate, trusting, honest, and reciprocal relationship in which we both recognize the wonder of birth and the inherent lack of guarantees. We trust in you, our clients, to stand with us in the same way we stand with you at personal, professional, and political risk so that you may have your choice in care and birthplace – even in difficult trials and unexpected outcomes.
Whenever possible, decisions about your care will be collaborative. Situations may arise in which the professional judgment of the midwife and/or collaborating consultants must be relied upon exclusively for the safety of you and your child, as detailed above. However, home birth enrollment is ultimately at your discretion. In doing so, you agree that neither the midwife, birth assistant(s) or any other persons present, nor Sacred Hearth Midwifery & Wellness, PLLC will be held personally or professionally liable or responsible for any and all undesirable antepartum, intrapartum, birth, postpartum, and/or newborn outcome(s) including but not limited to those potential risks or complications that may lead to unexpected, catastrophic maternal and/or fetal/neonatal injury and/or death. You may opt out of home birth at any time you desire, though all fees paid or unpaid will not be refunded. Your records, physical examinations, and laboratory reports will be used to continually evaluate the safety and appropriateness of your enrollment. Do not hesitate to ask questions or voice concerns at any time.
Our relationship will be built in trust and getting to know one another as you prepare for the expansion your family and all the human experiences that go along with that. We aim to be a small part of the community in which your child is welcomed. We limit our practice to an absolute maximum of six births per month so that we may be present with you and your family, though we commonly select two to four births per month. We are grateful for you as you consider your home birth journey with us.