Ask Us Anything About… Midwifery

Barbara Schindo – Good afternoon and thank you for joining us. You are watching Ask Us Anything about Midwifery. I’m Barbara Schindo. A growing number of women are choosing to give birth outside of a hospital. In 2020, more than 45,000 women gave birth at home, which is an almost 20% increase from the previous year, according to data from the CDC. A lot of other mothers are choosing to give birth in hospitals but opting for routines or methods that allow them to move around during labor, as opposed to just being in a hospital bed. In both cases, midwives can help. So, joining us today to talk about midwives and how midwives can help mothers through pregnancy, childbirth, and things that come afterward is Katie Watkins. Katie is a certified nurse-midwife with Penn State Health, Obstetrics and Gynecology. Katie is here to talk with us about midwifery and she’s also able to answer your questions. So, if you are tuning in and watching us live and you have a question for Katie, please feel free to drop that in the chat box right below this video, and even if you’re watching on playback, if you did not catch this live, you can still put a comment in the box and we will get an answer for you. Katie, thank you so much for taking the time to join us today and talk about midwifery. So —

Katie Watkins – Thank you. Thanks for having me.

Barbara Schindo –  Sure. Let’s start with one of the — let’s start with very basic. What is a midwife? What does a midwife do?

Katie Watkins – Sure. So, a wife means being with women. So we have extra training compared to just like a regular nurse. And we can take care of women throughout the lifespan. So, pre-puberty, puberty, through pregnancy, delivery, postpartum, and then even normal well women care.

Barbara Schindo – Okay. So it sounds like a very intimate, I guess for lack of a better word, a very intimate relationship where you work quite a bit with the mother and then baby after the birth.

Katie Watkins –  Yes. Yes. It is. We’re very lucky that we’re able to build a relationship with women and kind of follow them throughout the lifespan instead of just having small snapshots.

Barbara Schindo –  Sure. And that actually leads right into my next question. Talk a little bit about what’s the relationship like between a patient, you know, whether it’s a new mom who’s never had a baby before or one who has already had a baby but didn’t use a midwife previously, you know. What’s that relationship like between midwife and patient?

Katie Watkins – Sure. I think one of the kind of the biggest things to note is that midwives have nursing background compared to physicians which are more — have a more medical background. So I think that nursing side tends to come out in our care in terms of really trying to form relationships with our patients, getting to know them, really trying to hear what they want out of their care and trying to give them a say and options in their care.

Barbara Schindo – Okay. Thank you, Katie. So, let’s talk about a mom or soon-to-be mom who has never used a midwife before. Why — if there’s somebody who is considering having a midwife to be part of their birth experience, what do you think they would need to know about it?

Katie Watkins – Sure. I think that one thing that a lot of people don’t know is that when most people think about midwives, I think they think about us, you know, doing home deliveries. And while there is a large group of us that do that type of thing, not all midwives work in that type of setting. So you can still have a midwife and have midwifery care even if you choose to have your baby in a birth center or a hospital. We still are able to form those relationships and really centralize our care around you, the mom, and the family and what you want with your care. And we are there to advocate for you. And I feel like patients with midwifery care tend to have more, I guess you could say active labors and have more decision-making in terms of what they want out of their labor and birth experience.

Barbara Schindo – Okay. I feel like I should be taking notes because, actually, your response there just sparks two questions for me. I’m glad that you brought up the, you know, the idea that, you know, when somebody thinks about a midwife, I agree that, you know, the first thing that would come to my mind is having a home birth or having a birth outside the hospital but that’s not as, you know, as you’re here to talk about, that’s not necessarily the case, that midwives are part of a team that also work, you know, in tandem with obstetricians or physicians as part of the birth experience as a whole. So, talk a little bit about, you know — so midwives — talk about how you work together with obstetricians, physicians, versus, you know, a mom having to choose one or the other.

Katie Watkins – Sure. Yeah. So, especially at Penn State Health Hampden Medical Center, we have a very collaborative team. In our office, we have midwives, nurse practitioners, and our physicians. So if something arises while you’re here seeing us in the office, we always have a physician that we can kind of bounce ideas off of or even refer the patient to if they need to. In the hospital, we always have at least one midwife in the hospital and always at least one physician. In the hospital as well, there’s always a neonatologist, or baby doctor, there as well with us. So you really get the whole team. Generally, if you have a healthy, normal pregnancy and delivery, there are times when you will only see one of the midwives for the whole duration of your pregnancy and delivery time. But if something were to come up that we needed a physician help or ideas, the nice thing is, is that we work very collaboratively. So, they could manage the more medical side of something, say if you have like diabetes or issues with your blood pressure but we’re still able to manage your labor and do your delivery.

Barbara Schindo – Okay.

Katie Watkins – So kind of get the best of both worlds.

Barbara Schindo – Yeah, so you just kind of took the phrase right out of my mouth. I was going to say it sounds like a really good meshing of a kind of a clinical but also a holistic experience for folks who are looking for sort of a partnership in that way. And one of the other things you had said that sparked my interest in your last response was you had said that you think that women who work with midwives have maybe a more active labor. What does that mean?

Katie Watkins – Sure. So, you could discuss your — or discuss experiences with other women and some of them might tell you that, you know, when they were admitted to the hospital, they kind of got strapped to monitors and were kind of bedridden just because that was the institutions, you know, practices, but it doesn’t always have to be the case. We really encourage moms to stay as active as they can during the whole labor process and at Hampden, we actually have multiple things to help with that. One of the things is, is our rooms. The labor rooms are very large there. So, there’s a lot of space that moms can be up and active in the privacy of their own rooms. We also have two different types of monitors. One, what we call like a walking monitor where you’re still attached to wires but it can hang on your IV pole and you can actually walk around the unit with them. And then there’s another type that works basically with Bluetooth. It’s like a sticker that goes on to the mom’s belly that talks via Bluetooth to the monitor, and that, you’re not really attached to any wires. It can get wet, so you can even get in the shower with that one. But it also allows you to kind of walk around the whole unit. So those are just a couple of the things that we have. We also have peanut balls and like the regular, like, workout balls that the moms can use. So, we really encourage moms staying active. If at some point, you know, the moms decide they would like an epidural or something else for pain management, that’s totally okay, and we have a lot of options as well trying to keep them active even once they kind of have to stay in bed with the epidural. With the peanut balls, the nurses are very involved with our patients, helping with position changes and, you know, encouraging moms to even kind of stay somewhat active in the bed even after their epidural.

Barbara Schindo – Wow. So, that’s a — you know, a lot of ways to stay active and move around and things that you might not think about until — especially for new moms who have never had a birth experience before. So, that is a lot of great information. So, again, you are watching Ask Us Anything about Midwifery with Katie Watkins. Katie is a certified nurse-midwife with Penn State Health, Obstetrics and Gynecology. And Katie is here today sharing with us a lot of good information about midwifery as well as what Penn State Health Hampden Medical Center has to offer in their labor and delivery as far as midwifery. So, if you are watching this, whether you’re watching this live with us now or you’re watching on playback later and you have a question about midwifery or a birth experience for Katie, please feel free to put your question in the chat box below this video and we will get a response for you. And also, if you — if you know some, you know, newly pregnant women or soon-to-be pregnant women who could benefit from this information, please feel free to share this so they can see that on their timeline as well. So, Katie, we do have a few more questions for you. So, my next question, talk a little bit about, you know, you had mentioned that a lot of women have already gone through a birth experience where they felt, you know, they got, they got to the hospital. They just got sent to a bed and they stayed in the bed until it was time to deliver. So, talk a little bit about how the — both the — the birth experience but also the prenatal experience will differ when a midwife is involved.

Katie Watkins – Absolutely. So, I do think that mentioning the prenatal care is very important. We like to start kind of discussing moms’ ideas for their birth story, I guess you could say, early on in their prenatal care, kind of getting them thinking what they want out of the experience, what we have to offer with them, and really kind of help guide them in their decision making early on so that when they get to the labor point, they kind of have an idea already of what to forward to, what their options are, and we also kind of know our patients a little bit better so that we can make sure that we support them in their views or ideas that we’ve discussed during their prenatal time. And, you know, some of the things we cover is everything from feeding method of baby with, you know, breastfeeding versus bottle feeding, pain management, whether they want a medicated or unmedicated delivery, and even some of the more emergent things that could happen during delivery but that were obviously equipped with the dealing with so that if, you know, something sort of urgent would happen during the labor process, the moms aren’t completely caught off guard.

Barbara Schindo – Oh, that is good to know and sounds like a very involved relationship. A lot of — I think that there’s a lot of things to think about as you’re preparing for birth, and having the help of a midwife to talk you through all of those things is probably immensely helpful to the women who are about to go through that. So, can you talk a little bit about, let’s say a woman decides that she does want to work with a midwife. What do midwives need from moms? What should the expectation — what should a mom expect going in about how are we going to build this relationship and how is it going to work?

Katie Watkins – Sure. I think that, you know, women should kind of go in with an open mind and also knowing that, you know, we want to be a partner in their care. This is their story that we’re kind of a tiny piece of, and we really want moms to get out of the experience what they want. And whether that is they want to come in and just be on the monitor and have an epidural and kind of go to more traditional medicalized route, that’s okay. If that’s what they want, then we want to support that. Also that, you know, we do like forming relationships with our patients and really getting to know them. So it probably will be a little bit of a more, I guess you could say like intimate relationship with the midwife and the patient, versus if they were, you know, going to a physician or a more — to a more medicalized practice.

Barbara Schindo – Okay, Katie. Thank you. And I do, I have one more question for you before we wrap up here. But for those of you that are watching here with us live, if there’s anything that you’re wondering about midwifery that we have not touched on here yet, please feel free to put your question in the comment box below this video and we can ask your question of Katie and she can get an answer for you. So, Katie, one of the things that you mentioned is that the relationship with the mom doesn’t just stop — doesn’t just stop when the birth happens. Midwives also help about what, you know, what comes after. Can you talk a little bit about how midwives work with moms after the baby is born?

Katie Watkins – Sure. So, even after delivery, typically, it’s one of the midwives that you’ll see that will come check on you each day while you’re in the hospital. We’re able to help with, you know, the normal immediate postpartum with the mom and also the baby. We all have some sort of training in lactation or feeding. So, we’re able to help with that part as well. Some midwives actually are able to provide some newborn care up to like the first 28 days of life for the newborn. We don’t do that here. But we still have, you know, some knowledge on that. And then, we do like to follow our patients pretty closely postpartum, in terms of seeing them following up outpatient. And then we encourage the patients to kind of stay with our practice if they would like to and follow through for their regular well women care. We can do their regular annuals. We can help with, you know, birth control if that’s something that they’re interested in for their family planning. And we also see patients for problem visits, you know, GYN or OB problems that come up throughout the lifespan.

Barbara Schindo – Awesome.

Katie Watkins – So, we really, yeah, kind of, it, we have a large scope that we are able to practice in here.

Barbara Schindo –  Yes. I was just going to say that sounds like so much more than just your “I’m going to have a baby and now I give birth,” that you are very much — you’re there to help support them during the whole process and afterwards, so that’s fantastic. So, Katie Watkins, a certified nurse-midwife with Penn State Health, Obstetrics and Gynecology, thank you so much for joining us today and talking with us about midwifery. If you are a viewer and you are watching this on playback and we did not answer your question about midwifery, please, we will still be able to get you an answer even after this is over. So, if there’s something we missed, please still put your comments in the comment section below this video and we will get a response for you as soon as we can. And we’re going to share a little bit more information about midwifery in the comments as well. We had recently published what’s called a Medical Minute on our newsroom that features some advice from Katie about midwifery. So, Katie, thank you again for joining us and sharing your expertise, and thank you for watching.

Katie Watkins –  Excellent. Thanks for having me.