These were done with a rented GoPro Hero7, an Ice Light and a beige curtain in her community pool, where she spends a lot of her time. I picked the GoPro Hero7 for its high-res capability, but a setting was not chosen or got changed and the images turned out pretty small. And it was exhausting, so we got what we could in only 20 minutes before we had to haul our bodies ashore. But we had fun!

Her third birth was to be another HBAC and I began hatching wild plans to be the birth assistant and the doula and the birth photographer and loan the birth pool and do the placenta and do all the things. But complications popped up and suddenly we found ourselves at George Washington University Hospital for an induction that was already halfway done by the time I showed up a few hours after it started!

My friend is a great awe-inspiring birther and I know she doesn’t feel that way in the moment (I mean, who does?). So I hope the pictures I took show her everything I see in her. She took this huge and sudden change in birth plans in stride. Only a TENS machine for pain relief (and she gave it a rave review!) Seeing this surprise baby boy’s face for the first time reminded me so much of how her oldest son looked at me all quizzical when I met them for the first time. Then I even had a brief….the briefest…pang of desire for another baby of my own, but my back seized up just from sleeping in the hospital chair while waiting a record 8 hours for them to release the placenta to me, and I figured it was best I didn’t give birth again.

It’s been pretty amazing to see her family expand and that crazy little baby who wouldn’t drink any pumped milk turn into a 11-year-old who plays violin and has two younger siblings. Still forever indebted to her support of my daughter and me!

(And it’s been amazing to compare my photography from her last birth to this one!)

So I set immediately to work along with the other two Chosen Ones to come up with a name, a brand, a website for this new group of midwives, all of us except Bayla on the cusp of getting our licenses while already burned all the way out on constant call time. I envision a Yorkshire Storks USA-type approach with weekly peer review and a call schedule so our clients can get to know every midwife and maybe choose one that fits them best, AND we can get some sleep or some drinks sometimes. I am really excited. Anyway, that’s why MY website looks the way it does and why I haven’t blogged about any of the stunning births I’ve photographed in the meantime.

I still want to photograph births alongside midwifing. It is my creative outlet that has never stopped being amazing to me even when it gets weird, like the time I lived in my car outside someone’s home for a whole day so as not to miss the birth and then I missed the birth anyway.

Anyway this is not that birth! This birth was at George Washington University which is on my very short list of hospitals that I will continue to serve as a birth photographer. I hope you can see why in the images!

This is a very DC family doing interesting DC things! One of the aspects of my work I feel I will have to discontinue soon is maternity and newborn photography, but I am really reluctant because this is when I really get to know people, learn about their work and their lives, learn something new, and also maybe get to hang out in DC as a “local”! I had not been to any of these photographed locations before this day. DC can be really beautiful when framing it with some new life and excitement for the future.

A Child is Born – Lennart Nilsson

*The Birth Book – Dr. William and Martha Sears

Birthing from Within– Pam England and Rob Horowitz

The Birth Partner, Third Edition: A Complete Guide to Childbirth for Dads, Doulas, and All Other Labor Companions – Penny Simkin

*Bump – Kate Evans

*The Food of Love – Kate Evans

 From Conception to Birth – Alexander Tsiaras

*Husband-Coached Childbirth- The Bradley Method of Natural Childbirth – Robert A. Bradley, MD.

Ina May’s Guide to Childbirth – Ina May Gaskin

Men, Love and Birth – Mark Harris (this one is a great read for male partners)

*The Doula Book- How a Doula Can Help You Have a Shorter, Easier, and Healthier Birth -Marshall H. Klaus

The Official Lamaze Guide: Giving Birth With Confidence, 2nd Edition – Lothian and Devries

*Orgasmic Birth –  Elizabeth Davis and Debra Pascali-Bonaro

The Pregnancy Book – Dr. William and Martha Sears

Pushed – Jennifer Block

Spiritual Midwifery – Ina May Gaskin

*The Thinking Woman’s Guide to a Better Birth – Henci Goer

The Yoga Birth Method – Dorothy Guerra

* If you are pressed for time, these are the books I find essential!

Well.  Apparently nobody on Kent Island gives birth.

In truth, everyone on the island has to cross the Bay Bridge -famous for Ocean City Summer Gridlock- to Anne Arundel Medical Center, or over to Shore Medical Center in Easton for hospital births, or bring a midwife from over an hour away any way you slice it. Not ideal! Either way, someone runs the risk of getting stuck in that beach traffic. AAMC gets the better reviews but the idea of going into labor on a Sunday afternoon and getting locked in on that bridge had me twitching.

So, whilst I continuously got hired by people in Baltimore, Washington DC and Delaware, I spent my free island time going to EMT school at the friendly local fire department, and apprenticing all the way down in southern Maryland.  Waiting for the mysterious and elusive Kent Island Local Client.

Finally!  A local Centreville native contacted me, but she was due to give birth right around the time I was moving off the island!  (Cue the Sad Trombone.)  She knows all about that commute life- she and her husband were actually living separate lives during the week due to both of their Army commitments.  Her babe took a little of the pressure off me being Somewhere Else in Maryland when labor started, by clearly signaling that he was ready to be kicked out on a particular day.  Until then, we had some fun doing all of the photo sessions I like to do!

First was a milk bath session, done in her normal alcove bathtub with some grocery store flowers, vines from her yard, and a gallon of milk!

Next was an Eastern-Shore style maternity session at their cozy home on the shore.

This image is one of my favorites even though it has nothing to do with maternity- it features watermen coming in at the end of a long day, and the silhouette of the Bay Bridge in the sunset- you have to squint.  About as Eastern Shore as you can get!  I really miss the Kent Island sunsets.

And finally the big day- my client was induced under the watchful and protective eyes of her mother, sister, and husband who knew right where she likes to be pressed and massaged.

After all that hard work, the chap wedged himself into an asynclitic OP position and decided he had enough.  The next images were taken by dad and the anesthesiologist- didn’t they do a great job?   While I always try to nudge myself into a spot into the OR in case of c-section, and usually get denied, I give my camera to the chosen birth partner with some guaranteed-to-work settings to just point-and-shoot and they never disappoint.

His molding made it immediately obvious what had caused all the ruckus and pain!

And when I came back the next day he had unfolded into a beautiful chubby guy ready to eat and party.

And yes, even though he is my precious doula baby and I like to think I make connections with them, he had nothing but mean mugs for me during his newborn session!

I was so glad to have connected with some Eastern Shore locals for birth as a takeaway from my one year on the island- I would have never seen some of the hideaway beautiful spots on the shore nor learned about the particulars of crab pots and crab preparation!  The births are always my favorite memories from all the places I have lived.

One of my most vivid memories of my own labor was spending hours on my hands and knees on the bed, face buried in the floral chintz bedspread, and when my eyes managed to part open for a brief moment, all I saw was more floral wallpaper.  It became a focal point, thinking about my gentle and soft childhood of the early 1990s that the decor evoked, which wandered to how I would redecorate this room, and how that wallpaper and bedspread had to go.

In a post on Facebook a few years ago, Special Beginnings announced that it was finally time to redecorate that room, the most popular birthing room, which led to a huge outpour of memories and feedback from moms like me who did the same thing in labor-staring at all the little purple bouquets with a mix of disdain and nostalgia.  It was very polarizing- half loved the homey, comforting grandma decor and half needed to see it gone. But now that it was really happening, the wistfulness overcame us and we all begged for a scrap of the wallpaper for our baby books!

When I tiptoed into that room in the early morning hours with these clients for the first time in over 5 years, my heart sank when I saw the famous wallpaper was really, really gone- replaced with a warm lavender paint. The curtains were removed, leaving airy blinds that lift just enough to allow the nitrous oxide machine to exhaust outside- another improvement I did not have and probably would have loved!  However, the chintz bedspread and sheets are still in their full and devoted service!

Anyway enough about me!  This baby was born with the sunrise just as mine was 9 years earlier, supported primarily by his father and some Cheerios, and the rest of us just watching and listening. They made it look easy!

Dad’s hands are right in there to receive his baby as a reward for all the hands-on support and precision hip squeezes he provided

I feel these images are a perfect love letter to midwifery care- a midwife should ensure that the parents and family are central to their own experience, but be there to provide a literal backdrop of support.

Having been apprenticing for a few months at a birth center myself, I have come to appreciate all that goes into the smooth, safe and solvent operation of a birth center.  Freestanding, midwife-led birth centers are a critical part of the American birth landscape, and they have to constantly fight hard to justify their presence.

Matching pouts!

Special Beginnings has been out there, quietly holding their own and staying afloat with great outcomes for decades now, before ‘alternative’ birth and its associated hustles became A Thang.  I think it’s a testament to their no-nonsense, no-hype care how many people have birthed at Special Beginnings and went on to become birth professionals themselves.

I think it is so important to include siblings in the process, and that is where midwives excel. These two were right in there learning about their brother alongside the rest of us, normalizing birth as a nonmedical family event and mom/baby care as a family responsibility instead of a doctor’s authority.  Here’s the happy group now enjoying baby brother and his cheeks!

So if you think having someone who physically looks really unimpressed by what is happening would be helpful for you or your partner in your birth space, I’m your gal.  And surprisingly, this feature has served many folks through some tough and scary times.  Just look at Nikki if you’re overwhelmed- if she looks scared, you should be scared. If not, just keep looking at her and absorb that zen until you feel grounded.

Which is why I really like to consider my role as more of the partner’s doula.  Usually a birthing person brings someone she loves in with her, and me as the lil’ added bonus.  They have a trusting relationship, a good rapport, the inside jokes. Usually they also have the larger and stronger hands. So I teach them everything I know as they need to know it, and support them to do it or not do it, as they like.  Then they can just peek at my face if they are wondering how it’s going.

For example, this partner doula’d ME through this birth!  It was pretty long and arduous, but during each contraction he had a bright mantra of “Yes, Mrs. V!  Brilliant!  You’re a star!  Perfect!  Great job!  Come on!”  which was just the right thing for her.  I would never have come up with that!  And before long I started to depend on hearing the wonderfully British words of encouragement too.  The dad later told me that he liked that I looked bored- he figured, if I’d seen so many births and I wasn’t concerned, he didn’t have to be either.

So I think the birth partners- husbands, friends, sisters, dads, moms, grandmas, wives, whoever- are the main jam. They are the best doulas out there when given the support and permission to do so. After all, the Klaus and Kennell doula study did say that birth goes best when there is someone continuously in the room looking supportive- who doesn’t even have to be trained- who encourages partners to get closer and participate more effectively too.

This family was also one of the clients who the Nursing and Midwifery Council in the UK suddenly blocked the Yorkshire Storks from attending their birth, so I was able to go in and doula for them and provide continuity of carer. I was able to follow along with the whole pregnancy, and she was one of the first babies I was able to hear early with my Pinard and assess her early positions and movements so this was really special! I miss them!

When I arrived, I found her and her husband tucked into the tiny back bedroom, hands and knees over the birth ball. Her first words to me were:

“Is it supposed to hurt?  It doesn’t hurt at all!”  puuuuussssh

No, it’s great if it doesn’t hurt!  Can I just have a look and see….. And that is when I saw a tuft of hair inching out, in the same shade of pure white-blonde that her toddler son sports.   I feebly hand gestured to my client’s mother, visiting from Belarus, to start blowing up the birth pool in the front room, fully knowing she wouldn’t make it into the pool but it would at least give her mom something busy to do.  I asked my client if she was ok with giving birth back here in this room. Yes. We talked about calling the NHS midwife, with one of my eyes measuring the rapidly increasing size of the baby’s crowning head and the other looking at my client’s husband.  Too late, let’s just do this in a calm manner and sort it out later- phoning someone would bring loud and confused conversation into this space that was rapidly turning sacred.  Towels, yes. Chux pads, yes.  It’s warm. Ok.  I said if she wanted her husband to catch (I wanted her husband to catch…), she would have to let go of the firm and unwielding grip on his hands and let him get behind her. She couldn’t imagine moving (pushing paralysis had set in), so, it became my job by default.  But I was only there to doula!  One of my proudest moments in my career has to be managing to get this image of her son while also preparing to catch him.  (That’s my hand on the side there.)

Her toddler son was also present in that tiny room with us. They had put on Russian-language Frozen to distract him. He was coping absolutely beautifully.  As the baby’s head was born, I looked up at brother to see his eyes wide, but with no fear.  All of us totally silent except for Russian Elsa launching into ‘Let it Go.’  Apropos song for what was about to happen…..

Time shifts when you are waiting for a baby’s body to come, just as it shifts when you are the one birthing the baby.  What seems like ages is only a few seconds. As I was fully unprepared for this day on the whole, time was really warped, so when his head didn’t turn and his little body didn’t come after the next two full-on pushes, I had my client stand up and lie back down flat on her back so I could yoink her legs back (Mc Roberts) to see if that would facilitate things.  I have never been so happy to see a shoulder in my life, and as an added benefit, the father was able to catch his baby just like he wanted- just like I wanted for them.  The look on his face has to stay just a favorite memory as the next photo I caught was mom lying absolutely squashed into the corner wearing a squalling baby on her chest and a bright smile. Baby fine. Mom fine.  Placenta separation gush?  “Ok let’s call the midwife now!”  It had been only four minutes between head and body, but I’ll always wonder.

Because they weren’t expecting him to come at 39 weeks, they didn’t have everything ready yet, so they sent me out to fetch some nappies and a few tiny baby outfits after the NHS midwife arrived and took control. She was good-humored and unfazed by this tidy “Birth Before Arrival” scene. I remember “waking up” from the adrenaline rush while wandering aimlessly in Primark- “Wait, where am I? What did I come here for?  How did I get here?”

This image tells my story of the birth: me holding the placenta up while photographing, our matching henna still fresh from the mother blessing; the birthplace visible behind them on the floor; mom continues to take care of her older boy while fearless grandmother gets her first cuddle.

You can spy the poster that they had been using to teach their son about birth!

Later that day I had a parent-teacher conference. I made it back home just in time to attend, but not enough time to change my clothes. I sat there smugly wondering if they could detect the eau de amniotic fluid on me, and to this day I have no idea what was said to me in regard to my child’s progress.

Here he is on his first birthday! 

TENS machine and Depends- professional-level labouring

This birth also features my Birth Pool in a Box – MINI. This mom is tall, and she reported she would have preferred the Regular size pool.

Also at this birth I was given the postpartum reins for the first time. Check the placenta, do the placenta tour, weigh the baby (with one of my slings!), get her latched, get mom showered and fed, talk about vitamin K. There’s always a first time for everything, I will just say that…

She entered her big birth pool which was tucked into her eldest daughter’s room, where she had given birth with the Yorkshire Storks two years before. It was that birth that lit the spark within her to apply to midwifery school herself. I assumed a position up in the bunk bed, charting, observing and photographing from above since there was more than enough practical help available: husband, sister, older daughter, younger daughter, midwife, and birth companion.

Between contractions Claire would come right back to family life and interact with her youngest and joke with us. Her eldest would come in every so often, bend over the side of the pool and see if anything was happening on the business end, then dash out again. Claire was having such a lovely time birthing, smiling, enjoying her contractions, singing along to her music, using the gas expertly, giving us a play-by-play on her baby moving down past the anatomical landmarks. Just so rare, and what a privilege to see a mother loving and savoring her birth. Then she asked her husband to put on REM Automatic for the People and -all of us ’90s teens- suddenly were reminiscing about our formative years. Midwife Debs was scrunching up her face as she had already had an emotional day, and I immediately feared for my own emotional state as this album had always put hormonal young me into floods. Oh, God, was Nightswimming on this album?  I hope she’s birthed by then because I can’t keep down this lump in my throat that’s been there all week much longer…

“Nightswimming” came on,

Nightswimming deserves a quiet night
I’m not sure all these people understand
It’s not like years ago
The fear of getting caught
Of recklessness and water
They cannot see me naked
These things, they go away
Replaced by everyday

I picked at some lint on my dress until I could look up again, the grunts turned into powerful pushing-did I mention this was a surprise sex?  My favorite.  Suddenly the baby was looking up at me from under the water and disappeared again from my view as Claire scooped her up and was delighted at what she had just done. Another girl! “I have three girls!”  Her other two girls came running back up the stairs and we all just watched silently as she reveled in the baby and her accomplishment. The children were impressed but quickly bored, in keeping with my other experiences of children at births.  They knew lots more TV was in their future.

The at-home portion of the birth wrapped up exactly in time for me to attend my family’s going-away party.  I caught a ride back into Harrogate with the midwife and stumbled into the restaurant with that almighty Oxytocin High, which didn’t fade at all even when confronted by a guest-of-a-guest who was a newly-retired American OB-GYN, who just had to tell me that what I was doing was extremely dangerous.

I guarded the raw image files from this birth with my life as we flew home a few days later, backing up my backup of my backup.  Since then Claire has finished her first year of midwifery school, with a view to becoming an independent midwife, working like her midwives who showed her what birth can be like.  It is her I think of quite often when I think about the IMs’ uncertain future and my own trudge toward the midwifery finish line.  It is highly likely that Claire will be a Midwife before me, starting a full five years after I did!  I will take that as inspiration.

I remember starting the blanket right around when the UK independent midwives were prohibited from attending births, last December.  I hadn’t crocheted anything before this; I thought a pattern book with explicit step-by-step instructions would be just the thing to help me learn to crochet.  The first few rounds I spent worrying about my precepting midwives; how could they continue?  How could I help?  What about our clients? Before long, I had gotten the hang of crochet, and I got the idea to start crocheting some baby weighing slings as a fundraising effort for the proposed judicial review against the Nursing and Midwifery Council.  I made seven slings in total, raising £280. Ironically, I sold most of the slings to independent midwives. So the slings became a symbol of hope; the midwives could begin using them for the baby’s first weighing at the births they could freely attend again. Now, I hope these slings don’t become a symbol of what they may have lost….

We received word today that the IMUK midwives lost the judicial review against the NMC, and that an appeal would be futile. The NMC decision remains that their previous indemnity insurance product was inadequate. If they cannot come up with an insurance solution that will cover the highest imaginable catastrophic high-risk birth outcome payout + remain affordable for midwives and families, independent midwifery has come to an end in the UK. (Their original indemnity cost midwives £1000/year and families £400/birth, on top of the ~£4000 fee).

“We are devastated to have to tell you all that our legal challenge of the Nursing and Midwifery Council (NMC) has been unsuccessful. The court has heard the evidence and decided that the NMC did not act unfairly, did not act unlawfully.  Sadly, we must accept that decision since we don’t have the resources to take this legal action any further and the advice is that it is unlikely to be successful.

We also believe that the future lies in creating an insurance product for midwifery care that is women centred, that does not restrict women’s choices and that is ideally owned and run by women for women so that it is affordable for as many women as want it.  For this to happen we would need to find new ways of raising capital and we will need your involvement and support.”

I have no doubt that they will create a solution to the insurance problem. Whether it is affordable and legitimate is another matter. The independent midwives in Yorkshire are still able to attend births with the support and generosity of NHS Airedale Trust providing the insurance they need to continue intrapartum care.

But the paperwork. Oh, the paperwork. Pink sheet, yellow triplicate, peach sheet, postpartum notes, decisionmaking flowcharts.  During their weekly meetings, no longer were the midwives relaxing, peer reviewing, connecting with one another. Instead, they were buried under mounting hospital paperwork and when to do this and where to submit that. Never enough time. Driving what can be almost 100 miles to Airedale to submit that paperwork after long, hard births, just to get more paperwork. Never sure if they can enter other hospitals with their laboring clients or not. It’s the reality of insured, hospital-based midwifery, but the paperwork changes nothing about the independent midwives’ actual practice, and does nothing to improve patient safety and birth outcomes. It steals hours of unpaid time from the midwives, who already live and breathe for their clients and do without so their fees can be within reach for a wide range of clients.

The IMs of Yorkshire are grateful and thankful for the hospital’s generosity and innovation, and it may indeed be the way forward for the rest of the UK, but…this is no longer independent midwifery.

One of the mothers who was affected by the NMC decision. Only I was able to enter the hospital to attend her birth; her independent midwives could not.

And what about the 100 or so other independent midwives who do not benefit from an arrangement with a hospital trust? They are essentially left with nothing right now.  Their antenatal clients and potential clients are now coerced to enter the NHS hospital system, which they had been explicitly going out of their way to avoid.  The IMs still cannot enter the hospital with their clients in labor as a birth supporter/doula, which would seem to be an appropriate compromise that provides exactly the continuity of carer/increased safety that is ostensibly the goal of the NMC’s investigation. Is this truly a public safety/insurance issue, or a bid to end the uncontrollable practice of independent midwifery and a scheme to force IMs back to work for the NHS as it struggles with a severe midwife shortage?

I met a great many passionate IMs who told me they would stop doing midwifery rather than enter the NHS or work for a private employer. So that’s hundreds of years of experience, lost.  This has implications for NHS midwives, midwives in the USA, and around the world, too.  I consider the US to be about 10-20 years behind the UK in evidence-based care and human rights/informed choice in childbirth.  So this may be our future.

So I will be working on this blanket again tonight. Worrying about the midwives who can no longer work. Worrying about the midwifery students who planned to go independent. Worrying about the families who can no longer choose their midwife. Worrying about my precepting midwives who are stressed and overwhelmed. Worrying about my own future as a midwife.  Will I ever be able to lie under this blanket, once the worries are no more?