Get to Know MBC: Birth Assistant Rachel Lamb

My Time at a Haitian Birth Center: Heartline Haiti Maternity Center

Content Note: Sexual assault briefly mentioned without details.

Access to healthy birth is a human right that every woman should have access to, but sadly many women don’t.
  Imagine you are pregnant and want the best care for you and baby but have very few safe birthing options. Imagine you are in active labor and must take a motorcycle taxi two hours through muddy mountain roads to get to a safe maternity center. Imagine being an abused teen girl who must hide her pregnancy and baby from the world. Imagine finally finding a safe place to receive prenatal care and give birth when your options were dismal. Imagine finding a safe community that provides loving care with dignity and respect and wants the very best for you and baby. Heartline Maternity Center is that place for so many women in Haiti.

In early 2017, I was able to spend a few lovely months, as an RN, with Heartline Maternity Center in Port-au Prince, Haiti, and saw firsthand the excellent work they do. Fortunately, I speak Haitian Creole, from living in Haiti previously, and was able to use my nursing and language skills with this great maternity center. Grab a cup of tea, a cozy blanket and curl up while I tell you about these female warriors and the women they serve.

Heartline Maternity Center works to fight the orphan crisis in Haiti by advocating for women and babies, thus promoting strong and healthy families. They have an amazing program where women come weekly for group education and prenatal care by excellent Haitian and American Midwives, as well as Haitian nurses. Every Friday morning, a line of women stand outside the gate and hope for their chance at being admitted into the prenatal program. They have heard from their friends and neighbors about this wonderful program and know it may be their only chance at safe care. If they don’t get a spot at Heartline, their options are unassisted home births, traditional birth attendants with few resources, private hospitals that require a lot of money, or public hospitals that are overcrowded with very few supplies and resources.

If given a number for the day, they meet with the midwives and see ultrasound images of their babies for the first time. If they are a good match for the program, the women will start coming back every Thursday for lunch, an education class, and prenatal visits. Priority is given to the higher risk women, the very young and the older moms. By the time they come back to the maternity center to deliver, the women hopefully have owned their care and education and have formed a trusting relationship with the staff. When delivering, the women have midwives and nurses to labor with them in a cozy home-like setting, much like The Minnesota Birth Center. The midwives  and nurses guide them through the natural birth process with love and respect. After delivery, the moms and new babies stay in the beautiful postpartum area for an average of 4-7 days (until their baby’s stool transitions to the seedy, yellow breastfed color) while they establish breastfeeding and bonding. They are driven home upon discharge and the staff have the chance to welcome the new family to their home and often are greeted by excited family members. The care doesn’t stop there, though. The women are encouraged to continue coming to the maternity center with their babies for a weekly child development class for up to six months, as well as postpartum care.

When I was working with Heartline I was able to meet a wonderful young teen mom who epitomizes what they are all about. (This story is shared with her permission.) Sarah had delivered a precious baby girl, Sophia, a couple months prior to my arrival. Her life had taken a turn when she was sexually assaulted by a neighbor and became pregnant at the age of 13. This was a source of shame for her family and so much blame was put on Sarah. Luckily she found Heartline and received amazing love, care and education throughout her pregnancy and still to this day, almost a year postpartum. Because of the education she received, she was able to make wise choices to exclusively breastfeed her baby and was able to stand against many false cultural beliefs that were being pushed on her. Sarah has created a very strong bond with Sophia and has now been able to return to school, with the support of Heartline. She sadly has to hide the fact that she’s a mom from her school and classmates, but she has aspirations to be a midwife, and I know she will make a great one. She has been so well supported by the staff and midwives at the maternity center and because of it knows her value and worth. She is often found helping other young moms at the maternity center and is one of the wisest young women I have ever met. Heartline changed her story, and now she can change her daughter’s story.

During my time with Heartline, I saw the amazing staff walk with all kinds of women: young moms who were abused and expecting, moms who had lost previous babies and now had the care and education to safely deliver a healthy baby, moms who were newly diagnosed with HIV, moms who were full of joy for their new little one, moms who came hours on public transport to have care, moms with large families, and moms just starting their families….and all these women were loved and cared for so well. They all got crazy good education about pregnancy, delivery, and how to keep their babies healthy. The intent of the program is to teach and care for the women through one pregnancy and then they are able to go out and spread their knowledge to their communities. When you gain information that can save lives you don’t keep that to yourself, you spread it far and wide.

Women can change the world one conversation at a time. Midwives can change the world one healthy birth at a time.

~Written by Rachel Lamb, RN, Clinic Nurse and Birth Assistant at MBC: “Haiti is very special to me. I continue to be involved with the Haitian community in the Twin Cities, and I travel often to Haiti when I’m able. I love to tell stories about my time there, so feel free to ask me more about it when you see me at the Birth Center!”

Long Awaited – The Birth of Everett

After struggling with infertility for several years, my husband Devin and I were shocked and overjoyed to find out in March of 2016 that we were finally expecting!

Those 10 months were full of excitement, joy, and frankly a lot of fear. After trying to get pregnant for so long, we struggled to believe that it was finally our turn. We had a few moments during our pregnancy that fed into our sense of fear including a subchorionic hemorrhage.

We finally decided it was time to tackle our fear. Attending psychotherapy and our 12 week-long Bradley Method class significantly helped our fear. As we neared or due date, we continued to work with the Minnesota Birth Center midwives who helped us feel confident and at ease about our upcoming labor and delivery.

Unfortunately, my body was still pretty anxious, which started appearing in my blood pressure results. Whenever I would take my blood pressure at home it would be fine, but the minute I was at the birth center and thinking about how important it was for my blood pressure to be normal, it would shoot up.

This became concerning to our midwives and as my due date approached they suggested that I consider being induced at the hospital.

I came home from this appointment heartbroken and discouraged, thinking the birth Devin and I had planned for would not happen the way that we had dreamed. This happened on Tuesday November 8th, after a long and stressful day of work. We decided that night that I would start my maternity leave the next day and we would spend the day doing whatever we could to induce naturally, just in case our little guy was ready to make his appearance.

The next morning I scoured the internet for “natural ways to induce labor” and proceeded to try pretty much every one of them. I hooked myself up to my breast pump for awhile before Devin and I headed to see an old friend who is an acupuncturist, Dr. Ma. I used to work for Dr. Ma when I was in college and knew that he had great success inducing labor with acupuncture.

After my acupuncture treatment we headed to St. Paul to meet our midwife, Brigette, who wanted to monitor my blood pressure and our baby’s movement. Our little guy was looking great and my blood pressure was normal. I had been having consistent Braxton-Hicks contractions since week 30 of my pregnancy, but during our non-stress test Brigette informed us that they seemed to have a bit of a pattern. Brigette checked me and I was already three centimeters dilated. She offered to strip my membranes in an effort to get things moving and we agreed.

Devin and I went out to eat and enjoyed a delicious burger. We decided that our dogs needed a little bit of exercise so we decided to take them to the dog park. As we walked out the door I began having what I assumed was another Braxton-Hicks contraction, but this one felt different. It had a period cramp-quality to it. I remember looking at the clock and noting the time, 4:30pm. I felt excited but tried not to get my hopes up, knowing that this can sometimes happen after the membranes are stripped and it may not lead to anything.

We met my parents at the dog park and walked for about an hour. My contractions continued, about every ten minutes or so. On our way home from the dog park we stopped at the store and bought a going-home outfit for our baby. We returned home and by the time I was ready to sleep for the night my contractions had stopped.

I was able to get a full night of sleep and was woken up on Thursday morning with the same contractions that I had been having during the previous evening. They remained between 7 and 10 minutes apart and were easy to manage without many comfort measures. I spent the day setting up my out-of-office replies and getting ready to be away from work for three months. Devin had a doctor’s appointment and wanted to stop into the office to make sure everything was ready for him to take paternity leave as well. For some reason, even though I was in labor and already on maternity leave, it still hadn’t clicked that I would be having this baby soon.

My contractions stayed pretty steady throughout the day, between 7 and 10 minutes apart. When Devin got home from work, we decided to take a walk around our neighborhood. The weather that day was incredible for November, almost into the seventies! That evening our doula, Esther, came over for a few hours. We talked, prayed, and used the rebozo to help our little guy get into a good position. Within an hour after she left my labor began to change dramatically. My contractions became stronger and closer together. I decided to get in the bath to see if they eased up at all. They did not.

Devin and I got into bed and I quickly realized that I would not be able to stay still through the contractions anymore. I got up and decided to let Devin sleep. Despite being in early labor for a full 24 hours already, I still had not finished packing our bags. I decided to head downstairs and do some packing. At this point it was probably around 10:30 pm. I spent the next three hours or so laboring in the basement and attempting to pack our bags for the birth center. Around 1:00 am I realized that I could no longer distract myself from my contractions anymore and decided it was time to use some of the comfort measures we had learned in our Bradley Method classes. I went upstairs and decided to take a shower.

Unfortunately our water heater was not working very well. After a few minutes in a warm-turned-cold shower I got out and had a nice loud contraction right outside our room. This woke Devin up and he was instantly in birth partner mode. He reset the water heater and helped me through the next few contractions in the shower. Sometime just before Devin woke up I vaguely remember texting our doula to let her know that labor was getting intense. Soon after Devin got up he started communicating with Esther to update her on labor.

This is where things get a little fuzzy for me. In the early hours of Friday morning I went into the zone and could only focus on each contraction as it came. Around 3:00 am Esther came over and joined our contracting team. Like I said, I don’t remember much, but I remember trying different positions: sitting on the birth ball, leaning over a chair, on the toilet, and laying in bed, and even crawling on the floor! I remember having the urge to pull on things as each contraction hit and sometimes that thing was Dev’s hat, shirt, hair, anything!

While all this was going on, Devin and Esther were intermittently calling the midwives at the birth center and letting them listen to my contractions to help them decide when we would go in. There was some debate about whether or not I could still deliver at the birth center due to my blood pressure. Around 7:00 am my chiropractor, Dr. Ann, stopped by and adjusted me in our living room.

Around 9:00 am we decided it was time to head to the birth center. I remember stepping outside and feeling the crisp morning air on my face. It felt like I finally “woke up” from my labor-daze and I felt my awareness increase.

The midwives called just as we were leaving and let us know that they would let me start laboring at the birth center and that I would only need to transfer to the hospital if my blood pressure rose. We were overjoyed!

Devin hopped in the front seat of our van (yes, we bought a van for our one baby and two dogs- ha!) and I climbed into the front seat. Instantly, I decided that the thought of contracting sitting in the front seat of the car sounded terrible so I proceeded to climb to the very back of our van and squat. Devin laughed because I didn’t open the doors and walk back there, I crawled. Very dramatic. Dev looked at me with excitement on his face as we left our alley and said, “The next time we’ll be here we will be coming home with our baby!”

I had two contractions on our 7 minute drive to the birth center. I remember trying to get Devin to run a few red lights and feeling confused and mad that he wouldn’t do it, even though he kept kindly explaining to me that he couldn’t run lights when there were cars coming.

When we pulled up to the birth center we were greeted by Esther who was waving to us with a huge grin. She had just gotten the news that we could deliver at the birth center!

I came up to the door of the birth center and started frantically banging on the door and ringing the doorbell. The birth center is a big beautiful house located in a South Minneapolis neighborhood. I was keenly aware that we were close to the MBC neighbors and that I was pretty loud whenever a contraction hit.

After my frantic door banging our wonderful midwife Brigette met me at the door with a smile on her face. I stepped into our birthing room and noticed how bright and peaceful it was. The morning sun covered the big bed, the birthing tub and the chandelier. Brigette checked me and said I was already 6 centimeters dilated! She also checked my blood pressure which was perfect! It turns out I just needed a big distraction, like labor, to keep my blood pressure and anxiety down!

I headed straight for the shower and climbed right in, very thankful for a functional water heater. Devin joined me in the bathroom and we had a beautiful moment alone. He told me how proud he was of me and how he didn’t think he could ever love me more than he did today. It was a perfect moment.

Over the next few hours I labored all around the room, in the tub, on the bed, on the floor, and backwards on the toilet. Esther kept reminding us that our sweet boy knows our voices and encouraged us to talk to him. I found this deeply connecting and it helped me focus on the purpose of my labor.

At some point while I was in the tub I noticed I was feeling kind of “pushy.” Brigette offered to check me and said I was close to a 10; there was just a bit of a lip of my cervix left. I pushed while she helped my body move the lip with her fingers.

I hopped back into the tub and felt a rush of energy! This was it! The next step is baby! After a few pushes I was sure he must be ready to be born soon. I soon realized that pushing was not going to be a quick process for me and I began feeling discouraged.

After pushing for awhile I ended up backwards on the toilet again. For some reason that position felt the most comfortable to me. Soon I felt my water slowly break. It was totally different than what I was expecting, a slow trickle instead of the huge gush you always see on TV. Brigette offered me some peppermint oil to smell and it gave me energy. Devin was there for every contraction singing to me, squeezing my hips, and rubbing my back.

Soon it became clear that I was losing steam. Brigette told me it was time to eat something. I didn’t really feel hungry and I remember feeling a little annoyed that I had to try to eat. “Don’t they know that I’m busy contracting over here?” Between each contraction Esther would give me a bite of applesauce and a sip of coconut water.

After pushing for awhile it became clear that our little guy was stuck. Esther and Dr. Ann, my chiropractor who had arrived sometime in the afternoon, helped by suggesting different positions for me to push in, to help our little guy move down. At one point they had me doing a Spinning Babies move where I would pull my belly in toward my back during each contraction. I remember those contractions being super strong. At some point I moved to the bed and ended up pushing on my back while Brigette held a mirror up so I could see the progress I was making. The pushing on my back seemed to do the trick to get him unstuck. I remember feeling discouraged each time I would see his head making his appearance, only for it to disappear as the contraction subsided. At some point on the bed I remember feeling like my contractions were not really stopping in between. I remember Brigette telling me to rest after each contraction but I felt like they were coming one after another!

I was getting tired, hot, and discouraged after pushing for over three hours. They had moved a fan to me that was blowing on me to cool me down. Just as I thought I couldn’t keep going I heard Brigette tell the birth assistant to move the fan once the baby was born so it didn’t mess with his breathing.

I remember thinking, “What?! He is actually coming?” I got another rush of energy and realized that I had to push him out NOW! My body must have known that I needed gravity to help me. All of a sudden I found myself crawling off the bed and grabbing the labor sling hanging from the ceiling. With the next contraction I pushed out my baby’s head. I felt like I had accomplished the world and I felt like resting and waiting for the next contraction to push out the rest of him. It became clear that this was not going to work and my team instructed me to keep pushing! Evidently our little guy came out with his hand at his face. No wonder he had been stuck for a few hours! I got down on my hands and knees and pushed him out completely, and Devin was right there on the floor with me to catch him!

At 6:24 pm on November 11th our son was born.

Devin and Brigette handed our sweet boy to me through my legs and, still on my hands and knees, my sweet boy and I locked eyes for the first time.

He looked up at me with this adorable squinty pout that melted my heart. He was perfect and he seemed so familiar to me.

Brigette suggested I bring him to my chest and I held his small warm body against me. Devin cried and held us and we enjoyed our first moment as a family of three.

I moved to the bed and delivered the placenta, which I barely noticed because I was so enthralled with the little person on my chest.

As soon as I delivered the placenta, I looked at Brigette’s face and knew something was not quite right. She quickly and calmly called for backup and within seconds I was hit with a shot of Pitocin in my leg. Brigette administered cytotec and a nurse was hooking me up to an IV. I was hemorrhaging.

To be honest, I was so overcome with baby-induced bliss that I barely understood what was going on. I had so much faith in my birth team and they were so professional and calm that it barely registered that I had been in danger.

It turns out my uterus was pretty tired from contracting for so many hours and it couldn’t be bothered to keep contracting without a little help. I lost almost a liter of blood in a matter of minutes.

Once I was stable I got all stitched up, with our baby still on my chest. I remember experiencing this flood of energy and happiness. It was like nothing I’ve ever experienced before. I could not stop talking! Maybe it was the cocktail of oxytocin and other hormones or the fact that I had barely said anything but all of a sudden I wanted to TALK! Our wonderful birth team obliged me.

At some point we realized that our precious son needed a name! We had already decided on his first name but spent some time going back and forth between two middle names. We finally settled on Everett John. Everett means strong and brave, the blessing and prayer we wanted to speak over him after we experienced so much fear during pregnancy. Our prayers for strength and bravery were answered during labor and delivery and his name is a reflection of this.

While I was being stitched up, sweet Everett, who was peacefully laying on my chest, latched for the first time and began to nurse. I remember feeling so overcome with awe. How do babies know to do that!?

After getting stitched up, Dr. Ann offered to adjust Everett and Devin. This was the first time since he had been born that he left my arms, two hours later.

At some point our wonderful birth team brought in a plate of fresh-made bread with honey and butter. After not really eating much since the night before I don’t think anything had ever tasted so good! Soon Esther and Dr. Ann said their goodbyes and it was just the three of us, laying in bed and snuggling.

After spending some time resting and snuggling, Brigette came back in to do the newborn exam. The birth assistants drew me a postpartum herbal bath and I relaxed in the tub while Devin and Brigette did the exam. It turned out our little Everett was 9 pounds, 3 ounces! No wonder it took so much work to get him out!

Soon after, Devin and Everett joined me in the tub. On my labor playlist there was a lullaby by the singer Sara Groves. Whenever I would hear it in labor I remember thinking that eventually I would get to sing it to my baby and it gave me strength. Devin played the lullaby as we all snuggled in the tub and I started crying for the first time since Everett’s birth. It was a perfect moment. We finally had our baby.

After our bath we got all packed up and climbed into the car. I immediately started shaking. It seemed my body finally realized the ordeal it had been through. We made it home in five minutes and my parents and sister were waiting for us.It was midnight. They met Everett and there were lots of tears and laughter. My mom had made us lasagna and they tucked us into bed with our lasagna, which I remember was the best thing I’d ever tasted. It turns out birth makes me ravenous. By 1:00 am the three of us were all tucked in and ready for bed. It was incredible to spend our first night in our own bed. All three of us slept all night and woke up refreshed at 9:00 am the next morning. We basically spent the next three weeks in bed marveling at our beautiful miracle.

I am writing this just under a year later. Everett will be one this week. He has been the biggest blessing we have ever received and has brought our family so much joy and strength, just like his name.

~ Sara P.

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Honoring an MBC All Star

On October 5th, 2017, Tricia Balazovic was presented with the 2017 AABC Community Award at the American Association of Birth Centers Conference in Anchorage, AK.  As Tricia’s colleague and friend for 5 years, it was an honor to present it to her.  Below is the speech given for the presentation. ~Mary-Signe

Let me tell you about Tricia Balazovic.

Do you know one of those people who can look at a problem and immediately see several different solutions from several different perspectives? That is Tricia’s baseline.

She is a savvy consumer of everything including healthcare. When she was looking for a different experience for the birth of her second child she naturally sought out the new option in the Twin Cities, an out of hospital birth center called Minnesota Birth Center. The experience she had during her pregnancy and birth convinced her that she should start to devote her considerable talents toward strengthening this institution.

She started at the Minnesota Birth Center by beginning a doula internship program. She did this on a volunteer basis. This is a program that exists still today and has provided the benefit of clients receiving doula care, and doulas receiving experience in out of hospital birth and midwifery model of care.

Tricia has a background in business and economics and one day she asked Dr. Calvin, the owner of the practice, if she could see some of the financial information. With that simple question and the wise answer from Dr. Calvin of “yes” Tricia has been influencing Minnesota Birth Center and maternity care in the greater Twin Cities metro area.

She has done so many things to advance the operation of the birth center. I cannot give you the details of all of them because I think we have a finite amount of time here.  Let me just brag about one of her accomplishments. After learning about health care billing from the ground up on her own, she has worked tirelessly to make MBC in-network with EVERY payer in the Twin Cities. Birth Center birth has become a realistic option for so many families in Minnesota who would not have been able to afford it because of her tireless, thankless, invisible work.

I want you, Tricia, to know that we see your work. We know we would not be where we are without you. Without the hours, phone calls, frustrating conversations, run-around emails, and general misery of dealing with multiple payers, the Minnesota Birth Center would not be where we are.

Tricia, we cannot thank you enough. I am so honored that we can present you with this commendation tonight as a concrete recognition of your integral place and value to Minnesota Birth Center and the families we serve.