Since I’ve been pregnant, I’ve spent a lot of time talking to Whitney. She has provided my life with so much value that I wanted to bring her on the blog.
Let’s be honest, if you aren’t pregnant or aren’t planning to get pregnant at some point in your life, this post is not for you. But I got you covered! Stalk any of these post:
Whitney is very experienced when it comes to being a midwife. She’s attended about 120 births & is very well-educated. She really knows her shit when it comes to everything baby. In this post you can expect to learn more about birthing options, drugs vs. no drugs, a ton of books & resources, & what really happens after your water breaks.
With that, let’s meet Whitney.
+ Introduce yourself & share your background as a midwife.
Hi, I’m Whitney Stolman, LM ( Licensed Midwife), CPM ( Certified Professional Midwife ). I am 37 years old, & I have a 2.5 year old son. I attended births ( around 120 total ) over 7 years before having my son, first as an apprentice, then as an assistant midwife, & then as an LM.
I went to the Birthingway College of Midwifery in Portland, OR, which is a 3 year midwifery program to train out-of-hospital midwives. I did all of my apprentice & assistant midwifery births in Oregon at a busy out-of-hospital birth center, where we attended homebirth & birth center births. I then moved to California & worked in a small homebirth practice for a few years, but I stopped working when I was about 30 weeks pregnant.
I still have my license & credentials current, but I am not attending births right now. For me, it’s really hard to think about going back on-call with a small child ( I am just on-call for him 24/7 now lol ), but I do still have a passion for working with moms & babies in some capacity. Working with women as a consultant for pregnancy & postpartum issues is a good, happy medium, as I still get to talk about all things pregnancy, birth, & parenting related, & navigate the journey with women & families. I do love being a stay-at-home mom- thank goodness my tiny boss is cute to get me through the challenging times!
+ What are the different options when it comes to giving birth? Tell us all the different ways – water birth, hypnobirth etc.
Birth is unlimited! I think one of the most amazing & challenging things about it, whether as a pregnant woman or care provider, is that it’s almost impossible to predict or make any guarantees about how the birth will go. As a midwife, part of my job is to talk to expecting moms about what their ideal birth looks like, plan for that, but also discuss what could result in a deviation from that plan. Sometimes a birth goes too fast to even set up the birth tub, so the mom doesn’t get the water birth she hoped for. Sometimes a hoped-for home birth results in a transfer to the hospital. As a midwife, we are on the journey with the family, so we are there to integrate & process with them, the joy & the disappointment, the good & the bad.
At home, no birth location is off limits! I have attended births on the bed, over the toilet, in tubs, showers, outside, etc. Midwives are flexible, quick-thinking, creative, & follow a woman’s lead, barring any health concerns about mother or baby, which can get us into some interesting birth positions :).
As far as childbirth preparation styles, there are many styles of classes- the Bradley Method, Birthing From Within, Hypnobirthing, Hypnobabies, to name a few. They all teach basic information about the labor & birth process. Each teaches different techniques of coping through labor. The Bradley Method is a partner-based coping style, while Hypnobirthing & Hypnobabies are about using hypnosis & listening to specific meditations/breathing techniques.
Birthing From Within uses art, journaling & creativity to process through emotions & prepare for birth. Both Hypnobirthing & Birthing From Within have books as well as classes, so you can dabble in a few different styles. Wherever you plan to give birth, I recommend taking a childbirth class that is not affiliated with the hospital. You will get much more information & tools out of it! Even as a midwife planning a homebirth, I took a birth class ( Hypnobirthing). For me, it was a valuable tool while pregnant & good for me & my partner to do together, but to be honest, it didn’t help me at all in labor!
+ Can you walk us through what really happens after the water breaks? Is it like the movies?
Great question! It is nothing like the movies which annoys me to no end! So the biggest misconception from media portrayal of water breaking is that water breaks with a huge gush & then labor contractions begin immediately & are very painfully. This is never the case.
Water breaks as the first sign of labor usually about 10% of the time, & contractions can begin immediately, but usually it’s gradual & sometime within the next 24 hours. I have seen women whose water breaks & contractions don’t begin for 5-7 days! Without the force of contractions, if water breaks as the first sign of labor it is usually a trickle, not a huge gush. It can take some time to determine it is actually amniotic fluid, not urine, but it usually becomes clear as the fluid continues to come out with position changes of mom or baby, like going from standing to sitting.
So about 90% of the time water breaks in labor, usually in transition or close to birth. Rarely the water never breaks before birth & babies are born in their amniotic sac, or born en caul. This is seen as a special or promising sign for that baby’s life. I’ve never seen this in a hospital birth, as it’s rare to begin with, & in the hospital, if a woman’s water hasn’t broken on it’s own, they are likely to intervene & break it for her before birth.
+ Tell us more about home births.
Homebirths- such a huge topic! Where to begin.I think it begins with midwifery care in general. So under the care of a midwife, prenatal visits are on the same schedule as standard obstetric care. We see women monthly until about 28 weeks, then biweekly until 36 weeks, & then weekly until labor.
Prenatal visits are an hour, so that is very different than the standard amount of time spent with an OB. We assess so much more than the clinical well-being- blood pressure, lab work, baby’s position & heart rate, & baby’s growth are of course all important. But most of the visit is spent getting to know our client & her family. A woman’s whole life affects her pregnancy- is her toddler sick? Her husband deployed? Lost her job? How is her nutrition?Her sex life? Her hopes, dreams, or fears about the upcoming birth or role as a mother? Having continuity with a provider & building a relationship of trust with each client serves everyone. In labor, the midwife has now become a familiar energy & someone who the mother is intimately comfortable being with at one of the most exposed & vulnerable life events.
Another huge piece of midwifery care is informed consent. Every aspect of care is presented to women as a choice, acknowledging each woman as responsible for her own body & her baby, & that her intuition & needs are unique & valid. For example, midwives offer routine ultrasounds & gestational diabetes screening, but a client can always decline. We present many resources & information for a woman to understand the risks & benefits of each standard screening or procedure, & she gets to make a choice. Pregnancy & birth are normal functions of the female body & the sexual life cycle of a woman. Coming from that place, from a place of trust & normalcy, is often a breath of fresh air for women, as standard obstetric care has really medicalized pregnancy & birth.
The standard obstetric approach to pregnancy & birth in this country doesn’t yield great results- there is a 30-50% cesarean rate in most hospitals nationwide. The maternal mortality rate in the United States is rising over the last 15 years, especially for woman of color, & for mostly preventable reasons, such as hemorrhage infection. The United States has the highest maternal mortality rate when compared to all the other developed nations. Currently the US ranks 46/183 countries when looking at maternal mortality rates worldwide. That’s shocking to many!
Midwives are on-call for their clients 24/7 when they are in their due range, which is anywhere from 37 weeks to 42 weeks pregnant. After the birth, midwives do postpartum care in the client’s home for the first two weeks after birth. The postpartum care schedule can vary some practice to practice. When I was attending births, we did visits in the client’s home at 1 day, 3 days, & 1 week postpartum. We had the clients come to see us at 2 weeks, 4 weeks, & 6 weeks postpartum. A few midwives in the San Diego area offer care through the first year after birth, with clients coming in at 3, 6, 9 & 12 months postpartum. This care is invaluable & possibly the biggest distinction between standard OB care & midwifery care. So many questions in those early days! Monitoring a baby’s growth, how breastfeeding bottle feeding is going, how sleep is going, is the mom depressed? anxious? happy? is she back at work? How’s the parents relationship evolving in their new roles? Just the support of someone to talk to helps endlessly. Midwives can also do well-woman care & give contraceptive advice for future family planning.
On average, prenatal care, birth, & postpartum care with a midwife costs around $5,000. Compared to the cost of a hospital birth ( around $20,000- $30,000 for a normal vaginal birth ) it would be very cost effective for insurance companies to cover midwives & homebirths. However, birth is a big business, & the largest source of income in the hospital system, & they would like it keep it that way. Some insurance companies are coming around, & will cover nurse-midwives, birth center births, & some parts of homebirth midwifery care.
+ What are some natural things you can do during labor & birth which would surprise the audience?
What gets the baby in gets the baby out ;). Boosting oxytocin is a great natural way to stimulate labor to begin, or to augment a slow labor. Nipple stimulation, manually or with a breast pump, sex/orgasms, & intimacy between the parents-to-be, & among all who are present at the birth, all boost oxytocin. Laughter also boosts oxytocin. I had one client watching Grumpy Old Men & have her baby about 15 minutes later! Amazingly, semen is full of prostaglandins, which soften & ripen the cervix, so sex in the last weeks of pregnancy helps to prep the body for labor. Medical cervical ripeners such as cervadil are prostaglandins, trying to mimic what nature already provides.
Also midwives have many natural tricks in our birth bags :). Herbs, homeopathics, essential oils, & flower essences can do wonders for everything from shifting a labor pattern, changing a woman’s emotional state, & helping to control bleeding or blood pressure. Water is also an amazing tool! I know when I was in labor you really couldn’t drag me out of the birth tub.
Although midwives do have a large arsenal of natural remedies, I think it’s important to note that licensed midwives in California also carry IV fluid & IV setups, oxygen, & all the same anti-hemorrhagic medications the hospital has available to use. We are not licensed to use medications to augment labor, like pitocin. In hospital births when they are using Pitocin to induce or augment labor, that is synthetic oxytocin. However, Pitocin doesn’t stimulate all the other neural pathways & hormones that natural oxytocin does ( an increase in prolactin & endorphins, & a decrease of adrenaline ) to counteract the pain & induce a sort of altered conciousness. That is why most women describe labors where Pitocin is used as much more painful. We do not administer epidurals & we do not use continuous fetal monitoring in labor. If there is an indication that a baby needs to be monitored continuously, that would be a reason to transfer to a hospital.
If you are considering hiring a midwife, it is a great question to ask about her birth supplies, her experience with more emergent situations, & the transfer/cesarean rate in her practice. Within my community, an average transfer rate to the hospital is about 10%, & cesarean rate is about 5%, substantially lower than the average hospital rate. Things do come up in births, such a shoulder dystocia, hemorrhage, or a baby that needs some help to get started breathing after birth. Midwives are trained & capable to deal with these scenarios, & to determine when a situation requires medical care that is outside the midwifery scope.
There are resources online with great interview questions when considering hiring a midwife, or doctor, for your pregnancy & birth care. There are many choices out there! Most midwives offer free consultations as they want potential clients to find their right fit. Some midwives may have more experience with herbal remedies, while others tend to use pharmaceuticals as their first go-to. Some midwives may be more emotive, others more practical. Each woman has to find the right fit of a provider for her & her family.
+ If someone chooses to go with the no drug option, how much pain are we talking? – asking for someone who knows nothing about birth.
Every woman has a different pain tolerance, & pain experience leading up to giving birth. So this is a very hard question to answer across the board :). Some women describe natural birth as not painful at all, bordering on pleasurable or even orgasmic. Or that contractions were painful but pushing was not. Or vice versa. Length of labor, the amount of support a woman has in labor, & her own preparation all influence the pain perception. Sometimes shorter labors are experienced as more painful than a longer labor, as the body’s hormones haven’t really had time to catch up with the physical process.
From my own experience, I will say labor is pretty painful, intense, & it is work. It’s like a marathon, both mental & physical. But my memories of the exact sensations of how labor felt have faded substantially. It’s hard to even describe! It’s not like anything I have felt before or since. However, how I look back now & integrate the experience is much different than how I saw it a few years ago.
Labor is pain with a purpose. The natural labor process has value. The hormonal interplay between mom & baby, & the peak levels of oxytocin at birth ( the highest ever in a woman’s life ) serve to bond her to & fall in love with her baby almost instantly. The “I did it” feeling after a natural birth primes a woman to feel confident & strong moving forward in the mothering journey. I am not saying that a woman with a planned or unplanned cesarean, homebirth transfer with an epidural, or any other variation of birth doesn’t feel strong & confident to mother. All I am saying is that we live in a time where many people are afraid of or dislike pregnancy & birth.
The home birth rate in this country is about 1%, so medicalized birth is the norm, & almost half of births are surgical births. I think we as woman, & as a society need to take a serious look at what has become routine birth practices & question everything. Inform yourself as much as you can as you are your & your baby’s best advocate. It is when women go into pregnancy, labor, & birth blindly trusting their care provider ( doctor or midwife ) that I see the most disappointment with their care & experience.
There are so many places where standard medical care tries to deviate from the natural process. Interventions sometimes do more harm that good. Science is not perfect. For example, ultrasounds can be very inaccurate for assessing gestation & fetal weight, especially the further along a woman is. Inductions based on these ultrasounds can lead to a premature or smaller baby than expected, leading to more interventions & time in the NICU. In fact, prematurity/ preterm birth complications are the leading cause of death in children under 5 in the United States. In nature we don’t force a flower to bloom before it is ready. We don’t interfere with other mammalian births. Large mammals like horses or elephants choose to birth at night, in the dark, in small, quiet spaces. We are not so different, but the hospital environment doesn’t lend itself easily to support natural, undisturbed birth.
+ What mistakes do you see in the hospital delivery room? ( This is all your opinion ).
I have seen medical mismanagement that was very traumatic. I have seen doctors being coercive, threatening, overly forceful ( both verbally & physically ). I think when people say that a healthy baby is all that matters, that really undermines the value of birth & the woman’s ( baby and family’s ) experience. A healthy baby and a traumatized mother shouldn’t be what we are settling for.
In the hospitals they look at birth on a time-based model. So if there isn’t cervical change as quickly as the provider wants to see, they begin to intervene. Interventions are like a cascade- one often leads to another. This often stresses the mom or baby to such an extent that the woman needs a cesarean, & leaves the birth experience feeling either like the doctor needed to save her or her baby’s life, or her body is broken in some fundamental way. Neither of these are confident ways to leave one of the most pivotal experiences in a woman’s life.
It’s documented that cesarean rates rise near the end of a shift or in the evenings/weekends. Doctors want to plan birth around their schedule or convenience, & that’s not how birth works. I think the hospital is a very hard place to have an empowering, joyful birth. Women are often fighting for their choices to be heard & respected while navigating a very hard physical experience. Birth plans are often laughed at. Women who don’t follow the hospital status quo are labeled as difficult & troublesome. There are plenty of great providers working in hospital systems, but for me, I could never do it.
When I transferred to the hospital in labor, I had a very abrasive physician who obviously didn’t respect midwives or home birth. My midwife ( who has been practicing for 30 years, probably longer than the OB who took over my care ) stayed with me in the hospital the whole time until my son was born, actually missing another client’s birth to be with me. The OB refused to take a report or my records from my midwife, acting instead as if I had no prenatal care at all. She delayed giving me an epidural for 2 hours, which I believe was punitive as she just didn’t like what I represented. My health or baby’s health was not a concern- other than lack of progress- there were no issues with his heart rate or infection, but my water was broken. When I was first admitted, two nurses checked my cervix, first the admitting nurse, & then the doctor’s nurse. The doctor came in 10 minutes later to check me, insistent about it, & didn’t listen to me when I declined due to a concern about infection. ( After the water is broken, providers should be more cautious about inserting anything into the vagina unnecessarily. Vaginal exams are done with sterile gloves, but can still push bacteria from the environment/vagina up towards the cervix, uterus, & baby).
There was zero need for me to checked 3 times in an hour, especially since I had been 6 cm for 18 hours! When the doctor roughly checked anyway, me she declared I was 4 cm, even though both nurses had said I was 6 cm. She also stated there was thick meconium, which is the baby’s first bowel movement, which they sometimes pass before birth if they are distressed, or sometimes just a more mature baby. ( I was 41 weeks & 2 days pregnant when I went into labor ). Either way, the fluid was clear & there was no meconium at that time. I asked for another doctor, which is my right, & the OB said that there were no other doctors on-call at the time. I found out later that Kaiser always has two OBs on staff at all times. So she lied about that to me, although I have no idea why she wanted to stay on as my provider. She lied about my dilation, the meconium, & didn’t act in my best interest by not reviewing my medical records in pregnancy & labor up to that point. She violated my patient rights by not giving me another provider, & didn’t listen to my refusal about the vaginal exam, or use any informed choice, which is also a patient right.
I filed a complaint about her care after the birth to Kaiser & to the medical board, & only got back rote letters of acknowledgement, but no action taken against her. The point of sharing this is to say, no matter how educated or informed a woman is as a patient, hospital providers & protocols can steamroll anyone. My own advocacy, & that of my partner, wasn’t enough to stand up to her. It’s sad to me that this will always be a part of my birth experience.
I know before I had my son I was very interested in birth stories from other midwives or providers, as there is a preconceived notion that it will be a harder birth than average. Well, I would say that was true for me. However, I did end up having a vaginal birth, & I never had any struggles with breastfeeding, which was hugely important to me, likely the two things that kept me sane as I processed the birth I did have. I will say it was much harder than I anticipated, particularly the recovery.
+ What are some things that make for a wonderful birthing experience?
♡ A doula! I wish every woman having a baby in the hospital had a doula! Some hospitals have volunteer doula programs, or you can hire a doula within the community. Doulas are excellent resources prenatally, & often the only consistent presence during a hospital birth, offering emotional & physical support. They will help navigate the hospital environment & help you advocate for your choices for you & your baby.
♡ A birth plan. Educating yourself prior to birth about what’s most important to you.
♡ Hiring the right care provider & remembering that you can change providers at any time if you aren’t feeling heard or respected.
♡ Surrounding yourself with the best support for you- husband, mother, friends, sister, etc. Maybe you don’t want anyone else at your birth. Do what’s best for you!
♡ Preparing for the postpartum prenatally- freeze meals, set up a meal train, hire a house cleaner, delegate!
♡ Plan to spend two weeks in bed bonding with your baby, learning to breastfeed, & healing. The more downtime a woman takes right after birth, the better for her long term physical & sexual health & mental well-being. ( I didn’t leave my house for 3 weeks after my son was born. I needed every second of that healing at home ).
+ Why does my back hurt so fucking bad & what can I do to fix it?
Well, this—->> article here.
Your whole body & center of gravity shift and adapt during pregnancy. Regular chiropractic care, acupuncture, & other types of energy work ( cranial sacral, myofascial release ) a pregnancy support brace, and good shoes ( supported arches, low or no heels ) can all help the physical/ structural support. Also sleeping with a pregnancy pillow & using a lumbar support pillow while driving or sitting for long stretches, like at work, can really help too.
I’m a believer in the mind-body connection so painful low back can also be about your root chakra, & the huge life shift that is coming & uprooting your whole base, and what’s grounding you right now is changing. Talking with family/ friends, walking, therapy, yoga, meditation, pilates- working on the energetic & emotional body is great while pregnant! Be mindful if you are just starting a new workout of any type while pregnant, or pushing yourself too hard with workouts you have always done, as your body has much more of the relaxin hormone than it normally does, especially in the third trimester, so it’s easier to overdo it & injure yourself.
+ What are some misconceptions about labor?
I think a misconception is that there is any way that is better or easier than another to give birth. I do not think a home birth or natural birth is right for everyone & I never try to sway a woman into midwifery care if that isn’t right for her. But what I do encourage is that women really delve into pregnancy & birth and do their own research! Know what it means to choose a planned cesarean. Know what it means to want a vaginal birth with an epidural. Know what it means to want a natural birth. Then, optimize how you are going to work to get the birth you hope for with the right team, location, & support. Don’t make choices out of fear or thinking that there is an easy way out, because there isn’t.
+ What are some good books or resources you recommend?
Here are some of my favorites! YouTube is also a great resource to watch birth videos. You can find videos of any type of birth experience- from homebirths, water births, twin birth, cesarean birth, breech birth, siblings at births, planned epidural births, freebirths ( birthing without a trained professional ), & more. If you start a video or chain of videos that aren’t working for you or have something that scares you, turn it off & change your search :).
♡ Books ♡
Ina May’s Guide To Childbirth by Ina May Gaskin
Ina May’s Guide to Breastfeeding by Ina May Gaskin
The Womanly Art of Breastfeeding by Dianne Wiessinger
The Birth Partner by Penny Simkin
The Thinking Woman’s Guide to a Better Birth by Henci Goer
Childbirth Without Fear by Grantly Dick-Read
Gentle Birth, Gentle Mothering by Sarah Buckley
Pushed by Jennifer Block
The Natural Pregnancy Book by Aviva Jill Romm
Gentle Birth Choices by Barbara Harper
The Birth Book by William Sears and Martha Sears
Mindful Birthing by Nancy Bardacke
♡ Websites ♡
*beautiful affirmation cards for pregnancy, postpartum, and mothering.
The Business of Being Born on Netflix
+ For someone trying to get pregnant, what would you recommend?
Optimize your health, nutrition & exercise for around 3 months before trying to get pregnant. Eat clean whole foods, organic, little or no sugar, no caffeine, or alcohol. It’s nice to give your liver & kidneys a nice cleanse before getting pregnant as pregnancy taxes those organs, especially if you are just coming off of any oral hormonal birth controls, as the liver is already taxed.
It’s normal for it to take 6-12 months to get pregnant, so relax & try to enjoy the trying :). Taking Charge of Your Fertility by Toni Weschler is a fabulous book for learning more about your menstrual cycle, when you are ovulating, & maximizing your chances to conceive each month. As well as pregnancy tests, you can get ovulation predictor kits which can also be a helpful tool when trying to get pregnant. Women are only fertile for 24 hours a month, while semen can live in the vagina for 3-5 days- so timing is everything!
Acupuncture is one of my first recommendations for supporting fertility if it is taking longer to get pregnant or you want to be proactive. For women over 35, the current recommendation is to see a fertility specialist if you are trying to get pregnant for 6 months without success.
+ And lastly, is my butt hole gonna rip?
Most likely, no. Tearing while giving birth is common, but such a severe tear is not. Tears are ranked from 1-4 degrees. A tear through the anal sphincter is a 4th degree tear, & not common to see in a normal vaginal birth. Some interventions like the use of a vacuum, which isn’t too common, can cause a more serious tear. Most tears I have seen are 1st or 2nd degree tears that with rest & time ( within 3-6 weeks ) will heal completely fine. Women who have epidurals & can’t feel the strength of their pushes are more likely to have a tear, as they can’t gauge & pace their pushes with the feeling of their own tissue stretching.
A good provider can coach you through pushing to protect your perineum, with or without an epidural. Nutrition & overall tissue health & integrity plays a role in tear prevention. A diet high in healthy fats & omegas shows a correlation to tissue health.
+ Pimp yourself out. Where can everyone find you? (Feel free to talk about your own experience with your own son if you want to).
With my son I was planning a homebirth but I ended up transferring to the hospital in labor as I was staying at 6 cm dilated for a very long time. I labored at home for about 24 hours, & I was 6 cm for 18 of those hours! My midwife broke my water after about 12 hours of no progress in dilation, and 6 hours later when I was still 6 cm, that’s when we decided to transport. When I transferred to the hospital it was another 30 hours before my son was born, so my total labor was 57 hours! You can read the full story on my blog here.
Would love your guys’ feedback. If you have anything to add please do.
+ checkout this q&a on labor pain & epidurals.