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Why you might need a midwife during labor: A conversation with Patty Kartchner, CNM

Patty Kartchner has been guiding women through labor for more than 30 years, first as a doula, and today as a certified nurse midwife. We chatted with her about what it’s like to have midwifery care during birth.

Q: How is birthing a child with a midwife unique?

We consider helping women through active labor to be part of our job, not an extra. Midwives are there to provide as much physical and emotional support as a woman needs to bring her baby into the world. People who have that labor support have shorter labors, fewer interventions, and better breast feeding experiences. A big reason for that is when you know the person you need is close by, you don’t produce as much adrenalin.

Q: What does labor support look like?

It can be as simple as monitoring how she is responding to labor. Or it can be more physical, like rubbing her shoulders or showing a partner where to push on her back. Sometimes it’s reminding her to go to the bathroom or offering options for comfort, like a birth ball. If a patient is becoming loud, seeing that the midwife is calm can help her husband and support people remain calm, too. We also remind women of what to expect in the next hour or two of labor, so it will be less scary when it happens.

Q: How do midwives support women emotionally?

Birth isn’t just a physical experience, it’s a psychological passage. A woman goes from not being a mom to being a mom for the first time. With subsequent babies, a woman becomes a mom of two or three or four. Midwives can help women feel okay with how she’s going to do it. We don’t have value judgements around whether pain management is used. We just want to help women have a birth experience they can look back on and be happy with. Afterward, we help a woman process her labor and find the high points and the character she showed.

Q: Why do you help women process their labor?

When women go into labor, time can blur. I can fill in details, like what time her water broke or when her grandmother went home, and put events in chronological order. Those first few hours are magic. Your baby is only one hour old once. It helps them put the facts into perspective and rebuild memory. Also, I can help identify strengths that she showed that she might not even be aware of, which can be empowering.

Q: What does it mean to trust a woman in birth?

I never want to usurp her power to know what her body is doing. We don’t get a lot of strokes in our culture for body awareness. I’m going to trust what women say. I can offer suggestions and make them aware of options, but I trust them to know what they need.

Q: What is your highest goal when it comes to helping women in labor?

One of my mantras is “one labor at a time.” Help me make this experience what she needs it to be—empowering, healing, or not as scary. As midwives, we want to help each woman feel well-attended to and cared for.