Monday, September 04, 2006

8/31/2006 - Amy Wallace of Little Tree

Today I found my health care provider for this pregnancy! Her name is Amy Wallace of Little Tree, and she's a Certified Nurse Midwife with St. Joseph's Hospital. She has a bachelor's degree and a master of science degree in nursing and eleven years of experience as a midwife. I had done some reading about midwifery, but wasn't positive it was the right choice for me until I spoke with her in person. Amy's friendly demeanor and her obvious professional competence put me right at ease. Her office is five minutes from our house in an adorable, historical shop front building. She spent nearly two hours with me, reviewing my medical history and records, explaining what midwifery is, taking blood and urine samples for labwork, examining me, and answering all my endless questions.

We listened to the baby's heartbeat for the first time! It was going at 155 beats per minute, which is within the range of normal. She confirmed that the peanut is the right size for 10 weeks. And she determined that my bone structure will provide enough room for a good sized baby (something I was worried about since I have a short torso). She also said I have excellent muscle tone, which should help me recover after birth.

Birth!! Woah! We are having a baby! Sometimes it's still hard for me to grasp.

I am really excited about delivering at St. Joseph's Hospital. We haven't taken the tour yet (we get to do that a week from saturday) but we've taken an online tour. Their LDR (labor, delivery & recovery) suites have lots of wonderful features like whirlpool tubs, a birthing bed with many positions, birthing bars, and other "birth accessories" that help during delivery. St. Joe's is a big proponent of skin-to-skin contact immediately after birth and of rooming in. The LDR suites are set up so that the baby's immediate after birth care and admission procedures can be done bedside.

For those of you who are not familiar with the practice of nurse midwifery, you may have some questions. I know I did.

Q. Does this mean you're going to deliver at home?
A. No. Amy works with a group of Certified Nurse Midwives who practice with St. Joseph's hospital in downtown Denver. St. Joseph's has delivered more babies than any hospital in Colorado, and their birthing unit, called The Baby Place, is a spa-like setting and has been nationally recognized. We will have access to all the latest technology, and should anything go wrong we will be in the ideal setting to address it.

Q. So I guess this means you won't be able to have anaesthesia during labor?
A. Actually, I will. Anaesthesiologists are available 24/7 at St. Joe's. Whether I plan ahead of time to use it, or whether I opt for it unexpectedly during labor it will be available to me. I will have all the same choices in this regard as any other delivering mom.

Q. Does this mean you won't be using an obstetrician?
A. That is correct. As long as the baby and I continue to be in good health, we will continue in Amy's care. If I happen to develop a serious condition like gestational diabetes or high blood pressure during pregnancy, I will transfer to the care of an obstetrician. Amy has access to board-certified obstetricians 24 hours a day, should she need to consult with them regarding my care. And of course if I feel at any point in time that I would be more comfortable with an obstetrician I have the ability to transfer over.

Q. What if you have to have an emergency C-section?
A. No problem. Should I need an emergency C-section or should any other condition arise that would be best addressed by a doctor, board-certified obstetricians are available 24/7 to provide that care. Likewise, should there be a problem with the baby necessitating a stay in NICU, St. Joe's has a nationally recognized NICU.

Q. Is she going to wave crystals over you or give you potions made with eye of newt?
A. No way! Amy's practice follows the norms of Western medical methods. With a masters of science in nursing, she is a trained medical professional and she shared with me that she takes research seriously. For those of you who know me well, you know that with my scientific background I would not entrust my pregnancy or our sweet little peanut to a health care practitioner operating outside the standards of Western medicine.

Q. Is this covered by insurance?
A. It sure is. In fact, health insurance companies are big fans of Certified Nurse Midwives. The patients of CNMs tend to have shorter stays in the hospital and fewer medical interventions, which equate to lower costs for the health insurance companies. It also typically means an improved experience for the patients.

Q. Are you putting yourself and your baby at risk by opting to use a midwife instead of an obstetrician?
A. It goes without saying that if I thought that even for a second I wouldn't even consider using a Certified Nurse Midwife. Certified Nurse Midwives are highly competent professionals. They screen their patients to confirm that they are good candidates for using a midwife's services, and they monitor patients throughout pregnancy for issues that would necessitate a doctor's care.

Obstetricians shine brightest in high-risk pregancies or pregnancies with complications. In contrast, midwives' strong suit is in managing normal, healthy pregnancies. They have more time available to spend with their patients. They make education a priority. They have time to make their patients feel listened to and to help them feel comfortable with this amazing journey. While obstetricians are usually only present during the final moments of delivery, midwives are present throughout labor and delivery. Even if I had to transfer into the care of an obstetrician during labor, she would still be present to offer emotional support. I am choosing a midwife because I hope to get better, more personal, more complete care than what I could expect from an obstetrician.

I feel comfortable working with a Nurse Midwife because I believe that the risks to myself and the baby are no greater than working with an obstetrician, especially in light of the facilities and resources she has access to. In addition, I feel that Amy's practice and midwifery in general better address the whole woman and the whole pregnancy. I have never felt so fully cared for by a health care professional than I did with Amy. And not because she was nice or made me feel good. But because of her solid medical professionalism and her ability to address issues you almost never hear a doctor discuss: nutrition, breastfeeding, birthing options, and anaesthesia options.

By choosing to work with Amy I feel that my preferences will be honored, my concerns will be addressed, and this pregnancy and birth will be an enriching experience.

Here are some things I really like about Amy's practice:
  • In addition to the time she spends with patients one-on-one discussing all sorts of issues related to pregnancy, child birth, and child care, she offers a wide range of classes at Little Tree. Childbirth preparation, breastfeeding, infant care, cloth diapering, the circumcision decision, and how to carry your baby in a sling.

  • One option she offers is something called "Centering Pregnancy." It's basically like a group doctor's visit. It's a two hour appointment, during which each patient gets individual time with the midwife followed by group time spent on education and answering questions. Dads often come to these appointments, and women with a range of due dates participate. This is only optional, but I think this is a good fit for us. Since we don't know many people in Denver - and don't know anyone yet with small kids - I think this is a great way to become involved in a community of new parents.

  • Every week she hosts a free gathering from 11-12 called Parent Chat. Each week they have a different topic, and people gather - some patients and some not - to discuss various topics of interest. It's another opportunity for education and connection with other parents and parents-to-be.

  • She also provides well-woman care, so even after the baby comes I can continue to see her for my annual checkup.

You can read more about St. Joseph's Certified Nurse Midwives here. And if you have a chance, take a tour of St. Joseph's Baby Place to see the amazing, spa-like setting we will be delivering in.


Anonymous said...

hey heather, it's ashley! sorry, I'm nursing while typing...I'll try my best to make sense here. anyways, I'm just so happy for you guys...there are few words to describe how awesome feeling your baby move around in your tummy is. I think a midwife is a great option for you...I wanted a birthing pool and texas women's laughed in my face haha...but really, it sounds like she has some great classes and resources. I'm glad you're learning how to sling! slings are the best...I'm addicted to them. I swear I have one to go with every outfit. we're also about to start cloth diapering, so let me know if they have any good tips for you because I'm thuroughly confused by the process. I'm sorry you're feeling so crappy...that will subside. I have fun stories about upchucking in front of people if you ever feel like you're the only one. keep drinking that ginger tea, and pick up a tin of those ginger altoids...also pretzels, saltines (duh) and graham crackers really helped me. oh, and taking your prenatal at night may help a little bit...those horse pills tend to make people feel a little queasy. okay, I'll shut up now, but I'll keep reading, so update often! if you want to reach me, my email is send your mom and sister my love, and tell arwin I said congradulations and I know you two will make incredible parents.

Anonymous said...

Where do I find Amy Wallace these days? Also, looks as if Little Tree is no longer in existence. Do you, by chance, have other midwife recommendations?

Thank you!

Heather Marie said...

Bellyfriend, there doesn't appear to be an email address I can respond to you at, so I'll just reply here. I believe AW is still affiliated w/ the nurse midwives at St. Joseph's Hospital in Denver, but if you are looking for a midwife to be present at your birth, then you probably want to keep looking, as she does not attend births. Unfortunately I would have to say I cannot recommend St. Joe's program, as you don't really develop a close relationship with ONE midwife, you don't know who will attend your birth, and they are in & out of the room like doctors instead of present throughout. In fact my midwife left midway through my birth as it was the end of her shift. My by birth ended up in an emergency C-section, which maybe it would have anyway, but it was not the experience I was going for.