Do You Trust Your OB/Midwife?

Monday, September 10, 2018


I was recently asked a question in an interview that I have not been asked before. "No offense, but how do I know you are who you say you are?"


This question was asked right off the bat by a father during an interview in their home. I usually schedule potential new client interviews at Deb's, so that the family can meet all of us, see where prenatal appointments will be held, and get an idea of the drive they will be making every 2 weeks or every week as their birth draws nearer. Our appointment schedule has been quite busy, and the family lived closer to me, so I visited with them in their home instead. 


"I mean, you could be anybody walking in here," he continued. And I agreed with him. That is a valid question. 

It's usually the case, and it was the case in this instance, where the one who is pregnant is the one who has done the reading, searching, and talking with her friends about what she wants from her birth experience and care provider. It can come as a shock to a partner whose only experience with birth has been from tv shows or maybe a couple hospital births. "You want to do what?! Who is this person who will be coming into my home?”


I acknowledged that he was right to question me and gave him some websites where he could verify my credentials.


Part of what makes home birth work so well is the relationship and trust midwives build with our clients. Our goal is that by the time we come to your home to assist you in giving birth, you will have become very familiar and comfortable with us, and you will trust that your family is in good hands. In the rare event that complications arise, we want you to feel confident that we will make the best decisions possible, refer out when necessary, and continue to support you through a change in plans. Feeling safe during labor helps labor to progress normally.


If I need to show proof of the claims I make (for example, I mentioned that in almost 22 years of nursing, I’ve never been involved in a lawsuit) in order to earn credibility, then I’m ok with that.  I’ll be happy to show you a website where you can check that out for yourself.


I have updated my "Meet Paula" page with links to the pages where you can verify the licenses and certifications I hold. Just click on the link, type in my name and number, and voila. You’ll see my nursing license was issued in January 1997, it’s currently active, and I’ve had no disciplinary actions.  You'll see my education and memberships. I hope that this will provide evidence that I am passionate about my work and serious about protecting the safety of mother and baby. 


I’m also clear about the fact that while I am a licensed nurse, I’m a midwifery student. I work under the supervision of Deb Phillips, who is licensed by the state and holds the CPM credential as well as a Midwifery Bridge Certificate. Deb will be with me at prenatals and at the birth, and you will get to know her very well, too. For allowing me learn with you (thank you!), you get a big discount. 


As always, if you have any questions for me, I am happy to answer or call/text me.


Arkansas Blossoms
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We are surrounded by information! Between Google, Pinterest, blogs, and other social media, it seems you have all the information you need to know about having a baby right there at your fingertips. Maybe your friend, who had an unmedicated birth last year, has a ton of books you can borrow, and she can give you the scoop on what giving birth feels like.  Maybe you are planning to get an epidural as soon as you feel contractions, and you figure the nurses will tell you what you need to know. Besides, you and your partner are both pretty busy. How are you going to find time to squeeze in a class? Is it really necessary to take a childbirth class? Well, no, it's not necessary--you are going to give birth whether you take a class or not! But there are advantages to preparing yourself before you give birth.. The most important reason to take a class with a live instructor is to prepare yourself for the realities of today's healthcare system. The vast majority of Labor & Delivery nurses are caring and passionate about their work, and they want to see you have an awesome birth. The reality is that Labor & Delivery can be an extremely busy place with a lot of big stuff happening. As much as the nurses like to sit down and explain everything you need to know and patiently answer all your questions, sometimes higher priorities pull them in different directions. Things would go more smoothly for everyone if you were prepared for the routine stuff ahead of time. Some people may think that childbirth classes are only useful if you are planning an unmedicated ("natural") birth, but here's the truth: even if you are planning to accept pain medication "as soon as I can have it, please and thank you!" it is unlikely that your birth will be a pain-free experience. You may find that there is a lot more discomfort than you were expecting, and the anxiety and tension that often accompanies being in an unfamiliar situation will increase that discomfort. The comfort and coping techniques you learn in your childbirth class will be useful in a variety of circumstances in a hospital setting. Especially while you're waiting for and getting your epidural. You also want to make sure your information is accurate and unbiased. A lot of the online information...well, you can't really be sure it's factual and based on good evidence or if it's based on someone's opinions. There's a lot of junk to sift through.  What kind of childbirth preparation is available? A childbirth class series meets several times over regular intervals (for example, a two-hour class every week for 6 weeks.) You will find this kind of class offered by certified childbirth educators (such as Lamaze or Bradley), midwives, doulas, and some hospitals or birth centers. A disadvantage of a series of childbirth classes is the time you will have to set aside time for the classes. For the introverts among us--you'll have to be around other people. But there are some advantages of signing up for a class series. You will have time to absorb the materials. Each week, as you recap what you already learned before moving on to the new material, you absorb a little more and remember more.  Ideally, your class should be one where you are actively participating--asking questions, discussing, participating in learning activities, and practicing. Actively participating will help you retain the information. For relaxation exercises and comfort techniques, we recommend practicing so that when the time comes, you and your partner will already know what to do. The first couple times you try the techniques, it may feel awkward! After you go home and practice, then come back the next week and do them again in front of your instructor, you'll begin to feel more confident, and they will become more natural to you. That's the idea. As you are reflecting back on what you learned the previous week, you will probably have more questions. You can write them down and bring them to the next class for discussion. In a class with other couples, you may hear questions you hadn't thought of, and these variety of questions usually open the door for some great discussions. Seeing the same couples over the course of a few weeks may help you to make new friends! A one-day class may be taught at a local hospital or birth center, by a childbirth educator, a midwife, or a doula. These classes are easier to fit into a busy schedule. A hospital class will usually include a tour of the hospital and information on that particular hospital's policies and routines, which can reduce stress when it's time to check in.  Some childbirth educators offer private classes in your own home. Private, in-home classes also offer a more relaxed, personal setting for those who would rather not participate in a class with other couples. A disadvantage of a one-day class is that, although you'll get information, it likely will be a condensed version rather than comprehensive information.  You may retain less than you would learning the material over time. You may not have time to practice comfort techniques and may forget them when the time comes. Online classes, such as Birth Boot Camp offer a variety of options to customize your experience and work at your own pace, making it very convenient for busy families.  Some people do very well learning from videos, and if you are motivated, this may be ideal for you.  The disadvantage is not having face-to-face, hands-on guidance, particularly with comfort techniques. Also, nobody is holding you accountable for attending, and there is a lot of material to get through...are you sure you'll complete it? If you would like more information on childbirth class options, such as what sort of educators, classes, or in-home options are available in your area, feel free to email orcall/text me.
Paula Ross
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If not, let me introduce you!  NORA is an infusion we recommend to our pregnant clients, made from a blend of nettle leaf, oatstraw, red raspberry leaf, and alfalfa. This delicious infusion will help keep you hydrated, nourished, and may help with some of common minor discomforts of pregnancy. We recommend drinking a quart daily, beginning in the second trimester of pregnancy and continuing while you are breastfeeding.  Stinging Nettle Leaf (Urtica dioica) is one of the most nutritious plants, containing calcium, potassium, protein, beta carotene, trace minerals, iron, and vitamins A, C, D, and K. It is used as a blood builder to treat anemia and promote circulation, to increase milk supply, and decrease menstrual bleeding or bleeding after childbirth. Oatstraw (Avena sativa) is one of my favorite herbs. Not only is it very nourishing, it is calming and mood-stabilizing. Prepared as an infusion, it provides protein, is high in B vitamins (except B12), calcium, magnesium, and contains all macro- and trace-minerals in high amounts. Plus, it has a pleasant, mellow taste.  Red Raspberry Leaf (Rubus idaeus) contains vitamins C, E, B2, B3, calcium, zinc, selenium, phosphorus, potassium, and iron. It is used to tone the uterus and ease uterine spasms. It is said to make uterine contractions more effective, and to increase breastmilk. It also promotes healthy bones, nails, teeth, and skin. Alfalfa (Medicago sativa) contains a wide variety of minerals including iron, calcium, magnesium, phosphorus, sulfur, chlorine, sodium, potassium, silicon, and trace elements. It is also a good source of Vitamin E, Vitamin C, Vitamin K, and protein. It is said to cleanse the blood, aid in blood clotting, alleviate allergies, aid with digestion, promote healthy bones and teeth, help with headaches, and soothe sore joints. It is nicknamed “the father of all foods.” To make an infusion, mix 2 parts Nettle and Red Raspberry Leaf to 1 part Oatstraw and Alfalfa. Place about an ounce of the herb mixture in a quart Mason jar, pour boiled water over the herbs, cap tightly and let sit at least 4 hours to overnight. Then strain the herbs and drink over the course of the day. Add a little honey, if you like. Deb generously provides NORA to all our homebirth clients. If you want to order some for yourself, all these herbs are available online through Mountain Rose Herbs, Frontier, or even on Amazon.
Paula Ross
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I have a little tradition on New Year’s Day of reflecting back over the previous years, as I plan for the year ahead. I browse our photos and scrapbooks, and I read through my Facebook memories. I noticed that that on this day in 2013, my midwife was visiting our home for a postpartum visit, newborn screen, and signing the birth certificate for our seventh baby. (The Baby turned five years old a couple days ago!) There were many joyful posts and pictures of the new baby. Reading through all the joyful posts about the baby’s birth, I still remember... nine months prior to that... sitting alone in my bedroom with the door locked, watching that positive line grow darker on the pregnancy test. I couldn’t breathe. Honestly, I had a meltdown. I had suffered postpartum depression with my previous two pregnancies, panic attacks with the last one, the baby had just turned a year old, and I was just beginning to see the light at the end of the tunnel. I didn’t see how I could possibly go through it all again. I felt guilty and ashamed that I wasn’t happy, that I didn’t want to be pregnant again. As the mother of a large, Christian family, I was supposed to see children as blessings, welcome a new baby with an open heart, and feel joy at adding to my family. There weren’t many people I could share my true feelings with. I mostly kept them to myself and went through the motions. The holiday season, full of joy and celebrating, is typically the time of year when we get the most calls from moms who have received a positive pregnancy test, full of excitement, hope, apprehension, anxiety, and questions. I understand that not everybody feels joy or excitement about that positive result. If you are not happy about your positive pregnancy test, I want you to know that it’s ok to feel that way. You are not a bad person because you have those feelings. You are not alone. I hope you will reach out and talk to someone. If you need someone to talk to, I am here to listen. And I promise I won’t judge.
Paula Ross
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Right now the media is full of recipes for leftover turkey. What all can you do with leftover turkey? It’s endless! You can find recipes for turkey enchiladas, turkey quesadillas, turkey chili verde, turkey stir-fry, turkey soups, turkey casseroles, turkey tetrazzini, turkey spaghetti, turkey... But I want to give a shout out to the bones. Don’t throw out the turkey bones! They can make a very nourishing broth to be used for illnesses or recipes that call for broth. After you’ve pulled all the meat off the turkey, put the bones in a large stock pot. I add an onion or two, a bulb of garlic, peppers, celery, herbs like rosemary or thyme...whatever I have on hand. Add 1 tbsp of apple cider vinegar to help draw the minerals out of the bones. Fill the pot with water, covering the bones. Simmer all day. After it has cooled, strain the liquid into containers, and store them in the freezer. Whenever I need a recipe that calls for broth, or when someone in my family becomes ill, I pull this broth out and heat it up. Bone broth at the first sign of an illness helps keep us hydrated, and the protein, calcium, magnesium, and other minerals supports our bodies’ ability to repair themselves. The garlic, onions, and herbs strengthen our immune systems and help our bodies fight off whatever germs we’ve been exposed to. This, along with plenty of rest, cutting out the sugar/processed foods, and herbs like elderberry and echinacea have been tried-and-true at helping us get over whatever we've been exposed to more quickly. In addition to being hydrating, nourishing, and immune-boosting, homemade broth is more delicious and satisfying than the canned broths in the supermarket! Our Thanksgiving turkeys yield several quarts of delicious bone broth. The same process can be done with vegetables to make vegetable stock. When you are cutting up your onions, celery, broccoli, carrots, or whatever, save the parts that you would normally throw away, simmer them together, and strain for veggie broth. From our family to yours...Happy Thanksgiving!
Paula Ross
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Many of my friends have been anticipating the first day of fall for weeks now. My Facebook newsfeed has been overtaken by pumpkin spice memes, pumpkins, hoodies, football, bonfires, boots...and TODAY is the long-awaited first day of fall!  Except nothing resembling "fall" is happening outside. It's 94 degrees out. I'm even going to skip the football game this evening; I'm afraid I'll melt. (Go, Yellowjackets!) Everybody who's been in Arkansas for any length of time knows to not expect Fall at the end of September. We already know it's going to be awhile longer before we start feeling fall temperatures. Even though we know that, it's still a little of a bummer when the first day of fall gets here...and it's still summer. It reminds me of the end of my pregnancies. After my second pregnancy, I had come to expect that I would go past my "due date," and by a lot. Not days, but weeks. I was already in the habit of giving a "due month" when people would ask. And still, when my due date would pass, I would be a little bummed to still be pregnant, to show no signs of delivering a baby anytime soon. Or even worse--to show a few signs, get my hopes all up, and then still have lots of pregnancy left! Just remember, nothing can last forever. Not summer, not pregnancy. Babies will come when it is time, heat waves will finally give way to crisp mornings. Then crisp mornings will give way to frost, frost will give way to spring buds, spring buds will blossom into barbeques and days at the lake...and before you know it, the baby will be taking her first steps. So hang in there, Arkansas friends...especially pregnant Arkansas friends! Our fall is on the horizon! 
Paula Ross
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Whatever comes your way can do it. You will get through it. You have what it takes. Just breathe.     
Paula Ross
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Image courtesy of Catherine Anne Photography One of our frequently asked questions is, "Do you do water births?" The answer is yes, we do! Laboring and/or birthing in the water is a popular option among our home birth clients.  We have two birth pools, which we loan out at no charge (there is a $30 charge for the disposable liner.) We will give you instructions on setting it up, how to fill it, when to fill it, how to drain it, and anything else you need to know. The above photo is one of our tubs in use. The water is approximately chest deep and covers your belly when full. (That's me in the photo. I loved my waterbirths!) Another question we are frequently asked is, "What do you think about waterbirth? Is it safe?" The short answer is yes, we believe waterbirth is safe, based on our experience, along with the current literature. We have seen that immersing in a tub of warm water benefits laboring mothers by helping them relax, helping them to get into comfortable positions, making it easier to cope with contractions, and decreasing their perception of pain. If our client chooses to stay in the pool to birth the baby, we have not seen any increase of adverse outcomes for the baby in our practice. If you would like to read more about this birth choice, Evidence-Based Birth published an excellent article on water birth, written by Rebecca Dekker, PhD, RN, APRN, in which she thoroughly examined the existing research that has been done on water birth (and there is an 80 page annoted bibliography available of all the research studies that have been done.) The conclusion: For women, there are several benefits associated with waterbirth. There is strong evidence that waterbirth is associated with a lower episiotomy rate, and that women who use waterbirth will have higher rates of intact perineum and use less medicine for pain relief.The benefits or risks for the newborn are less clear, but so far the evidence shows fewer or equal NICU admission rates for waterbirth babies compared to babies born on land.There have been rare case reports of breathing problems or infections in infants after waterbirth, but these risks have not been seen in the large, recent, prospective studies on waterbirth.The ACOG/AAP opinion statement on waterbirth contained major scientific errors and was an inaccurate and incomplete review of the literature.Their opinion statement should not be relied upon to make informed decisions about the availability of waterbirth for women. Based on the data that we have,waterbirth is a reasonable option for low-risk women during childbirth, provided that they understand the potential benefits and risks. If women have a strong desire for waterbirth, and there are experienced care providers who are comfortable in attending waterbirths, then at this time there is no evidence to deny women this option of pain relief. Although we need more research on waterbirth, the available research shows that universal bans on waterbirth are not evidence-based. Although getting in the tub during labor is a possibility at some of our local area hospitals, none of them allow water birth. Hospital policies mandate getting out of the tub before pushing begins. If a water birth is what you desire, and home birth is an option for you, there are experienced midwives in Arkansas who are comfortable attending waterbirths. I would love to chat with you about it! Give me a call or text at 501-436-8525, or contact me here.
Paula Ross
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  It seems like I am on a never-ending quest for healhy snacks. Not just healthy, but also delicious--I want them to be more enticing than the less-healthy snacks I crave. And kid-approved, too. Oh, and let's not forget frugal...keeping enough snacks to satisfy all my hungry mouths during the summer can amount to a nice chunk of change. Yes, such a snack exists. I present to you...healthy chocolate milkshakes. Easy to make... One banana  A dollop of peanut butter A tsp cocoa powder A cup of milk (regular, almond, coconut, whatever you prefer) A cup of ice Blend until creamy. Adjust the milk and/or ice to your desired consistency. Add a little stevia or a squeeze of honey if you want yours a little sweeter. The overripe bananas that the kids won't touch are perfect for this. Slice them up, stick them in a plate on the freezer, and use them when ready. You can store them in a ziplock after they are frozen, but mine never stick around that long. Frozen ripe bananas blend up nicely into an ice-cream-like consistency.  Do you ever keep treats stashed away to savor during those victorious moments, when everyone is down for a nap or quietly occupied, and you have a few precious moments for yourself? This tastes decadent enough for one of those moments.  This has broken my drive-through-Sonic-for-half-price-milkshakes-after-8pm habit. And hey, when the kids come find you and see that you have a treat, this is one you won't mind sharing.  
Paula Ross
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The word "midwife" means "with woman." Midwives have been attending births for centuries and are known for providing personal attention and warm, compassionate care to mothers and babies. An apprentice midwife is a midwife-in-training and practices under the direct supervision of an experienced midwife. I am permitted by the health department to practice midwifery under the supervision of Deb Phillips, LLM, CPM. I am also working toward the credential of Certified Professional Midwife (CPM), which is awarded by the North American Registry of Midwives. I am at the phase of my apprenticeship where I am stepping into the "primary" role, with Deb assisting and supervising. While I am seeking my own clients, Deb will be present with me at prenatal visits and births until I am licensed, and even beyond that, as needed. Midwives typically attend births in pairs, rather than alone. Why would you want to hire an apprentice to attend your homebirth? In a nutshell, when you hire me, you get me...AND Deb! As an apprentice, I charge less than licensed midwives. It's a sweet deal.  I believe in you. I believe you are strong, intelligent, and capable. I believe your body is able to birth your baby. I believe you are able to make decisions that are right for you and your family. As your apprentice midwife, I will monitor your health and your growing baby's health during pregnancy and birth, I will provide you with accurate, evidence-based information to answer your questions, and I will provide you with watchful eyes, listening ears, a soothing touch, compassion, and warmth throughout our time together.  From the moment you hire me until your last postpartum visit at 6 weeks, I am always available to answer your questions or listen to your concerns. If you need extra help with breastfeeding, I can provide that. Read more about what to expect at prenatal appointments and at your birth. "But what if...?" Things do occasionally pop up that are beyond anyone's control, regardless of where you give birth. We have plans in place to handle the unexpected. Before becoming an apprentice midwife, I was a seasoned Registered Nurse, as well as lactation consultant and doula. I have 20 years experience in assessing normal vs abnormal and handling urgent situations when they arise. My supervisor, Deb Phillips, is a reputable, experienced licensed midwife who has been practicing for around 35 years and has caught more than 1000 babies (with no stillbirths or maternal deaths.) She attended the births of my babies born at home, and I am honored to be able to learn from her.  In addition, Deb has another apprentice, Rebecka Ockay, who is also a massage therapist and a doula. The three of us typically attend prenatals and births together. Imagine having an experienced midwife, massage therapist, registered nurse, lactation consultant, and doulas attending to you as you labor and birth in your own comfortable room! We are your dream team! Between the three of us, you can rest assured that you are in experienced, capable, supportive hands. Are you looking for an excellent team of midwives in Arkansas? Contact me!
Paula Ross
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In February of 2017, the American Congress of Obstetricians and Gynecologists issued an opinion statement on approaches to limiting interventions during labor. Among their recommendations and conclusions was that continuous one-on-one emotional support by support personnel (doulas!) benefits laboring women. "Evidence suggests that, in addition to regular nursing care, continuous one-to-one emotional support provided by support personnel, such as a doula, is associated with improved outcomes for women in labor. Benefits found in randomized trials include shortened labor, decreased need for analgesia, fewer operative deliveries, and fewer reports of dissatisfaction with the experience of labor (1, 17). As summarized in a Cochrane evidence review, a woman who received continuous support was less likely to have a cesarean delivery (RR, 0.78; 95% CI, 0.67–0.91) or a newborn with a low 5-minute Apgar score (fixed-effect, RR, 0.69; 95% CI, 0.50–0.95) (1). Continuous support for a laboring woman that is provided by a nonmedical person also has a modest positive effect on shortening the duration of labor (mean difference –0.58 hours; 95% CI, –0.85 to –0.31) and improving the rate of spontaneous vaginal birth (RR, 1.08; 95% CI, 1.04–1.12) (1)." This one-on-one emotional support, so valuable during labor and birth, is just as valuable in the first few weeks at home! As new parents adjust to new roles, new schedules, and new demands, a postpartum doula helps the whole family transition into their new "normal." This week, doulas are being recognized and celebrated worldwide for their contributions to birthing and new families. World Doula Week begins every year on March 22, the Day of the Doula, and continues through March 28. This week, I want to say THANK YOU to all the wonderful doulas in my life, for all the loving support you provide to new and growing families!



Baptist Health Expressly For You--breast pump rental, bra fitting, support group, 24-hr breastfeeding help line. (501) 202-7378


Breastfeeding Reassurance and Support--a Grant County breastfeeding support group. 


ICAN Central Arkansas--International Caesarean Awareness Network


La Leche League of Arkansas


Blogs & Websites


Dr. Aviva  Romm


Evidence Based Birth


Science & Sensibility


Spinning  Babies 


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Arkansas Blossoms Birth Services
Sheridan and North Little Rock, Arkansas
Phone: 1-501-436-8525

Home Birth ~ Water Birth ~ Lactation Support ~ Breastfeeding Help ~ Doula ~ Childbirth Classes ~ Breastfeeding Classes ~ Placenta Encapsulation

Serving Sheridan, Little Rock, Bryant, Benton, Malvern, Hot Springs, Arkadelphia, Pine Bluff, White Hall, Star City, Dumas, Monticello, Rison, Redfield, Camden, El Dorado

"Let all you do be done in love." 1 Cor. 16:14
© 2016-2018 Arkansas Blossoms Birth Services