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A Licensed Midwife on the Transformative Power of Birth
Birth is transformative. Not just for the baby, but for the mother who goes through her own “birth” in the process. Hayley Oakes, a licensed midwife based in Los Angeles, has had a front row seat during hundreds of births. Her stories reveal how unique the birth process can be and the universal thread that…
How long have you been working in this field?
I have been officially working in maternal health and infant wellness since 2010. I completed the DONA doula training with Ana Paula Markel at BINI Birth. Prior to that, I was exposed to babies, birth, midwifery care, and doulas in 2008, when I worked at the Prenatal Yoga Center in New York City. I worked at the front desk doing administrative work (I was an undergrad student at the time) and it was then that I knew I wanted to work in this field.
What led you to becoming a midwife?
After completing my doula training, I volunteered at a midwife’s birth center doing administrative work. I was able to sit in on prenatal visits and observe births. Eventually, the midwife told me, “You are meant to do this and you should.” That instilled a lot of confidence in me and encouraged me to go back to school.
What is a common misconception people have about midwives and out-of-hospital births?
The biggest misconception is about the care that is provided. Most people think midwives are only present during the birth, with towels in hand and nothing else. They often confuse the role of a doula with a midwife.
A doula is trained to provide emotional and physical support during labor. Their purpose is to help women have a safe, memorable, and empowering birthing experience. They do not perform any medical procedures.
Midwives are licensed medical health care professionals. They are trained and certified to care for and manage low-risk, healthy women during the childbearing year. During the pregnancy, they perform lab work and monitor the baby’s growth and development. They also discuss nutrition, exercise, and stress with the mother. During labor, midwives monitor the baby’s heart rate with a hand-held ultrasound device. They carry medical supplies and medications (IV antibiotics, DeLee suction traps, Amnio-hook, anti-hemorrhagic medications, oxygen tank, suturing materials, Erythromycin, Vitamin K, etc.) for both the mother and baby. Essentially, the midwife carries a mini-clinic in her birth bags.
In your experience, how common is hospital transfer?
The national statistic is that 1 in 4 first-time mothers transfer to the hospital. In my experience, it depends on the volume of clientele. I have seen as low as a 7% transfer rate and up to 25%.
However, most of those transfers are non-urgent. They are usually due to maternal exhaustion, need for pain relief, or augmentation of the labor. Both the mother and baby are stable, but intervention is needed (i.e. an epidural). Less than 1% of transfers are true emergencies.
What is the most difficult part of the job?
The most difficult part is being on call. While the work is extremely fulfilling, you can appear flaky and unreliable to loved ones. There are dinners, celebrations, shows, movies, and gatherings that have to miss because someone is in labor. This can put a strain on personal relationships.
What is the most rewarding part of the job?
Seeing the transformation in a woman’s sense of power and confidence after giving birth. There is so much shock, awe, joy, tears, sweat — it’s a beautiful thing to witness and the greatest high in the world. That sense of accomplishment often has a positive impact on her approach to breastfeeding and bonding. Knowing I was there to help her navigate that journey is such an honor.
What is one of the greatest lessons you’ve learned in this field?
Birth teaches you to be humble and present. It forces you to have intentions but not expectations. It teaches you that it’s not about the setting, the care provider, or the mother. There are so many other factors that are at play. As one of my clients, Sarah, so beautifully put it, birth is ‘so dark and so light and all of it sacred’.
What advice would you give a new mother who wants to have an unmedicated birth?
Watch birth videos and read positive birth stories. Get to know laboring women’s behaviors and sounds. The more they know about it, the less fear they will have experiencing it. People often say, ‘Women have been giving birth naturally since the beginning of time, so why can’t I do it?’ My response is that those women used to see birth all the time. It was normal. Today, we only see birth in movies, and it is always depicted as a horrific event.
What are some of the basic health, diet, and lifestyle recommendations you give your clients?
Imagine yourself training for a marathon. You would never show up to the start line having spent the last few months eating loads of sugar and not exercising. One has to train physically and mentally.
Eat a high-protein and low-carb diet. This will help control blood sugars, satisfy pregnancy cravings, and prevent excessive weight gain (which leads to more complications during and after the birth).
Exercise regularly. Aim for walking 3-6 miles/day or doing an hour of cardio. This allows the baby to find the best position in the mother’s pelvis and prepares the mother for the endurance she will need for labor and birth (which can be up to 12-24 hours long).
Decrease stress. When there is a constant stream of stress hormones coursing through the mother’s body, this increases the risk of complications for both her and the baby. Have a daily practice of deep breathing, centering/meditating, yoga, and talking to the baby. This naturally lowers your blood pressure, pulse, breathing rate and allows the body to recover from a constant state of being in the ‘fight or flight’ mode.
Bodywork in the form of chiropractic care and acupuncture are key in preventing and/or treating aches, pains, and other issues. Lastly, take a great childbirth preparation series. Knowledge is power!
Do you have a self-care routine?
I try to eat well and go for a walk every day. I take a lot of supplements: Chinese herbs, probiotics, omegas, vitamin D, vitamin B complex, and ginkgo bilboa. I also drink a lot of wellness shots (turmeric, lemon, garlic, cayenne). I see a chiropractor weekly, not because anything is wrong but just as preventative care. Every other week, I see a therapist to touch base emotionally. Periodically, I will do some journaling, coloring, or water coloring. You can’t beat a good Korean spa day or at-home facial steam and mask. I try to practice what I preach.