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Welcome to the world, baby Henry!

IU Health Methodist Hospital

Welcome to the world, baby Henry!

The IUHP Midwifery practice welcomed its 100th baby on Valentine’s Day. His birth didn’t go as planned, but it represented the ultimate in collaborative care with IU Health physicians.

By Maureen Gilmer, IU Health senior journalist, mgilmer1@iuhealth.org

Rachael and Eric Carmichael had a grand plan for the birth of their first child. They hired a doula and a midwife and prepared for an unmedicated water birth.

Little Henry Alfred Carmichael had other plans.

Lucky for all three that they were under the care of IU Health midwives at IU Health Methodist Hospital because after an exhausting 34 hours of labor and three hours of active pushing, Rachael ended up delivering Henry on Valentine’s Day via cesarean section.

It was not the delivery she or Eric expected, but they are nonetheless pleased with the support they received every step of the way.

“Despite it being difficult, I don’t think Eric or I look back on the experience as such,” Rachael said a week after Henry’s birth. “We had incredible support from our midwife, from our doula and from our labor and delivery team.”

The couple first met with Darla Berry, manager for Nurse Midwifery Services at IU Health, last year when Rachael was 8 weeks pregnant and knew that this was the route they wanted to take.

“Neither of us had had an experience with midwifery before, but the relationship that was built allowed us to feel comfortable with whatever was to happen,” Rachael said. “We trusted the process and trusted their knowledge and their advice.”

CELEBRATING ONE YEAR WITH 100 BIRTHS

While many people might believe that midwives assist only at home births or in birthing centers, Methodist has long worked with midwives to give women more options in their birth experience.

Just over a year ago, IU Health launched its own midwifery program. Berry came on board first, followed by three more midwives later in the year. Henry is the team’s celebrated 100th baby.

Babies are born at Methodist, though later this year all labor and delivery will move over to Riley Hospital for Children when it opens its long-anticipated Maternity Tower. The new Riley tower will offer a full complement of labor and delivery rooms, private mother-baby suites, OB emergency and triage rooms, a fetal operating room, three additional ORs and a Level 3 neonatal intensive care unit, which when combined with the existing Level 4 Riley NICU will represent the largest NICU in the state.

Although the Carmichaels had definite ideas about how they wanted their first child to enter the world, they understood from the beginning that babies are unpredictable. That’s why they were glad to have the experienced team at Methodist right there should they need medical support.

“We were really happy to be at Methodist, especially because it’s such a large care unit for babies, and if there was anything really extreme that happened we knew we would be in good hands,” Rachael said. “Meeting with the midwives throughout the pregnancy, we had our best-case scenario in mind, but we also knew that babies come when they want to come and how they want to come, so we had appropriate expectations going in.”

While some may view midwives and obstetricians/gynecologists as competitors, Berry said from the beginning her team has presented itself as more of a complementary practice for women who seek a different birth experience.

“This couple’s experience really highlights what we’re all about,” Berry said. “We have the capacity to meet women where they are. The advantage is we’re in the hospital. We are just footsteps away from our backup should we need them. Often we don’t need them, but they are right there and the transition to care and the continuation of care really and truly is seamless. We are all on the same team.”

A WEEK OVERDUE

Rachael was already a week overdue when her labor began early Saturday morning, Feb. 13. She labored at home for eight hours with support from her doula and Eric, before arriving at Methodist just after noon that Saturday. She labored unmedicated for 17 hours, using multiple strategies in an attempt to get things moving, and pushed for three hours. It was at that point that midwife Victoria Floyd called in the medical team for a consult.

“They said you can keep pushing and we can try these other interventions, but he’s not going to come out this way,” Rachael remembered the doctors telling her. ‘He’s not going to fit. A C-section is the best option at this point.’ I was exhausted, and we decided pretty quickly to move forward with this new plan.”

Once the decision was made, things happened quickly. Rachael, who was given an epidural, remembers that one of her labor and delivery nurses came into the OR with Eric and her, which comforted both of them.

“It was a milestone moment in our lives,” Eric recalled thinking at the time. “I love the mystery of birth, and I felt a certain reverence for the process.”

Even though the birth wasn’t unfolding the way he had anticipated, the “reveal” was just as powerful, he said. “We had been waiting to meet this person for so long.”

Henry was a healthy 8 pounds, 14 ounces.

Rachael was able to hold her newborn and have skin-to-skin time within minutes of the delivery, but she acknowledges feeling pretty out of it at the time. It had been a whirlwind, but mom and baby were healthy, and that was the most important thing in that moment.

WHEN BABY TAKES A DETOUR

Dr. Nicole Scott, an OB/GYN who practices at the Coleman Center at IU Health University Hospital and delivers babies at Methodist, said most of the time obstetrics, labor and birth are a normal process.

“Really, us being there, whether a midwife or a physician, is for those moments when things don’t go as planned,” she said.

“It’s a collaborative process. Midwives have incredible roles for labor support and when trying to have unmedicated deliveries and minimal intervention, but sometimes at the end of the day in order to get a healthy mom and a healthy baby we have to go to Plan B,” Dr. Scott said.

“Our physicians are there for those Plan B moments, and in this case the 100th delivery was a C-section despite all best efforts. Sometimes that happens and we’re grateful and happy to provide that support for our midwives.”

For Berry, the midwifery practice’s 100th birth perfectly illustrates the partnership and collaborative care with IU Health medical providers.

“It’s really hard for women who seek midwifery care and really have a well-thought-out birth plan, and then when it takes a hard detour, sometimes there’s some work to be done to process that,” Berry said. “But kudos to the team. The transition to physician care was seamless. Sometimes you have to go all the way to the wall to know that you went all the way to the wall and this baby is not coming out how you planned.”

The beauty of a hospital-based midwifery practice is that midwives are there for women throughout their labor experience, but they are also just a doorway away from a full complement of OB/GYNs and maternal fetal medicine specialists should they be needed, Berry said.

Rachael and Eric are philosophical about the experience – their gratitude for bringing a healthy Henry home last week far outweighing any disappointment.

“We just had a really amazing experience with the midwifery team, with the staff at Methodist. It was all just incredible and more than we could have anticipated,” Rachael said.

Her husband agreed. “It was about the connection and the relationship and the care provided. That’s what made it such an amazing experience.”

Photos by Mike Dickbernd, IU Health visual journalist, mdickbernd@iuhealth.org

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