1) Moms planning a home birth are planning for a low intervention birth. Is the same true for their breastfeeding goals? Do women delivering at home plan to exclusively breastfeed and avoid formula intervention?
Yes. Most women who are planning natural birth also plan to exclusively breastfeed. However, there are situations where a mom chooses not to breastfeed. She may be a victim of sexual abuse or was unable to breastfeed a previous child. We ultimately want women to make the decisions they are most comfortable with after having been provided with as much education and support as possible.
2) What kind of support can a homebirth midwife provide to breastfeeding mothers that is different than a midwife in a hospital or birth center setting?
We offer a lending library that includes breastfeeding books. We offer a one hour prenatal visit so the mother has ample time to discuss her questions, goals, and fears about breastfeeding.
3) What role do you take in prenatal breastfeeding education?
In addition to the support and information provided prenatally, we also suggest the utilization of outside resources like breastfeeding classes, lactation consultants, and La Leche League meetings.
4) What aspects of homebirth uniquely facilitate breastfeeding initiation and establishment?
We are adamant about the necessity of skin to skin contact between mom and baby, with as minimal interruption as humanly possible. Every aspect of the postpartum experience works better when you just leave them alone. Moms heal faster and babies want to nurse when they are not being poked, prodded, and taken away from mom for reasons that could, in most instances, wait.
5) Describe your breastfeeding-specific training. Does it differ from the training hospital midwives have?
I am not familiar enough to speak on the training of hospital midwives. My experience has grown through living and learning. I nursed all four of my babies at various lengths, based on my education and abilities at the time. I am learning all the time through my clients’ experiences ranging from no intervention to the necessity of an IBCLC or pediatric ENT. I also continue to learn through the support of my peers.
6) Describe the well baby care homebirth midwives give in the first 48 hours. How does this care screen for breastfeeding obstacles?
We usually stay with the mother after birth until baby has latched and is nursing well. If this doesn’t happen for some reason, we are in constant contact until it does. We listen to what moms are describing and make the call for further help based on what they are reporting. We may make another trip back to the house, or, if it seems like an issue that is out of our scope of knowledge, we will refer first to an in-home lactation consultant who is willing to assess mom and baby while maintaining the need for skin to skin contact in their own environment.
7) Do women with gestational diabetes, PCOS, or other endocrine disorders birth at home? What special feeding support do these dyads receive from a midwife?
Yes, and we don’t tend to do anything special unless we are finding it to be an issue. The premise is that it is normal and natural unless it’s not. We aren’t in the business of fixing things that aren’t broken. If we need to refer out for these things, we will.
8) Do Homebirth midwives facilitate informal milk sharing between clients? Why or why not?
Yes. However, not all moms are comfortable with that and we support that, too.
Baby not gaining weight, latch that just isn’t getting better despite our suggestions of different feeding positions, mom in extreme pain with cracked, blistered, and bleeding nipples.
10) If a client chooses not to breastfeed, what alternative feeding do you recommend and why?
I usually don’t do much recommending of formula, but I suppose an organic formula of some type if they must. It is extremely rare that a client of ours comes to their six week postpartum visit and is not still exclusively breastfeeding. If they are supplementing with formula, they have already been working with a lactation specialist and have made those decisions together.
Bonus question 11) Share your favorite nursing memory.
Rachel Hart I am a traditional midwife and CPM. I moved to Atlanta from Las Vegas with my husband and four children in 2008. I am a graduate of the University of Nevada, Las Vegas with a Bachelor’s degree in English. I began my midwifery journey through an apprenticeship training program in 2005 and began my own practice in 2007. All four of my children were born at home, the last birth unassisted. I joined Beth at Birthing Way in 2010.
Helping women realize their true power and potential as a woman and mother through the birthing process has been a privilege. I have really enjoyed attending births with the lovely families here in Georgia. I also support the birth community as Secretary of the Georgia Midwifery Association and as Membership Director of the Georgia Birth Network.
