Ohio Senate Bill 140

Ohio Senate Bill 140 has been formally introduced and seeks to improve access to freestanding birth centers by addressing the long-standing issue of hospital transfer agreements. Under current regulations, all birth centers in Ohio are required to maintain a written transfer agreement with a local hospital—an administrative hurdle currently preventing the Cincinnati Birth Center from fully opening. 

A question many have is: but what about when transfer is a necessity? Wouldn’t a hospital transfer agreement create a smoother transition?

Actually, the requirement is a redundancy that simply creates a barrier to a family’s choice of provider. Let’s take a closer look.

The Redundancy of the Transfer Agreement Requirement

As requirements currently stand, a birth center must hold a written transfer agreement with a local hospital in order to open its doors. However, many hospitals, particularly those with obstetric departments, are unwilling to enter into these agreements—often because birth centers are viewed as competition. This creates an artificial restriction on the establishment of new birth centers and limits choices for families seeking out-of-hospital birth options.

In reality, birth centers already have well-established protocols for emergency transfers. Midwives are highly trained in risk assessment and are skilled at identifying when a laboring person or newborn may require a higher level of care. Transfers, when necessary, are carefully planned and executed for a seamless transition to hospital care. 

The idea that a birth center needs an agreement with a hospital to safely transfer a client ignores the fact that hospitals are already legally required to accept and treat any patient in an emergency. This is a redundancy that has been abused by the medical system in many scenarios.

The Revised Bill: Creating Stronger Protocols without Barriers

The revised version of Senate Bill 140 acknowledges the importance of having a structured transfer process without imposing unnecessary administrative red tape. Under the new framework, birth centers will be required to have a written transfer plan with clients. This plan will outline the process for hospital transfers, ensuring that every family understands what will happen in the rare case that higher-level medical care is needed.

Additionally, many birth centers already work with clients to pre-register with a local hospital. This proactive approach ensures that, in the event of a transfer, hospital staff have all necessary medical records on file, allowing for a smoother transition and minimizing delays in care. 

Group B Strep - Can I Have a Home Birth?

You’ve probably heard of Group B Strep, and if you’ve ever had a child you’ve probably had to test for it. Are you still eligible for a home birth if you test positive?

The simple answer - yes! You can still have a home birth if you test positive for Group B Strep. There are just a few extra steps you may need to take and discuss with your midwife.

Group B Strep - What Exactly Is It?

Group B Streptococcus (GBS) is a common bacterium that can be found in the digestive and reproductive tracts of healthy adults. While typically harmless and often temporary, GBS can pose serious risks to newborns if transmitted during childbirth, especially if they are premature or have weakened immune systems.

GBS Testing During Pregnancy

Pregnant women are usually screened for GBS between 36 and 38 weeks of gestation. The test involves a simple swab of the vagina and rectum, which is then analyzed for the presence of the bacterium. A positive result indicates that the individual is a GBS carrier, though this does not necessarily mean the baby will become infected.

About 25% of pregnant women will test positive for GBS, and about 1 in every 200 babies born to mothers who test positive will develop symptoms.

Risks of GBS for Newborns

While GBS doesn’t usually cause symptoms in adults, it can lead to severe infections in newborns, including:

• Early-onset GBS disease (EOGBSD): Occurring within the first 24-48 hours after birth, this can result in pneumonia, sepsis, or meningitis.

• Late-onset GBS disease (LOGBSD): Developing between one week and three months after birth, this form can also cause meningitis and other complications.

• Other complications: Preterm labor, stillbirth, and infections in the mother, such as urinary tract infections or chorioamnionitis, can also be linked to GBS.

Treatment Options for GBS in Hospital and Home Birth

The standard medical approach for those who are GBS-positive giving birth in a hospital is intravenous (IV) antibiotics, typically penicillin or ampicillin, administered during labor. This significantly reduces the risk of transmission to the baby. However, some may seek alternative options, especially in home birth settings.

For those planning a home birth, GBS management involves careful consideration of risks and alternative treatment strategies. Some approaches include:

1. Informed Decision-Making: Home birth midwives provide education about GBS, its risks, and potential interventions, allowing families to make choices aligned with their values and comfort levels.

2. Holistic and Preventative Measures: Some midwives recommend probiotics, garlic, chlorhexidine vaginal rinses, and dietary modifications to promote a balanced microbiome and potentially reduce GBS colonization.

3. Antibiotic Administration at Home: In some cases, midwives may administer IV antibiotics at home if the mother chooses this option and the midwife is trained in IV administration.

4. Monitoring and Early Detection: Babies born at home to GBS-positive individuals are closely monitored for early signs of infection, such as respiratory distress, temperature instability, or difficulty feeding.

5. Emergency Transfer Plan: If a newborn shows signs of infection, immediate medical intervention in a hospital setting is crucial. Midwives attending home births have established emergency transfer protocols for timely care if needed.

While conventional treatment involves IV antibiotics, alternative management strategies may be preferred by some families. Open communication with your midwife or other healthcare provider is important to go over risks, explore options, and create the safest possible birth experience for both parent and baby.

Midwives vs. Nurse-Midwives - What's the Difference

Have you ever wondered about the difference between midwives and nurse-midwives?

The terms “midwife” and “nurse-midwife” are often used interchangeably, but they are not the same. While all midwives are trained to provide the same level of care throughout pregnancy, birth, and postpartum, their paths to practice do differ in some areas.

Breakdown of CNMs, CMs, and CPMs

There are three main types of midwives - Certified Nurse-Midwives (CNMs), Certified Midwives (CMs), and Certified Professional Midwives (CPMs). Below is a breakdown of their key differences:

Regulatory Recognition and Practice in Ohio

Ohio has specific regulations governing midwifery practice, affecting CNMs, CPMs, and CMs differently. Below is an overview of how each type of midwife is recognized and regulated in the state.

Certified Nurse-Midwives (CNMs) in Ohio

• Legal Status: Recognized and licensed as Advanced Practice Registered Nurses (APRNs).

• Regulatory Body: Ohio Board of Nursing (OBN).

• Scope of Practice: CNMs can provide full-scope midwifery care, including prenatal, birth, postpartum, gynecological, and primary care.

• Prescriptive Authority: CNMs in Ohio can prescribe medications but must have a Standard Care Arrangement  with a collaborating physician to do so.

• Birth Settings: CNMs can legally practice in hospitals, birth centers, and home birth settings.

• Practice Limitations: While CNMs are licensed in Ohio, the requirement for physician collaboration can limit their ability to practice independently.

Certified Midwives (CMs) in Ohio

• Legal Status: Not recognized or licensed in Ohio.

• Regulatory Body: No regulatory oversight in Ohio.

• Scope of Practice: CMs are trained to provide the same midwifery care as CNMs, but because they do not have a nursing background, they are not legally permitted to practice in Ohio.

• Prescriptive Authority: Not applicable in Ohio, as CMs are not recognized.

• Birth Settings: CMs cannot legally attend births in Ohio.

• Practice Limitations: Without state recognition, CMs are unable to obtain licensure or legally offer midwifery care in Ohio.

Certified Professional Midwives (CPMs) in Ohio

• Legal Status: Not licensed or regulated by the state of Ohio.

• Regulatory Body: No state oversight—CPMs are not recognized by the Ohio Board of Nursing or the Ohio Medical Board.

• Scope of Practice: CPMs specialize in home birth and birth center care for low-risk pregnancies

• Prescriptive Authority: CPMs cannot prescribe medications in Ohio.

• Birth Settings: CPMs primarily attend home births and birth center births

• Practice Limitations: Because Ohio does not regulate CPMs, they cannot access hospital privileges, order laboratory tests, or provide prescriptions. 

Advocacy efforts continue to push for CPM licensure in Ohio to expand midwifery care access, particularly for families seeking out-of-hospital birth options. Regulatory changes could provide greater legal clarity, improved safety measures, and increased options for midwifery care statewide.

Which Type of Midwife Is Right for You?

Choosing between a CNM, CPM, or other type of midwife depends on factors such as birth preferences, desired setting, and state regulations. Those seeking a hospital birth or a midwife with prescriptive authority may opt for a CNM, while those planning an out-of-hospital birth may prefer a CPM or another midwife trained in home birth settings.

Regardless of the chosen provider, midwifery care has been proven to improve birth outcomes, lower intervention rates, and provide a more personalized approach to maternity care. 

Healthy Pregnancy Meals and Snacks

Proper nutrition plays such a huge role in the health of both mother and baby that it can feel overwhelming trying to figure out what you should and shouldn’t eat while pregnant. 

This article will break down some of the key nutrients needed during pregnancy and some meal and snack ideas that are high in these nutrients. Keep this list nearby so you can spend less time foraging for snacks and more time nourishing your body!

Essential Nutrients for Pregnancy

First, let’s take a quick look at some of the main nutrients you need while pregnant and which foods carry them.

1. Folate (Folic Acid) - Supports neural tube development and prevents birth defects

• Sources: Leafy greens, citrus fruits, beans, fortified grains

2. Iron – Helps produce extra blood for both mother and baby, preventing anemia

• Sources: Lean meats, spinach, lentils, fortified cereals

3. Calcium – Supports fetal bone and teeth development.

• Sources: Dairy products, leafy greens, almonds, tofu.

4. Protein – Aids in baby’s growth, cell production, and overall development.

• Sources: Eggs, poultry, fish, beans, nuts, dairy.

5. Omega-3 Fatty Acids – Essential for brain and eye development.

• Sources: Salmon, flaxseeds, walnuts, chia seeds.

6. Fiber – Prevents constipation, a common pregnancy discomfort.

• Sources: Whole grains, fruits, vegetables, legumes.

7. Vitamin D – Helps with calcium absorption for strong bones and immune function.

• Sources: Sunlight, fortified milk, eggs, mushrooms.

8. Choline – Supports brain development and reduces neural tube defects.

• Sources: Eggs, chicken, peanuts, dairy.

Meal Ideas for Pregnancy

BREAKFAST

Spinach and Cheese Omelet with Whole Grain Toast

This protein-packed breakfast is rich in folate, calcium, and choline.

• Ingredients: 2 eggs, ½ cup spinach, ¼ cup shredded cheese, 1 slice whole grain toast.

• Instructions: Scramble eggs with spinach, cook until firm, add cheese, and serve with toast.

Oatmeal with Chia Seeds and Berries

A fiber-rich, omega-3 packed breakfast that supports digestion and energy levels.

• Ingredients: 1/2 cup oats, 1 tbsp chia seeds, 1/2 cup mixed berries, 1 cup almond milk.

• Instructions: Cook oats with almond milk, stir in chia seeds, and top with berries.

Avocado and Egg on Whole Grain Toast

A nutrient-dense breakfast packed with healthy fats, choline, and fiber.

• Ingredients: 1 slice whole grain bread, 1/2 avocado, 1 poached or scrambled egg.

• Instructions: Mash avocado on toast, top with egg, and season as desired.

LUNCH

Quinoa and Chickpea Salad

A fiber-rich, iron-packed meal that’s also high in protein.

• Ingredients: 1 cup cooked quinoa, ½ cup chickpeas, cherry tomatoes, cucumbers, feta cheese, olive oil, lemon juice.

• Instructions: Mix all ingredients and drizzle with olive oil and lemon juice.

Lentil Soup with Whole Grain Bread

A hearty, iron-rich meal loaded with fiber and plant-based protein.

• Ingredients: 1 cup cooked lentils, 1/2 cup diced tomatoes, 1/2 cup carrots, 1/2 cup spinach, vegetable broth.

• Instructions: Simmer all ingredients in broth for 20 minutes and serve with whole grain bread.

Turkey and Avocado Wrap

A protein-packed and folate-rich meal to keep energy levels stable.

• Ingredients: Whole wheat wrap, 3 oz sliced turkey, 1/2 avocado, spinach, hummus.

• Instructions: Spread hummus on wrap, layer with turkey, avocado, and spinach, then roll up and slice.

DINNER

Grilled Salmon with Sweet Potatoes & Broccoli

A well-balanced meal loaded with omega-3s, vitamins, and minerals.

• Ingredients: 1 salmon fillet, 1 small sweet potato, 1 cup broccoli, olive oil, seasoning.

• Instructions: Grill salmon, roast sweet potatoes at 400°F for 30 minutes, steam broccoli, and serve together.

Baked Cod with Rice and Brussels Sprouts

A meal high in omega-3s, fiber, and essential minerals.

• Ingredients: 1 cod fillet, 1/2 cup brown rice, 1 cup Brussels sprouts, olive oil, seasoning.

• Instructions: Bake cod at 375°F for 20 minutes, roast Brussels sprouts with olive oil, and serve with rice.

Stir-Fried Tofu with Vegetables and Quinoa

A plant-based meal rich in protein, calcium, and fiber.

• Ingredients: 1/2 cup quinoa, 1/2 cup tofu cubes, 1 cup mixed vegetables, soy sauce, garlic.

• Instructions: Cook quinoa, stir-fry tofu and vegetables with garlic and soy sauce, and serve together.

SNACKS

Greek Yogurt with Berries & Nuts

A calcium-rich snack that also provides protein and healthy fats.

• Ingredients: 1 cup Greek yogurt, ½ cup mixed berries, 1 tbsp chopped nuts.

Peanut Butter & Banana on Whole Grain Toast

A perfect balance of protein, fiber, and potassium.

• Ingredients: 1 slice whole grain bread, 1 tbsp peanut butter, 1 sliced banana.

Cottage Cheese with Pinapple

A protein and calcium-rich snack with a hint of natural sweetness.

• Ingredients: 1 cup cottage cheese, ½ cup pineapple chunks.

Hummus and Veggies

A fiber and protein-rich snack to keep you full and energized.

• Ingredients: ½ cup hummus, carrot sticks, cucumber slices, bell peppers.

Pregnancy Super Smoothie

A nutrient-packed smoothie loaded with folate, calcium, and omega-3s.

• Ingredients: 1 cup spinach, 1 banana, ½ cup Greek yogurt, 1 tbsp chia seeds, 1 cup almond milk.

• Instructions: Blend all ingredients until smooth and enjoy!

How to Involve Siblings During Home Birth

Bringing a new baby into the family is a big deal - especially for older siblings. Their world is about to shift in a major way, and wondering how that transition will go can add stress on top of bringing a newborn into the home. If you’re planning a home birth, you might be wondering: Should they be part of it? Will they be interested? Will they freak out?

The good news? With a little prep, siblings can actually be a really sweet part of the birth experience and witness birth as a natural and beautiful event rather than a mysterious or overwhelming process.

Prep Older Siblings for a Home Birth

Preparation is everything. You don’t want your toddler waking up in the morning totally confused about why you’re in a birth pool when he just wants his breakfast. Here are some tips to set them (and you!) up for success:

1. Talk About Birth in an Age-Appropriate Way
   Explain how babies are born in a way that makes sense for their age. Keep it simple for little ones (“Mommy might make some loud noises that help the baby come out!” “It can get a little messy, but mommy is not hurt and everything will get cleaned up later.”), and a bit more detailed for older kids. Consider showing them a calm home birth video so they are aware of what it may look and sound like.

Picture books, videos, and storytelling can help make the concept more relatable. Some great books include Hello Baby by Jenni Overend and Welcome With Love by Jenni Overend.

1. Let Them Help Set Up
   Kids love to feel involved! Let them help set up the birth space by picking out blankets, choosing a special toy for the baby, or making a “Welcome Baby” sign.

2. Make a Plan
   Decide in advance where your child will be during labor. Some kids will want to be front-and-center, and others may be floating in and out. Having a trusted adult available to support and guide them—such as a grandparent, friend, or doula—can provide flexibility.

   Make sure you have a backup plan - birth can sometimes become intense, so make sure the child has a cozy place to go to if needed. If labor kicks in at night (as it so often does), will they wake up or sleep through it? Have a plan in place for every timing scenario.

3. Play “Pretend Birth”
   Children often process emotions through play. Use dolls or stuffed animals to act out labor, pushing, and meeting the baby. This is a fun way to help them learn and feel ready for the real thing!

How to Involve Siblings in the Birth Process

If a child wants to be a part of the big moment, their role can be as interactive or observational as they and you feel comfortable with. Here are some ways to make them feel included:

• Being a Birth Partner – They can offer water, cool washcloths, or hold your hand.

• Announcing the Baby’s Arrival – Let them be the first to say, “The baby is here!” If the baby’s sex is a surprise and they are old enough to know the difference, they could be the ones to announce if it is a boy or girl.

• First Greetings – Allow them to gently touch or talk to their new sibling right after birth.

• Cutting the Cord – An older child could be involved in cord cutting under supervision.

• Taking Photos or Drawing the Moment – Giving a child a small camera or letting them draw a picture of the birth scene can help them feel included and remember the day.

Remember, it’s up to the child if they want to do any of these things at all! Let them take the lead on how much they want to watch or be a part of the process.

Helping Siblings Transition After Birth

Once the baby arrives, emotions can be mixed—joy, excitement, and even jealousy. Here are some ways to make the transition smoother:

• One-on-One Time – Spend special moments with your older child to reassure them that they’re still an important part of the family. Even just 10 focused minutes can make a huge difference.

• Let Them Help – Ask them to help with small tasks, like picking out the baby’s clothes, grabbing a diaper, or singing a lullaby.

• Validate Their Feelings – If they’re struggling, let them know it’s okay to express their emotions! Remind them that they’re still super important and that love keeps growing with the family.

• Make Them Feel Special – Help them embrace their new identity as a big sibling with a “helper” badge, a special book, or a one-on-one “big sibling date.”

Home birth can be such an incredible experience for older siblings, as long as they are prepared and supported. The key is making them feel included, respected, and loved.

At the end of the day, this is a huge transition for everyone, but with a little planning (and lots of patience!), you can create a foundation for a strong sibling bond and a cherished family memory.

Postpartum Recovery Tips

Congratulations, you’ve brought a new life into the world! While so much focus is on your little bundle of joy, let’s not forget about you. Postpartum recovery is a big deal, and taking care of yourself is just as important as caring for your baby.

The postpartum period, often referred to as the "fourth trimester," is the time when mothers need to allow their bodies to recover and heal. Not only have you just given birth, but you also need to recoup after 9 months of pregnancy!

Physical Recovery: Take It One Day at a Time

Rest, Rest, Rest
Your body has just done an incredible thing, and it needs time to recover. No matter where or how you gave birth, listen to your body. Sleep when you can (easier said than done, I know) and don’t be afraid to say “no” to nonessential visitors or tasks.

Fuel Your Recovery
Eat good food—like, really good food. Think hearty soups, proteins, and fiber-rich snacks. Keep a water bottle handy, especially if you’re breastfeeding, because staying hydrated is key for healing and milk production.

Healing Your Way

Ice packs, sitz baths, and perineal sprays will be your new best friends. After the first 24 hours, switch out the ice packs for heat. Traditional postpartum wisdom suggests avoiding the cold as much as possible - that means not going barefoot on cold floors (hello, fuzzy socks!) and avoiding cold foods. 

Heavy bleeding (lochia) is normal after birth, and using pads instead of tampons will help reduce the risk of infection. 

Pelvic Floor TLC

Your pelvic floor has been through a lot, so start slow with gentle exercises like Kegels. If things still feel “off,” a pelvic floor therapist can help get you back on track.

Emotional Support for New Parents

Acknowledge the Emotional Rollercoaster
Hormonal changes can trigger mood swings, known as the "baby blues." Hormones are working overtime, so give yourself some grace. If you’re feeling down for more than a couple of weeks, don’t hesitate to reach out for support.

Build Your Village

Whether it’s your partner, family, friends, or even a postpartum doula, having people around who “get it” can make all the difference. Don’t be afraid to ask for help—it truly takes a village.

Talk It Out
Sometimes, just talking to someone about how you’re feeling can lighten the load. Be honest with your partner or a close friend, and if you need professional help, that’s okay too.

Watch for Red Flags
Postpartum depression and anxiety are more common than you might think, and they’re nothing to be ashamed of. If you’re feeling overwhelmed, disconnected, or hopeless, reach out to your healthcare provider.

Prepping for Postpartum Life

1. Prepare Your Home

• Set up a postpartum recovery space with essentials like a water bottle, snacks, diapers, wipes, and soothing items.

• Stock your kitchen with freezer meals or easy-to-make recipes.

2. Learn About Baby Care

• Familiarize yourself with basic newborn care, such as diapering, swaddling, and feeding, before delivery.

3. Arrange Help in Advance

• Enlist friends or family to assist with household tasks like cooking or cleaning.

• Consider hiring a postpartum doula for professional guidance.

4. Plan for Feeding Support

• Whether breastfeeding, formula feeding, or a combination, access support from lactation consultants or pediatricians if needed.

The postpartum period is intense, but it’s also a time of profound growth and love. By focusing on your recovery, leaning on your support system, and giving yourself grace, you can navigate this season with confidence. Remember, taking care of yourself isn’t selfish—it’s the best way to care for your baby, too. You’ve got this!

What is Delayed Cord Clamping?

History of Delayed Cord Clamping

Delayed cord clamping (DCC) is the practice of waiting a period of time after birth before clamping and cutting the umbilical cord. Historically, immediate cord clamping was standard in many parts of the world despite limited evidence supporting its benefits. Early clamping has actually been associated with increased risks of neonatal anemia, intraventricular hemorrhage in preterm infants, and respiratory complications.

Recent guidelines have shifted to endorse delayed cord clamping. The World Health Organization (WHO) and other international bodies have updated their recommendations to support DCC, recognizing its benefits in improving neonatal outcomes.

Why Practice Delayed Cord Clamping?

Delayed cord clamping typically involves waiting at least a few minutes after birth or until the umbilical cord stops pulsating before clamping. This allows the baby to continue receiving blood from the placenta, a process called placental transfusion. 

At Cincinnati Birth Center, we allow parents to decide when they want the cord clamped, but our policy is to typically wait about an hour.

After birth, the umbilical cord still contains a significant volume of blood—up to one-third of the baby’s total blood volume. As the baby takes its first breaths, changes in pressure within the heart and lungs help to draw blood from the placenta through the umbilical cord. The placenta continues to deliver oxygen-rich and nutrient-laden blood to the baby while their circulatory system transitions from reliance on the placenta to independent breathing and circulation.

DCC Benefits for Baby

1. Improved Iron Stores
   Research shows that delayed cord clamping can significantly increase a newborn's iron stores. A study published in The Journal of Pediatrics found that infants who experienced DCC had higher ferritin levels at four months of age, reducing the risk of iron deficiency anemia—a condition that can impair cognitive and motor development [1].

2. Better Circulatory Transition
   DCC supports the baby’s circulatory system as they adapt to life outside the womb. By allowing blood flow from the placenta to continue, the baby receives more red blood cells and stem cells, improving oxygen delivery to vital organs during the critical neonatal period.

3. Reduced Risk of Intraventricular Hemorrhage
   Preterm infants benefit immensely from DCC, with studies showing a reduced risk of intraventricular hemorrhage (bleeding in the brain) and sepsis [2]. These benefits are particularly important for babies born before 37 weeks.

4. Boosted Immune Function
   The additional stem cells transferred during delayed cord clamping play a role in repairing tissue and boosting the immune system, offering long-term developmental benefits.

Benefits for Mother

1. Facilitates Natural Birth Processes
   Waiting to clamp the cord may encourage a physiological third stage of labor. This helps the placenta separate naturally, reducing the risk of retained placenta, which can lead to postpartum hemorrhage.

2. Enhanced Bonding Opportunity
   Delayed cord clamping often pairs with immediate skin-to-skin contact, creating a calmer postpartum environment that supports maternal-infant bonding and successful breastfeeding.

3. Improved Postpartum Outcomes
   By allowing the placenta to fully deliver its blood supply, the process may lead to a more complete uterine contraction, aiding in reducing postpartum blood loss.

While DCC is beneficial in most cases, certain situations, such as severe fetal distress or maternal hemorrhage, may necessitate immediate cord clamping. Parents should discuss their preferences and birth plans with their care provider to ensure the best outcomes.

From improved iron levels in newborns to enhanced postpartum recovery for mothers, DCC is an important practice that should be part of informed discussions about birth plans.

What Is Meconium Aspiration Syndrome?

Meconium aspiration syndrome (MAS) occurs when a newborn inhales a mixture of meconium (the baby’s first stool) and amniotic fluid into the lungs. About 5-10% of babies born through meconium-stained amniotic fluid develop MAS, which can lead to respiratory complications. 

Meconium is typically passed after birth, but in some cases, especially if the baby experiences stress during labor, it may be released into the amniotic fluid before delivery.

How a Midwife Diagnoses MAS

During and immediately after delivery, the some or all of they following symptoms might prompt a midwife to suspect MAS:

• A slow heart rate before birth

• Presence of Meconium-Stained Amniotic Fluid when the water breaks

• Respiratory Symptoms after birth, such as rapid breathing, grunting, nasal flaring, or cyanosis (a bluish tint to the skin)

• Low Apgar Scores

• Unusual Lung Sounds indicating fluid in the lungs

Immediate Steps a Midwife May Take

If she suspects MAS, your midwife will take the following steps to stabilize the baby:

1. Clear the Airways: Suctioning the baby’s nose and mouth immediately after the head is delivered can help clear meconium before the first breath.

2. Stimulation: Gently stimulating the baby to cry can encourage effective breathing.

3. Positioning: The baby may be positioned to maximize airflow and reduce strain on the lungs.

If symptoms persist or worsen, the midwife may provide supplemental oxygen or initiate resuscitation until further help is available.

In many cases, MAS is not immediately obvious and symptoms may not show up for hours after birth. In this situation, your midwife may recommend transferring to a hospital as a precautionary measure. Hospital treatments usually include oxygen, suction, and antibiotics to treat infection. They may extend to using a warmer to maintain body temperature, tapping on the chest to loosen secretions, or using a ventilator in more extreme cases.

Meconium aspiration syndrome rarely leads to long term complications and babies usually heal quickly within a few days. 

Home Birth vs. Birth Center Outcomes

There is a constant back and forth about the safety of planned home birth vs hospital birth. Sometimes a “compromise” is reached where it is agreed that going to a birth center is a “safer” option rather than having one's baby at home. 

Recent research shows that planned home births are just as safe as planned birth center births for low-risk individuals [1]. This finding may help families who are exploring their birthing options to feel more at ease when considering a birth at home.

Home Birth vs. Birth Center Study

The study compared outcomes in planned home and birth center births among low-risk individuals, revealing important data for families considering their birthing options. Both settings demonstrated comparable safety for maternal and neonatal outcomes, underscoring that with proper planning and skilled providers, home births are as safe as birth center births.

Key Findings

• Maternal and Neonatal Mortality: There was no significant association between either setting and increased rates of intrapartum or neonatal death, with a calculated rate of 1.07 (confidence interval 0.68–1.67).

• Transfer Rates: Planned home births showed a lower rate of transfers to hospital care compared to birth center births, highlighting effective management of the birthing process at home.

• Hemorrhage Risk: Unlike some misconceptions about home births, the study found no association with increased risk of postpartum hemorrhage, supporting its safety when attended by qualified providers​.

Why Both Settings Are Safe

1. Low-Risk Selection
   Eligibility for both settings is based on stringent criteria. Individuals must have uncomplicated pregnancies, with no significant medical or obstetric risk factors, ensuring that they are well-suited to non-hospital births. Most pregnancies qualify as low-risk, but if you have questions, ask your provider.

2. Qualified Providers
   Certified midwives and other trained professionals lead care in both settings. These providers follow evidence-based guidelines, conduct thorough prenatal assessments, and are qualified to manage complications if they arise.

3. Emergency Transfer Plans
   Both settings emphasize well-coordinated plans for hospital transfers in the rare event of complications. Clear protocols, combined with proximity to medical facilities, are essential for ensuring timely care if needed. Transfer rates are actually lower for home birth than for birth centers, which may reflect higher levels of preparedness and personalized care in the home setting.

Benefits of Midwife Care

Midwife-led care carries a lower risk of unplanned cesarean and instrumental vaginal deliveries, augmentation of labor, epidural/spinal analgesia, episiotomy, and active management of labor third stage [2]. Whether at home or at a birth center, midwife care is a safe option for most women that carries a range of benefits such as:

• Lower rates of medical interventions (e.g., cesarean sections, inductions).

• Greater continuity of care, with personalized support from midwives.

• Higher maternal satisfaction, often attributed to the autonomy and comfort of birthing in familiar environments​

The findings in this study and others highlight the importance of integrating midwifery-led care and community-based birth settings into the broader maternity care system. This way, more families have access to safe and respectful care and can make decisions aligned with their preferences and clinical circumstances. 

Check Yourself! Cervical Exams at Ho

Whole body health is important - and that includes “down there!”

Performing self-cervical exams is a great way to get in touch with your anatomy and understand more about your reproductive health. Knowing how to check your cervix is a window to learning about your fertility, menstrual cycle, and even labor progression.

Why Self-Cervical Exams?

Self examinations put the knowledge of your body back into your own hands. 

Our healthcare system often keeps people reliant on doctors for basic information about their bodies, but doing your own cervical checks helps you to take an active role in understanding what’s normal for you. 

This awareness can help with:

Fertility Tracking

Cervical position and cervical mucus change based on your cycle. Your cervix is higher and softer in your fertile window and releases a stretchy, egg-white-like mucus ideal for sperm survival and fertilization.

Pregnancy Changes

Toward the end of pregnancy, your cervix softens, moves lower, and may begin to dilate. Self-checks in labor can help you gauge how far along you might be.

Healthcare Decisions

When you know your anatomy, you’re in a better position to advocate for yourself in healthcare settings, making decisions that align with your needs.

How to Perform a Self-Cervical Exam

Don’t know where to start? No worries! A lot of women are unsure of how to navigate this part of their bodies at first.

Here’s a simple step-by-step guide to performing a cervical self-exam. It may feel a bit strange at first, but with practice, it can become a comfortable part of your routine.

1. Prepare: Wash your hands thoroughly to avoid introducing any bacteria. Get into a comfortable position (such as sitting on the edge of a chair or squatting) where you can easily reach your cervix.

2. Use Lubrication: A small amount of water-based lube on your fingers can make the process far more comfortable. Remember to stay relaxed and to not tense up!

3. Insert Your Fingers: Insert two fingers (usually your index and middle fingers) slowly into your vagina. Feel for a round, firm structure towards the back, which might feel like the tip of your nose. If you’ve given birth before, it may feel slightly softer or have a small dimple in the center.

4. Assess Cervical Position and Texture: During your cycle, you’ll notice changes in your cervix. When you’re fertile, it will feel soft, open, and may be higher. At other times, it may feel firmer, lower, and closed. As you practice over time, you will become familiar with these sensations and better understand the phases of your cycle.

If you’re ever unsure, it’s always okay to ask for help or guidance from a healthcare provider. Just remember that you are the most important decision-maker when it comes to your body and that checking yourself puts you in control of your healthcare journey!

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Want to support safer Ohio birth options and get a cool “Check Yourself” t-shirt? Visit us at the Buckeye Birth Coalition and grab yours!