Austin midwife Joan Smith with babies from her PregnancyCentering® group
With our Austin Midwife Spotlight series, we are giving our beloved midwives an outlet to express why they love what they do. Our first interviewee is Joan Smith, who has been with us for 13 years!
What, in your opinion, separates a true birth center from a hospital birth center?
Well, a freestanding birth center, such as AABC, is not run by the hospital, and in our case, we are providing the benefits of the evidence-based midwifery model of care, which leads the way in safe, satisfying and cost-reduction in maternity care. But most importantly, we are accredited, which means we are held to the highest standards of safe, high-quality care for mothers and babies. To be accredited, we must only employ highly qualified staff, and properly train them to give safe and evidence-based care. We must not employ the invasive and risky interventions that a hospital or unaccredited birth center might use.
We also must perform frequent risk assessments on our clients, to insure that only low-risk clients are provided for, with the plan of out-of hospital birth.
How does the level of personal care differ between an AABC midwife and an OBGYN?
Well, not all OBGYNs are the same, but in general, one of the biggest differences between our care, and midwifery care in general, is that we spend much more time with our clients. During prenatal care we always have 30-60 minute appointments with our clients, and in Centering we have 2 hour appointments with our clients at every visit. This gives us time to get to know each other, find out what each mother needs, and provide the complete assessment, education and enhanced education, which are the hallmarks of the Midwife Model of Care.
The Midwife Model of Care is in contrast to the Medical Model of Care, which is based on the idea that the client needs to be cured of disease processes, either through medicine or surgery.
For our healthy, low risk mothers, and babies, this only interferes with the physiologic, normal process of pregnancy and labor.
How does AABC being around for 28 years set it apart from other birth centers? Is there something about it that’s unique to the fabric of Austin?
Experience is the one thing you cannot buy or sell, and with experience comes wisdom. We have had time to determine what works the best for our community, and are always striving to improve and meet their needs. In the 13 years I have been at the birth center, I have never seen more hard-working and dedicated staff, who are creative and incredibly determined to be the best they can be as professionals, and advocates for our clients.
The other benefit of our being the most experienced birth center, as well as the largest birth center in the country, is that our track record of safety is there for all to see. All of our health statistics and outcomes are available through the state’s Department of Health Statistics. As we are an accredited birth center, our statistics are also kept and compiled by the American Association of Birth Centers, and are published regularly.
As members of this organization we have access to these to insure we are monitoring our own safety and quality of care. They are also published regularly, as in the Journal of Nurse-Midwifery.
We are unique among all the birth centers in Texas, that we’re also providing the innovative program of CenteringPregnancy® group prenatal care. We are the only out-of hospital Centering site, which has been shown in study after study to lower the rates of premature birth, low birthweight babies, and infant mortality, as well as many other associated birth outcomes. It also increases breastfeeding rates and has been shown to improve outcomes in mothers’ experiences of prenatal care, undeniably the wave of the future. We are very excited that we are the recipients of the March of Dimes’ support in this program, through grants and education of our staff to provide our services.
How did you find out about AABC?
Through the American College of Nurse-Midwives. I am a member now for 20 years, and have been an active chapter member within this association.
Why did you want to become a midwife? How do those ideals guide your work today?
After working as a labor and delivery nurse for 9 years, and seeing how OBs had managed low-risk, normal pregnancies as if they were high-risk, causing the over-use of technology, I noticed that these created complications and poor outcomes for these mothers and babies. I wanted to provide an alternative, to improve maternity care. I wanted a chance to focus more on education, and have more time caring for our clients as a partnership.
As a feminist, and a humanist, I was appalled at the perils of “state of the art” care in the hospitals. Especially the private, physician-owned hospitals that made more money, the more they did to intervene. I became a nurse and midwife educator, in birth centers, hospitals and in hospital-run birth centers. Of all of these I found the best experiences and outcomes in freestanding, accredited, midwife-led birth centers. That is why I am still here today!
As a midwife, there is nothing to compare with the loving, family and woman-centered care and the camaraderie I enjoy at AABC!
I wanted to care for women through their lifespan, not just at the time of birth, so that I could develop a relationship with them, and help prevent complications, and have a more enriching as well as meaningful experience through these relationships.
What’s your favorite part about working at AABC?
Being with the women we serve, and their families, year after year, watching their families grow and flourish!
I also feel like I am part of a big family at AABC, with lots of big and little sisters, working together and playing together, watching their families grow as well!
Do you have any favorite memories from your time at AABC?
So many, hard to start and recount them. The wonderful parties and reunions for our birth center clients are a big highlight, the women having triumphant VBAC births after their Cesareans, and especially our fellow midwives’s births at the center!
What advice do you have for moms choosing where to have their birth?
Do your research, and educate yourself and your family by looking at the evidence. Visit with your prospective providers and ask questions, and search your hearts and your families’ hearts, to find a place and caregivers that you trust. Nothing matters more to most women than their birth experiences and outcomes, and above all, trust yourself!
