Tuesday, May 01, 2012

Blog Carnival! BirthWell LA & Mari Oxenberg

Welcome to Childbirth Today's 2012 Blog Carnival - honoring the busy month of May and all of the celebrations of midwives, nurses, doulas and childbirth educators...AND mothers!  Our first blog carnival entry spotlights a wonderful midwife from Los Angeles, Mari Oxenberg.

Although some people joke “midwife” refers to “that bump in the middle of the wife,” the term stems from Middle English, meaning mid for “together with” and wif for “woman.” So, literally, a midwife assists other women in childbirth. More specifically, both doulas and midwives provide support through the childbirth process– emotional, spiritual, and physical. However, a midwife is medically trained (as a Primary Health Care Provider).

Meet Mari. At 19, she witnessed a friend give birth naturally in a hospital with a nurse-midwife while a professional midwife acted as her doula (labor support person). She said, “It was the most beautiful thing I'd ever seen and tears streamed down my face when the baby girl was brought up to her mother's chest. I knew at that moment that I was going to help women birth.”
This moving experience compelled Mariposa Oxenberg on a life-long journey that has taken her though training as a doula, certification as a registered nurse, a two year homebirth apprenticeship, prenatal yoga teacher training, and a masters from Philadelphia University, in the Science in Nurse-Midwifery.

Many years later, now, a mother herself, Mari lives in beautiful Topanga Canyon where she and her mentor Marina Alzugaray founded Birthwell LA, a complete childbirth service. Using her expertise in homebirth and water birth, Mari strives to guide women though childbirth with love, confidence and grace.

Birthwell LA offers a wide variety of services to support women: midwifery, doula, pap exams, cranial-sacral therapy, acupuncture, medicinal herbal support, Ayurvedic counseling, prenatal yoga, Touch Therapy, pregnancy massage, and preconception and nutritional counseling.
Midwives stress the importance of communication, body awareness, utilizing old world and modern techniques to reduce the risk of childbirth complications. Offering a more personal, holistic approach to pregnancy, midwives honor cultural differences, personal preferences and encourage family participation in birth process.
Homebirths allow women to remain in the comfort of their own home, which decreases the fear which, in turn, can slow down the labor. A clean, non-industrial environment decreases the possibility of acquiring hospital infections and birthing at home is also private: the mother is in her own bed, surrounded by her own things and there is no rush to perform or to deliver on schedule. However, if intervention is needed (like c-sections or pitocin augmentation) for high-risk pregnancy a hospital is a better choice.
The presence of a midwife can diminish the length of labor, the need for pain medication, the use of forceps, and the possibility of a cesarean delivery.
According to Mari, Western medicine often “sees birth as a disease, something that needs medication and hospitalization.” And one of the great down falls of so-called modern medicine is that is “doesn't treat each woman and birth as sacred but rather just another patient to run through the system.” In a modern hospital, many women feel disempowered, ignored or like they have no control over the birth of their own child.
The entire system tends to “traumatize and perpetuate [an] immense fear of childbirth.” Also, medical “interventions can cause damage to women's bodies and increase the risk of future pregnancies.”Bottom line is that the insurance companies are running the show and they control the doctors.”

Mari’s philosophy about pregnancy and birth is that it is a natural process and “when left to her own devices, a woman can birth her babies no problem.”As a midwife, Mari tends to be “hands off and only intervene when really necessary” because she feels “birth professionals do too many vaginal exams.” Keeping intact a mother-to-be’s sense of power, she asserts, “a good midwife can tell how much her lady is dilated by the sounds she makes.” Mari truly believes fear equals pain, and that when “women birth without fear, they move away from painful births in exchange for a very powerful and intensely sensual process.”

Compared to other health professionals, a midwife’s relationship with an expectant mother is more personal, more in tune with life. Birthwell LA offers the following services: hour long prenatal visits, TLC, nutritional counseling, an attitude that birth is a normal life process not a disease, in-home prenatal visits, 24/7 support, the opportunity to have siblings at prenatal visits and at the birth (which is amazing for bonding), all the time women need to ask questions and get proper answers, all the time needed to birth, personalized care and, perhaps most importantly, they encourage women to take responsibility for their bodies, babies, and birth.

Q: Mari, why do you feel, for healthy mothers, home birth is better?
A: Well it's not what I feel, it's what is evidence based that is important and home birth is as safe as a hospital birth for healthy women. My opinion is that women are better taken care of at home and the family bond is stronger at home. Women are respected and their birthing process whatever that may be is allowed to unfold.

Q: How often do you see mothers to be?
A: If they start their care in the first trimester then they typically have about 14 prenatal visits. Then I see them the day after the birth, day 3, day 7, week 2, week 4, and then the final visit at 6 weeks. I am also available to them for their annual well-women care for their PAPS etc. as well as with them for the entire birth process.
During a prenatal checkup, we go over the wellbeing of the mother. This includes her emotional state, her relationship, her diet, her vital signs, her lab work etc. Then we check the baby's heart rate and measure her belly. I also give belly massages and assess the baby’s position and growth.

Q: During labor, do you let mothers to be do whatever they want (eating, position, water)?
A: Yes! Whatever they want. I make suggestions if I see something that might work better or to encourage hydration and nourishment. I am there as their guide through the labor and birth process, but the woman is the director of her show.

Q: After the baby is born, midwives complete the circle and ensure that baby and the new mother are happy and healthy. What happens during a post-natal check up?
A:I assess the well-being of the family, assess the mother and baby. Make sure mother is doing well and baby is healthy. Help with breastfeeding and assess the situation in the home. Observe for any complications and postpartum depression.

Q: Concerns some women have about midwives include emergency situations and birthing complications. What happens if something goes wrong?
A: I don't wait around for bad things to happen, and I am not attached to the location of a birth. I am trained to assess the cues that a birth isn't going well or that the baby is not happy. If I am given any signs that it would be better for the outcome to be in a hospital, we go in.

Q: Have you ever dealt with a casualty?
A: I have dealt with emergency situations at birth. Midwives carry with them drugs to stop bleeding and resuscitation equipment and oxygen. We are trained in neonatal resuscitation and adult CPR.
We carry IV equipment and use dopler's to monitor the baby's heart rate. We also have equipment to assess mother's vital signs. Herbs and homeopathic remedies that aid the labor and birth process.
Q: As a midwife, have you ever missed a birth?
A: Never

Q: How was your baby born?
A: My little Kira was born in our home in the birth pool. It was amazing, and I did not have any pain. More like strong menstrual cramps.  I took a long time to open and I stayed 5 cm for a long time. My midwives began to worry that I wouldn't progress. It was just that the contractions were not strong enough. So they called in an acupuncture therapist, Azita Moallef, and she did an intense treatment on me. Within an hour of her finishing, my labor totally changed and I began to have long strong contractions that began to move the baby down. Moments later I shocked my midwives because I was completely dilated and ready to push. I then got in the pool along with my husband and pushed my baby out in 20 min into her dad's hands. No tearing or anything. The hot water is just so amazing in labor and helps to relax the body so it can open and stretch easily. I would not do it any other way.

Mari Oxenberg, RN, MS, CNM
With a passion for nurturing women and families and a love of babies, Mariposa Oxenberg began her journey into midwifery in 1996 when, after graduating Pine Manor College in Boston, she witnessed a beautiful birth. Mesmerized and enchanted with the miracle of life, she embarked on a path that would take her through the many facets of birth in America with a goal of learning as much as she could. Mari trained at Babies By the Sea Birth Center in Key West Florida where she also founded Birthwell Doula Services and taught prenatal yoga. When her friend and colleague Dr. Kelley Valle became pregnant, she approached Mari with the idea to create a Prenatal Yoga Video so that all women could benefit from the Integral Prenatal Yoga class Mari instructed. Together, they birthed Birthwell Yoga for Pregnancy and Childbirth Preparation which is now featured in the Birthwell Gift Boutique. In 2001, Mari graduated from nursing school in the Florida Keys and moved to the Berkshire mountains in Western Massachusetts where she discovered how to be a “nurse-doula” and navigate hospital protocols while allowing her patients gentle and conscious birth experiences. Mari received her Masters in Science in Nurse-Midwifery in 2010 and acquired a taste for research. Her thesis looked at “The effects of prenatal yoga on perineal integrity in childbirth”. Living in beautiful Topanga Canyon and now a mother herself, she is joined by her mentor Marina Alzugaray, Certified Nurse Midwife,  as they transform Birthwell into a complete childbirth service. Using her expertise to specialize in homebirth and water birth, Mari strives to support and guide women though this most powerful time of their lives with love, confidence and grace so, as they transform through their powerful birth experience, they can be excellent and confident mothers.

Social Media: https://www.facebook.com/BirthwellLosAngeles

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