The Farm Midwifery Center

A Birth Story: Rhodes Wilder

Sara and Casey got to The Farm on Monday, January 11th, two weeks before her "due date". Normally couples are asked to be there about a month before but because of the Christmas holidays and work schedules they waited a little while longer. I eagerly joined them a week later. 

January 25th had come and gone.  No big deal.  We believed the "estimate" part of estimated due date. As I talked about in my previous post, Sara was doing every (natural) thing in the arsenal of tips and tricks to help things along. It was reassuring that the baby's activity level was still very high.  In addition to the natural induction things she was doing, she continued to work from our home-away-from home cabin. Work was a good distraction and she wanted to have all of her maternity leave for after baby was earth-side. There were periods of rest and naps as needed.  Visits with Carol and the other midwives continued to be a weekly highlight. 

In an effort to move things along naturally and at the advice of her midwife, Sara began to see a local chiropractor for adjustments and acupuncture. She had seen a chiropractor throughout most of her pregnancy while in Georgia. Thursday, February 4th, 41 weeks +  4 days, her 4th visit to the chiropractor was followed by a delightful lunch in Lawrenceburg at Bliss: Farm Market and Café .  A stop at Kroger for a few more groceries on the way home and I decide to pick up the only weapon in the natural arsenal that she hasn't yet tried, castor oil. It was something we'd already discussed and suggested by Carol as an option. I had used this with my late babies, years earlier.  I'd remembered taking a half a bottle at a time of the nasty stuff. It's cheap, less than $2 a bottle and often does the trick. I'd reread the section of Ina May's Guide to Childbirth, "beginning after a full night of sleep, one tablespoon added to scrambled eggs or mixed with fruit juice".   Sara decided she would take a tablespoon dose early in the morning, before breakfast, whenever she got up for a bathroom trip.  I headed to bed.  

They stayed up just a little while longer. Feeling a bit down and discouraged and anxious to meet her baby, tired of waiting, Casey took Sara to the banner that hung across the kitchen. She and I made this together just before her Blessingway. One by one he lovingly held her and read her the affirmations. Such a precious way to lovingly close the day and bring peace to Sara! I love the way he loves and cares for my daughter!

friday, february 5th

She woke up around 5:30 am for the usual early morning bathroom trip and took the one tablespoon dose, returned to bed.  (Imagine drinking melted crayons, only worse.) When I got up I made her a breakfast of grits, some pineapple and decaf coffee. When we talked to Carol a little later she said that it wasn't enough and that she did need to take a half a bottle.  So, Casey and I concocted a smoothie with a bigger dose and poured a tall glass.  Sara was tired, drank her smoothie and took a morning nap. There was a small amount left in the blender that didn't fit in her glass, so being the fearless man that he was, Casey decided to not let it go to waste and get a taste of what she was experiencing. And he did!  

After a bit of rest I encouraged her to be upright and we worked on some more Spinning Babies techniques, specifically the Dip the Hip:figure-8 movements. It was a cold, crisp, clear day and some fresh air and movement would do us all some good so we headed out of the cabin and into the woods for a hike. Two miles round trip, hills equivalent to climbing 7 stories.  This was another piece of untouched beauty with hills and creeks.  So beautiful! She was having contractions as we hiked but we didn't time them, just slowed or stopped as needed. As we got closer to the cabin Sara asked for the keys and made a beeline for the bathroom as the morning smoothie was beginning to do it's job! Casey had to wait his turn in this one bathroom cabin.

Innards cleaned out, more room for baby to move down, more Dip the Hip and she could feel him adjusting. We also did lots of side lunges with a chair, squats, Rebozo sifting, sidelying release, and double hip squeeze.  Contractions were now steady and pretty close together at 4 minutes apart. Definitely more intense but the spacing, intensity, and other indications made us question if this was indeed active labor. Not the typical pattern. Casey was working on getting dinner ready while I worked with Sara.  It was getting late in the day with a lot of activity. If this was it then labor was not going to stop.  We took a break and Sara rested for about an hour.  Contractions stayed about the same.  We were using the Full Term app to time contractions every so often. A useful tool to see if the Longer-Stronger-Closer together pattern we are looking for is indeed happening. (This app also has a kick counter.)

Call the Midwife

She and I strategized about how to proceed to stimulate labor or if she should try to rest more. Since she was in a really good place mentally Sara called Carol to come by and check her. It's nice having your midwife just around the corner.  She was happy to come by and was over shortly. The time was 7:30pm. Sure enough, Sara was not only more dilated than two days earlier but things had softened and thinned out as well, about 2 cm. As Carol finished her exam Sara's water broke! A small gush as first but when it happened the three of us burst into laughter! Casey was still in the kitchen and wondering what was so funny.  The cool thing was that Carol immediately checked her again and all our laughter had loosened her up even more, easily to 3 cm in no time with some good laughter.  In a minute's time she was already more dilated and there was an incredible new energy and excitement in the air. We also got a good laugh telling the story of Casey taking part in the castor oil smoothie. He is always game for good bathroom humor! Carol said she was sure there would be a baby before daylight then returned home until we really needed her.

With dinner ready we enjoyed a light meal, too excited to eat much. As expected, contractions quickly changed after her water broke and were coming on stronger and more in her back.  She also felt waves of nausea but handled it well. Casey had gone back to the kitchen, wanting to get it all cleaned up. I began to try and get the word out to the inner circle of family and friends to light the birthing candle that we'd given them at her Blessingway and pray for her as they shared in the anticipation.  (Note to self: I should have assigned someone to pass the word along.) I continued to work with Sara but as the intensity changed she needed Casey close and he was called into active duty! They slow danced together or stayed face to face, keeping her focused and relaxed. I worked with heated rice bags and counter pressure to relieve her back. Lavender oil in the diffuser and candles scented the air, strings of lights throughout the cabin, the wood burning stove warming this sacred space, a carefully selected playlist of songs, all coming together, creating a sweet atmosphere, perfect for keeping those good birthing hormones flowing! 

Many of her birthing waves were one on top of the other.  With each one either Casey or I would remain inches away, face to face, breathing together, encouraging her, making low, earthy, moaning sounds along with her. These back-to-back contractions are intense! In spite of all this Sara was a total goddess! She was radiant, relaxed and beautiful, as powerful and intense as I've ever seen her! And I could see Casey falling even more in love with her, as he witnessed his wife handle herself throughout labor. She needed him and wanted him to stay close! They were a sweet birthing team! In the months before he was a little unsure of how hands-on he would be.  All of that had gone away and he was all in

Feeling Pushy

One of the beautiful thing about the natural childbirth and a home birth is the freedom to move about as you please. Initially we were in the main living area and she was standing, moving her hips in a figure 8 swaying, slow dancing, leaning on the kitchen bar, on the birthing ball, frequently trying various positions. She stayed hydrated and emptied her bladder regularly, also important components in the process.  After a couple of hours she eventually deciding to try an all fours position on the bed. This new position seemed to be a good change for a while then at some point she had the urge to push. Not trying to push, it was just happening involuntarily. There were other positive signs that labor was moving right along. This was a bit worrisome for Casey since it was just the three of us there. He gave Carol a call and let her know how Sara was doing. Another trip to the bathroom and time to fill the tub. While the clawfoot tub was filling, Casey hung another string of lights on the shower curtain rod. I was able to take a another turn staring into the eyes of my laboring daughter, encouraging her, vocalizing right along in low primal tones. Warm water was a huge relief! In between each of these waves a soft, relaxed, and peaceful smile would come to rest on her face. Often times during these short breaks they would softly kiss. Sweet and passionate, naturally working with her body to reduce anxiety and increase oxytocin, an extremely calming hormone that produces a feeling of peace. 

She still wanted to push and this was making Casey uneasy. I didn't see a head but we also had the lights low. I did ask her to self check. She could feel his head, and it was softer than she expected, but he was still not at a crowning stage. I wasn't concerned about him coming before Carol returned. I was unsure however, about her urge to push, not knowing how dilated she might be. (As a doula, we are a non-medical part of the birthing team and do not do internal exams, if anyone wondered.)

Carol arrived totally unhurried. She was her usual calm self. She watched Sara labor for several minutes, listened to the baby's heartbeat, then tried to check her in the tub. Too hard to tell so we moved back to the bedroom for a better exam...8 cm but with an anterior lip and some swelling. (3 to 8 cm in a span of 3 1/2 hours.) In order to reduce that swelling Carol asked her to remain on her right side and not push. My goal was to keep her as relaxed and comfortable as possible with light massage, heat, etc. Casey restarted her beautiful playlist again.  


This was the most difficult part of her labor so far and yet she handled the challenge with strength and determination.  One of the most moving parts of her labor for me was her singing along, word for word, loudly and most beautifully to David Crowder's "How He Loves"! Powerful worship during one of the most difficult parts of her birthing time! She'd been resting as instructed for about an hour when pressure became really strong in her bottom. Fullness and pressure and another check. Almost complete! Once again, time for the bathroom. Fresh hot water in the tub and back in after some time on the toilet. It may seems strange at first but a great place to allow those pelvic floor muscles to open and relax.

Once again the tub was a relief! Sara moved about in the tub and experimented with several positions: side lying, sitting upright, squatting, squatting with the rebozo over mine or Casey's shoulders. Throughout this whole process there was absolutely no complaining! Ever!!! Sara's eyes and gaze were intense. Wide open, bright and totally focused during each wave, never doubting her body's ability or worrying about the next contraction. She vocalized throughout, always controlled, low and sensual during the first half, raw and roaring through transition and at the end of every contraction, a burp! Then relaxed, into a warm and peaceful smile, often more soft open kisses.


A strong urge to push, she could feel his head and we could see a small amount of head showing. This was a small bathroom and too crowded for a good waterbirth. It was time to get out, use the toilet and return to the bedroom where Carol had set up all her supplies.  The other two apprentice midwives, Sara and Tania had also arrived sometime earlier. Reclining with Casey on her right, me on her left, we supported her upper back and shoulders and legs while Carol was working to help baby's head out. Tania kept applying oil to Carol's fingers. Sara was working so incredibly hard, pushing but getting worn out! We fetched some ginger ale for quick energy, sipping between periods of pushing. Carol also asked for the black cohosh she had been taking for the past few weeks, having her take more doses fairly often. After 45 minutes of working like crazy with little movement Carol asked Sara, "how would you feel about getting up and emptying your bladder?"  Her reply made us all laugh out loud, "that sounds awful!" but with no argument, a tiny bit of persuasion and a good deal of help, we made our way back to the bathroom, one more time.

The time on the toilet, an empty bladder, being upright and the movement it took to get there began to speed up the progress.  She pushed some in the bathroom but then was ready to move back to the bed. Another contraction as she reached the edge of the bed.  I supported her from behind as she instinctively moved to a squat to push. I was praying for her, that she would have the strength she needed. Back on the bed, same places as before and it still took time and a lot of work from Sara and Carol, working together to coax this baby the rest of the way out. I was beginning to be concerned as I watched how Carol was working to sort of pry his head out. We had a mirror, flashlights, plenty of oil, and more coached pushing that planned. At one point Sara asked if he was stuck. I can't remember exactly how Carol answered but we knew he needed to be born soon!  (Sara: "She said 'stuck is a relative matter... it's up to you.' She was so gentle, but I knew I better dig deep!)  Shortly after, I rather strongly said PUSH!!! Later Carol said she was glad that I did because she didn't want to be the one to say what needed to be said at the time. (Sorry I yelled at you sweetie... but it was for a good cause!)


Then finally, this baby's head was born!!! He was born with his eyes WIDE OPEN, facing me, staring me straight in my eyes!!! Without saying a word, Tania and I exchanged a "do you see this?!?" moment! I remember talking softly to him but I have no idea what I said. With the next push he was fully born, 4:59 am! Carol said "reach down and take your baby". There was that crazy confusion that often happens in that moment of exhilaration and exhaustion. I helped him slide onto Sara's belly and she slid Baby Rhodes to her chest. Warm blankets covered mom and baby. His color was good, he was crying the cry we actually love to hear, working out his new lungs. Suctioning and back rubbing to stimulate breathing. He had a MAJOR cone head! Time to bond, skin-to-skin, plenty of blankets but no hat!

Then the BIG POO happened! Meconium all over Sara, running down her right side. I attempted to clean up the rather large sticky tar-like mess but it didn't work too well. Rhodes was favoring looking to his left so Casey and I switched places so that he was able to see his new baby better from the other side. Around 15 minutes after birth the placenta was delivered, cord still attached, then Casey cut the cord! The placenta was examined to make sure it was healthy and complete.

Midwife Sara instructed Casey to take off his shirt for some skin-to-skin with Rhodes so that we could quickly get the meconium cleaned off Momma Sara. With that she came up behind him and before he knew what happened, yanked Casey's t-shirt off. Casey took his new baby in his arms and right away Rhodes latched on, yes, to his DAD's nipple! We all got a kick out of this!

Back to mom, more warm clean blankets and more time for Sara and Casey to get to know their new baby. A sweet and precious time, he was very alert, bright eyed, active, latching onto momma now, exploring her breast and beginning to figured it out. His head was very cone shaped at birth due to his asynclitic presentation but during that first hour, swelling diminished dramatically! The midwives continued to check both mom and baby but in such an unobtrusive way that we hardly noticed. After an hour or more of bonding time it was time for baby to be fully checked over and Carol to attend to Sara's repair.

Midwives Sara and Tania took time for a thorough newborn check up, just a few feet away on the dresser while Casey looked on. I stayed with Sara while Carol took time and lots of care with her and she never flinched. Casey then got to weigh his him, 7 lbs, exactly!

These dear women packed up their gear, we changed the sheets, Casey held his new baby, I helped Sara in the bathroom, got her situated so she would be able to rest. Finally, they were able to settle down for a bit of early morning breakfast in bed and some much needed sleep!  

As this new little family were alone at last and resting comfortably, I was tired but still somehow wide awake and on an adrenaline rush. In between loads of laundry and some kitchen cleanup we shared tea and I enjoyed having 2-3 hours listening to Carol, Tania and Sara discuss the birth as they charted. They said this was a challenging birth because of his asynclitic presentation but couldn't say enough good things about how well Sara handled the birth. I know that her positive attitude, sweet spirit, and unwavering determination made a lasting impression on this wonderful trio of birth workers! I am incredibly proud of this woman and honored to be an intimate part of this amazing journey!

Permalink: A Birth Story: Rhodes Wilder

The Farm - Amish Country

The Farm Midwifery Center provides services beyond the gates in Summertown, Tennessee. Many families, like my daughter and her husband come and stay there for the birth of their babies. Other local families seeking a home birth call on this practice for their care.  Another large group that is served by these amazing midwives are the Amish women and families in nearby Lawrenceburg.

In the birth stories told in Ina May Gaskin's books are writing about attending these births. Anytime we would go into town you would see the horse and buggies. We'd see Amish families at the chiropractor's office and shipping in Walmart and Kroger, everything from their groceries to a mattress to lumber transported by this version of real horse power.  We were about 2 weeks into our stay at The Farm.  At the end of our usual weekly prenatal visit Carol asked me if I would like to go with her the next day as she made her rounds to several Amish homes.  It was of course a YES! What an opportunity!

Carol Nelson is a midwife, but she is also a nurse. Her "beside manner" is personal, warm, and from the heart.  It's very much about relationships and trust as well as the medical side of the practice. Holistic. Calling on the first family was a gentleman in the last stage of prostate cancer. As she cared for him in the privacy of this patriarch's bedroom I had the opportunity to visit at length with a young woman in her early 30's about her life and the births of her 7 children. The youngest was a sweet little girl, about 5 who was very shy. I was an outsider, English,  and she was not sure about me. She nibbled on a baggie of dry cereal as her mother and I talked. We lived vastly different lives and yet we shared several things in common. We talked about the births of our children, having chickenpox while pregnant, sewing (a treadle sewing machine was close by), dealing with fibromyalgia. A few other young children, cousins, would pop their head in the front door every so often during the visit. Although she had heard of Georgia she had no concept of where it was located, even though our state borders Tennessee. She had never been outside her community. Schooling is only to 8th grade or age 14, whichever comes first. They feel that any further knowledge will undermine their beliefs and is pointless. Carol spent plenty of time with this sick man, made him more comfortable, taught his son how to care for him, left them with catheter supplies and instructions. The man's wife provided hot water from the wood burning stove and a basin for Carol to wash her hands before we left. This family had heavy hearts caring for their very ill loved one.  

This first house we had seen a few days before on our way to neighboring farm where we bought fresh eggs, milk, and meat. From the outside this Amish home was a bit scary looking, like something on a movie set. Rambling, pieced together and worn. A muddy dirt drive and chickens running about here and there.  Clothes lines and a washing machine on a porch...a non-electric washing machine like I remember from my grandparents home over 50 years ago. Inside was neat and very warm from a wood stove in the center of the home.  Simple. Walls were all white with the plain wide boards for trim painted a dark shade of blueish gray. Windows were plain and clean, trimmed with similar plain boards and paint. Wood floors, kerosene lamps here and there for lighting at night.  Pegboards held hats, bonnets and extra aprons.  No knickknacks or other decorative items in these homes. No pictures other than a large calendar which hung on the wall of each home. No comfy sofas or recliners in these homes, only straight back chairs and an Amish built rocker. 

The next home was on the other side of the tracks, so to speak. We stopped and spoke to the husband on the road as we were on our way in and he was on his way out. These people all know Carol.  They recognize her car as we would approach, and she knows them. This home was larger, seemed newer. In addition to the wood burning stove in the center of the home was a simple closed stairway leading upstairs. We stayed downstairs but I was curious about what was above! A late teen or 20 something daughter was busy washing dishes in the next room while we were there. I saw her entering with water, heard her working and saw her exit but we never spoke.  No running water. No electricity.  Water from the outside, hand pumped and heated on the stove. dishes washed in a basin using handmade lye soap.  

The woman we were there to see needed some blood work, ordered by her doctor. She was in her early 50's, had diabetes, some blood pressure issues. Very friendly and talkative, simple but well spoken. We all three chatted  for a bit while Carol did the blood draw and took her blood pressure, recording information with pen and paper pulled from her bag.  We could have left it at that but it is about the relationship with this community. The conversation continued about various family members and what was going on with their health, with their pregnancies. Carol was also finding out important information about who was expecting and although second hand, how they were handling a difficult pregnancy. I was just taking it all in. Trying to figure out the genealogy of the characters and follow the plot was interesting to say the least! Was it okay for her daughter to continue to take buggy rides with her history of miscarriage and this pregnancy of multiples?  This was better than anything on reality TV!

In their world they do not use the modern conveniences that we take for granted. At one point in our conversation this wife and mother couldn't remember a detail about something with her daughter's health and went to a large oak desk for a stack of letters tucked away in a drawer. She found the letter and the information to ask Carol. She would relay this to her daughter. This was a flashback for me. I remember when long distance was rather expensive and something you wouldn't do every day, maybe once a week and then we'd watch the time to avoid a large phone bill. Back in the day I lived far away from my parents and we wrote actual letters like those on a regular basis. I kept many of those cards and letters, now in a box in the attic. Trying to imagine not being able to pick up the phone and call my parents or text and call my kids, but solely rely on paper, pen and postage stamps sort of blew my mind!  I'm grateful that we are able to communicate easily and often but I do appreciate the handwritten letter or note.

As we left I noticed the freshly washed dishes laid out. It was not meant to be the look of an Instagram post simplicity and beauty was there. It would have been so wrong for me to take a picture. My mind knew I needed to remember that moment.  Clean stacked dishes neatly arranged on a plain but sturdy wood table. Serving and mixing spoons hung on a wood pegboard at eye level with a plain white cloth, gathered on a sting or wire, like a small curtain between the utensils and the wall.  

The last home was to see a young expectant mother. This was her third baby. A young toddler was napping and snoring on the floor on a pillow while we talked. A baby girl was asleep in a crib in the parent's bedroom.  This was the first prenatal visit for this pregnancy. She was unsure of how far along she was and had had only one period after the birth of the last baby 8 months ago. She was about the same age as my granddaughter. This young mom went to the out house to provide her urine sample. Carol talked to her about the importance of keeping her blood pressure and blood sugar under control, nutrition, vitamins and supplements. In another "we take for granted" moment I thought about all that is at our fingertips with education. We have an endless supply of information about pregnancy and all things related. Carol was needing to gently guide this "experienced" young mother so that she would have a healthier pregnancy this go around. We moved to the bedroom for a brief exam. From her measurement, LMP, symptoms, Carol estimated this baby to be due in late July. Late July with no air conditioning, heavy dark clothing, two young babies to care for in the meantime. It made me appreciate central AC and a lot of other things!

The only toy I saw was a faceless cloth doll.  Faceless as to not make an idol or graven image. The baby girl was wearing the same style dress as the other women and girls, even at this young age.    Dark blue, long sleeves, long skirt on the dress, head covered, no shoes but long black socks.  Cloth diaper.  Cloth diapers and washing without the aid of hot running water and electricity.  Carol told me that they'd often hang diapers that were not soiled but (urine) wet diapers on the line to dry and reuse. A terry washcloth folded to a triangle was safety pinned to the dress front as a bib.  Another safety pin was tied with a piece of yarn and tied to a pacifier. Safety pins and lots of straight pins hold their clothing together, even their underwear. Women's clothing does not use any buttons although men are allowed.  No zippers, no elastic, no bras. Men and boys use suspenders only, never a belt.  Shoes for men, women and children are totally utilitarian, heavy black boots, thick black socks. 

We stopped at a clinic on the way back to drop off the blood samples of the day and my head was swimming with all that I had witnessed. Carol was as patient with me and my questions as she was with Sara and every person we had seen that day. She called the physician that cares for the first two people we had seen. Listening to the conversation between them on speaker phone I heard what I already knew about this amazing woman, that she is an extremely valuable healthcare provider and connection to the Amish community!

I know that I was given an extremely rare opportunity.  This day was one of the many priceless gifts bestowed on me during my time in TN.  I was invited to journey to a foreign land inside the borders of rural Tennessee.  It was an incredible privileged and honor and I will forever be grateful to Carol Nelson for inviting me and to the Amish families who allowed me into their homes.    

While I wasn't directly doing "doula" work on this outing I grew to appreciate Carol even more and want to incorporate building trust and relationships with those that I work with, not simply to attend a birth. The way of life within that community is very different than what we are used to and there are many challenges as a result, yet she is able to care and guide in a non-judgmental way. Her gentle approach and peaceful bedside manner provide a unique quality of care I hope to strive for in my practice.  


Permalink: The Farm - Amish Country