An Interview with a Midwife by Mike Hart

An interview with Michelle Levins of Heights Midwifery

Tell me a little about your background. How did you decide to become a midwife?

As a mother, I am a natural caregiver and the role of midwife was one I took to very well. I had three hospital births, where none were bad, I just felt like it could have been better. I hired a midwife with my fourth, and it began my love of midwifery.

I was already working as an IBCLC prior to the birth of my fourth, but wanted to be a part of the birth world. Shortly after the birth of my fourth, I started photographing births and quickly realized I wanted more and decided to become a doula. I worked with a few obstetric clients as well as a few midwifery clients. I enjoyed doula work more then photographing, but it still left me wanting more. I spoke with the midwife I used during my fourth pregnancy about assisting her and shortly after started apprenticing with her. I went to the prenatal exams, births and postpartum exams of her clients and loved the interactions and the strong relationship that was built between most clients and the midwife. It took me one year before I officially enrolled in the Association of Texas Midwifery Training Program.

What exactly is a midwife and what do they do? 

A midwife is a professional who cares for low risk women during their pregnancy, birth, and postpartum period. We typically start seeing clients between 8-10 weeks. We monitor the mother and baby throughout the pregnancy for adequate growth and nutritional health. An appointment with a midwife is similar to that of an OB but much more in-depth. We monitor vital signs, do lab work when indicated, listen to the fetal heart tones, but we also discuss stress, exercise, mental well being, and answer any questions or concerns the parents might have. Midwifery is based on informed consent: keeping the client informed and having open dialogue with parents. A midwife is only part of the team; the parents are the other half.

Could you tell us a little about the history of midwifery?

Midwifery was established long before obstetrics. Many older women in the community provided care to pregnant women and passed along their knowledge to other women wanting to become midwives. As time passed, the promise of a pain-free childbirth made its way and obstetrics and hospital births grew among the urban middle class. Midwives continued to provide care to the underprivileged women in their community. For decades midwives were seen as uneducated and dangerous. Laws and regulations came into play and the community midwives were required to be licensed and regulated. Schools were formed for midwifery education and standards have to be met. Midwifery has been gaining in popularity in the United States and is beginning to be more mainstream in all social classes. However, the reasons it is most sought after is parents seek to be more involved in their prenatal care, are becoming more educated about risk of interventions and drugs, and desire a more natural option for pain management during childbirth.

What are some of the advantages of having a home birth with a midwife over a hospital birth?

Personally, as a midwifery client, I enjoyed getting into my own bed, eating my own food and not being separated from my family after giving birth. For clients, some of the advantages I see is they are less inhibited with moving around, being vocal, and being nude. They are in their own comfort zone, so they feel safe and free. They birth in more natural positions, they tolerate the normal pain of childbirth easier, and find deep comfort in having their family there. I see advantages for their partners too. They are more involved in the laboring process but also feel more comfortable because they are in their own space. The staff doesn’t change at certain times; there are no restrictions on movement, showering/baths, or drinking or eating. All those things add up in big ways for the clients. Additionally, the rise in the cesarean rates due to interventions is at an all time high and many clients feel uneasy even walking into a hospital.

Are there circumstances where you would not recommend a home birth and how do you handle any complications that might arise?

Not every woman is low risk. There are certain medical conditions that would prevent a woman from being a midwifery client. There are also some factors, such as advanced maternal age, that may be considered a risk but may not disqualify a woman from risk midwifery care. Some clients that start out low risk later develop a condition that makes them higher risk. Midwives typically have an OB they can consult with or send a client to for further evaluation. Midwives do ongoing risk assessments throughout the entire pregnancy, labor, and postpartum period.  We are also trained in basic life support, neonatal resuscitation and carry medications to handle some complications.

How would you recommend our readers go about choosing a midwife?

Choosing a midwife is very personal. I recommend to all my prospective clients to interview at least one or two other midwives. It is important to feel comfortable asking questions. You have to trust your health care provider and feel confident in their ability to handle issues if they arise. Ask a lot of questions when you interview a midwife; not just about how they handle situations but how often they transport to the hospital. You should also ask if they bring a birth assistant, how many clients do they take that are due the same month, do they have vacations planned, where the appointments take place and what the fees involved in care are. One of the most important factors is trust. Also remember, it is never too late to change health care providers if you don’t feel comfortable or feel your provider dismisses your concerns or wishes.

Are there other birthing professionals that you work with before, during or after a birth?

Some of the other professionals I refer to or recommend for clients in pregnancy is a chiropractor, massage therapist, child birth educators, breastfeeding classes, birth photographers and doulas.

Is there anything else that you'd like to share with our readers?

The pain of childbirth is often seen as something to fear. It is a natural emotion to feel; yet childbirth in reality is nothing like we see on television or in movies. When allowed, a woman’s body will guide her and work with her to birth her baby. Just like childbirth, there are many myths around midwifery. I would encourage every expecting parent to at least call a midwife and chat with them. Lastly, I would encourage all expecting parents to read some well written books on pregnancy and childbirth, breastfeeding and to be always be active in your care.

Michelle Levins, Heights Midwifery

[email protected]



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