Homebirth Options in Alabama

Over the past two weeks or so many women have found themselves questioning the wisdom of going into a busy hospital where the sickest among us are congregating in order to deliver their baby. We're being told to avoid gathering in large groups, so those who were already hesitant about going to the hospital have started researching midwifery options in Alabama.

Yes! Midwifery and homebirth is legal in Alabama, and there is likely a CPM (Certified Professional Midwife) serving your area. She is trained to monitor a pregnancy through prenatal visits, labor, and postpartum visits. If there are problems that make a hospital birth safer, she will advise you to have your baby there. However, if you are low-risk she can take care of you and your baby at home with less interventions in the process than you would have at the hospital while avoiding viruses and bacteria foreign to your family.

The best place to start would be here, the Alabama Midwives Alliance website. You can contact a midwife serving your area up an interview. I have to add a small plug here for the midwife I apprentice with, Rebekah Myrick, because we now have the option of doing prenatal visits here at A Nurturing Moment in Huntsville! Find her information on her website. 

Other options would be to give birth across the border in Tennessee if you don't like the idea of birthing in your own home. Midwives there have done that before, and would be able to give you guidance on how to do that. The website for the Tennessee Midwives Association can give you the contact information.

We Welcome our New Owner!

by Glenni Lorick, IBCLC

Michele Trosclair was the first
owner of A Nurturing Moment.

I am so excited to announce that A Nurturing Moment is taking the next BIG step in its history! Regina Woodley is purchasing the boutique and will continue offering the best lactation care available!

A Little History

In May of 2005 Michele Trosclair, a former NICU nurse, opened a tiny maternity and breastfeeding boutique in Madison because she felt that breastfeeding moms needed a place where they could get good nursing bras and supplies as well as support. I first met her that summer when I introduced myself and offered to help with the breastfeeding support. We quickly outgrew our tiny space on Slaughter Road and moved to a much more spacious location on Hughes Road where we had room for meetings and classes. In late 2006 we expanded to a second location on Airport Road, eventually closing the Hughes Road location in 2008.

Regina Woodley nursing baby Talia
at work at the store.

In October of 2008 I bought A Nurturing Moment from Michelle because her husband was being transferred to Colorado with his job. We saw a lot of growth from 2008 -2011 when I made the decision to purchase Huffman's Baby Furniture and move to the Rosie's Cantina Shopping Center. I quickly realized that I wasn't really that interested in selling Baby Furniture, but I did love having the Best Chairs Nursery gliders and recliners available for moms. We moved into our current suite in 2012.

In 2015 Kailey Dozier approached me with an idea to incorporate 4D Ultrasound into our offerings, and our partnership with The 4D Ultrasound Lady began. Then in June of 2018 right after my second grandchild was born, Kailey and I switched roles. Instead of her renting from me, I began renting space from her. We shortened our hours and returned to our main focus of supporting breastfeeding mamas!

Regina Moves to Town

Regina's daughters McCulla and Kyleigh are
already giving mom a hand at work!

Regina moved here from Texas in November of 2017. She had reached out to me, and we had corresponded a little bit, but we didn't actually meet until the summer of 2018. I invited her to help with our Athens breastfeeding support group on Fridays since she lives in Athens, and over the course of the next few months we grew much closer. She began doing some consults for A Nurturing Moment that year, and I was really impressed with her skill set and her compassion for moms. She also became an admin on Huntsville Mommy Milk Meet-up, offering terrific advice to our mamas.

Not only is Regina an IBCLC, she is also a doula and an herbalist. She is also in the process of becoming a Certified Professional Midwife. Last April I broached the subject of her buying the store very tentatively. I honestly had expected to be here at ANM until I died because I just hadn't met anyone I felt truly comfortable selling the store to. I knew if I ever sold it, I would only sell to an IBCLC who loved the Lord and had a heart for ministry to moms. I wasn't sure Regina would even be interested, but I knew she was the right person and hoped she would say yes!

Unbeknownst to me, Regina had a dream of opening a store someday. She didn't know how to approach me to ask if I would be willing to sell ANM to her at some point, so when I asked her if she might possibly be interested, she thought it would be a lot further down the road, but she was definitely excited about the possibility. She gave birth to her tenth baby at home in November, and felt like she would be ready to move forward after the beginning of the year.So this week is our transition week!

I get to spend more time having fun
with my precious grandchildren!

The Best Is Yet to Come

Regina will continue to offer the same amazing service that you have come to expect from A Nurturing Moment. I will be focusing my energies on my work at Athens Limestone Hospital, a new ministry to women called the Dandelion House, and my precious grandchildren!

I want to thank all of you for allowing me to serve you for the past 14 years. It has been such a privilege. I feel like Michele gave birth to A Nurturing Moment, I have raised it through its adolescence, and now Regina will take it into adulthood. I can't wait to see where Regina and ANM go in the future!!

2020 MOM Foundation Calendar

The 2020 MOM Foundation Calendar will be here in less than 3 weeks, so it's time to order yours now! As you're doing your Cyber-Monday shopping, be sure to include your favorite doctor, nurse, midwife, lactation consultant or doula! This beautiful calendar filled with images of nursing mothers makes the perfect gift. Ten different local photographers are represented in this year's calendar with thirteen stunning photographs.

The MOM Foundation supports low income and teen moms with breastfeeding help, nursing bras and discounted pump rental. Each year your purchase of a calendar helps to allow the foundation to continue providing this much-needed help.

The presale price is $20 for one calendar or $18 each for two or more. If you would like your calendar to be mailed to you, please include $5 for one or two calendars and $10 for 4 or more. Calendars will be mailed in order to arrive in time for Christmas. The Presale is  December 2-10, so be sure to get yours today!

If you plan to pick up your calendar in the store, please put that in the notes. Otherwise, let us know you would like it to be sent to you and pay the corresponding amount! The $20 option is for one calendar to be picked up the store. The $36 option is for 2 calendars to be picked up in the store, and the $25 option is for one calendar to be mailed to you. If you want something different, please choose your own amount to send.

To All You Beautiful Moms

by Amanda Robison

We started our family in 2011 after my husband’s first deployment. God blessed us with an incredible little girl with her daddy’s strength and all her mommy’s sass! We had plans of expanding our family after she turned 2, but another deployment separated our family for 18 months. When we were ready to try, we found ourselves holding countless pill bottles and syringes instead of a baby as we underwent several infertility therapies.

Finally, after 3 years we saw the faintest blue line and heard the sweetest heartbeat. Sadly, the tiny little boy that filled us with so much joy was not meant to be ours, and his heart stopped at 10.5 weeks. Our D&C was followed by an emergency surgery to remove what we thought were cancerous cells. Finally, 2 months later, after 3.5 years, 5 surgeries, 2 IUIs and countless prescriptions we saw another faint blue line. We held hands and prayed at every ultrasound until we heard that precious thump, thump. On April 17, 2019 God blessed our tiny family with a beautiful rainbow. She came into the world with a calmness about her and a spirit that puts all those around her at ease.

Our breastfeeding journey has had ups and downs, but I’m so incredibly proud of the journey and our success. I want to share some encouragement from a post wrote in Huntsville Mommy Milk Meet-up this week.

To all you beautiful moms:

The weeks are long and crazy hard to survive. The early mornings to shower, nurse, pack lunches, get everyone ready and out the door on time are nuts. The day is packed with meetings, e-mails, paperwork, phone calls and pumping. The evenings are a rushed scene of homework, cooking, cleaning, bath time, laundry, bedtime routines and prepping for the next day that lasts late into the night. 

This mama’s bones are tired and her heart is aching...was I enough today? Enough of a mommy to an infant so she knows, despite her time at daycare, I’m always here for her and think she was worth all the nights spent praying for her? Enough of a mama to the little girl, who isn’t as little as she used to be, so she knows that despite her new attitude and ever-growing curiosity about the world around her that I’m never NOT in her corner and will always be on the sidelines cheering the loudest? Enough of a wife to the husband who has seen all my highs and all my lows and loves me with all my flaws? Enough of a friend, a co-worker, a colleague, a chauffeur, a shoulder to cry on and a safe place to all those in my little world needing me? Truthfully, probably not and truthfully that’s okay. I’m doing the best I can and that’s okay. 

There’s beauty in both my success and my defeat, my triumphs and my failures. There’s still 2 little girls who light up when I walk into a room and think I’m pretty awesome, even on the days I know my best just wasn’t enough. There’s still peace in early mornings, just before the dawn fills the sky and the house is still, that I remember God blessed me with this craziness and someday my heart will ache again longing for the mess and chaos.

To those families who cradle emptiness and those families who mourn for the tiny bundles they’ve lost, we see you and we mourn with you. For those that are holding their gifts and rocking their tiny rainbows, we rejoice with you. If I’ve learned anything on this journey, it’s that God truly works in mysterious ways and there is reason hidden in the madness. I count my blessings daily that a couple of high school sweethearts were blessed with 2 precious baby girls and given an opportunity to sit front row as they grow and leave their marks on the world around them.

I Was Able to Have a Breech Baby Vaginally!

by Jessica Reese, Guest Blogger

Baby Elias was a vaginal breech birth!

Summer 2018 after a short amount of trying we were pregnant with my second child.  Unfortunately, we found out at the 12 week ultrasound appointment that the pregnancy was due to a blighted ovum and I needed to have a D&C to clear the remaining tissue that did not pass on its own.  We were able to become pregnant on the first ovulation post D&C with our third child.  For the beginning of all of our pregnancies, I go to see Dr. Michael Podraza at St. Francis Women's Health and Fertility in Memphis, TN. Dr. Podraza will see patients as soon as they get a positive pregnancy test.  He is also a doctor trained in Naprotechnology, which means that he incorporates natural family planning (cycle charting) into his approach.  I see him because I have hypothyroidism and luteal phase deficiency, and he provides a different approach than most OB/GYNs or Endocrinologists.  Since, I have luteal phase deficiency, he prescribes progesterone injections up to 14 weeks to help maintain the pregnancy.

At 16 weeks, I was able to get a transfer appointment with Dr. Aguayo in Huntsville, AL.  Dr. Podraza had placed me on daily progesterone suppositories starting at 14 weeks because of a previous preterm birth at 35+3 weeks.  Upon transferring to Dr. Aguayo, she suggested switching from the suppositories to Makena (progestin in oil) for weeks 16-36.  During weeks 14-24, I had ultrasounds to check my cervical length to see if a cerclage was needed to prevent preterm labor.  Fortunately, my cervix remained long and closed.

Since, I had had a previous preterm baby without warning signs, this pregnancy I was cautious to get several checks for preterm labor whenever I had too many consistent contractions in an hour.  Upon one of these preterm checks, I received a positive fetal fibronectin test.  Since, there is a high false positive rate with the test Dr. Aguayo had me come into her office for an ultrasound to check my cervix.  This ultrasound show a low level of amniotic fluid (4 low pockets and a single acceptable pocket).  Due to the result of this ultrasound and preterm delivery history, Dr. Aguayo referred me to a Maternal Fetal Medicine specialist from Brookwood, Dr. Antonio Gonzalez-Ruiz  for a more extensive ultrasound.  I received weekly ultrasounds from Dr. Gonzalez-Ruiz's office, each showing my baby boy was happy and healthy, but my fluid level was staying within the low-normal range and my baby, since the beginning, was staying in a breech position.

I had an ultrasound at Dr. Gonzalez-Ruiz's office at 35 weeks, and we discussed with him regarding attempting an ECV.  He suggested that the ECV may not work due to the lower fluid levels, but it was a very low risk procedure.  He also encouraged us that when he was practicing in Ohio with 12 midwives, that he would let people like me who fit certain criteria attempt a vaginal breech birth if they desired.  He told us a good candidate for a breech birth in the hands of an experienced provider was not unnecessary risk.  After, speaking with Dr. Aguayo's office I learned that she only performs ECVs at 38 weeks or later and in conjunction with either induction or, if the ECV fails, performs a c-section.  Since, I was worried that I had had a previous fast, progressing labor and a preterm birth, I really wanted to attempt the ECV sooner to avoid being very far along with a breech baby and rushed into an emergency c-section.  I was definitely influenced by the research in this article:y/.

Upon asking for recommendations, I got a consultation with Dr. Joshua Johansson to attempt an ECV. He agreed to attempt the ECV and suggested using the epidural, since there was a lower chance of success with lower fluid levels.  At 36+5 weeks, Dr. Johansson attempted an ECV, unfortunately after 4 attempts the baby did not turn.  However, the baby tolerated the ECV well and his heart rate did not drop.  Dr. Johansson stated that sometimes he would offer people a second attempt, but in this case he felt it would not be worth the time.

Dr. Bootstaylor's criteria for a vaginal breech birth.

During this process, I had also tried spinning babies to help turn the baby.  I was seeing a Webster trained chiropractor, Dr. Misty Browning, to help create space for the baby to move.  Because I realized there was a decreasing chance the baby would turn before labor, I assumed I might have to have a c-section due limited options.

Since I was still very worried about having a fast labor with a breech baby, and not having any skilled OBs in the area, I was considering what I could do.  Upon the recommendation of Dr. Gonzalez, at 37 weeks I got a consultation with an experience breech provider and Maternal Fetal Medicine Specialist Dr. Brad Bootstaylor  at See Baby in Atlanta who told me I was a good candidate for a breech birth. He said he would be willing to accept me as a late transfer at 39 weeks if I was motivated for a breech birth. Interestingly enough, See Baby's motto is "Bring Birth Back."

At this point, I was still torn on the decision.  I had my 38 week appointment with Dr. Aguayo, and she discussed the c-section with us.  She also told us that I could be a good candidate for a vaginal breech birth, but she was unable to do it and there was no doctor in Huntsville that would do it.  She also said I would be a candidate for a VBAC for the next pregnancy, but that in all future pregnancies I would always be considered a VBAC.

Still weighing my decision I had an appointment with Dr. Gonzalez that Tuesday to discuss his view on the breech birth.  Monday night at 5:30 PM after I was home from work baby Elias kicked the amniotic sac and my water broke.  Since, with my daughter my water broke and labor did not begin until around 20 hours later I knew I would have time to drive to Atlanta for the birth.  My parents came and got our 2 year old and my husband and drove to Atlanta.

We called Dr. Bootstaylor's office and he called us back and stated I may not want to go into the hospital until I was further along in labor.  When we got to Atlanta we got a hotel in downtown Atlanta to rest and wait for labor to begin.  Much later in the evening I was having some regular contractions that I was working through in the shower.  Since the contractions were regular we decided to check into the hospital.  At that point I was 4 cm dilated and 80% effaced and station -2, since I had a fast labor previously I decided to stay in the hospital.  While I was at the hospital, my blood pressure was very erratic during monitoring.

Later that morning, Dr. Bootstaylor came in with a nurse midwife trainee to discuss my progress and care.  He was concerned that my blood pressure numbers were high and erratic and I was still 4 cm and 90% effaced and station -2. He explained that there were some decisions we needed to make.  Dr. Bootstaylor said if I stayed in the hospital with higher blood pressures and labor stalled, and already being a higher risk with a breech baby then it seems more likely to start discussing a c-section per hospital protocol.  Also, he said with breech it is not ideal to augment the labor with Pitocin, especially at this first labor stage.  He told that we do have the option of taking an AMA and leaving the hospital.  He said if I stayed in the hospital with erratic blood pressures, then they would want to monitor my blood pressures, and I wouldn't be able to have the freedom I would at home to rest, eat, and move around which are all things that help labor progress naturally.

Jessica and Elias with their birth team

We discussed our options with Hannah Ellis, our doula, and we decided that I would take the AMA and we would stay close to the hospital.  After we left the hospital we went and ate lunch; I got a large ribeye steak, and then I went and rested.  A little bit later I asked my husband Jarrod if he wanted to walk from our hotel for 20 minutes to the Ponce Street Market and get some gelato.  So we walked, and I got some gelato.  As I was eating my gelato, I began to feel some more contractions picking up, especially walking back to the Airbnb.  When I got back I laid down for 20 minutes, and then I felt the need to go to the bathroom.

I had two bouts of diarrhea, and I decided to get in the shower and start working through contractions and timing them.  While I was laboring in the shower I did a lot of hands and knees to manage the back labor.  My contractions remained 5 minutes apart and we notified Dr. Bootstaylor that the contractions had picked up and labor was moving smoothly.  Hannah  also noticed blood signs of change in cervical dilation.  My contractions continued to be 5 minutes apart and I was thinking my labor might last another 6-7 hours.  I could also talk quite a bit between contractions.  After quite a long contraction, I felt baby Elias make a big rotation to get in position.  Then instinctively with the next contraction I started squatting.  Hannah asked me if I was feeling the urge to bear down, and I said yes.  She said we need to go to the hospital now.

She called Dr. Bootstaylor, and I got in the back of our van and tried not to push on the way to the hospital.  As I got to the hospital, we pulled up to the valet parking and I walked as quickly as I could to the elevator to get up the stairs.  Elias' booty was hanging out before I was getting on the elevator.  I got to L&D and they got me into a room quickly and I got up on the bed in hands and knees.  Kim Holderfield, Dr. Bootstaylor's trainee was already there.  Since I came in so far along, there were several people in the room.  One nurse was able to get right by my ear and get me to focus and tune everyone out.  Dr. Bootstaylor arrived a little bit later.  The nurse helped me focus on pushing and making every push count by pushing past the contractions to get the head out quickly.

Elias Jude Reese was born on 5/14/19 at 8:06 EST with 4.5 of active labor 6 lbs 2 oz and 20" long.  Thanks to Dr. Brad Bootstaylor and midwifery student Kim Holderfield who did most of the delivery as he guided her.  Elias was healthy when he was born, and only needed some bulb syringe suction which is typical of breech babies.  Dr. Bootstaylor encouraged us to have delayed cord clamping.  I am very thankful to have the option and shared decision making and shared responsibility provided by the See Baby team.