One of my favorite parts of being a postpartum doula is connecting my clients to other great resources in our area. Recently I interviewed Ash Johnsdottir, CPM LDM of Willamette Birth to gain a better understanding of her approach to birth.
Ash is a licensed and certified professional midwife who lives in Corvallis, Oregon. While studying botany, she developed an interest in plant medicines used for childbirth and fertility, which led her to her lifelong passion for midwifery and women’s health. After starting midwifery school 2007, she started attending births in 2009. Since then, she has cared for women and their families in Utah, Texas, and Oregon, at two different birth centers, and with several homebirth practices.
She graduated magna cum laude with her Bachelor’s Degree in Midwifery from Midwives College of Utah, and was named student of the year among the largest graduating class in the history the school for her achievements in the field of midwifery. She has published in Midwifery Today, and is currently working on other articles for publication in academic midwifery journals.
Before getting her Oregon midwifery license, Ash worked with over a dozen senior midwives, encompassing a wide variety of practice styles. She has also continued to study and work with herbal medicine extensively, especially the uses of herbs for women’s health.
What inspired you to become a midwife?
For most of my life I didn't know modern midwifery existed- I thought it had ended back in the "Little House on the Prairie" days! Although I had long known that I wanted to study some sort of field related to women's health, nothing seemed like the right fit for me. I have always been interested in plants and botany. At the time I lived in Utah and I was reading a field guide to local medicinal herbs- I was amazed to find so many plants that were traditionally used for fertility and during childbirth, and while researching these plants I learned about modern midwifery. I knew at once it was my calling and enrolled in midwifery school. Thankfully, I was blessed to live near Salt Lake City, which has one of the best midwifery schools in this country.
What is it that makes you passionate about home birth?
Everything! There's nothing like home- because it is their space, women are comfortable and empowered in ways they wouldn't be in a hospital or birthing center. I've attended birth in many settings, and there are so many little things that make home birth sublime and special. No shift changes, "hospital smells," strangers, hospital routines, gowns, etc. Your partner or other children aren't visitors, and they won't be turned away after visiting hours. Sleeping in your own bed after birth (we change the linens!), etc. The support- a midwife who stays with you throughout your labor instead of a nurse who is caring for many women and a doctor who may just drop in to catch the baby as they are being born. There are other things that can happen in any birth setting but home provides special support and is the place where these things successfully happen at the highest rates- things like giving birth in an upright position, being active during labor, natural & unmedicated birth, providers who respect the family by keeping talk to a minimum and eschewing "chatting", delayed cord clamping, skin to skin, etc.
Home birth is my passion, but I'm also very glad for modern medical care and hospital birth! Not every pregnancy is low risk enough for home birth, and not all women prefer to give birth at home. Also, a minority of women who plan for a home birth will need to transfer care at some point. There are wonderful things at the hospital that are essential when needed and can't be provided at home- epidurals, cesarean births, the NICU, and certain types of skilled care providers who only work in hospital settings. Home birth midwifery care is my passion, but I don't believe in always staying home! I strive to provide careful, evidence based care, and I don't hesitate to consult with another provider or transfer care if a client needs it.
What kinds of services or support do you offer postpartum to your home birth clients?
v Immediate postpartum care after birth, monitoring of mother and baby. Any necessary assistance with latch and first feed. Postpartum suturing of the perineum and any tears from childbirth within my scope of practice (if necessary). My assistants and I stay for many hours after the birth. We don't leave until we've cleaned up everything from the birth, started the laundry, and mom and baby are stable and resting!
v In home postpartum visits for your family typically at 24 hours, three days, and one week after birth. Postpartum office visits are at two weeks, four weeks, and six weeks. Visits typically take at least an hour. Herbal, nutritional, medical, and midwifery care as needed at each visit. Screening and assistance for perinatal mood disorders. Help with coordination of postpartum community support.
v Filing of official birth certificate with the state of Oregon. Baby footprints and keepsake birth certificate. Newborn metabolic screening, performed by midwife and processed by the state of Oregon.
v Well newborn and baby care through six weeks.
v Lactation and breastfeeding assistance by midwife.
v Assessment and support for healing of perineal tears and support for pelvic floor recovery.
v Holistic care specialized for cesarean recovery, if necessary.
v Complete well woman physical exam and PAP smear at six weeks.
v Counseling and care for fertility or contraception, if desired, including fitting for barrier methods or counseling regarding fertility awareness.
Would you still recommend a postpartum doula if someone has a home birth?
Absolutely! Even though as a midwife I provide totally comprehensive support for the postpartum health of mother and baby, outside the visits family can still need a great deal of support. A postpartum doula can help with practical matters a midwifery practice simply can't handle. As a midwife who is caring for many different families in all stages in all stages of childbearing and with a family of my own, I can't stay the night or come for over for anytime for several hours to help with whatever mother and baby need. But this is exactly what a postpartum doula does! A mother needs to rest to recover, hr partner needs to rest to continue working, a midwife needs to rest in case she gets called out to the next birth, but the postpartum doula is ready to step in and help! I am so glad postpartum doulas exist so that I can attend to the medical, health, and midwifery concerns of the postpartum period while the postpartum doula aids my client with the practical matters of the postpartum. We simply aren't meant to care for our very young babies in isolation- a mother all by herself with a newborn (and maybe several other children) while her partner heads back to work is the perfect recipe for stress, exhaustion, delayed healing, and postpartum depression. Humans used tolive more collectively, often in multi generational homes where families could meet these needs. In today's world, a postpartum doula is essential to fill in the gaps created by modern life!
Thanks, Ash, for taking the time to let us know a bit more about you and your services!