The timing couldn’t have been better, said certified nurse midwife Darla Berry, who helped deliver little Isla Mae Nelson, the first child of Rachel and Josh Nelson, at IU Health Methodist Hospital last week.

By Maureen Gilmer, IU Health senior journalist, mgilmer1@iuhealth.org

She is 7 pounds, 13 ounces of cuteness and she is now the poster child for IU Health’s new midwifery practice.

After all, what better way to mark the recent opening of the hospital system’s first midwifery practice than with the arrival of its first baby.

The timing couldn’t have been better, said certified nurse midwife Darla Berry, who helped deliver little Isla Mae Nelson, the first child of Rachel and Josh Nelson, at IU Health Methodist Hospital on Tuesday afternoon.

It was a speedy delivery for sure. Rachel had been texting with Berry that morning as her labor began, but by the time she arrived at the hospital at 2:30 p.m. she was fully dilated, Berry said. “We had a baby at 4:04.”

She, Josh and Rachel were beaming Thursday morning while Isla Mae squirmed and squealed, shortly before mom and daughter were discharged from the hospital.

“The stars aligned perfectly,” said Berry, manager of Nurse Midwifery Services for IU Health. “I am over the moon.”

She is the lone midwife in the practice at this point, but three others have been hired and will start in March and April. The practice is housed at the Artistry Building, 404 E. Washington St.

2020 IS YEAR OF THE MIDWIFE

The World Health Organization has declared 2020 as the Year of the Nurse and Midwife, Berry said, because it understands globally “what we don’t get nationally – that midwives are crucial to health.”

A midwife for 20 years, Berry said she has long thought that IU Health and its female patients would benefit from a midwifery practice. After much discussion and collaboration between IU Health and the IU School of Medicine, it’s finally happening, she said.

“If you speak it into existence, sometimes the universe follows through for you,” she laughed.

Berry said midwifery is garnering a lot of attention nationwide at this point “simply because our outcomes are stellar.”

“I think the relationships we can create with women, the opportunities we can create for women to have midwifery care … we just catapulted ourselves ahead of the game.”

Rachel Nelson, whose husband is manager of Methodist’s wound care center, knew she wanted a midwife for her delivery, but she had to wait for IU Health’s new practice to open its doors. She was already 36 weeks pregnant before her first appointment with Berry, though she had been under the care of a physician and had done her homework when it comes to understanding pregnancy.

“I’ve done a ton of reading and research already and knew I wanted to find a midwifery practice to be able to partner with in this,” Rachel said before she gave birth. “I wanted someone who was an expert in a ‘normal’ birth. Having that partnership and that communication was super important.”

The two women connected instantly, Berry telling her patient that she would be “the guardian of all things normal” and would help navigate what Rachel wants with what the medical world says needs to be done.

Ironically, Josh met his wife’s midwife before she did, when both he and Berry attended an IU Health leadership conference in November.

“She waited very patiently,” Berry said of Rachel during their last appointment before Isla Mae made her grand entrance. “In terms of getting to know her, I feel like we’ve done some speed dating.”

But her medical care had been good, and Rachel was self-motivated to learn all she could.

“She is an ideal first patient, exceptionally prepared,” Berry said. “She is very low-key, so not a lot ruffles her, and I would include labor in that.”

The timing could not have been better for the practice, she said, “with a birth right out of the gate.”

METHODIST IS A LEADER IN CARE

For now, Berry will deliver babies at Methodist, which has established itself as a leader with regard to midwifery care, she said. Eventually, labor and delivery will move to the new mother-baby unit under construction at Riley Hospital for Children at IU Health.

While having a midwife is not necessarily about un-medicated birth, the hospital staff must support the option, she said. And the staff at Methodist does.

“The hardest work is already done for me in terms of building this practice and providing this service because I already have the nursing staff, management and administrators that are totally on board and supportive,” Berry said.

Physicians are on board as well, she said, noting that more and more medical interns and residents are gaining experience with midwifery in their education.

Berry said midwives offer a more personal birth experience for pregnant women.

“It’s my job as a midwife to help reconcile this often idealized picture of what birth looks like for women, especially those who’ve never had a baby, and talk through what your options are in terms of medication, intervention, monitoring and how to balance it.”

Having a midwife doesn’t mean a woman has decided to have an un-medicated birth, Berry said, but it is certainly an option. Rachel chose to forgo medication and has no regrets. The labor and birth were pretty much what she hoped for, she said, and her baby girl came out healthy and strong. Had there been complications, however, Methodist staff were prepared to step in.

“We work very closely with physicians,” Berry said. “If there are any questions prenatally, then we consult. If questions or concerns come up once labor starts and you’re in the hospital, we’ve got staff in house 24/7. So someone is there to offer a second set of eyes, consult or to transfer care if that’s what needs to happen.

“We’re not out here doing wacky, wild, unsupported stuff,” Berry said. “Our care philosophy is research-based, and my job is to help women walk that path and know what their options are and know why they’re choosing to do or not to do something.”

MIDWIVES CAN TREAT WOMEN FOR LIFETIME

The new midwifery practice presents opportunities for women of all ages to seek care from practitioners who have a passion for supporting women. While midwives are most associated with delivering babies, they can treat women at any time, Berry said.

“As midwives, we are ‘with women’ and we are with women for a lifetime, so I can see you as a teenager and help you through irregular periods and birth control, through the child-bearing years, and I can stay with you through menopause.”

Berry, a mother of four herself, had an obstetrician deliver her first two children, then delivered her next two at home with a midwife. She describes the moment when a woman meets her child for the first time as “sacred,” and believes everything should be done to protect that moment.

“We are here to ensure that every woman knows they have one person on this side of the fence in the medical arena who will listen to them and help them navigate the system, which is often so ridiculously complicated.”

Berry believes IU Health’s new midwifery practice is one more piece in the puzzle that will help address Indiana’s high maternal mortality rate – 41.4 women die for every 100,000 births – which is more than twice the national average.

“What this practice and an endorsement by the School of Medicine can do is solidify our place at the table as midwives and as owners of that midwifery body of knowledge that acknowledges we are a piece of the solution to this problem.”

To schedule an appointment with IU Health’s new midwifery practice, call (317) 944-8231.

Photos by Mike Dickbernd, IU Health visual journalist, mdickbernd@iuhealth.org