Speciality Births

In my midwifery care, I am deeply honored to walk alongside families navigating specialty births such as twins, breech presentations, VBACs, and even VBAC2s. These journeys call for thoughtful preparation, clinical skill, and a foundation of prayerful discernment, trust, and evidence-based care. I provide thorough, ongoing informed consent conversations so families clearly understand the benefits, risks, and alternatives, empowering them to make decisions that align with both their values and the way God is leading their family. Specialty births often include a larger support team—such as an additional experienced assistant, collaborative providers when appropriate, and clear transfer plans—because preparation brings peace. My commitment is to offer vigilant, physiologic birth-centered care while humbly recognizing that each birth is sacred work. I strive to steward these moments with wisdom, skill, and faith, trusting the Lord in every step while ensuring families feel informed, supported, and never alone.

Breech, Twins, & Vbac's

BREECH

What is Breech

A breech pregnancy is a unique presentation in which your baby is positioned bottom, feet, or both downward in the uterus rather than head down. While breech presentation is a normal variation of birth, it carries increased clinical considerations and requires careful evaluation and skilled management. At Birthing Miracles – We Nurture You and the Miracles You Are Carrying, we are committed to providing thorough, evidence-based care while honoring your autonomy and informed decision-making throughout this experience.

Nature of Breech Presentation

Breech presentation occurs in a small percentage of term pregnancies. Vaginal breech birth can be a reasonable option in carefully selected candidates with appropriate provider experience; however, it carries increased risks compared to vertex (head-down) birth. These risks include cord prolapse, head entrapment, birth trauma, fetal distress, need for emergent transfer, and increased likelihood of operative or cesarean delivery. There is also a higher statistical likelihood of hospital transfer during labor or postpartum compared to vertex births. Understanding these risks allows for thoughtful preparation and planning.

Model of Care

Ongoing Assessment

Our care model for breech pregnancy includes careful screening and continuous reassessment to determine eligibility for out-of-hospital birth. This includes:

Detailed informed consent discussions reviewing benefits, risks, and alternatives
Assessment of breech type (frank, complete, footling)
Pelvic evaluation and review of maternal health history
Ongoing monitoring of fetal growth and well-being
Ultrasound evaluation as indicated to confirm presentation, flexion, and estimated fetal size
Continuous risk assessment to determine ongoing eligibility for planned out-of-hospital breech birth

If at any time safety parameters are not met, transfer of care or birth setting will be recommended.

Larger Birth Team

Due to the unique needs of breech birth, a larger and highly experienced birth team will be present. This typically includes your primary midwife and at least one additional skilled provider or assistant trained specifically in physiologic breech birth. Emergency equipment for maternal and neonatal care will be readily available. Clear hospital transfer protocols are established should complications arise.

Body Preparation & Supportive Care

Chiropractic care and body balancing techniques may be encouraged during pregnancy to support pelvic alignment and fetal positioning. While these measures may promote comfort and balance, they do not eliminate the risks associated with breech presentation.

Labor

Birth Considerations

Vaginal breech birth requires a physiologic approach with careful monitoring and minimal unnecessary intervention while maintaining readiness for prompt action if needed. Specific intrapartum risks include cord prolapse, delayed descent of the body or head, head entrapment, fetal compromise, postpartum hemorrhage, and neonatal resuscitation. Continuous assessment during labor will guide recommendations. If complications arise that exceed out-of-hospital safety parameters, transfer to a hospital setting will be advised.

Alternatives to Planned Out-of-Hospital Breech Birth

Alternatives include

planned cesarean delivery,
hospital-based vaginal breech birth with a supportive provider, e
xternal cephalic version (ECV)

to attempt turning the baby head-down, or transfer of care to obstetric management. These options have been discussed, and you understand you may choose transfer of care at any time.

Acknowledgment

Informed Decision-Making

By choosing care for your breech pregnancy with Birthing Miracles, you acknowledge that:

You understand the increased risks associated with breech presentation.
You understand that recommendations may change if safety concerns arise.
You consent to ongoing assessment, the presence of a larger skilled birth team, and established transfer protocols.
You understand the potential need for hospital transfer or surgical delivery.
You have had the opportunity to ask questions and receive evidence-based information.

Our commitment is to vigilance, transparency, and compassionate support as we nurture you and the miracle you are carrying, ensuring you are fully informed and thoughtfully prepared for this birth journey.

https://www.acog.org/clinical/clinical-guidance/committee-opinion/articles/2017/04/planned-home-birth

TWINS

Birthing Miracles –

We Nurture You and the Miracles You Are Carrying

A twin pregnancy is a unique and complex journey that carries both great joy and increased clinical considerations. At Birthing Miracles – We Nurture You and the Miracles You Are Carrying, we are committed to providing thorough, evidence-based care while honoring your autonomy and informed decision-making throughout this experience.

Nature of Twin Pregnancy

Twin gestation is considered higher risk than a singleton pregnancy due to increased likelihood of preterm birth, growth variations between babies, anemia, gestational diabetes, hypertensive disorders, malpresentation (including breech), postpartum hemorrhage, and increased need for medical intervention. There is also a higher statistical likelihood of hospital transfer during labor or postpartum compared to singleton births. Understanding these risks allows us to prepare proactively and thoughtfully.

Model of Care

Increased Monitoring

Our care model for twins includes closer monitoring to promote safety and early identification of concerns. This includes:

Monthly appointmets to 28 weejs then Weekly prenatal appointments beginning at 28 weeks gestation
Ongoing nutritional counseling to support optimal fetal growth and maternal well-being
Lab monitoring as indicated (iron levels, glucose screening, etc.)
Ultrasound evaluation at approximately 36 weeks to assess fetal growth, fluid levels, and positioning
Continuous risk assessment to determine ongoing eligibility for out-of-hospital birth

**Additional ultrasounds or consultations may be recommended if concerns arise.**

Larger Birth Team

Due to the unique needs of twin birth, a larger, experienced birth team will be present. This typically includes your primary midwife, an additional skilled midwife or assistant trained in twin and breech birth, and support personnel as needed. Emergency equipment for both maternal and neonatal care will be readily available. Clear hospital transfer protocols are established should complications arise.

Chiropractic

Body Preparation

Chiropractic care is strongly encouraged throughout pregnancy to promote pelvic balance, optimal fetal positioning, maternal comfort, and improved physiologic birth dynamics. While chiropractic care does not eliminate risks, it may support alignment and comfort as your body adapts to carrying two babies.

Labor

Birth Considerations

Twin birth carries specific intrapartum risks, including cord prolapse, malpresentation of the second twin, fetal distress, need for emergent transfer, postpartum hemorrhage, and potential need for operative or surgical delivery. Continuous assessment during labor will guide recommendations. If risk factors arise that exceed out-of-hospital safety parameters, transfer to a hospital setting will be advised.

Self-Nurturing

Maternal Responsibility

Twin pregnancy requires intentional self-care. Adequate protein intake, hydration, rest, supplementation as recommended, stress reduction, and early reporting of symptoms (preterm contractions, decreased fetal movement, headaches, visual changes, fluid leakage, or bleeding) are essential components of shared responsibility in care.

Alternatives to

Out-of-Hospital Twin Birth

Alternatives include hospital-based midwifery or obstetric care, planned cesarean delivery, or co-care with maternal-fetal medicine specialists. These options have been discussed, and you understand you may choose transfer of care at any time.

Acknowledgment

Informed Decision-Making

By choosing care for your twin pregnancy with Birthing Miracles, you acknowledge that:

You understand the increased risks associated with twin gestation.
You understand that recommendations may change if safety concerns arise.
You consent to increased monitoring, weekly visits after 28 weeks, a 36-week ultrasound, and the presence of a larger birth team.
You understand the potential need for hospital transfer.
You have had the opportunity to ask questions and receive evidence-based information.

https://www.acog.org/clinical/clinical-guidance/committee-opinion/articles/2017/04/planned-home-birth

More Info

VBAC BIRTHS

& RECOMMMENDATIONS

A pregnancy following a prior cesarean birth requires individualized planning, careful review of history, and ongoing risk assessment. At Birthing Miracles – We Nurture You and the Miracles You Are Carrying, we are committed to providing thorough, evidence-based care while honoring your autonomy and informed decision-making as you consider a Vaginal Birth After Cesarean (VBAC), including VBAC2 when applicable.

Nature of VBAC

Many women are appropriate candidates for VBAC; however, prior uterine surgery carries specific risks. The primary concern is uterine rupture, which is statistically uncommon but can be life-threatening for both mother and baby if it occurs. Additional risks include uterine scar dehiscence, hemorrhage, fetal distress, infection, and need for emergent transfer or repeat cesarean delivery. There is a higher statistical likelihood of hospital transfer during labor compared to a pregnancy without prior cesarean. Understanding these risks allows for proactive preparation and shared decision-making.

Model of Care

Ongoing Assessment

Our VBAC care model includes comprehensive evaluation and continued monitoring throughout pregnancy. This includes:

Detailed review of prior operative and birth records when available
Thorough informed consent discussions reviewing benefits, risks, and alternatives
Pelvic floor assessment to evaluate muscle tone, balance, scar tissue impact, and overall birth readiness
Recommendation for pelvic floor therapy when indicated
Third-trimester ultrasound evaluation of the lower uterine segment to assess scar thickness and integrity (when available and clinically appropriate)
Ongoing monitoring of maternal and fetal well-being
Continuous risk assessment to determine ongoing eligibility for planned out-of-hospital birth

If safety parameters change at any time, consultation or transfer of care will be recommended.

Birth Team

Preparedness

Due to the unique considerations of VBAC, a prepared and experienced birth team will be present. This may include your primary midwife and an additional skilled assistant. Emergency equipment for maternal stabilization and neonatal resuscitation will be readily available. Clear hospital transfer protocols are established in the event of suspected uterine rupture or other urgent complications.

Labor

Birth Considerations

Labor management for VBAC emphasizes physiologic progression while maintaining vigilant assessment for signs of scar complications, including abnormal or persistent pain, fetal heart rate abnormalities, vaginal bleeding, or changes in labor pattern. Specific intrapartum risks include uterine rupture, hemorrhage, fetal compromise, and need for emergent cesarean delivery. Continuous clinical assessment will guide recommendations throughout labor.

Alternatives to Planned Out-of-Hospital VBAC

Alternatives include planned repeat cesarean delivery, hospital-based VBAC with obstetric support, or co-care arrangements. These options have been discussed, and you understand you may choose transfer of care or change birth setting at any time.

Acknowledgment of Informed Decision-Making

By choosing VBAC care with Birthing Miracles, you acknowledge that:

You understand the risks associated with labor after cesarean, including uterine rupture.
You understand that ultrasound evaluation of scar thickness does not eliminate risk and is only one component of assessment.
You consent to pelvic floor assessment and recommended supportive therapies.
You understand the potential need for hospital transfer or surgical delivery.
You have had the opportunity to ask questions and receive evidence-based information.