Photos Jason Huynh
We’ve all seen it play out in old movies. A woman goes into labor and the midwife begins barking orders. “Quick! Get me some twine, scissors, clean cloth and boiling water!”
Thankfully, over the years medicine has advanced. With more sophisticated methods, childbirth is safer than ever before.
However, across the country, women are having far fewer babies than they used to, and they are now more likely to wait until they are older to do so.
Janet Adamy, news editor at the Wall Street Journal covering demographics, discussed the trends on WBUR’s On Point program. She finds the numbers to be pretty striking.
“We did a chart going back a hundred years. The 2017 birth rate was 60 babies per 1,000 women each year. That’s about half of what it was in the 1960s. So it’s a pretty dramatic drop.”
But before we go all “The Handmaid’s Tale” on you, research shows the decline in fertility isn’t biological, but based in economics.
Since the 2008 recession, many families have found themselves feeling more cautious about adding the cost of a child to their budget, and have been choosing to wait until they feel more financially stable.
Also, many women are completing college and pursuing careers in order to secure a middle-class wage before deciding they are ready to start a family. The current overall average age of first time mothers in the United States is 26, while the average for women with a college degree is 30.
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- Photos by Ashley Mitchell Photography
Modern-Day Midwives
In spite of the decline in births, midwives are enjoying a noticeable rise in popularity. Certified nurse midwife Macie Goff at Harbin Clinic Women’s Center Cartersville has seen the use of nurse midwives increase dramatically over her two decades in the field.
“People are becoming more familiar with how a midwife actually works,” Goff said. “Most people used to imagine a home birth with lots of chanting and kneeling on bricks. We are actually in the office and in the hospital, providing complete care for women in all of their OB/GYN needs.”
Goff is the newest member to the team of certified nurse midwives on staff at Women’s Center Cartersville. The other midwives are Susan Nelson Crisp, Kim Millsap and Valerie Smith, and according to Harbin Clinic OB/GYNs Dr. Ben Warren and Dr. Steven Spivey, more and more women are choosing to include a certified nurse midwife in their pregnancy care plan.
“Midwives are also an important resource for women well beyond pregnancy,” said Dr. Warren. “They’re available to support our patients for all stages of obstetric and gynecological care.”
The midwives at the Center are board-certified nurse midwives as well as certified nurse practitioners. This means that they can provide a full range of care, including primary care, gynecologic and family planning, preconception care, prenatal care, childbirth and postpartum care.
“I feel that the contribution that we midwives provide is greatly appreciated by our doctors and patients,” says Smith. “The most rewarding part of what we do is being able to empower women to make well-informed choices as they navigate profound transitions in their lives.”
“Our patients can be assured that our nurse midwives are well prepared to address high-risk pregnancies and other pre and post-natal concerns,” says Dr. Spivey. “This makes them an invaluable addition to the care our patients receive.”
A Different Kind of Care
When Ashley Mitchell and her husband Lee got married, they were young, fresh out of school, and he was joining a team for the Florida Marlins baseball franchise.
“We knew we wanted to wait to have children,” Mitchell said. “As a semi-pro player, Lee wasn’t making much money and was spending a lot of time on the road. It didn’t make sense for us to start a family anytime soon.”
Imagine their surprise when they discovered she was pregnant at 25! Mitchell’s cousin recommended that she start seeing nurse midwife Macie Goff, and Mitchell liked her straight away. Now, three babies later, Mitchell says she would drive to Texas if she had to for Goff to deliver her child.
“After our first daughter was born in 2008, we knew it would be a while before we tried for another,” Mitchell said. “When we did decide it was time, we went through three miscarriages before we had another baby girl. Macie was there for every bit of it, encouraging us to keep the faith that we could get pregnant again.”
The Mitchell’s added a third daughter in 2017 and say their family is complete, but Mitchell will continue to see Goff for all of her gynecological needs. Goff has been Mitchell’s only medical provider for eleven years, and she is thrilled with the relationship they have developed. She knows she can trust Goff to help her through anything.
As a birth photographer, Mitchell has the interesting perspective of having been present at many more births than her own, at multiple hospitals and with varying care providers.
“Midwives are able to spend more time and focus on the mother and the process, and to respond to the family’s desires more flexibly,” she says.
Mandie Mansfield, a patient of Susan Nelson Crisp’s echoes Mitchell’s sentiments, adding that she feels very supported by her midwife.
“Susan has been there for me not just physically, but emotionally, too,” Mansfield said. “She is always available for my questions, and even once spent 30 minutes on the phone with me when I needed a lot of advice.”
Comprehensive Medical Support
Proof of the benefit of nurse midwife involvement goes well beyond the personal experience.
Studies show that women who involve a nurse midwife in their prenatal care are less likely to require interventions such as electronic fetal monitoring, epidurals, episiotomies and cesarean sections. This means healthier outcomes for mothers and their babies, and an easier recovery time.
Allie Startup has been a patient at the Women’s Center for about seven years and has used the nurse midwives for all three of her births. Breathing complications with her last child made for a frightening and fast-paced situation that nurse midwife Kim Millsap handled with wisdom and a calm, capable approach.
Millsap has developed quite a reputation in the region for her excellent care. She was recently named a top Atlanta-area midwife by Atlanta Baby magazine. “Kim’s style of keeping things light, even in the midst of a stressful situation made all the difference when things got scary,” Startup said.
State-of-the-art services round out the complete care at Women’s Center Cartersville. In-office ultrasound services provide convenient prenatal care. The Harbin Clinic midwives — along with Drs. Warren and Spivey — are well prepared to address high-risk pregnancies and special deliveries at Cartersville Medical Center. The clinic is equipped for testing for all prenatal concerns such as diabetes, chromosome anomalies and spina bifida.
Ashley Mitchell said that of all the births she has witnessed, she would choose the Harbin Clinic Women’s Center Cartersville midwives at Cartersville Medical Center, every time.
“I love the nurses and facilities there, and I know from experience that I can count on the best care from the providers at the Women’s Center.”
