09-18-23 Midwifery with Brittany Winland

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Episode Transcript

(00:00):
Mix when I was six five.Good morning, it's Christina Woolford. Welcome
to Lady Barts with doctor Richard Villarrealof Adena Women's Health. Good morning,
doctor Villarreal, Good morning to you. How are you. I'm doing great?
How are you? I am happyto be here. A beautiful day.
That's good. Now we do thisevery month, doctor Villarial. We
have a topic that deals with women'shealth and we've got that again this month.

(00:22):
So so what are we talking about? And you want to introduce your
special yest today? Yes, todaywe're going to talk about midwiffery, which
is exciting. We have eight midwivesat Adena and I have one of our
newest midwives with us today, BrittleyWinland, and very excited to have her
here. She's been you know.The fun part is when I was at
Adena, she was one of ourlabor and delivery nurses. Nice, so

(00:45):
really exciting. So we have aspecial bond there and we you know,
I've worked with her for a longtime and it's great. And then we're
going to find out a little bitabout it why she decided to become a
midwife. But I found you know, she is a BSN MSN SO and
she got to be a senate ofthe Kentucky Christian University and then she went
on to become a midwife at theFrontier Nursing University in Kentucky. So it's

(01:07):
very exciting to have her here today. We're going to talk about Midwiffree get
rid of some of the misconceptions andjust so everybody understands it. And we
have a great group here at Adenaand very excited to talk to you today.
So thanks for coming, Thanks forhaving me so well, let's just
start from the beginning. Since youknow, you were labor and delivery nurse,
you know, which is fun andwe love having you. She's a

(01:30):
great flavor and delivery nurse and wewere really excited to have her as a
midwife now because she's so pleasant totalk to and the patients really like her.
So what made you change to becomea What made you decided to want
to become a midwife? Well,I started when I first started at Adena.
I decided to become a labor anddelivering nurse at Adina because of the

(01:53):
level of care that I was toldthat was happening at Adena. I was
originally working about an hour way,so I left that job and came here
decided to stop driving ten minutes anddrive an hour instead because of a level
of care that the patients received hereat Adena. And after watching that for
about five years, well maybe morelike four years of how the midwives do

(02:15):
it, I was like, guy, I want to do that. I
don't want to just be the onethat turns the patients and brings them their
water. I want to be Actuallythey are in doing the delivery of the
baby and taking care of the women. Well that's awesome. Well, you
know you brought up the level ofcare. aDNA is a Level two hospital,
which means that we take care ofbabies or women that deliver babies from

(02:35):
thirty two weeks on. And oneof the other neat facts is that we
have Children's hospital that takes care ofour babies at delivery, so in our
NICKU and from the thirty two weekson, so we have the physicians from
Children's Hospital that are there twenty fourseven and so they help us. They
take care of all the babies thatare born, so we always have special

(02:58):
care for all of our children thatare born. So it's very excited.
So we have it's a nice relationshipthat we have with Children's Hospital, and
we've had this for a number ofyears now. So well, let's talk
about midwiffery. So when you gotstarted, so you came in as a
new midwife and joined the group becausewe knew that, you know, we
wanted you was you know, whenyou were going through it and everybody's like,

(03:21):
oh, we want Brittany. Wewanted to come back because she was
such a wonderful nurse and everybody likedyour personality, and so you came back
and said, what was it like. It was a little bit different going
from the nurse role to being theprovider and happened to make the decisions.
But I was welcomed in very easily. I feel like it was like I've
just been in with family, Likefrom not just the midwives, the doctors

(03:44):
as well. No one gives mea hard time when I ask questions.
They some of them have little booksfor me to sign in because they know
I'm coming to ask a question.But they've just been really good about welcoming
me into being a provider. Andone of the nice things is it's it's
a learning process. You know,I've been doing this thirty years, but
you know, I still learned things, and you know, I uh,
when I went from Adena, Iwent up to Maltcarmo for a while and

(04:08):
came back, and I remember workingwith some of the labor and delivery nurses
there that have been nurses longer thanI've been a physician, you know,
and you can still learn from them, you know, and which is nice.
And I learned, you know,some of the patients, you know,
some of the things. I washaving a rough time getting some of
these babies out, and he said, try this, and try this,
he said, you know, I'vedone this for you know, forty years,

(04:29):
fifty years. I'm like, wow, you know, And so they
did. They have some great ideas, and some of the midwives up there
just nice. But this group inparticular is super special and I can't say
anything but wonderful things about them.So that's great. So you know some
of the things, you know,you're you were great at labor delivery,
so you knew all this stuff asfar as pregnancy and things like that,

(04:50):
but you had to learn a littlebit more about the gynecology and things family
planning and stuff like that. Sothat was part of your training, right,
Yes, So we are mostly dopregnant. See, that's where our
focus is. But we can alsotake care of women from adolescents all the
way through menopause. And that's definitelywhere I had to learn the most is

(05:10):
those areas in between. And it'sa lot, I mean, but you
do everything from talking about the pregnancy, the counseling or wanting to become pregnant,
talk about birth control, you talk, you can do paths and marriage
to do their annual examinations and thingslike that, right and then even you
get into menopause and you can talkabout hormones and things like that, right,
yes, and then for any ofthe STD testing things like that,

(05:34):
or rather just times. You know, the nice thing about what the midwives
that I've found is that they justhave time to talk and they'll sit down
with you. And that's one ofthe special things about seeing a midwife.
Right. Yes, we typically havelighter schedules and have the time to be
able to have those conversations and reallygo over options and make sure patients know
that their choice is at the centerof the decision making, that we're going

(05:58):
to give them all the options andencouragement to make the decision that's best for
them. So let's let's talk aboutmidwiffery. So I think there are a
lot of misconceptions out there about midwiffery. And you know, you think,
you know, some people think aboutmidwives and they think, oh, they
think way back to you know,the the old West. You know,

(06:20):
they deliver out in the you know, the boondocks and everything has done home
deliveries and so that's not true,right, and not at you know,
we do all our deliveries right atthe hospital, but there is some midwives
that can still do homeworths. Wespecialize here in trying to bring the home
worth experience to the hospital, andthat is just having someone to do labor

(06:43):
support with you. They are justthings that you wouldn't necessarily get at home,
but we can do it at thehospital as well. So you've give
them that TLC. Yes, youknow that that home experience, but you
also have the safety net of ifanything would happen booth, you've got it
taken care of, yes, becauseyou always have a physician. When you
guys are on call every night,right every day and every night twenty four

(07:04):
seven, we have a midwife inthe hospital. You guys rotate and there's
always a physician there with you.So that's another one of the misconceptions.
If you know, well, ifI see a midwife, if something happens,
what am I going to do?But the nice thing is is that
there's a physician there that if youneeded a necessarian section or something like that,
they get it taken care of rightaway, so there's there's no problems

(07:26):
with it. So I think it'sthe nice thing for me as a physician
is to say yes because they cangive you this, but if you need
us, we're here. Absolutely.That's the part that makes me more comfortable
and wanted to stay at Adena isknowing that we can collaborate with the our
physicians and anytime that we need aphysician, they're right there and like I
literally in a room away. Yeah, and so they're there there again also

(07:49):
twenty four seven. So it makesit really really nice. And the same
thing goes from the offices too,because you've got the physicians there. You
know, if it's something that youhaven't seen or you're not sure about,
you always have a physition to collaboratewith, and I think that's what makes
it special. So you have thatspecial person that you want to you know
see, and then you know,if there's anything else that gets a little

(08:11):
bit complicated, there's always you know, somebody else that they can ask a
question too and get you taken careof. So it makes it wonderful for
them. Brittany I, my youngestis twenty one years old. I spent
twenty one years. I gave Ruthall four of my children at Adena,
and it was great back then.But you talked a little bit about,
you know, home births, butyou're kind of bringing that to Adena,
So I didn't know there weren't awhole lot of choices twenty one years ago.

(08:35):
There were some, but what aresome of the choices for folks?
Some of the birth choices folks haveat Adena. So we offer the peanut
ball, which is our big tool. Their different positions. A lot of
a lot of us have went towhat was called spinning babies, so different
maneuvers and things that we can hopeyou get in and position wise to help

(08:56):
get your baby out. We doshowers, we have monitoring that allows you
to labor in the shower, andus still monitory at the same time,
just birthing balls and just different positionsthat we can get you in and things
we can do in the hospital.They have some really neat positions. So
they talk about and we say them, but I always get them wrong,

(09:16):
the names of them. But theyreally work. I mean, they help
bring the babies down. Like youmentioned the peanut ball, which is basically
a big circus peanut. That's circuspeanut. Yeah, and literally you know
you put your leg underneath it andabove it and basically what does it opens
up the pelvis so that the babycomes down a lot easier. We didn't
have this way back when, right, and all these new things have come

(09:37):
through a lot of the midwives usea lot of this stuff, and so
a lot of physicians have also incorporatedthat into their care. And because the
nurses actually are the ones that aresaying, yeah, do this, it
works, So midwise have done this, and so we're like, sure,
we'll do it. Well, that'sgreat. Back then, I mean I
just laid in the bed and gavebirth, you know, I mean it
was I felt like things were weird. But I think it's a lot more
commonplace now. You know that peopleare these women are more involved in their

(10:01):
birth and they you discuss a birthplan beforehand, right, I mean you
discuss how you want it to go, and of course, you know,
things happen and it didn't always happenthe way you want to. But that's
a nice thing that women are moreinvolved in that and can make these choices.
Yeah, I think that having ababy now is more of an experience
that you want to have it.It becomes a wonderful thing. And you

(10:22):
know beforehand, you know, inthe old days, you know, the
mom would come in and the dadwould go to a waiting room. You
know, yeah, my mom talkedabout it and they would come back out
here as your baby, right,And so now you want it to be
a whole family experience. So momand dad are there and sometimes some other
people are there for their birth.And the nice thing the midwife have really
brought this out. It really madethis into a nice birth in our family

(10:46):
experience, and it's a wonderful thing. And so it's nice because you know,
I've done this for so many yearsto see how it's changed over the
years. You know, where atthe beginning, we will we have mom
and daddy in there, and nowit's mom dad and you know mom's mom
or dad's mom or you know otherpeople and but it's wonderful. And then

(11:11):
I think, you guys are therea lot, You're in the rooms a
lot. Yeah, I think thatI try to be in there as much
as possible, being at the bedside, especially with women that plan to have
births without any assistance as far aspain medication or of the girls. Those
women sometimes require extra attention and youhelp them focus and you do a lot

(11:35):
of you give them breathing techniques,breathing techniques, a Roman therapy. We
do a lot of Romo therapy.I have like a little I call it
my goody bag. It's got likea what is it called a diffuser,
so diffuse different types of oils intothe room. I've got a comb for
like a birthing comb to help withbirthing like the labor pains. I have

(11:56):
a star projector that puts like agalaxy up on the ceiling just like Yeah,
I'd just like to create a vibein the room and music just to
make it just like they're a littlearea to help them cope. Well,
it's not, and we didn't,you know, do a lot of things.
But you know, one of theother misconceptions is that midwives don't use
pain medications and that's not true,that's not true at all. I would

(12:18):
say majority of our deliveries I Aninahave pain medicine or an epidural, but
you don't have to if you don'twant to. But yeah, there's there's
no reason not to. And themidwives are very comfortable with epidurals, with
the spot, you know, anyof that, and and they're they're very
good. They can prescribe medication too, so if you need new bad or
you need something else that they cando all of that. Right, So

(12:43):
we've we've covered one of that numberof the misconceptions. Another one is,
like we'd mentioned at the beginning,is that you guys only do pregnancy,
and that's another misconception. And sothey say, well, if you see
I see a midwife, then youknow, I still have to go back
to my physician. But in truth, they can stick with you, right,
Yeah, they for the most part, they can stay with us before

(13:05):
pregnancy, through pregnancy after and thenfor any most not a whole, but
most QI N needs and if there'sanything, we can refer them to the
appropriate position. So that makes itreally nice, and it makes it nice
for the providers because there's only somany of us, and they can extend,
right, you know, the numberthe patients that come in. That's

(13:26):
what I was thinking, because youknow, as a patient sometimes you call
and it's like, well, wedon't have an appointment for three weeks or
for six weeks or you know,something crazy like that, because you guys
are busy. There's how many womenin Ralth's County and there's there's how many
providers, how many O, B, G, I N. So that's
great. I think the midwives areare definitely filling something that has been desperately
needed here in Ralth's County that theycan do these things, I think.

(13:48):
So, you know, one ofthe nice things that we talked about on
the show a lot is that,you know, we're trying to get the
women to understand you need to takecare of yourselves, right, and so
if you don't take care of you, who's going to take care of your
family if you're not there. Sothat's part of this whole thing. You
know, there's only so many ofus. Obstetrictions and kind of coologists and

(14:09):
the midwives are there, so thereis not a reason that you can't be
seen, and we are expanding,which is the good part. We're everywhere
in all the off size and you'reeven in Hillsboro now, right, So
I mean we're in Circleville, we'rein Waverly, we're in Jackson, we're
in washing court House Greenfield in Hillsboro. Okay, perfect, And so it

(14:35):
makes it nice that you can getin. We have care close to home
now and so midwives and the physiciansare in each of these sites, so
it makes it great. So again, I think it's very important for the
women to understand you need to takecare of yourself and midwives are a great
way to do this. So let'stalk about some of the other things about

(14:58):
Midwiffree. So, would you encouragesomebody to become a midwife? Yeah,
I think so. I think Ithink it takes a special person to be
able to do it. Sometimes theschedule is a little odd for some people.
You know, we do two officedays and then a twenty four hour
call, so that can be different. But if you love birth and love
taking care of women, not justbirth, but just taking care of women

(15:20):
in general, it's the perfect job. I feel like, definitely since I've
became a midwife, that I canreally take care of women so it's a
very fulfilling job for sure. Yeah, particularly wouldn't they get, you know,
birth, give a special bond withthe women when you deliver one of
their children and uh, and thenyou know, caring for them afterwards.
I mean, that's the best partof my job. I mean, delivering

(15:41):
the babies was always my favorite partof it. And you gotta love it,
and you do. So let's talkabout your education. Okay, So
let's talk a little bit about that. So let's let's go over that.
So I went to Maysville Community andTechnical College to get my eight in And

(16:02):
at that time, I did notknow that I wanted to be a labor
and delivery nurse. That was notat the forefront. But I had a
kind of traumatic experience with my firstbirth and had a fantastic labor and delivery
nurse and I said, every womandeserves that treatment that she gave me.
So that kind of started it forme. And then I started in Maysville,
Kentucky as a nurse, and thenmoved to Hillsborough and then went to

(16:23):
Highland District and worked there for aboutthree years and got my BS in through
Kentucky Christian and then came to Adena, and then one of the midwives at
the time was actually going through schoolwhen I started, and I just watched
her transition and how well it wentfor her and just decided that's what I
wanted to do. So I justfinished school not too long ago, and

(16:48):
nothing's great more happy to have you. So most of the midwives are either
masters or doctorate. Correct, sothey passed all the requirements for the national
certifications they can do this. Theypassed the Midwiffery certification and so that allows
them to do everything and even prescribemedications. So that makes it perfect form.

(17:10):
Now, what's the difference between Somepeople will ask about duelists, So
is there a difference between a midwifeand dula? For sure, duels are
fantastics. They're wonderful tools to havein your birth. They're there to support
you and help you adhere to yourbirth plan and make sure that your goals
and once are at the forefront.But they're not able to deliver the baby.

(17:32):
They're not able to prescribe medication,they're not able to make any medical
decisions. They're there to as asupport person. Okay, so they're more
for just like the laboring. No, I mean, there's duelas that are
postpartum dulaism that they'll help you afterwards, that they'll come and help with baby
care and help make sure that you'retaken care of, which isn't important,
but they're just not able to makemedical decisions or firstcribe medications. So can

(17:57):
they work together? Can the duelwill be there the birth? Okay?
Yeah, So we've had dulas cometo you know, to be at the
delivery soon and they're there and theydo they can help with the women to
relax and talk to them and things. But you know, you've got your
midwife and basically she could do allthat anyways, so she does it all.

(18:18):
So it makes it really nice.So we've had our Midwiffery group started.
We had a couple of midwifes thatcame first, right, so we
had I think it was Natasha andMolly, Yes, that came first,
and then the group has grown fromthere. When I started, I think
there was four or almost five,and now we're at eight. So it

(18:40):
makes it really nice and that's kindof helped our group become more generalizing out
into all of our regions, whichhas made it really nice for all the
women so we're really excited about that. We have you guys go, I
mean to get you out. Ithink one of the issues is that people
don't know we have midwives. Youknow, they don't you know, they

(19:02):
haven't known what midwives were or whatthey can do. And we're trying to
get them out in the community sothat they can do things. So if
you'll see them, you know,they're out the county fairs, you'll see
them at a lot of the festivalsthings like that. Come up and ask
them if you have questions about midwifferyabout what you do, you know they
will be glad to answer that.And I think they're all very very easy

(19:25):
to talk to, which makes itreally nice. So when should somebody start
with a midwife if they want togo throughout of a midwife instead of ob
gyn. I mean, I knowyou said they can do it from from
fairly young. It shouldn't be theteenagers or the young or should they go
to an obg I in first.They don't necessarily have to go to an
obg I on first. They cansee us as a teenager all the way

(19:45):
through, unless they're at certain medicalconditions or things that are outside of our
scope of practice. Okay, andthen how about like post menopausal women,
should they just just skip it?I mean, if they're already done having
babies, should they just see doctorVillareal or what I mean, I recommend
that when they're seeing me, justbecause I'm newer. But there are a
lot of midwives are very well trainedin menopausean hormone therapy. But if there's

(20:07):
like I said, if there's anythingthat's out of the out of our scope,
then we would send them off todoctor Villarol, So are any of
my partners. So it's really justit's really just a choice. It's just
another it's a nice choice. Everybodydeserves choices. And I always say that
about everything, is that choices aregood, you know, because it's just
not one person isn't good for everybody. So somebody may come in, you

(20:30):
know, and love me, oranother person may come in and say he's
not for me. Perfect said,I've got wonderful partners. There's you know,
midwives, I got physicians, whateveryou want. We have males,
we have females, and it makesit really nice. So there's somebody for
everybody here, you know, outthere. And the nice thing is even

(20:51):
for the teenagers, which makes itreally nice. It's it's easy for them
to talk to some of these youngermidwives, Yeah, to get in there
and they can talk to them andthey can relate to them, and it
makes it really easy because a lotof the things I've found with the teenagers
is the crucial conversations that they needto have and they need to hear,

(21:14):
and a lot of times it's thetime that you need to spend with them,
you know. So it's there's alot of bullying and there's a lot
of you know, sort of pushingyou to have intercourse early, you know,
not just necessarily from the boys,but from your peers, you know,
from the girls too, you know, and they think it's a right

(21:36):
of passage and it's not. AndI think the nice thing is is when
you know they're thinking about something likethat, to come and talk. You
know, if you know, yourmom is great, your grandmother's great.
But sometimes if they want to getan outsider's opinion, you know what,
the midwise or even the physicians,they're never going to say anything that's wrong
for you. They're always going totry to steer you in the right direction,

(22:00):
for sure. And I think youlike taking care of the younger women,
right, Yeah, And it's goodbecause you're easy to talk to and
that's what a lot of them need. And especially in this day and age,
you see so many of them,you know, with issues with anxiety
and depression and everything else, andsometimes it just takes somebody to sit down

(22:22):
with them and say, you knowwhat, I'm here, it's okay,
and whatever you need will take careof it, or whatever your problem is
will fix it for sure, andbe able to explain it to them on
their level to I think that helps. So it's it's very very important and
we always bring it down to theirlevel so that they understand everything. And
that's the nice thing about it.It's nice that you can kind of,

(22:45):
for lack of better term, shopfor a provider than you know. I
did this one. I was ameetup a provider. I don't know,
it's last year. Sometime. Iwent on the Adena dot org website there
and they had the pictures of allthe physicians and you know, what they're
practice was, and a little bioa little bit of all of them,
so you could see that. SoI could see where these you know,

(23:06):
especially like we said, maybe theseyoung women would want to shop around and
say, oh yeah, Brittany lookslike like she's she's kind of young and
she she would fit this and andthat's great and people can do that.
I know, you encourage that,and you know, and people can come
kind of like interview the doctors alittle bit. You know, you can
set an appointment and it's okay toswitch, you know, like you said,
it's not gonna hurt anybody's feelings.And I think that's what you want.

(23:30):
You can need to find somebody thatyou can talk to, and I
think it's it's easy to do,and we've got such there's a wide range
of all the personalities for sure,midwives and physicians that you can get in
and talk to them and see whatworks for you. And the goal is
to be comfortable and if you feelyou can share things, realizing that anything

(23:52):
that we talk about stays there,it doesn't go outside that room. That's
part of our our oath. Wedon't talk about that stuff. We don't
talk about people, We don't talkabout anything medical outside of the room with
you. And that's the nice thingabout it. So you know that stuff
is confidential and we just want youto come as you are so we can

(24:14):
treat you and make sure that youget everything that you need. Right.
So just sort of I want tocap off, you know a little bit
about midwiffrees. So Midwiffrees at AdenaAdena takes care of women pregnancy thirty two
weeks and up. Midwives are verycomfortable with all this. We have eight

(24:37):
midwives now, Brittany, as atAdena and also in Hillsboro. So we
want to make sure people understand thatthat you can get out there and also
at any of our other sites.We have midwives and physicians that are out
there the Midwest will take care ofyou from your teenage years all the way
up through menopause, and they're comfortablewith all of that. Okay, if

(25:00):
someone's interested and saying, you know, maybe maybe I want to go to
a midwife instead of an oobi joyin. So how did they do that,
Brittany? They just go to theAdiena website. How they how they
get appointment with you? Guys,they can go to the the Adiena website
or they can call into the officeand just ask if to see a midwife
for whatever their concern is or whatevertheir need is, and they'll be glad
to get them right in. So, yeah, So we have the main

(25:22):
site at Adena Adina dot A worker. I believe that easy. That's easy
to get on there. Well,there's lots of navigation, you know,
there's ways that you can look up. It's super easy. It's really user
friendly. Right, and you know, do you have the phone number seven
seven nine seven two zero one.It's a seven four zero area code.
So that's easy to get in andyou get right in to the phone lines

(25:45):
and then the nurses will get y'alltaken care of. Yeah, that's the
neat thing. You can talk toa human two, which is nice because
you know, maybe somebody's like,well, I don't know, you know,
I've got an issue. Maybe maybeit's okay for the midwife. Maybe
they'd rather not. But that's agood thing is you can talk. There's
always an option to talk to aclinic staff member. Yes, and somebody
has always answered, I believe me. I have asked all kinds of stupid
questions, so they've heard it all. So don't don't feel like it's a

(26:07):
stupid question. You know the question, it's not stupid, right, right,
well, right, and they're thereto answer it and they can say,
well, you know, maybe itwould be better to go here,
or yes, that would be fine, you know, so they can answer
all your questions. So don't don'tnot call. That's the thing. Just
call and talk to a human andthey'll get you set in the right direction.
Absolutely, is there anything that youwant to say before we end?

(26:29):
I think you know, excited thatyou're here. I'm excited that you're a
midwife with us. I think we'vecovered everything. I'm excited to be here.
I totally am happy with my choiceto be midwife and thankful to be
here at Anya. It's one ofthe best choices I've made, happy deserved
women here. So and then anybodywants to, you know, talk about
midwi Rebrick, You'll be happy totalk about that. And you know,

(26:52):
got to Hillsboro here and put anythingthat you need. We're always around.
So again, remember for the women, take care of yourself. It's important.
Absolutely, Thank you so much again, doctor Richard Villarreal and Brittany Whitland,
who is a midwife at Adena.Again, if you want more information
on midwiffery, you can always goto that main website, Adena dot org

(27:12):
and get you where you need togo with that, so again Lady Parts
with Doctor Richard Villarreal. Here's thethird Monday of every month at ten am
right here on Mix one oh sixfive in Chilla Coffee. You can also
catch the podcast on the free iHeartRadioapp. Just open up the app,
click on podcast, and then doa search for Lady Parts with Doctor Richard Villarreal.