Archive for the ‘Uncategorized’ Category

Reasons to Consider Home Birth During a Pandemic

Friday, April 10th, 2020

brene brown quote superimposed on image of midwife listening to fetal heart tones during labor

These pandemic days are a source of anxiety for everyone. No matter where your anxiety level started out, it’s higher than it was before the lockdowns started. For pregnant women, this anxiety now comes with considerations for your birth that you never imagined. Fear is a real issue, and many women are turning to home birth or unassisted birth. Whether it’s out of fear of the virus, fear of being alone*, or fear of losing autonomy, you deserve answers. You deserve options. You deserve humane, individualized, evidence-based care with a provider who can meet you right where you’re at. 

Here are four strong reasons to consider switching to home birth care during the COVID-19 pandemic.


1. Support people of your choice.

As of right now, I am not limiting who you can invite into your home during your labor and birth. The primary reason for this is that you have a human right to a support person of your choice to be present. And I do not believe that I have the power to infringe on that right. Period.

Whether you are planning to have only your partner attend you, or you desire to have your entire family along with a doula and a photographer, or anything in between, I support your right to surround yourself with anyone you need. As your midwife, I trust you to set your own common-sense parameters for visitors that would apply regardless of any pandemic. 

From there, it is my responsibility to maintain my own good health practices, including proper hygiene and disinfecting procedures. I will modify what I do in order to make sure your home remains a safe, healthy place to give birth.


2. Germs.

Frankly, the hospital is where sick people congregate. Hospitals are the epicenters of the COVID-19 pandemic, as they should be. That is, after all, why we have hospitals — to treat the sick. If you are healthy and low-risk, it might be a better option for you to stay home to have your baby and minimize your chance of exposure to the virus (as well as other hospital-borne infections).

You and your family are already colonized to the germs present in your home, and it is much simpler to control the environment. 


3. Autonomy.

As a midwife, my job is to educate and inform you as fully as possible regarding all of the choices you need to make regarding your pregnancy, labor, birth, and in the days beyond. It is your job to make the decisions. After that, my role is to support you in every decision you make. This means that you are in the driver’s seat the entire time, and I am your navigator and guide. 

Unlike many hospitals that have banned doulas, banned VBACs, or instituted other restrictive policies, I have no desire or right to decide for you what should or should not happen during your pregnancy, labor, and birth. It is my job to create a space in which you can make these choices for yourself, with my help and guidance. Sometimes, that help will involve transferring your care. If it comes to that, it’s a decision you and I make together, sharing the responsibility.

This can feel a little daunting at first, as you start to carry more of the responsibility that comes with true autonomy. However, you will find your confidence growing with every decision you make. There is nothing like it. 


4. Safety.

Study after study continues to confirm that home birth is, indeed, a safe option for most women. One of the largest was a study conducted in 2009 in the Netherlands that looked at over 500,000 births. Its conclusion states that “…planning a home birth does not increase the risks of perinatal mortality and severe perinatal morbidity among low-risk women, provided the maternity care system facilitates this choice through the availability of well-trained midwives and through a good transportation and referral system.”

A new study conducted in 2019 by McMaster University concludes that “…low risk pregnant women who intend to give birth at home have no increased chance of the baby’s perinatal or neonatal death compared to other low risk women who intend to give birth in a hospital.”

Basically, this means that having your baby at home is just as safe as having your baby in the hospital, as long as a well-trained provider is in attendance, and you can quickly get to a hospital if the need arises. And even within those parameters, there is a lot of wiggle room. Talk to a midwife and find out if you would be a good candidate for home birth. After all, birth is designed to work if no one is there to help, but it’s a lot safer if someone is there who can help if it’s needed.


So, what now?

If you have been contemplating a home birth during this troubled time in our country, I encourage you to do your research, then call me. Contact me soon! Regardless of lockdown, I am taking time off-call this summer to devote to my family during summer break. I am taking due dates up through May 22nd, then beginning again as early as July 30th, 2020. 







*Thankfully, this policy in NYC was rescinded, but women are still limited to only one support person during their labor, and many are forced to leave two hours after the birth instead of being able to stay overnight. 



Something Wonderful This Way Comes

Wednesday, September 13th, 2017


pfb classes 2017Can you feel it? Autumn is in the air, finally! (Insert groans and moans from Desirre here. 😉 ) With it comes change, a letting go to make way for the rest and restoration of winter, and then the unfolding blossoming of spring!

You may have recently visited the site, and noticed that our Fall series of childbirth and breastfeeding classes have been canceled. That is because things are changing here at Preparing for Birth as well! We are entering a new season, letting go of the same old way of doing things, allowing our teachers a season of some rest, and gearing up for a brand new way of doing things!

Mothers and their partners are changing in the way they approach things, and so should we if we hope to continue to serve the Colorading Springs area with effective, relevant, and interactive classes.

I would love to hear from you, our community, what you want most from a childbirth and breastfeeding class. If you have taken classes, or plan to, what is most important to you?

Is it the information and content itself? Do you want to watch videos, or would you prefer more discussion and group work? How do you feel about interactive and relevant games? Hands-on technique instruction in breathing, relaxation, and basic comfort techniques? What topics are most important to you?

Let us know in the comments!

Grace & Peace,


So You’re In Early Labor. Now What?

Monday, April 24th, 2017


One night, you are awakened from slumber at the beck and call of your compressed bladder. No, wait. That’s not it. There’s a crampy tightness that feels familiar. Where have you felt that before?

Menstrual cramps! It feels crampy. Weird. You decide to get up and move to the bathroom. After a few minutes, you get back and bed and feel more cramps. Hm. Weird.

Could this be it? It could be! This is it! You’re finally in early labor!

You know this because the contractions are coming, no matter what you do. You’ve had a big glass of water. You’ve gotten up to pee. You’ve had a snack. You’re content to let the rest of your house rest while you anticipate the birth day to come.

So you’re in early labor. Now what?

You think back to what your midwife told you, and you remember that she gave you several things to do during this slow building time.

  1. Let Your Midwife Know. As soon as you know you’re definitely in labor, she’ll want to know. She or her assistant might swing by to check on you and baby, or just triage you over the phone, depending on what’s happening and your needs.
  2. Rest. This is not the time to try and “get things moving” by taking a long walk, doing nipple stim, or anything else that is supposed to speed things along. This is the time to conserve energy. If you can talk through your contractions, you can sleep through them.
  3. Eat & Drink. Whatever time your labor starts, eat normally. One good meal is often enough to sustain you through the work to come. No food is off-limits, though it’s wise to keep in mind that you may throw up, so avoiding choking hazards or harsh foods might be a good idea. Comfort foods are wholesome, nourishing, and encourage happy hormones. Also, keep drinking. Water, juices, herbal teas that you enjoy, smoothies, and broth are all great candidates. Whatever sounds good.
  4. Do Life. There is no reason to put off that quick trip to the store to get milk and bread, or going to the movies. There is no reason to go out if you didn’t plan to, but just going about your day, doing your best to ignore what’s happening. At this point, it’s really no big deal, and it helps your progress if you can be content, happy, and moving.
  5. Distract Yourself. Sometimes, especially when it’s your first baby, it’s so hard to keep your mind off your contractions. But the rule of thumb is that you must ignore them until they demand all of your attention, whether you like it or not. Conserving energy in early labor is paramount! Don’t use breathing or coping techniques from your classes yet either. They contribute to the sense of time, and can make you far more tired than you need to be. Instead, watch funny movies, go to the park, go out on a date with your partner, bake a birthday cake, start a slow cooker meal for after the birth, or call a friend to chat.

I like to tell people to “be in denial” about their labor until their labor gets all up in their face! Just take care of yourself, pretend like everything is normal, that nothing is going on, and let your body keep the secret just a little while longer. You will be shouting to the world in your own way soon enough, so save your breath. Smile. 

“To move into active labor, a woman must give up ideas of how she thought labor might be; in other words, she must surrender.” ~Elizabeth Davis in Heart & Hands

Open up to the path your labor has chosen, and surrender time.

Grace & Peace,

VBAC: You’re The Number One Stakeholder

Tuesday, April 19th, 2016

Add headingIn this line of work, informed consent and refusal is paramount. There is not one factor more ethically important than accurate fully informed consent. Without it, a care provider is practicing unethically, and patients are deciding blindly. Without it, it is far too easy for doctors, hospitals, and insurance companies to steamroll patients in their desire to protect the so-called “greater good.” The greater good argument is just a nicer way of saying “The end justifies the means.” An argument most people dismiss as childish at best and despotic at worst.

Nowhere is this more true than in making medical decisions. No government has the right or the jurisdiction to decide ahead of time what would be in anyone’s best interests to choose one course of action over another. The only exception to this is when one’s decision would interfere directly with the safety or life of another human being. Very few medical decisions will directly result in putting another human in mortal danger. Even smoking isn’t guaranteed to produce cancer in every individual. Rather, there are risk factors linked to smoking that make it far more likely. Yet, we don’t ban smoking entirely! We understand that each individual has a right to do with their lungs what they like.

“Unless we put medical freedom into the Constitution, the time will come
when medicine will organize into an undercover dictatorship to restrict
the art of healing to one class of Men and deny equal privileges to
others; the Constitution of the Republic should make a Special
privilege for medical freedoms as well as religious freedom.”
~Benjamin Rush
(one of our Founding Fathers)

Why does this change when it involves a uterus? Medical institutions seem to have the mindset that women give up their rights when they cross the threshold of the labor & delivery room. Up for discussion in Colorado are the midwifery regulations. Up until last week, everything was going smoothly, and midwives were going to be given some reasonable freedoms to better care for the women who choose home birth. At the last minute, ACOG tacked on an amendment to HB-1360 to remove the option for midwives to care for women desiring a VBAC at home. It passed the House, and is now on the Senate floor this week.

Rewinding a bit back to decisions that interfere directly with the safety or life of another human being. Doesn’t VBAC do that very thing?


It does not.

Most medical decisions fall on a spectrum. They are not black and white, right or wrong. There are degrees of risk. And those degrees vary among different women. They even vary among different pregnancies in the same woman! How on earth can there be any government regulation that allows for every possible variation in these risks? How can any government regulation account for every arbitrary circumstance? Every irregularity?

They can’t.

And they should not.

Who then, is best equipped to balance the risks of VBAC against the risks of a repeat cesarean? The woman who is pregnant is the number one stakeholder. Period. End of story.

“But what about the baby?” Yes. What about the baby, indeed. That baby has a mother more intimately connected to him than anyone else. There is no one more fit to make decisions in regards to the risks baby may incur during any given birth than his or her fully and accurately informed mother. Not the doctor. Not the hospital. Not the insurance company. And certainly not the government.

That’s my story, and I’m sticking to it.

Please — do your homework. Educate yourself. Speak up! Start here:

VBAC Facts
International Cesarean Awareness Network
Science & Sensibility: Too bad we can’t just ban accreta…

Want to do something about it? Visit the Colorado Midwives Association Facebook page, and follow their posts. They are posting updates regularly. They are sharing specifics like who to call, and what to say. Easy peasy.

When it comes to VBAC consent: You are the number one stakeholder.

Thank you!

Grace & Peace,
Tiff Miller, CCCE, Student Midwife

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Rock the Boat: Call the Colorado state senators TODAY!

Friday, April 8th, 2016

Maybe you believe your vote doesn’t count in general elections. That your voice makes no difference. I won’t try to convince you otherwise. However, what DOES count is your phone calls and emails to your Senators & Representatives–in your state AND in Washington! Whether you voted for them or not, EVERY phone call represents hundreds of voters to them.

I challenge you to set an example for your children, and pick up your phone. Teach them how, even if our favored politician loses the race, we can still participate and have an impact on the process of lawmaking on issues that matter to us.

It took me FIVE minutes to make five quick phone calls, and another five minutes to send five emails to our state senators.

Vote or don’t vote, but rock the boat!

Thank you!
Grace & Peace,
Tiff Miller

From Karen Robinson, former CMA president:
I’m seeing a lot of messages flying across Facebook asking people to contact certain members of the Colorado House Health Committee (Sue Ryden, Beth McCann, Susan Lontine and Lois Landgraf) to tell them not to Colorado Registered Midwives from attending VBAC at home.

It’s important to note that this bill is no longer in the House, it will move to the Senate next week. So while I think it’s fine to contact those four women, I strongly suggest everyone start contacting their individual state senators instead–along with the following members of the Senate Health Committee:

  • Kevin Lundberg (he will be the bill’s sponsor): 303-866-4853,
  • Larry Crowder: 303-866-4875,
  • Irene Aguilar: 303-866-4852,
  • Beth Martinez Humenick: 303-866-4863,
  • Linda Newell: 303-866-4846,

Copy and paste the following into an email to each senator (thanks to Ramona Webb for the suggested script):

Dear Senator __________,

HB-1360 will be voted on in the Colorado Senate soon, and it contains an amendment stripping away home birth parents’ rights to have a registered midwife attend their birth if they have had a cesarean before. This language was not in the previous bill regulating
direct-entry midwives …

If home VBAC (vaginal birth after cesarean) with a registered midwife is made illegal, I am afraid that many VBAC mothers will choose to give birth at home without any medical assistance rather than plan a hospital birth and likely repeat cesarean. Registered midwives are trained to monitor the mother and baby for problems and transport to the hospital if complications arise.

Please vote to remove this recently added amendment, and preserve the rights of Colorado home birth parents!

Thank you,
(address & phone)

Last, but not least, please take the time to sign this petition, right now. Just click on the heading.

Safe Homebirth VBAC options for Colorado Women


Learning Curve

Sunday, October 11th, 2015

12983954_10208481659654579_6833767883080805340_oHomeschool. Husband. Midwife studies. CAPPA. Childbirth classes. Home management. Family. Friends. It’s a lot, folks. No wonder things, and sometimes people, fall into the cracks and get lost.

“Can’t you just cut something?”

Well, sure I could. Anyone could cut anything if necessary.

That isn’t the question, and I’m not complaining. I’m entering a new season. A season of growth and change for my  business and in my family.

And it’s hard.

Really, really hard.

But it’s good too.

So, so good.

I am stumbling my way through a new learning curve. It’s the road less traveled, and I’m not looking back.

Has it really been two months since I’ve written anything?

Speaking of cutting things. Guess what goes first?

Writing anything that doesn’t fit in a Twitter post.

All those good habits a writer is supposed to have? I don’t have them. But I need to write. I’ll figure this out eventually. Perhaps, one day, I will choose to write and write and write instead of scroll.

Facebook is gone from my phone. And more words are tumbling around in my mind and heart, trying to break out. I see it in my list of drafts that is ever-lengthening, and never turning over into a publishable post. Or even a coherent thought.

What, even, do I write about?

Grace & Peace,

A letter to a midwife’s mamas

Tuesday, September 15th, 2015

This, So, so much, THIS.

Menstrual Monday: Lunaception

Friday, August 14th, 2015

Well, this is interesting. I’ve never even heard of this process. I think I might try it.

Drink More Water: Creative Ways to Stay Hydrated in Pregnancy.

Monday, July 6th, 2015

Click to see more posts on healthy pregancy.

Click to see more posts on healthy pregancy.

“Drink more water.”

It seems to be the pregnancy panacea. Having a lot of Braxton-Hicks? Drink more water.

Feeling tired? Drink more water.

Having headaches? Drink more water.

Constipated? Drink more water.

How many of us feel like we are paying our care provider to tell us to stay hydrated? In Colorado it’s doubly tough, because of the arid climate and extreme temperature changes. It feels like we have to drink twice as much as those in other areas of the country to maintain any decent level of hydration, even when we are not pregnant.

Of course, the best way to stay hydrated is to drink water. So, since we should drink more water, we don’t want to drink water. We begin to crave soda, sweet tea, and chocolate milk instead. This is because we are drawn to that which we should not have, by our very nature. Silly humans!

Still, we do get bored drinking plain water. Especially when we think our choices are between crushed or cubed iced. Hydration doesn’t have to be boring though! There are myriad ways to stay hydrated, and here are just a few–some with recipes linked–to get you started:

  • Herbal teas, hot or iced. Most do not contain black or green tea, and are naturally caffeine-free, if that is a concern for you. They also come in a plethora of flavors. The fruit flavors are especially delicious iced in the summertime.
  • Infused water. This is the “in” thing right now. At least it’s in for a reason–it’s delicious! Explore Pinterest for infused-water recipe overload! Like these unique combinations, or these that have an interesting twist.
  • Flavored sparkling water. This works better if you make your own. That way, you can avoid sugars, artificial sweeteners, and artificial dyes. Just mix up some sparkling water with a little bit of your favorite fruit or vegetable juice. Add ice, and enjoy!
  • Eating high-water fruits and vegetables. Think watermelon, cucumber, celery, and others. Of course, you can’t measure those in ounces, but every little bit helps!

“That’s great,” you might say. “But how am I supposed to get that enormous quantity of liquid into me in one day? The simplest way is to treat yourself like a toddler. Rewards. Positive consequences. Bribes. Whatever you want to call it. The simplest form of this is to make it your goal to get your water in by dinner time. Then, if you reach your goal, treat yourself. A square of chocolate, a scoop of ice cream, that movie you’ve been dying to watch, or any other treat that will help you stay on track.

Hydration is important in pregnancy, for so many reasons, but that’s another post for another day.

What are your favorite ways to stay hydrated in pregnancy? What are your least favorite?

Tiffany & Desirre.

Two lies and a truth: Formula Feeding campaign is off base

Wednesday, June 17th, 2015

As positive as the ad’s message seems, it’s only a marketing veneer laid over the substance. The substance being that breastfeeding advocates need to be quiet.