PUBLISHED: 10:27 AM on Tuesday, September 5, 2006
Prenatal care with a personal touch

Courtesy photo
  Johanna Koranda and Debbie Gillespie opened Inside Passage Midwifery.
You try not to look at the little readout window before a full minute is up, then, there it is, a second pink line.

A rush of emotion fills you as the knowledge sinks in that you are pregnant. Worry may soon overtake feelings of elation but can be reduced by good prenatal care.

An option is to enlist the care of a midwife. A midwife is specifically trained to assist a woman through prenatal, birth, and postnatal periods of her pregnancy, providing expert and compassionate support at each stage.

This is precisely what Johanna Koranda and Debbie Gillespie had in mind when they opened the doors to Inside Passage Midwifery in February. The goal of Inside Passage, which takes all forms of health insurance, is to provide informed, healthy choices each step of the way.

The choices start with where to have an appointment, your home or their office. For those with toddlers, having a prenatal appointment at home may be a huge benefit. For others, a trip to their comfortable office, located on in the City Center Chiropractic office at 800 Glacier Avenue, is preferable.

An appointment lasts from one-two hours, where Koranda and Gillespie discuss health, check on the baby's development, give sound nutrition advice and address any concerns.

Working together allows them to back each other up, share on-call duties and provide two informed opinions as issues come up. They offer prenatal massage with each appointment, which has many noted benefits for the mother and baby-to-be.

The choices continue with the option to have your baby at home, or at the hospital, with midwife support. Nationwide, the choice of out of hospital birth is only about 1 percent. In Juneau it is much higher at 15-20 percent. Whether in the hospital or at home, the midwives bring a unique blend of training, competence and compassion to each birth.

Alaska's midwife certification standards are among the most stringent in the nation. When asked what was the biggest hurdle to overcome in getting certified, Gillespie said it was the paperwork. When she came to Juneau about three years ago, she had already attended more than 800 births. She had to provide documentation for each one, which took several months to compile the information.

Koranda's response was seeing complications, as preventive care works so well. She traveled to El Paso, where she first met Gillespie, and trained at a high volume clinic, in order to get a chance to see things that could potentially go wrong.

When considering homebirth, some are concerned that they cannot get their home clean enough. Gillespie said that the germs found in a home are often "friendly" or at least familiar to the dwellers.

A hospital is more sanitized, but it is also unfamiliar, and the newborn will not spend a great deal of time there before coming home and meeting the "familiar" germs of his or her new home.

While birth is not a sterile event, it is part of the midwives training to quickly and quietly clean up the mess, allowing the new mother and baby to begin bonding right away.

When asked how many homebirths transfer to the hospital, Koranda stated about 8-10 percent, mainly for lack of progress or for pain medication.

"It's wonderful that we have a good place to transfer care too, instead of being out in the middle of nowhere," Koranda said.

In the event of a transfer, Gillespie and Koranda will remain with their client through the birth and afterwards, working alongside the medical staff.

One of the biggest choices facing a new mother is whether or not to use pain medication during labor.

Koranda and Gillespie agree that it is fine for a mother to choose pain reducing medications.

However, they also believe that with a good atmosphere, proper support, and when a woman is free from fear, that labor doesn't have to hurt. An option provided by Inside Passage is instruction in hypnobirthing, which uses self-hypnosis techniques and works with the body to achieve a safe, narcotic-less birth, free of fear that causes pain and discomfort. K

oranda said that childbirth is often depicted as a traumatic, painful experience, not taking into account how empowering it is. Often, a woman who chooses to labor without the aid of drugs comes through and smiles at the end knowing that she has done this amazing thing. And the babies are born more alert. All this experience helps promote family bonding.

"Part of what were doing is trying to help people live good lives from the beginning," Gillespie said.

The personalized care experienced at Inside Passage doesn't have to end once the child is born.

Koranda and Gillespie continue to follow-up for 6 weeks after birth. Gillespie is also a certified naturpathic doctor, which is essentially a family practice doctor who is trained in doing natural therapeutics rather than medications and surgery.

The training to become an ND starts with the same courses required for a four-year pre-medical degree. Alaska licenses its NDs, which is good for the people in the community, said Gillespie, otherwise anyone could call themselves an ND.