Face Presentation

Kneeling in awe of the unfolding birth before me, I quickly realize that I am in unfamiliar territory. I see swollen tissue that perhaps is a urethra emerging or that ambiguous vaginal tissue that presents before the vertex. Another contraction and clearly, it’s the baby’s lips. Soon the eyes emerge and in between, barely perceptible is his nose. The mother asks, “what is that?” And I can emphatically tell her it’s her baby’s face presenting first.

Face presentation happens in approximately 1 out of every 600-800 births, often this can be a longer labor and/or a longer second stage, if there is progression.

This was a quick labor, seven hours in total. I joined this birthing family in transition, barely having time to listen to the fetal heart rate before she felt like pushing. As she was standing and swaying her hips she said, “I hope you’re not going to make me stop moving.” This child was in a hurry.

Typically, during labor, a baby’s head becomes flexed, chin to chest, with the crown presenting first as it is the least significant diameter. By comparison, the fetal face presents a larger cephalic diameter that needs to negotiate the pelvis. Here is where pelvic shape can play a significant role in the passage of a baby.

Factors that could influence a baby’s presentation include genetic disorders, multiple nuchal cords, pelvic shape, multiparity, or black race. Or there may be no identifiable reason.

Babies who make this journey will have significant swelling and bruising of the face and molding of their heads as seen in this photo. During their journey out, their heart rate might show signs of stress, with slowing heard during contractions and pushing. This child’s heart rate was strong throughout.

IMG_1271The stars were in alignment for this baby, fast labor, ample pelvis, and a 10-minute second stage. I am in awe of women and their journey’s through labor and honored to have been in attendance at this particular birth.

Miles for Midwives 2019

Hi all,

It has been a long standing tradition that MCNYC has participated in Miles for Midwives, and this year is no different.

Miles for Midwives is 5k run and gathering to bring attention to the vital work that midwives do.  We do this for our friends, our families and our future as a whole.

This year is extra special because Shar’s daughter, Seijan, will be running alongside to support the cause.  We ask that you kindly take some time to explore this cause and donate to it as well. We also ask that you tell everyone you know, and if you want, going our team!

Hope to see you all in person or in spirit at Prospect Park on October 5, 2019!



Reflections of a Fledgling Midwife

This summer as a midwifery fellow with Shar and Carol has been remarkable. I feel so privileged to have become part of the family that is MCNYC, to have shared in the excitement and joy of expecting families and to have been present as they welcomed their new babes.

I have been immersed in the “birth world” for 5 years now, as a labor and delivery nurse and midwifery student, but this summer gave me a new degree of respect and appreciation for the birthing process and the strength and power of women. It also showed me that there is another, more humane and family-oriented way to care for women and their pregnancies at a time when I was disheartened by the many limitations of hospital-based practices.


Shar and Carol support and nurture the families they care for in a way that I had never before seen from a provider. They gave me that same degree of support as a fledgling midwife—generously teaching me the ins and outs of running a business, the skills of careful palpation, basics of herbal remedies, and how to hold space for laboring women in a place that is theirs rather than ours. I will be forever grateful to them for this experience.I am also so thankful to the families who opened their homes to me and let me be part of their experiences. I learned so much from each of them.

And here is what I will remember most: a four-year-old girl waking up in the middle of the night to find her mother moaning deeply in the pool in their living room, and then, sleepy-eyed, pulling up her little chair to the edge of the pool and resting her head in her arms, watching her mother, turning to me now and again, smiling in wonder at her mother’s strength. 


U.S. Women’s Equality Day

element5-digital-ls8Kc0P9hAA-unsplashToday is the anniversary of the establishment of the 19th amendment to the U.S. Constitution. The new amendment, ratified August 18th but made official on August  26th of 1920, provided that the right to vote for white U.S. citizens “shall not be denied or abridged by the United States or by any State on account of sex.” From years of sacrifice and effort by all involved in the Civil Rights Movement, the Voting Rights Act of 1965 was declared and prohibited a range of discriminatory state voting practices. At least on the books (reality differs from the legal literature as felons cannot vote, gerrymandering is legal, and other voter restrictions interfere with a true democratic vote), everyone, despite race or gender, can now participate in the United States government. Because of these efforts and legislative changes, we take the time today to celebrate the work of suffragists.  Continue reading “U.S. Women’s Equality Day”

Baby’s First Haircut

pasted image 0 (1)According to common superstition, eating a lot of spicy food or suffering from frequent heartburn during pregnancy might mean that a baby will be born with a full head of hair. If that is the case for your baby, you might soon be thinking about scheduling an appointment at the barber shop. For some parents, cutting their baby’s hair for the first time is just another chore on the list of many things parents are busy doing. For others, it is a time to remember and cherish. Those parents might purchase keepsake trinkets or mark the date and length down in a baby book. Some parents might find that they are experiencing a lot of anxiety and stress when booking the appointment because they are worried about their baby feeling afraid or uncomfortable and wriggling around.  Continue reading “Baby’s First Haircut”

Fetal Ejection Reflex

Dr. Sarah Buckley is a trained General Practitioner in New Zealand who is qualified in obstetrics and family planning. She advocates for homebirth, having had her own four children at home. On her episode of The Ultimate Health Podcast, she discusses a small portion of the information she has on the hormonal physiology of labor. More of her experience and knowledge on pregnancy and childrearing can be found in her book, “Gentle Birth, Gentle Mothering” her report, “Hormonal Physiology of Childbearing ” , or by checking out her website at https://sarahbuckley.com/ .  During the podcast episode, she said something striking and worth talking more about, “every extra person at the labor adds an hour to it”. 

dr sarah buckley
from Dr. Buckley’s facebook page: @drsarahbuckley


This was a lighthearted and not exactly scientific way of summing up a very important concept to understand about labor: if the birth-person is undisturbed and feels safe and comfortable, the labor could naturally occur with relative ease. Likewise, if that person is being probed and interrupted by a bunch of strangers, they might never experience what Dr. Buckley talks about as the “fetal ejection reflex”. 

Continue reading “Fetal Ejection Reflex”