Midwifery Spotlight - June 2010

This month, the Midwifery Spotlight would like to shine on Lynnette Gerhard. After 40 years of service to many women and their families, Lynnette is leaving the Skagit Valley Medical Center to retire. Below, Lynnette tells us how she became a midwife and what that has meant to her life.

In Lynnette's words:

As a student nurse, I felt I had come home when I reached labor and delivery. Following graduation, I was fortunate to find work as an L&D nurse. I enjoyed the work, but found it hard to share such an intimate time with a woman, only to have her disappear from my life following delivery. While I was working in New Jersey, I became aware of midwives as a possibility and applied for the program at Columbia University.

The Midwifery Program at Columbia University in the early 70’s was an 11 month program of 2 semesters and a short summer session. I began in the fall of 1970. As I was in my seventh month of pregnancy at the time, I was the lab for many of our prenatal concepts. The arrival of Brandon Michael Porter in February of 1971 delayed completion of the program for one year. I joined the following year’s class in February of 1972, finishing with them in July of that year.

The family moved back to Washington state following graduation. There was as yet no licensing here for midwives. For two quarters I served as Clinical Instructor in pediatrics at the University of Washington. In April of 1973 the state legislature passed the statute that would lead to licensing of Advanced Practice Nurses, including nurse-midwives.

In July of that year, my daughter, Karen Leslie Porter, was born and shortly thereafter the family moved to Tonasket, WA. Initially I was very occupied with my young family. However, I yearned to put my midwifery training to use, so I kept track of the legal status of midwives. By 1975, The board of Nursing was still writing its Rules and Regulations.

However, in Tonasket there was a Family Practice group concerned about the large number of women delivering at home in the surrounding area with no knowledgeable person in attendance. In that time of counter-establishment revolution, they estimated that as may as 25% of babies in the county were born at home with no medical care. They reasoned that at least some of these women would come to a midwife, especially if she were willing to deliver them at home. Therefore, we began to work together. I proposed an internship period, since I was by then 2 years out of school and was still practicing under simple RN licensure. They agreed to supervise me closely at first and by the time I was working on my own, I was finally licensed as an Advanced Registered Nurse in the first batch of licenses issued. My number is 0000018!! I did my first deliveries in that small 30 bed hospital. There was no obstetrician in town and often the nearest physician was 15 miles away. I also delivered my first home birth baby in Tonasket. I remember that when the call came, I hurriedly gathered my supplies and drove the 5 miles to the house. Things were obviously moving pretty fast and the requested preparations hadn’t happened. As I unwrapped supplies, I tossed the wrappers into a cardboard box that was handy and proceeded to catch a healthy baby boy very shortly. When the excitement was over, I went to gather up the wrappers. I discovered that the box was home to 4 kittens! We did laugh about that.

In November of 1976, My husband and I separated and I moved with Brandon and Karen to Mount Vernon Washington to work at the Mount Vernon Birth Center, owned by Dr. Winnifred Bradford. Ruth Halvorson, CNM was already working in this practice and lived upstairs in the Birth Center. Ruth was a wonderful mentor and support. Many nights when I met some new situation, I would call for her. She would come down in robe and slippers and guide me through with great patience. I have precepted many students over the years. Each and every one has been blessed by Ruth’s patience, as I couldn’t do other than pass it on.

Being on call as a single mom certainly had its challenges. Fortunately, I had both understanding co-workers and wonderful, flexible children. If a call came in the night, I could pack up the children, their clothes for tomorrow, and breakfast ingredients in 5 minutes and off we would go. I always carried sleeping bags in the car so they could settle in the clinic downstairs while I labored with families upstairs. When they would wake up in the morning, I would see little heads peeking around the corner. They knew if I had gloves on, they should go downstairs and play for a while. Otherwise, breakfast would happen in the kitchen very shortly.

I worked at the Birth Center from 1976 to 1980. During those years great changes happened in the world of birthing. Husbands began to be welcomed in hospital labor and delivery rooms. Breast feeding began to be supported more universally. Childbirth preparation classes became widely available. Midwives became more widely used. In our state, Birth Center licensing became possible. In addition, CNM,s were granted privileges at Skagit Valley Hospital. The Northwest Chapter of the American College of Nurse-Midwives grew from a very small group of non-practicing CNMs to an active group influencing every aspect of maternity care in our state. Meanwhile, two important statutes were passed. One mandated that nurse practitioners, including nurse-midwives, be paid by insurance companies for the same services covered for physicians. The other gave a woman the right to choose her provider for women’s health care without a referral from a physician. These laws broke down huge barriers to midwifery care. We take these things for granted now, but in those years, we celebrated each victory as we stayed grounded in the wonderful work with women, babies, and families.

In July of 1980 I married Dan Gerhard and moved to Asotin, WA. A year later we welcomed another daughter, Bethany Ruth Gerhard. The next year I began working to secure hospital privileges in nearby Clarkston, but was unable to find the sponsoring physician required. I spent the next year teaching Lamaze classes and writing patient education materials for a women’s clinic in Lewiston. At the end of that time my husband was transferred and we moved to Longview, Washington. After three years of working unsuccessfully with the local hospital and obstetricians to get hospital privileges, I opened Special Delivery, a home birth practice.

It was gratifying to again be practicing. Women came to me for many reasons. Many had had unsatisfactory hospital experiences. Some simply wanted to birth their babies in familiar surroundings with their families. Others had no insurance and couldn’t afford or couldn’t find care elsewhere. Whatever their reasons, these women shared some wonderful birth experiences. My very favorite happened on a beautiful summer day. I had scheduled for that afternoon my usual 2 week before due date visit to find the house and be sure all was ready. However, I had just returned that morning from visiting a new family when the call came. “My water broke this morning. I knew you were coming this afternoon, so I thought I would just wait, but the contractions are coming pretty strong now so I think you had better come.” I jumped back into the car--fortunately it was always packed and ready to go--and hit the road. It was a 45 minute drive and the directions were “park at the end of the road and come on the trail across the hill to the house”. I grabbed what I could carry and ran along the trail, in the door, and climbed down a ladder to the main floor. I found myself in a treehouse!! On a daybed in a bay window amid the branches of a tree lay my patient. Her husband and a neighbor (mother of six home-birthed children) were with her. She calmly asked, “ Can I push now?” Ten minutes later her beautiful baby girl was born into that beautiful sunlit peaceful room. I was totally unnecessary, but so thankful to be there.

In 1989 I accepted a position in Sacramento, CA to work with another CNM for a Family practice doctor. The return to hospital births was a great opportunity to update myself on current OB practice. I had not previously had a great deal of experience with electronic fetal monitoring or epidural anesthesia, for example. I learned a lot during my three years there, including the fact that I am not made to be a Californian!

In June of 1992 I found that my good friend Ruth Halvorson had been diagnosed with endometrial cancer and needed help with her practice while she was undergoing treatment. We had often talked of eventually practicing together again, so it seemed logical for me to return to Mount Vernon. My husband was ready for the move as well, so 2 months later, I found myself in a very busy practice. Those first months were a real adventure as there was no opportunity for orientation. After being away 12 years, I was not familiar with charting, supply location, community resources, or any of the patients. However, women and the process of labor had not changed and I was blessed with an excellent office manager, helpful nursing staff at the hospital and Dr. Logen who patiently answered even my most basic questions. It was fun to be back in the old Birth Center Clinic. The Birth Center itself had been closed for several years, but the Clinic was still much the same.

I remained in private practice for the next 10 years. The practice changed over the years as Ruth retired and other midwives came to work. We had two location changes and changes in office staff. We precepted many students from The University of Washington, CNEP, and OHSU. Through all the changes we continued to strive to provide the very best of care to women, listening to their stories, teaching them, advocating for them and sharing the best of ourselves with our individual gifts. In return, the women made our lives richer as they shared their families with us.

In the spring of 2003 I came to a difficult crossroad. My mainstay consultant, Dr. Logen, proposed to retire. Sarah Meyer, CNM needed to leave due to family concerns. The practice at that point couldn’t support two full time midwives and it was difficult to fill a part time position. Meanwhile the Skagit Valley Medical Center wanted to establish a midwifery service and approached me to join them. It would mean guaranteed consult availability, a full time partner midwife, financial stability and continuity of midwifery care in the Skagit valley. Reluctantly, I closed the doors of Ruth’s Midwifery Clinic in September, 2003.

Since then, I have been happily employed at SVMC working with Mary WathenCNM and nw Natalie Weatherby,CNM. These have been good years, but I am ready to retire, knowing that the future of midwifery in the Skagit Valley is in their capable hands.

As to what I will miss? There has been so much of my life immersed for so long in midwifery that I think the challenge will be in discovering who I am without it! I will miss the challenge of finding the individual needs of each woman and the best way to help her find her way through pregnancy and labor. I will miss seeing the joy and awe on the faces of new parents as they hold their new little one.

To new midwives--hold fast to your dreams and ideals. When the world seems jaded and pushes you to lose faith in the birth process, listen to women!! They will continue to amaze and reward you.

I have no definite retirement plans. I will visit with family and friends, tend the garden, read sew and sleep ALL NIGHT! I am sure that I will find new challenges in the next months, or perhaps new challenges will find me.

-Lynnette Gerhard

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If you know of a midwife who deserves to be in the spotlight, please email Kristina Chamberlain at kristinacnm@yahoo.com.