Midwives kept Emily’s natural birth plan safe and on track, despite complications

When Emily Lang found out she was expecting, she knew she wanted a natural, unmedicated birth.

And despite complications during the pregnancy—including gestational diabetes and preeclampsia—Emily and her husband, Jon, welcomed their new son, Judah, naturally.

Because Emily chose the University of Iowa Hospitals & Clinics Midwifery Clinic for her natural birth, she didn’t have to change her plan, even after she had complications.

With the support of certified nurse-midwife Amber Goodrich, MSN, ARNP, and UI Health Care’s team-based approach to maternal health care, Emily was always confident that she’d have immediate access to specialty OB-GYN care if she needed it. And when she did need it, Goodrich remained by her side.

Judah, Jon, and Emily Lang
Emily and Jon welcomed Judah into the world naturally with help from the UI Health Care Midwifery Clinic.

Having a natural birth was my goal, and I’m so proud I got to achieve it. Even with all of the complications that I experienced, they took care of me and helped me get through my birth naturally. It was an amazing experience.

— Emily Lang

Understanding, respectful support

Emily, 28, of Iowa City, Iowa, a pediatric nurse at UI Stead Family Children’s Hospital, already knew about the Midwifery Clinic and the certified nurse-midwives’ reputation for providing a nurturing, minimally invasive approach to labor and delivery. Being in the clinic’s care for an entire pregnancy reinforced that reputation for her.

“The midwives took the time to get to know me and develop a relationship with me,” Emily says. “I felt a deep level of trust with all of the midwives, and they made me feel safe and well taken care of. The midwifery team understood and respected my desires for a natural birth from the get-go, from early on in my pregnancy.”

The Midwifery Clinic includes eight certified nurse-midwives, and each supported Emily’s goals for a natural birth.

“I got to see several of the nurse-midwives during my prenatal visits, and they were all wonderful,” Emily says. “But when I met Amber, I felt an immediate connection with her. I was so excited that she was the midwife on call when Judah was born. I am sure that feeling so comfortable with her is what helped my labor progress so quickly.”

Midwives and OB-GYNs working together

UI Health Care’s team-based approach to maternal health care emphasizes collaboration between certified nurse-midwives and OB-GYN physicians. They share a communal work room to support that collaboration.

“They always know what’s going on with my patients, and I always know what’s going on with theirs,” Goodrich says. “It’s really a beautiful thing.”

Emily was diagnosed with gestational diabetes near the beginning of her third trimester. She developed gestational hypertension and then, ultimately, preeclampsia.

She feared her plans for a natural birth were in jeopardy.

“The stress of worrying about my blood pressure and preeclampsia—and making sure my baby was moving and kicking—plus my diabetes at the same time, was just too much,” Emily says. “I didn’t want to worry anymore.”

For the safety of the baby, labor was induced the day before her due date.

“I knew induction was the right decision,” Emily says. “I had already been having some contractions at home, and I knew my body was ready.”

‘Just like I’d hoped for’

Despite the labor induction, Goodrich was able to help guide Emily through an otherwise natural, anesthesia-free delivery, just as she’d wished. Emily was even able to labor for several hours in a tub to help ease some of the discomfort.

Our number one goal is to keep the mother and baby safe, but we do our best to accommodate their birth plan as well. We want to help make the birth experience special for our moms-to-be.

Judah was born on September 16, his exact due date, roughly five hours after Emily went into active labor.

As Emily recovered following the labor and delivery, she faced an additional, unexpected complication when a uterine hemorrhage caused her postdelivery bleeding to be heavier than normal. Goodrich did a sweep by hand to clear out Emily’s uterine blood clots.

Emily is grateful that she and her baby were in exactly the right place, receiving exceptional care from start to finish.

“Everyone cheered me on, and I just felt so empowered,” Emily says. “It was this beautiful, peaceful, serene delivery, just like I’d hoped for.”

Iowa City, Iowa