HONESDALE, PA — “I always joke that midwifery chose me,” said Christina MacDowell.

She’s a certified nurse midwife, a doctor of nursing practice, and the practice manager of women’s health at Wayne Memorial Community Health Centers, an independent affiliate of Wayne Memorial Hospital in Honesdale.

As a young child, MacDowell would find a pregnant woman at church to be her new best friend so she could feel the baby moving. Once the baby was born, Christina would move on to the next pregnant woman. “While I love babies, I really love the moms. Someone has to love the moms, and that’s me!”

When asked about the differences between an OB/GYN (aka an obstetrician/gynecologist) birthing model and that of a midwife, MacDowell laughed and said, “Everything! For one, we believe that having a baby is a normal part of a woman’s life cycle—something we are designed to do.”

Individualized education, counseling and prenatal care; nurturing and hands-on care before, during and after birth; minimized technological intervention; shared decision-making; and informed choice—these are all things at the forefront of the Midwifery Model of Care, she said.

“It’s really important to us as midwives to meet every single patient where they’re at, and we spend a lot more time with our patients learning about their individual wants and needs,” said MacDowell. “It’s really interesting how just being present and that shared decision-making and that informed choice can really change someone’s experience. When you have a baby, you look back at that for the rest of your life and it really shouldn’t be anything less than magical and safe.”

She explained that while she would never want to work without her physician partners and the capability to provide life-saving surgeries for mom and baby, the midwifery approach to childbirth is the only way she wanted to attend a birth.

When she was 16 years old, MacDowell wanted to be an OB/GYN after watching one birth a baby. “I received a bio pre-med degree from Indiana University of Pennsylvania, but the summer before I was going to start at Philadelphia College of Osteopathic Medicine, I saw Dr. Ken Bruce—a fertility specialist in Aspen, Colorado.”

Dr. Bruce employed three midwives in his practice. They were open to having MacDowell follow them around for a more holistic experience of what their practice had to offer. “After the first birth I saw them attend, I said, ‘If this is what I’m going to do, I want to do it like that!’”

She went home and pulled out of med school. “Despite my mother feeling like I was breaking her heart by not attending med school, it was the very best decision for me. I’m right where I belong.”

MacDowell started working at Wayne Memorial Hospital as a labor and delivery nurse in 2010. Upon completing her master’s degree in 2017, she transferred to Wayne Memorial Community Health Centers’ Women’s Health as one of two staff midwives.

“When you start anywhere, you’re able to see different areas with opportunities for improvement. So many conversations between people who dedicate their lives to healthcare are around what’s not working. So what do we do to make it better? That’s what my doctorate allowed me to do.”

MacDowell received her doctorate in nursing practice with an emphasis on quality improvement. She learned intricacies that allowed her to run her own project to improve timely access to care and the overall healthcare setting at Wayne Memorial.

“During my doctorate, I became very involved in process improvement and trying to create pathways for evidence-based care, but also checks and balances and establishing camaraderie among the team. I also really wanted to grow. To break down the barriers that had over 300 people in Wayne County go right past Wayne Memorial to birth their babies in another county.”

The New Beginnings Birthing Room

In just a few short years, Wayne Memorial Community Health Center’s women’s health practice expanded from two to four midwives, and MacDowell is looking to hire a fifth.  The staff also includes one part-time OB/GYN physician and three full-time doctors, with an eye to adding a fourth.

With the growth of available practitioners also comes a focus on work/life balance.

“I feel you have practitioners here that want to be here, that know that when they’re here, they’re on and are absolutely going to take care of the patients that are in front of them, but also know that this administration respects their time,” MacDowell said. “And when you have things working both ways, you have really happy practitioners, and I think that makes all the difference in the world. We’ve seen some great changes and I’m really proud of all of them.”

There are even families from New York City and New Jersey in the area who gave birth at Wayne Memorial during the pandemic, MacDowell said, “who are choosing to come back to have their second child at the Honesdale-based hospital because they had such a great experience.”   

Regarding other support for expecting mothers interested in what Wayne Memorial and the Women’s Health Center offer, there are a plethora of resources available.

There’s a support group called “Stronger Together,” where women can meet the midwives and gain a better understanding of what midwifery is.

The Midwifery Mingle occurs in October, and allows women of different age groups to get together and share concerns and things they have going on in their lives that other women can relate to. “Where we are, our journeys are all so different, but if you can meet other people where they’re at, it’s easier to bond with someone with like-minded people around you,” said MacDowell.

There is a board-certified lactation consultant in the hospital who offers consultations even before the baby is born. Additionally, all nurses in the hospital are trained in breastfeeding support, and there’s even a Facebook group called The Latch Lounge, dedicated to breastfeeding education.

“Before you’re discharged from the hospital, you’re scheduled for a postpartum visit four to six weeks after. We discuss baby blues and postpartum depression signs, symptoms, warnings and offer necessary treatment if needed,” said MacDowell “We have another Facebook group called Birth Lounge, full of postnatal education, and Wayne Memorial Community Health Centers offers us access to behavioral health specialists, so if it does come to something more pressing—there are some really intense things that can occur postpartum—we have resources and people available to help. There are lots of different avenues of support available.”

The most important part of it all, MacDowell said, “is healthy mom, healthy baby. Even when you stop believing in yourself, as midwives, we’re going to be here to believe in you.”

To learn more about Wayne Memorial Hospital’s birthing options and the additional support offered, visit www.wmh.org/wayne-memorial-hospital/giving-birth/.