I wanted to take the time to share this amazing video of our family when baby was just four weeks old. This unique and amazing video was created by Melissa Gomez at The Baby Mini Doc.
She's helping capture family's everyday and important moments in a mini documentary. Melissa is very great at what she does and her passion for the project is evident.
I can't say enough about how happy we are to have this beautiful memory.
How it works: Melissa asks you if there are specific things you are wanting to capture on film. This could be simple things such as a diaper change, singing a song or just playing with your family. Though you have goals for things you're trying to get on film, it doesn't feel forced at all. She spends time just filming the everyday, regular moments. She is not at all intrusive, even though she's just hanging out and filming for hours. You forget she's there filming, except for when she (or you) make a comment to something that's going on (which is so fun to share with her, by the way). We definitely had some laughs with her while we were filming. She was also great at making suggestions without making things feel posed or fake. It all felt so natural, even more than we expected it to be!
Doing a mini baby doc is an excellent way to capture those everyday moments, which go by so fast! It's a unique perspective too since these are the moments that are often forgotten when taking your own video or photos. Often as parents we find ourselves trying to get a photo or video of a milestone, but we overlook the everyday.
Working with Melissa on this project actually inspired me to try to capture my own video of the everyday (with a much less sophisticated iPhone camera). I have seen a couple articles about this come up too that suggest that you "take the picture", suggesting for parents (or anyone really) to take a photo of the "normal" daily stuff - reading a book, changing a diaper, feeding a baby, etc. It is so true and something we are striving to do with our baby and I definitely suggest every parent (new and seasoned) tries to do! These moments don't last long and time goes by so quickly, it's easy to forget. Even looking back on this video, which was about seven months ago, I can't even believe how things have changed. It feels like she's been in our lives for so long, but also so short at the same time!
We can't say thank you enough to Melissa for shooting this film, which is truly a precious memory and an experience we won't forget. I encourage everyone to check her out (especially those in NY area) and consider doing a mini doc!
Our video is here.
Find Melissa and The Mini Baby Doc here and on social media:
I realize that it's been quite a long time since I have posted on this blog! Our baby is now eight months old and time has really flown by. Everyone says it, but it's so true!
Being a mother/private practice midwife/business owner has kept me busy! I am very behind on some of my anticipated posts!
However, you can find me on Instagram! I am trying to build up my page and post shorter posts there (with pictures, obviously!). Please check it out and follow me! @midwife_mom_dot_com
I’ve always said I didn’t want a high maintenance baby. What does this mean, exactly? Well I’m not sure, but I think I thought I should have a baby that could soothe herself, sleep well and not need much attention. Now I’m a mother and I realize this is impossible.
I have always focused on the need for good sleep habits, even before the baby. We got the Snoo bassinet (highly recommended, but that’s for another post) to promote good sleep. We said we would sleep with baby in our room until at least six months as per the American Academy of Pediatrics recommendations. We would not sleep with baby in our bed. We also did not want to be so rigid about scheduling her that it kept us from living our lives.
Midwife note: The American Academy of Pediatrics has a bunch of guidelines for safe sleep. One of which is to have the baby sleep in the parents’ room (but not in their bed) for at least six months, ideally a year. See their recommendations here.
Flash forward to reality...
Her first two nights, Fiona slept in the Snoo but it wasn’t turned on. This was because the motion got us a little nervous at first with a tiny baby. We decided to bring it downstairs and have her nap in it so we could see it moving. We felt better after doing this and her third night home she slept in the Snoo with the motion and has been doing so since. There is a motion limiter function which we used for awhile, but now we don’t need to do that.
During her first few weeks, we often slept with her on our chests during the day. Newborns are so snuggly, how could you not? You can’t spoil a new baby and they like to be close to you. Also, that time ends quickly and it’s nice to enjoy every moment of it while it lasts.
I’m going to tell you a secret about the first few weeks that no one told me: babies sleep a lot (though in small bursts) and relatively easily, but this period ends quickly and then they WAKE UP. This is a real thing. We both felt like the first few weeks were great in terms of being able to get things done while she was sleeping. It helped that we were both home for 3 weeks together. It was a period of time where we were mislead. We thought, this is easy! We can do laundry and keep the house clean. What is everyone talking about? Sorry to burst the bubble, but friends, this period also passes quickly and then they WAKE UP.
Fred went back to work after three glorious weeks at home. My mom was visiting for the first two days he was gone and then it was just me and her. She wanted to be held. A lot. This coincided with me feeling better and ready to start exercising and doing more. It was a difficult time because I wanted to do more and was feeling physically better, but it was next to impossible because I was constantly feeding or holding her. I “resorted” to wearing her at least once a day to get things done. I felt like this was a compromise and a crutch. I have several pictures of me wearing her with expressions of defeat during this time. For the record, I did work out once that week, while wearing her. I did a very easy dance workout (Cize) and kept it low impact.
Midwife note: It is generally recommended to wait until 6 weeks postpartum to work out, after clearance from your provider. It’s really important not to do too much too soon, which can make your bleeding heavier or set back the recovery.
Meanwhile, we were very lucky at night. As early as 14 days old, she was consistently sleeping 3-4 hours at a time in the Snoo. We started a bedtime routine (more about that later) around 5-6 weeks. We were really inconsistent and late with bedtimes but we got her to sleep well. At this point, she was going to bed around 11pm, sleeping longest for about a 4 hour stretch, waking up once to feed and waking for the day between 7-9am. We knew we were lucky and we enjoyed our night sleep!
Weeks 5-8 were the hardest for me when it came to sleep (however this was when breastfeeding started to improve so at least there was one victory). I was pretty much feeling normal and wanting to do stuff. She was napping, but inconsistently and it was taking a bunch of steps to get her down (ball bouncing, white noise, swaddle). One day she barely slept all day for a nap and was super cranky. The next day, I vowed to keep track of her sleep and be sure she napped. I made sure she was going to sleep after 1-1.5 hours awake and she did better. Victory! Though it wasn’t enough for me - I wanted her to just go to sleep. Why did I have to soothe her and bounce and do so much to accomplish it?
She started herself on the eat, play/activity, sleep cycle around 8 weeks. She did this on her own and we didn’t have to “train” her. This means exactly what it says: she eats, then she is alert for awhile, then she goes to sleep for a nap. She does not fall asleep while nursing except on rare occasions (always at bedtime, sometimes the first morning feed or when she’s really overtired).
Around 8 weeks, I started a nap routine. I read about this and decided if she had a bedtime routine, she should also have a nap one. I made a list. I went through the routine. I put her down “drowsy but awake” like all the websites said. I offered her a pacifier. I felt like I would get the routine down for a day or so (with some frustrations, of course) and then I would go out the next day and feel like the whole thing was out the window the next day at home. This continued. I would spend all this time bouncing her, letting her cry some, soothing without touching her. You name it, I pretty much tried it. For a few days the “fading” method worked. Then our schedule was off for a few days and it was back to cranky baby needing to be soothed again.
Fiona only sleeps forty minutes for naps. It’s pretty much on a timer - she wakes up at minute forty. However, she wakes up happy and content and will happily lie in the bassinet for 5-10 minutes if needed. Are the naps short? Yes. But I’m aware of the timing now and I can run around and do what needs to be done (or take time to myself) in that time frame. And my theory is that she is rested or she would wake up cranky. Forty minutes is her nap timing (for now, anyway).
It wasn’t until today that I finally came to a realization. Fred was off from work and I got frustrated when she fell asleep after bouncing and cried. He picked her up, bounced for a minute and put her back. I said, “well I don’t want to do that, I want her to self soothe. I don’t want a high maintenance baby.” He pointed out that it’s working and it doesn’t matter we have to bounce or rock her. She’s a baby and that’s what she needs. Also it takes way less time (and is way less frustrating) to pick her back up and bounce for a minute than to sit there letting her cry, giving pacifier, shushing, etc.
I think my biggest concern was that I would have a high maintenance baby that no one would want to take care of. She needs to bounce to sleep? Who wants to do that? Again, Fred reminded me that a nanny or babysitter is paid to take care of her and do what she needs. The person we hired reinforced this (“taking care of her is my only job when I’m here”). Grandparents and other family - they just want to snuggle and spend time with your baby and will do what they need to do. Extra snuggling while bouncing and rocking? Yes, please.
I have spent hours reading websites about sleep. I bought a book about sleep. I have cried with her. I have stomped my feet in annoyance or left the room and gone into the bathroom for a brief respite. I have begrudgingly wrapped her in the wrap for the purpose of getting her to sleep. I’m realizing now that I spent so much time being frustrated when I didn't’ have to be. A few minutes (or sometimes 10-15 but not always) of bouncing and she sleeps.
So many things say not to do this. The put them down “drowsy but awake” is everywhere. Don’t rock them to sleep. Teach them to self soothe. Let them cry it out (CIO). Here’s my opinion and best advice: YOU DO WHAT WORKS FOR YOU. I’m not against the methods or advice above. But right now, my important reminder for myself is that I can avoid frustration and extra time by just taking the time from the get go to bounce. That alone is so valuable to me. Everyone tries to give you advice (books, family, other moms, etc). Take their advice if you want, but take the parts that work for you. If they don’t work, don’t do them and move on.
Also there is nothing wrong with an occasional “wrap nap”. Baby-wearing has many benefits for both mom and baby. Although I don’t want every nap to be in the wrap (but if you do, totally fine, because you do you), I am happy to wear her sometimes. Because the baby-wearing timeline goes by fast too. Take advantage of it while you can!
That said, if you’re curious about our routines (because people like knowing what works for others, right? Again taking what works for you), here they are.
It was August 9 and I was 39 weeks and 1 day (my due date can now be revealed and was August 15). The morning started out like any other for me. Around 10am, I started feeling some mild, but strong than my usual contractions/Braxton Hicks that I was also feeling in my back. Midwife note: Braxon Hicks is just a fancy name for contractions that don’t lead to labor and aren’t painful. They are still the uterus contracting, just much milder than labor. Many don’t even realize what they are. They often feel like the baby is “curling in a ball” or just feel like the belly gets tight.
I was thinking that “this is different” but also didn’t want to jump to the conclusion that it could be labor. I was supposed to go to the beach that day (about an hour away) and I really wanted to go. I first messaged Fred to see if he could talk. He called me back immediately (I guess this is what happens when you’re at the end of pregnancy). I told him what was happening, but also told him it was probably nothing. We agreed that I would go to the car wash first (the car desperately needed cleaning) and decide from there if I would go to the beach.
I felt contractions every ten minutes. They were noticeable but very mild. I got the car washed and then vacuumed it myself. I called Fred, declared I was fine and I decided to go.
When I arrived to my sister’s house, I didn’t say anything about what I was feeling. We went to the beach and enjoyed ourselves. We swam and played in the ocean. I continued to feel the contractions, but nothing about them changed. As we were leaving, we took a selfie and made sure to get Embers in the picture. My SIL told my niece that this would probably be the last time they saw me before I had the baby!
On the way home, I stopped for some donuts from a local place we like. The traffic was really bad. About 30 minutes into the drive (and not very far in distance), I started to feel the contractions and they were more painful. They were still every ten minutes, but definitely stronger. I kept calling Fred with updates. As I was getting closer to home, they were worse, but not enough to affect my driving or concentration. Fred was getting dinner ready (bratwurst and corn on the cob) to have it ready when I got home.
I got home around 5:30pm and we ate dinner. I started to breathe with the contractions just a little bit. Then I went up to shower and things started to be more intense. I started to breathe through them and concentrate more.
I came down around 7 and decided to call Jo, the midwife, and update our doula, Maya. The contractions were still ten to fifteen minutes. I was able to converse with Jo without having one. I said “this is possibly early labor and could stop” to both of them. Fred was thinking we should take a nap, and also got our guest room ready in case Maya wanted to come and stay over. We decided to lie on the couch to watch Parks and Rec.
We watched one episode before I said we needed to turn it off. I couldn’t concentrate. We went into the bathroom. I started to get cranky. It was about 8:15pm.
Every time something happened that I felt was important, I’d tell Fred, “tell them (Maya and Jo) that” and he was keeping in contact with them. I started to get contractions much more frequently and I was starting to get really vocal. We started the tub and I also tried getting in the shower. Nothing was helping.
Jo wanted to speak to me and I managed a quick conversation. She recommended I try to examine myself. This is technically difficult, but I managed to get on the floor and do it around 9pm. I was only able to estimate, but it felt about 4-5 centimeters, 80% effaced and I could feel the water bag bulging. For a person having her first baby, this really is considered “early labor” and things could go on much longer. Even though my contractions were only 3 minutes apart and very strong, I started to doubt myself, tell Fred I was “being a wimp” and that I couldn't do it. I got into the tub.
We have a large bathtub with jacuzzi jets, which was going to be great for labor. Not so. I couldn’t get comfortable. I moved in all positions. I asked Fred to spray me with the shower hose and it sprayed cold water. I yelled at him and he felt so bad. I ended up getting out after 5-10 minutes.
Fred had told Maya to come and she was on her way. At 9:30, I told Fred to tell Jo to come over too. I was thinking that I needed her to come to tell me to stop being a baby. I think that in my head, I knew I could be progressing fast, but I didn’t want to get into that mindset in case it wasn’t true.
Maya arrived at 9:50pm. At first, she said she wanted to just observe us before she helped. Then I got a contraction, screamed my head off and she was helping me right away. Fred was pretty stressed at this point too because I kept insisting it was still early and I was a wimp. I left the bathroom to come out and lie on the floor. I had him lay out a blanket and I laid down to try to die. It didn’t work. I also needed to get up and move when I got a contraction. Needless to say, lying down was short lived.
Jo arrived at 10pm. She wanted to examine me and then told me I was 7-8cm and bulging water bag. I said “let’s just go” (to the hospital). She agreed and told Fred to call the car. It was 10:15pm.
Fred realized he didn’t ask for a large car. He had ordered a regular sized car for the four of us. We got outside, I saw the sedan and got really annoyed. How were we all going to fit? We did, somehow. Fred sat in the front and moved his seat all the way up. Maya sat to my left and Jo to my right, but she was on the floor mostly. I faced the back on my hands and knees. We got less than a block away and I remembered we forgot my glasses. I wanted to go back. Everyone said no.
The car ride was about 45 minutes. I was screaming and mostly on my hands and knees the whole time. When we finally got to Manhattan, I watched every avenue and counted down until we got there. At 6th Avenue, my water broke. I started to push a little bit with contractions (uncontrollably).
When we arrived around 11pm, I was so happy to be there. Jo checked again and said I was fully dilated (10cm) and ready to push. I really wanted my dose of antibiotics because I was GBS positive, so I asked Lisa, the nurse, to give me my IV even though I was ready to push.
Midwife note: Group beta strep (GBS) is a bacteria that about 30% of pregnant people have and it does not cause any harm, except potentially when giving birth. In rare cases, it can pass to baby and cause a serious infection. The way to prevent this is for the mother to get antibiotics when she’s in labor. This is usually at least two doses, four hours apart. If not adequately treated, the baby is monitored for signs of infection. Infection is rare, but because of the potential, it’s recommended to get the antibiotics to protect the baby.
After the antibiotics, Jo and Lisa left for a few minutes. I started to push. It felt much better to push and I was able to focus on pushing and speak normally in between. When Jo and Lisa came back, I was getting closer to having the baby. Everyone was really encouraging.
The baby was born on August 10 at 12:10am. When Jo baby up and handed her to me, I immediately looked at her to see she was a girl. I exclaimed “It’s a girl!” and Fred and I were so happy. I held her close and we shared our joy. When I saw her I was surprised about how small she was because we expected her to be at least 8 pounds. She was a perfect 6 pounds, 8 ounces and a healthy baby.
We were beyond thrilled and happy about the experience and so happy to meet her. A huge thanks to my amazing team - I couldn't have done it without you all!
Today was my last birth and last time at the hospital while pregnant. I was originally thinking I would be scheduled this week in the office, but we had a mama need a scheduled cesarean birth and I said I wanted to go to that instead of the office. Jo was happy to work in the office instead so I could go to the birth (Chloe is away). It was also meaningful for me to go since I’d been through two other hospital visits (to try to flip their baby with an external cephalic version) with this couple.
Midwife note: An external cephalic version (ECV or version) is when a doctor tries to flip a baby from breech or transverse position to cephalic (head down). This is done at the hospital, under ultrasound guidance, by a trained doctor. In our practice, we like to try to attend these if we can to help support our client.
We also always attend the scheduled cesareans, even though we aren’t medically part of the birth. Generally the midwife on call will attend as a support person and familiar face for the family. We help support the person while getting set up in the operating room like with the anesthesia, getting prepped, etc (because the partner can’t be there for that part) and we help to be sure the parents to hold the baby as soon as possible and also take pictures, etc. Afterwards, we try to help with breastfeeding and skin to skin.
I woke up in the morning and decided to do a cardio workout. I chose a 45 minute TurboFire workout. This is a kind of dance and martial arts combo and can be low impact. I’ll admit that I’m not so great at it (my dance skills are subpar) but it’s fun and definitely gets the heart rate up and feels good to move. At one point, I thought I might look pretty funny dancing around with my 39 week belly, so I decided to video a portion of the workout. Little did I know, this would be my last major workout and last cardio before baby was born! (A clip of this video is available on my Instagram for those who follow).
The reason for the cesarean was for a baby who was breech and wouldn’t turn. In this case, we knew that she would be having a cesarean so we planned the date and time with the doctor and we also planned a more gentle approach.
Midwife note: Though some providers do vaginal breech delivery, it’s really uncommon to find a trained provider and not generally recommended. Cesarean is considered the safest mode of birth for breech babies.
Gentle cesarean is a relatively new concept in the birth world, which is gaining in popularity. This approach includes lowering the drape or using a clear drape to allow the parents to see the baby come out, delaying cord clamping and handing the baby to mom when baby comes out for immediate skin to skin. In our hospital, the staff is still getting used to this, but having an extra advocate for this (in this case, one of us midwives), it helps to achieve these goals.
Everything went well with the birth. At the time (since I’m writing this later), I was pretty sure this was going to be the last birth for me to attend before I had my own baby. While at the hospital, I had many people asking me about myself and my own upcoming birth. And in regard to how far along I was, as per usual, my answer was that I was due “soon” or “this month”.
As I was leaving the hospital, I started to get emotional about not returning as a midwife and coming back to have my own baby. It felt weird that I wouldn’t be going into my locker or get scrubs out of the machine for months. On my way down in the elevator, I saw a staff member that I knew. She asked me about myself and as I was telling her I didn’t think I’d be back before I had my own baby, I got emotional and started to tear up. Walking out the door, I took a look back at the lobby and entrance, and pictured myself coming back during my own labor. Little did I know that it would be the next night...
I have been doing a lot of preparation for the postpartum period. This is a great thing to do at the end of the pregnancy when all the labor and birth prep has been done. I’m constantly telling my clients to do this in the final weeks of their pregnancies. It’s a good way to spend some time (especially if you’re not working or working as much) and you’ll have some stuff done for after the baby when there’s zero time to think about it!
Today I made “padsicles”. I actually hate this name because it implies something like popsicles, which are edible, and these are not. They are frozen maxi pads with witch hazel and aloe (and other things if you choose). They are used for soothing a healing perineum. Here is the recipe I used, but there are SO many out there on the Internet. This project took about 10 minutes (I made 8 padsicles), but it is definitely something you won’t be thinking about after baby is born.
I have also been stocking up on food. I made some lactation cookies and frozen cookie dough. They were really yummy so I definitely ate some (so did Fred) and then froze the rest. Mostly though I rolled out a bunch of cookies in balls, then froze them. These can be popped in the oven whenever wanted and 10 minutes later, fresh cookies. Here is the recipe I used.
We have also stocked up on homemade frozen meals. My mother-in-law was SO amazing and cooked us at least 5 different meals for the freezer. We made one pasta dish and some frozen breakfast burritos too. The burritos were the suggestion of a pregnant friend and also super easy to make. We are fortunate to have a chest freezer, so we just piled it all in there, but even those with smaller freezers can make some of this stuff! Again, not something you’ll want to be doing after baby is born. Take out food gets old and not everyone has “meal trains” set up, so it’s a great way to have home cooked food after baby.
If you’re looking for a splurge or a great gift for your registry (or someone else’s), look into a postpartum chef like Alicia at Clover and Timothy. A friend of mine used this woman who she says was truly amazing. She will come to your house and cook. She provides meals that are healthy and support a healthy postpartum and breastfeeding. We are hoping to have her come as well!
Another great thing to do if you’re planning to breastfeed is to find a local La Leche League meeting and go to it (or at least figure out when and where it’s held). The meetings are held locally, usually once a month or so and are great support groups for nursing parents. They encourage people to attend even prior to having their babies. The groups are free. You can find your local group here.
Finally, read up on things like postpartum care, newborn care and breastfeeding! In my experience as a midwife, these are things that are often forgotten. There is usually a lot of focus on the birth itself, but then these areas get neglected. The labor and birth is such a small part of things and the postpartum, newborn and breastfeeding stages are so important! There are lots of great resources out there. I’ll admit, I haven’t read a ton yet, but am hoping to more in the next few weeks and will post them on the reading page.
Today was my work baby shower, which was such a nice surprise!
Originally we had a visit scheduled for 10:30am. Jo asked Fred to make up a reason to move it later, which he did. My prenatal visit was the last of the day so they could surprise me after.
After my appointment, we walked out to the front and they yelled surprise. It was really sweet! They had decorated the office with balloons and flowers. They ordered from Yasaka, which was so great since it’s my favorite. It’s hard not eating the raw fish there, but I love the pumpkin and sweet potato tempura rolls and there were plenty. Chloe even brought Peter Pan donuts which was so amazing. She also made her famous blondies which are so good.
It was a sweet surprise and so fun to celebrate with my work family!
We decided to go on a babymoon for a long weekend. Earlier in the pregnancy we went on a big trip to Hawaii so we just needed a little local getaway now. The goal was to be within a few hours of home and the hospital (just in case!) and to have access to a pool/water. There were a bunch of contenders, but ultimately we ended up picking Long Branch on the Jersey Shore. It’s no surprise really that we chose the beach! We stayed on a resort right on the beach which was awesome.
Just in case, we did decide to bring a few hospital essentials with us on the trip. This was a big reality check as I packed this stuff. Meeting our baby is definitely getting closer!
Midwife note: Be sure to clear any trips in the third trimester with your care provider! Some providers don’t recommend travel after a certain gestational age, even by car.
The goal of the trip was just to relax and spend some extra time together before baby comes. We ate good food, walked on the boardwalk, swam in the pool and the ocean, ate ice cream and even went antiquing a little on Sunday since it was raining. I even went for two runs on the boardwalk which was lovely! I love running near the beach. On the last day, we even splurged on massages which was really nice.
It’s crazy to think that this was our last little trip together before we become parents. I can’t believe how close it’s getting now!
I’m all about photos and documenting important times in our lives. I actually love being photographed (most of the time). Fred and I have some really special photos to document our lives and maternity was no exception!
We took our maternity pictures in June on the beach around 32 weeks. Since we love the beach so much, it was fitting that we went to Jacob Riis to do the pictures. I am so happy how they turned out!
The photographer is Lauren Colchamiro and she does all kinds of photography. We plan to use her for our family newborn pictures as well. Her link is also on my resource page.
I went to the dentist today to finish replacing an old crown I had. Today was the second appointment and much shorter than the first. It is something the dentist has been wanting me to do for a long time, and I’m so glad I did now rather than waiting until after the baby comes. After the baby comes, it will be so much harder to schedule! I generally really hate the dentist, so going more often during pregnancy and getting work done is a big deal for me!
Midwife note: Dental care is really important in pregnancy. There is some correlation with periodontis and pregnancy outcomes (American dental association). Regular dental care may reduce the risk of preterm birth, low birth weight and preeclampsia. This is in addition the benefits that regular dental care provides like helping with pregnancy bleeding gums (gingivitis) and erosion, etc. Many dentists recommend cleanings every 4 months in pregnancy. Dental procedures with local anesthesia are safe in pregnancy. Most women (and dentists) avoid x-rays, but they can be done if the abdomen is double shielded.
I have been wanting to run all week, but it’s been really hot. So I decided to swim instead. It does feel really good to be in the pool! Swimming was refreshing and I felt so light. I got several comments from older women swimming. One of them told me I did a really great job swimming which made me laugh.
Afterwards, I went to CityMD to get my TDaP vaccine. I have been forgetting to do this for several weeks and I really wanted to get it done. They were very nice and fast, and now it’s done.
Midwife note: There is a vaccine called TDaP (tetanus diptheria and pertussis) that is recommended by the CDC and American College of Obstetrics and Gynecology for pregnant women during their third trimester (ideally between 27-37 weeks). Pertussis (aka whooping cough) is potentially dangerous to newborns and they can't be vaccinated until they are two months old. By you getting the vaccine during pregnancy or postpartum, you can pass immunity to the baby. Here is the CDC recommendation.
A pregnant midwife living and working in New York City