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Fall Into Health & Balance

Portland Family  — Juggling priorities such as parenting, career, budgets and finding time for one’s loved ones leaves little time to even breathe, much less time to take care of oneself.  But the buildup of stress created by not paying attention to one’s basic physical, emotional and mental needs can contribute to serious health problems.

WHA.articlePortland Family asked four certified nurse midwives (CNMs), who work at the newly opened Women’s Healthcare Associates branch in Portland’s Northeast Gateway area, to provide some tips for managing the demands of everyday life.


“The tendency for many is to try and do everything possible,” MacKenzie said. “Well, that’s NOT possible. When some women describe what their typical week is like, it’s clear that a committee of people couldn’t achieve what’s on their plate.”Lauren MacKenzie, a CNM for the past 10 years and the mother of two (ages 4 and 2), counsels her patients to have reasonable expectations of themselves and their families.

Midwife services for women in every stage of life

In Oregon, certified nurse midwives are licensed, independent healthcare practitioners, much like physicians, but providing more interaction and time with their patients. They have hospital admitting privileges, are licensed to prescribe medication and consult with many types of physicians. Certified nurse midwives provide a range of obstetrics services such as:

  • Pre-pregnancy counseling
  • Prenatal care
  • Pregnancy group prenatal care
  • Childbirth planning
  • Labor support and delivery
  • Breastfeeding support
  • Postpartum care
  • Referrals for ultrasound and fetal monitoring
  • Women’s Healthcare Associates provides referrals to a physician partner for medical or surgical problems

Women don’t have to be pregnant to benefit from midwives’ services. They provide gynecology and well-woman services such as:

  • Family planning
  • Annual pelvic and breast examinations, including referral for mammograms
  • Gynecologic care, including PMS therapies
  • Pap tests, screening and treatment for infections
  • Menopause management
  • Evaluation and treatment of menstrual irregularities
  • Referral to a physician partner for medical or surgical problems

She tells patients to prioritize — to keep things focused on their family or whatever is most important — and to get some clarity about creating some spare time for themselves. “It’s valuable and parents need to spend on things they care most about. There’s just too much pressure on keeping schedules. They need to cut back and let go of extra stuff.”

Reach Out

Liz Labby, a CNM for the past two years, emphasizes the importance of getting away from it all, even if it’s just for a little bit of time. “I’ve told patients to lock themselves in the bathroom for a bit if they have to,” Labby said. “Some of my patients have pretty tough lives and sometimes it just gets to a point where you have to call a friend or a relative to get a break; or to commiserate.”

She notes that reaching out for human contact is important whether people are stressing about kids or not. “A lot of patients don’t have kids — I don’t have kids,” she said. “But often there’s a tendency to isolate. Finding time to interact with others is part of taking care of oneself. It’s not wasting hours of your time on Facebook or watching TV.  We can’t forget about the importance of human-to-human contact. It’s just a different level of support and connection.”

Maintain Healthy Routines

Jessie Kerstetter, another CNM at the Gateway facility, focuses on the importance of exercise and eating healthy in improving the body’s ability to ward off stress and illness.

“And absolutely no smoking,” Kerstetter says. “Smoking, alcohol and drugs are all debits to your body’s resilience. They suppress your immune system and allow diseases to take hold of your body.”

As a busy mother of a son and daughter, she integrates her exercise into her kids’ activities.

“Last night, when I took my son to soccer, I took a walk around the track while he was playing,” she said. “It’s a good way to relax, and to model an active lifestyle for my kids.”

Lauren MacKenzie finds value in quieting the world around her. “I preach the value of meditating, deep breathing and trying to relax the muscles; and it’s especially valuable to clear your head by taking a walk with a friend or by yourself.”

Reduce the Noise in Your Life

Katie Farnsworth, CNM, advises that a reduction in “screen time” can reduce anxiety and even help people sleep better. That means less television, smart phones, emails, Facebook and surfing the net.

“Not having any screen time an hour before bed is a good prescription for a better night’s sleep,” Farnsworth said. “I’m like anyone else — I get tempted to check my phone before going to sleep. Instead, just listen to some music and read a book.”

She said that pregnant women often are affected even more by the electronic assault on our waking lives. “The hormones during pregnancy can make it more difficult to sleep.”

For Farnsworth, it’s especially important to get enough sleep to perform at her best. “As midwives, we’re often awake at night doing deliveries,” she said. “So getting adequate sleep and exercise and eating whole foods is what I need to do. Also, heading outside to the mountain and into nature is really critical for me. I get a lot of energy from that.”

Guiding patients toward better living is an important part of what midwives do.

“I like working with women and men who are starting a family, and helping them work through the various transitions in their lives,” Jesse Kerstetter revealed. “This is a very intimate profession. We get to be with our patients through the good times and the hard times, too.”

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