Kiya Fox has been a certified nurse midwife with Novant Health’s Brunswick Medical Center since August. But she was a labor and delivery nurse for seven years before that.
“I wanted to empower women,” she said of her decision to return to school to become certified in midwifery. “I wanted to offer them a choice in their birthing experience.”
But midwives do much more than deliver babies. They function as primary care providers for women of all ages – from puberty through post-menopause. “It’s a very personal, individual level of care,” Fox of Novant Health OB/GYN - Bolivia, explained. “We think holistically first. We start with the least invasive therapy.”
The difference is evident in Fox’s exam rooms. “I don’t use stirrups in the office or in the delivery room,” she said. “It’s all about the woman’s comfort. I want to reduce her vulnerability.”
Adrienne Mazzetti, Fox’s first pregnant patient, appreciated the difference right away. “After meeting Kiya, I only wanted to see her,” Mazzetti said. “She listened to me and never rushed our visits.”
Mazzetti works in health care and said learning how to deliver “patient-centered care” was a big part of her education. It’s a specific approach, and clinicians may need to alter their communication style to effectively deliver this level of care. “Kiya is able to do this in combination with her holistic approach,” Mazzetti said. “That sets her apart.”
Midwives don’t shun OB-GYNs. In fact, OBs refer expectant moms to midwives. And Fox – the only certified nurse midwife delivering babies in Brunswick County, North Carolina – always has access to an OB during deliveries, if one should be needed. “Our practice isn’t segregated,” she said. “We’re all one group. We collaborate. If I have a high-risk patient or a woman who may need a cesarean section, I get one of our doctors involved right away.”
‘The dance of labor’
Many of Fox’s patients want what a typical hospital birth doesn’t usually offer – low light, soft music, essential oils. And to call the shots. “I tell my patients to trust their bodies,” Fox said. “Your body knows which way to move to help your baby rotate during what I call the dance of labor.”
Mazzetti wanted to do everything naturally. She even hired a doula, a trained companion who helps an expectant mom and her partner through childbirth. “She was passionate about no intervention,” said Fox. “She wanted to be up and moving, and she wanted to labor at home as much as possible.”
That’s exactly how it played out on Jan. 12 when Mazzetti and her husband, Damien, welcomed their firstborn – a daughter they named Shea. “Adrienne came in completely dilated and delivered shortly after,” Fox said. “It was everything she desired and a beautiful birth.”
Mazzetti had miscarried before. At the time, she had been planning to deliver at a hospital closer to their home, but she didn’t feel the staff was sensitive to her after the devastation of losing a baby. “I know it happens all the time, but it had never happened to me,” she said. “I felt like I was part of an assembly line of pregnant women.” She knew she’d go elsewhere for OB care when the time came.
“I’m willing to drive 20 extra minutes, each way, to get this level of care,” she said.
Mazzetti’s original due date was Jan. 5. When that day came and went, Fox began talking to her about the possibility of inducing labor. Mazzetti was opposed and tried natural approaches – massage, acupressure, primrose tablets and evening primrose oil, exercise, red raspberry leaf tea – to bring on labor. She walked two to 3 miles each day. She was prepared to be induced on Jan. 16 – but did everything in her power to deliver sooner – and without drugs.
Fox had to be “a little stern” during the induction conversation, Mazzetti said. “But she was compassionate and supportive and validated my feelings. She let me know the pros and cons of induction. She told me the potential consequences of waiting too long to be induced. She offered to step out of the room so my husband and I could discuss things privately. That helped give me the time I needed to let things sink in and make an informed decision. I didn’t feel pressured or judged in any way.”
Induction wasn’t necessary after all. On Jan. 11, Mazzetti woke up at about 11:15 p.m. in pain. She waited about 45 minutes – until she was sure these were contractions – to wake her husband and text Kiya. The midwife’s advice? “Once each contraction is worse than the one before it, it’s time to come in.”
The Mazzettis met Fox at the hospital at about 5:50 on Jan. 12. Shea was born at 7:16 a.m.
“I felt super-confident and safe,” Mazzetti said. “I couldn’t be more thankful for Kiya and all the nurses. Everything I wanted, happened.”