Ep. 214: Midwifery Before and Beyond Pregnancy & Postpartum, with Hamilton Yarbrough

Did you know that midwives can provide gynecological care outside of pregnancy and postpartum? While this used to be the standard practice, more and more medicine has moved inside of hospitals and toward physicians, but the role of midwife to the local community shouldn't be overlooked. Because of their unique skills and training, they can provide gynecological care that may better meet your preferences and needs. Certified Nurse Midwife, Hamilton Yarbrough, joins us to talk about her midwifery practice and the services she offers to women who are not pregnant or postpartum.

NOTE: This episode is appropriate for most audiences but does mention birth and trauma.

GUEST BIO: Hamilton Yarbrough is a wife to her wonderful husband Jordan of 10 years; they have two wild little boys Charlie and Lewis, both born at home (which is what sparked her desire to move into midwifery model with Homebirth). She has been practicing as a midwife for 8 years now and has had her own clinic for 5. She has helped over 500 mothers, sisters, and friends navigate the ups and downs of GYN care, pregnancy, loss, birth, and everything in between and loved every second of it!

SHOW NOTES:

Aurora Midwifery: https://www.aurorabhm.com/

Ep. 174: Faith over fear during pregnancy and labor, with Laura Ducote

Ep. 71: Advocating in the Dr.'s Office: Pelvic Exam

Transcript

Caitlin (00:25)
Welcome back to the Woven Well podcast. Have you ever thought about working with a midwife? Most who hear this question would assume that I'm talking about midwifery care for pregnancy or labor and delivery, those sort of things. But did you actually know that midwives are prepared to provide services throughout your entire reproductive life? That's exactly what we're going to talk about today. So even if you're not pregnant or trying to be, this episode is for you.

I've invited experienced midwife Hamilton Yarbrough to talk about the role of a midwife and how she can play an important role outside of pregnancy. And honestly, I can't wait for it. I think that's gonna be really interesting and I'm excited to hear what she has to say. So Hamilton, welcome to the show.

Hamilton Yarbrough (01:07)
Hey, thanks for having me.

Caitlin (01:09)
I'm so glad that you're here and I'm so interested in this. began, I'm not exactly sure when, but a while back I saw a post on Instagram that your office listed that was talking about, we have other gynecological services. I was like, ⁓ people never think about that. So I'm excited to talk about that with you, but I'd love to start by learning just a little bit about you and your work as a midwife. How did you get where you are today?

Hamilton Yarbrough (01:37)
Yeah, absolutely. And yes, GYN care is one of my favorite things to do and to have the like, just the relationship that starts a lot of times before pregnancy and also like getting to see women as they like evolve and age and mature and I don't know, it's really beautiful. I'm so glad to be here to talk more about it and all the things. My background started in the hospital setting. So I actually worked at a local hospital called Simon Williamson Clinic. And I was a midwife there for about two years and was of course catching babies, but about 75 % of our practice was gynecological care. And that ranged from somebody who just started their period and was coming in to be like, whoa, like. What's my cycle, what's happening here, what are all these things going on in my body, all the way to people who've gone through menopause and, you know, hormone replacement therapy, all the different things, all the natural methods to support your body. And so that's been, you know, I've had a pendulum swing some from that since when I started, but it gave me a really good breadth of...just really appreciating working in gynecological care and yeah, and loving that. And then I had my almost, maybe six and a half now, but six and a half year old at home in 2019. And I had always wanted to work in the community setting. So work in like birth center, home birth. And we had some visions ideas when I was at my hospital practice of like making a midwife led birth center. But after I experienced the really intentional, in-depth care of just community midwifery. For listeners who may not know what exactly that is, it's like in the hospital, we were allotted 10 to 15 minutes slots to see a client. And when I'm making care as I want it to be, we get an hour with you.

Caitlin (03:29)
Yeah.

Hamilton Yarbrough (03:30)
Honestly, sometimes we're stretching out, but I get an hour with you and get to have as much time as we need to really delve into what you're feeling in your body and your mind and your soul and like how all the things are impacting you and your lifestyle, not just, hey, okay, here are these like preventative tests that are due for you. How are you doing mentally?

Caitlin (03:42)
Yeah,

Hamilton Yarbrough (03:49)
so that's kind of where I started, went and did home birth, experienced home birth. I've had home birth for both of my kiddos and I just like immediately became sold. Like I knew from some short experiences in my clinicals in nursing school and in midwifery school that I thought I wanted to do out of hospital work, but until I like full body experienced it.

That's when I just was like, have to move into this realm. And so I did and yeah, that's what I've been doing ever since. And so I am on call for, catching babies and then also doing clinic. And I have my office over family wellness chiropractic off Valleydale road in Birmingham. And we just.

Caitlin (04:28)
It's amazing.

Hamilton Yarbrough (04:36)
Yeah, I love it. The space is very, yeah,
just like different than the traditional setting.

Caitlin (04:41)
Yeah, and I want to hear about that too because I love that you started in a hospital setting and then you have transitioned to be outside of hospital because like you said you got experience in both of those and I'm sure you saw just such a wide range of women and that's fantastic to get that kind of experience and so obviously I think a lot of people are familiar with midwives helping in labor and delivery ⁓ But it's funny, I was telling this to you before we started recording. Of course, in history, midwives were care throughout a woman's reproductive life. And then now we think of it just for pregnancy and delivery, but it expands. It goes so much beyond that.

So I'd like to hear a little bit of what that looks like. I mean, you already hinted at it, that it starts with first period and goes all the way through menopause, but maybe we could talk about that a little bit. Like what are the gynecological services that your clinic would offer?

Hamilton Yarbrough (05:43)
Yeah, absolutely. a lot of what I do is preventative care, preconception visits, annual or biannual preventative visits for wellness. And then, yeah, it just ranges completely. I honestly love when clients, parents send them in just to like chat about their cycles and like, be like, okay, yes, this is my like 13 to 16 year old who's like really wanting to know about this or sometimes like they have some symptoms that they're like, what is this? Is this normal? And like their parents are like, I don't know. want to, you know, and so then it like kind of starts a journey. So it's like, you know, and of course like the typical things too of like, oh, like I have a yeast infection. What do do? And sometimes it's just something as simple as that, that like starts the journey and starts the preventative health journey too of like, okay, well,

Caitlin (06:13)
Yeah. Yeah.

Hamilton Yarbrough (06:30)
How are we supporting your body's energy? What is your lifestyle like? And let's just be real, most teenagers are not.

I wasn't either. know, living like to their best energetic potential and all the things because they're out there, you know, eating fast food, having fun with their friends, which is also wonderful and great for their community. But yeah, so kind of just like shedding some light of like, okay, this is what it looks like when you're like making choices on your own. This is what your body can feel like. These are the different like phases and cycles and like you have this beautiful part of your body that you get to.

learn about and appreciate for this whole long season of your life. So that happens also too a lot of times when people are 30, it's not just when they're 16, you know. ⁓ So but that is what we can do and then also of course like just generally talking about talking about your health and like what impacts you and mental health, physical health, you may contend it from that, but I'm very much about How is our body functioning? know, are you getting outside? Are you getting sunlight? How that is going to impact you hormonally? Are you touching the earth? Are you touching the water? Whatever it is, you know, and also like at the end of the day, within all of that, I'm such a like, we are all individual human beings. And so one thing that may work like perfectly well for me may not work perfectly well for you. So here are like the things to try. And that may be like a big difference from like traditional care. I'm gonna put the ball back in your court and I'm gonna say, I want you to go experiment with all of these things and figure out what works for you. And then we can come back and we can troubleshoot, we can check lab parameters and see how things are improving or things like that. So the short answer is there are all kinds of wellness things that I do that can range from mainly preventative care and then also people will come to me with, my periods are irregular, what's going on? Can we troubleshoot them? Or I've had heavy bleeding and cramping, what can we do with that? Or I think I might have a UTI or a yeast infection or any of those kind of like.basic elements that people may experience from time to time that are signals from our body, right? Of like what's going on. And so yeah, so just troubleshooting all of that and you know also have a wide range of clients. I would say most of my clients are looking for a more holistic approach versus like hey just give me the traditional meds or whatever. But you know finding the avenue for that as well if needed.

Caitlin (09:01)
Absolutely. And I really appreciate that everything that you've just said is all positive based. How can we celebrate this? How can we learn more? This is a good part of your body and it's something that we're going to be living with for the next however many decades. And so how can we care for it and nurture it? I think that's a fantastic approach. And there sounds like there's a lot of permission in your practice to just come in for whatever your question may be. Whatever you're dealing with, whatever your curiosity is, and you can get support there. Sounds like you have a wide range of approaches that you have to each one of those. So if they did come in with an issue, you mentioned painful periods or yeast infection, or, you I mean, you listed lots of things, but would your approach automatically be different than the type of treatment that would be recommended in a hospital OB-GYN or what's your take on that?

Hamilton Yarbrough (09:59)
I guess it depends on who you're seeing. ⁓ But probably, yeah. So generally speaking, they're probably gonna just be like, here's some diphlocan if you have a yeast infection or whatever. Whereas I'm gonna be like, okay, like there are all these different parameters that we can go over. Do you wanna talk about, what's going on in your gut biome and your reproductive health and like, you know, what are your hygiene practices? Let's take some time to delve into those or whatever.

Caitlin (10:01)
Okay, fair.

Hamilton Yarbrough (10:24)
maybe we could consider the supplement or different things that are gonna kinda help. And then I'm probably gonna be recommending that you do coconut oil versus, or other just different alternative methods and giving you some options for that versus doing that right off the bat so that we can preserve some of that microbiome health. But I also totally have people who are like, no, this is miserable. I wanna just like.

figure out how to get it gone right now and then we'll like work on the stuff after. So again, it's just like where you are in your body and your season, like what feels right to you. It's kind of like the approach that I take to it.

Caitlin (11:01)
Yeah, that's great. everyone is going to need slightly different care. And so your flexibility and being able to provide that for them is very helpful and it's a very dignified approach. So I think that's great. You mentioned earlier, like getting lab work done to check for something or that sort of thing. Talk a little bit about that. Like how often would a patient also or client also need to get services from a hospital or another clinic or, you know, I'm thinking mammograms or ultrasounds or lab work. Like, how does that typically work if you go to a midwife clinic for all of your gynecological care? Do you also have to go to those others?

Hamilton Yarbrough (11:40)
So you don't necessarily have to go like into an office that, you know, a different office to see another provider, but I do not have like if you wanted to do a DEXA scan or mammogram or things like that in office. We do have ultrasound twice a month, but there's also local imaging centers that I can send folks to if they need pelvic ultrasound or things like that, because twice a month is great for OB clients usually, but it's not as convenient for our GYN folks, there's plenty of options for places to refer for GYN ultrasounds. So we will do that. Labs are in-house. funnily enough, a lot of GYN clients are like, I have needle trauma or phobias from different places and will only come see me to do their blood draws. And they're like, I don't care if we have to wait. I don't care if I have to pay you $50. I don't care if you're drawing my blood.

And I think that, I don't know, it's fair to a certain extent because you're not sitting there with, I mean, it's fair to all extents, but with your arm on a plastic chair and somebody under bright lights, it's like, it's cozy. And if you want to smell essential oils, you can smell essential oils and lay down on the chase and we're going to draw your blood. So it feels
just less stressful, I think, to the nervous system in general. But all that to say, the blood draw is available in the office. LabCorp is the main lab that we use just because Blue Cross Blue Shield is partnered with them. so, yeah, we draw it, send it off. And it just kind of depends on what we're following up with. if it's somebody... ⁓
who is checking in on annual labs needs to look at a history family wise or something and wants to do that for cholesterol or you know it may need to be done once a year or more frequently depending on what's going on or every two years or

All of those things, but the same thing, we're going to have kind of custom recommendations based off of your mammogram, your pap like all those things based off of your like history. And then there's kind of standard guidelines as well for those things. And then if you're looking for like, you know, preconception, wanting to make your hormones, make sure your hormones are on track or whatever, that may be like a one-time situation. It was like, yeah, they look perfect. Or it may be like, hey, let's check them again in three months after you've like done some different hormonal support work and come back,where they are. ⁓ So it kind of just it varies from person to person but yeah whatever they need.

Caitlin (13:57)
Yeah.

Well, and I just want to acknowledge to you talking about the comfy environment, you can smell essential oils, you can lay down if you want to, no bright lights. How different is that from the standard experience? I mean, pretty significantly. So even though you mentioned it very quickly, I just want to acknowledge that that that's a fantastic alternative just to have a place, a space that feels so much more comfortable. I know that means a lot. Now you mentioned Blue Cross Blue Shield. I know we're kind of wrapping up, but in general, does that mean that you accept insurance?

Hamilton Yarbrough (14:35)
wish they will not let me be in network with yeah doing home birth and it's it's a whole rabbit hole

I've considered something like that, but at this time I'm out of network. And one, I mean, I will say one of the benefits of being out of network is it really can be like whatever you need it to be. It doesn't have to be like, I have to file for these certain codes for you to be able to get reimbursed. And most of the time we can submit a reimbursement and you get some back. But it's, you know, I had somebody come one time, I guess it's happened more than one time, but

Caitlin (14:51)
Yeah.

Hamilton Yarbrough (15:06)
where you know she just needed to talk about I mean I think we spent 45 minutes of the hour just talking about like postpartum fears and like what had come up and like all the different things that she was processing, thinking about maybe moving into the pregnancy zone again. And that's valid, right? And if that's what somebody needs, I'm obviously not a therapist, but I think it's also really important for your provider to like be able to witness and hear all of those things before you move into that space that feels really vulnerable again. ⁓

Caitlin (15:24)
Yeah. Hmm.

Hamilton Yarbrough (15:38)
And so I will say that's like kind of the nice spot about not taking insurance is that really and truly like the visit be for whatever you need. If you've had GYN trauma in the past and you need to sit there for 40 minutes and let's just chat and you maybe say like actually today isn't the day I'm gonna come back in a month and try again or I want to do it myself you know self collecting your path you go for it. ⁓ And so

Caitlin (16:00)
Mm-hmm. Mm-hmm.

Hamilton Yarbrough (16:03)
I think that that's like that's a really nice part that I do appreciate about it.

Caitlin (16:08)
Absolutely, and I do think there is more more health care that's going outside of the insurance model. So you are certainly not the only one there. ⁓ Well, I appreciate you taking the time to share all of these things. I know you have a very busy practice, which we celebrate. You know, that's fantastic that you do. And so thanks for taking the time and being on with us today.

Hamilton Yarbrough (16:29)
Of course, it was great to chat with you.

Caitlin (16:32)
Listeners, I hope this has been helpful. ⁓ I realized that Hamilton is in the Birmingham, Alabama area. So if you are outside of that area, then you may be thinking, well, this is not super helpful, but it is helpful because you may have a midwife in your area that can specifically help you outside of pregnancy and postpartum your entire reproductive life. And they can provide great care and counsel. So you can look into options that are local to you. And if you are in the Birmingham area, then I'll make sure to have her information in the show notes.

If this episode was helpful, would you help us in return? Just take five seconds to leave a quick review. I cannot overemphasize what an impact this makes in allowing our podcast to be available to others. And if you're a woven client or want to be a woven client, then we're actually going to send you a thank you. So just let us know. As always, thanks for listening as we continue to explore together what it means to be woven well.