Empowering women

Local midwives share insights into profession

T-R PHOTO BY SARA JORDAN-HEINTZ Midwifery is more than merely assisting women through the childbirth experience; it’s addressing the healthcare needs of women at all ages of life. At UnityPoint Health Marshalltown Obstetrics & Gynecology, P.C., (OB-GYN), three women serve the community as midwives, including Melissa Koch, OB Clinical Educator, left, and Chris Fishel, a certified nurse midwife (CNM) and advanced registered nurse practitioner (ARNP). Not pictured is Autumn Schmoker CNM, ARNP.

Midwifery is more than merely assisting women through the childbirth experience; it’s addressing the healthcare needs of women at all ages of life. Midwives specialize in pregnancy, childbirth, postpartum, women’s sexual and reproductive health, and newborn care.

“We take care of women from puberty to menopause and all the way through their lives,” said Autumn Schmoker, a certified nurse midwife (CNM) and advanced registered nurse practitioner (ARNP). “Empowering women and letting them have a say in their healthcare is why [we are in this profession.]”

Schmoker is employed at UnityPoint Health Marshalltown Obstetrics & Gynecology, P.C., (OB-GYN), located at 407 E. Main St., along with colleagues Chris Fishel, CNM, ARNP, and Melissa Koch, OB Clinical Educator, who is in the process of completing her midwifery certification. Schmoker worked as a labor delivery nurse before earning her masters of science degree in nursing and nurse midwifery from the University of Cincinnati, the school in which Koch currently attends.

While women have been assisted during the childbirth process since the beginning of time, the practice of solely relying on midwives rather than a medical doctor, dropped in popularity before a recent resurgence.

In 1989 (when numbers first became available) midwives were the leading healthcare providers in just 3 percent of U.S. births. In 2013, that rate rose to 9 percent, with even higher rates of midwives being brought in to supplement a doctor’s care. From tracking fetal development, to helping alleviate the side effects of menopause, offering birth control resources, screening for depression, and prescribing medications, the roles of midwives run the gamut.

“I think one of the biggest challenges of this profession is dispelling the myths about being a midwife,” Koch said.

“People think we deliver babies by candlelight inside the home, but in today’s world, we are nurse practitioners who help women beyond just the pregnancy part of their lives.”

Fishel has served as a midwife at UnityPoint since February 2017. She has 30 years of experience in the field of nursing, and earned her midwife certification from Frontier Nursing University in Hyden, Ky.

“We have an empathetic approach, and we’re not just there for the birth, but for the whole process,” Fishel said. “We’re trained to look at birth as a normal process of life.”

Fishel, Koch and Schmoker assist women in the birthing center, located within the confines of the hospital, in which the OB-GYN facility is attached. They offer expectant mothers alternatives to the traditional birthing experience.

“We offer women the ability to walk around, soak in a tub, and use a birthing ball, which is like an exercise ball that helps in the progression of labor where they can sit and bounce on the ball,” Koch said.

“It’s really just individualized care. Everybody’s body is different.”

The midwives all noted they face challenges working in this field.

“There can be cultural differences with patients, such as breastfeeding, and language barriers,” Fishel said.

“But challenges can make the job more satisfying when you accomplish something.”

Midwives can stay with a woman during the entire labor process, whereas most doctors come and go, due to time restraints and other medical obligations.

“Sometimes it is just a midwife in the room and the (OB-GYN) doctor is only there for an emergency,” Koch said.

However, midwives are not certified to perform pregnancy-related surgeries, such as a caesarean section.

As a way of letting folks in the community learn more about midwifery and the women’s health services offered, an open house will take place on Tuesday, Dec. 5 from 5:30-7:30 p.m. at its facility.

Tours of the birthing center will be available. Light refreshments will be served.

For more information, the facility may be reached at: 641-752-4681.


Contact Sara Jordan-Heintz at 641-753-6611 or sjordan@timesrepublican.com