An Interview with Briana Bloembergen: Examining the Role of the Nurse-Midwife and the Benefits of Physiologic Birth

A new mother holding her newborn baby

Nurse-midwives specialize in the holistic care of women from adolescence through their post-menopausal years, and supporting reproductive health and the child-birthing experience. Midwifery breaks away from intervention-oriented standards of modern medicine, focusing instead on the body’s natural physiology through the birthing process. 

Briana Bloemberg is a Certified Nurse-Midwife with a decade of experience in midwifery both in hospital settings and in private practice. In addition to providing direct care for her patients, Briana has combined her passion with instruction to create educational content for Premiere focused on the physiology of birth for health professionals

Premiere: Tell us a little about yourself and what you do.

Briana: I graduated with my bachelor's degree in nursing in 2007, and went directly into labor and delivery practice. I really loved that, and the experience encouraged me to go back to school to become a Certified Nurse-Midwife (CNM) in 2013. I worked as a full-scope midwife for about five years until I left in 2020 to be a mom and raise a family of my own.

In the last few years I have focused more on education. I was an adjunct clinical professor for UNC Charlotte and a full-time faculty member at York Tech for about a year until I decided to pivot to building a postpartum coaching business called Midwifing Motherhood. I knew Megan Arbour when I was a student and she was my professor, and we reconnected through Premiere. Since then, I’ve been working with them to create content around childbirth, and I just finished my first course: Physiologic Birth for Labor and Delivery Nurses.

Premiere: Tell us about it.

Briana: Physiologic birth is the idea that the body is naturally designed to progress throughout labor and birth on its own without intervention. My course is intended to help labor and delivery nurses see where standard care deviates from natural physiological processes, what areas they can improve for supporting women physiologically, and the benefits of being mindful of those natural processes.

Premiere: Could you give a description of birthing in a hospital and what a midwife can bring to that experience?

Briana: The typical birth for a low-risk mom would begin when she arrives at the hospital in early labor, perhaps dilated 2-3 cm. The first thing they do is put her in a bed, and she’s allowed only ice chips. She’s also automatically hooked up to an IV of fluids she may or may not need. Hydration is important when you’re in labor, obviously, but there’s no reason you can’t just drink water in the early stages as you need it. Both of those things are interventions that are very clinical in nature, but don’t actually make a lot of sense. 

Then, she’s placed on continuous electronic fetal monitoring, which is a belt around her belly attached to a computer. As a result, the likelihood of her getting up and out of bed is pretty slim. Unfortunately, that’s about the worst place to labor because staying stationary slows the body’s natural birthing process. 

The fact is, birth is a magical dance between the mother’s body and the baby that needs some assistance from movement. Standing and walking in the early stages of the process actually helps her anatomy work with the baby as it descends.The body contracts, the hips are adjusting, and as the muscles relax and stretch they help to spread the joints and make space. That, in turn, supports the baby rotating to make its way down.

Standard medical interventions can have a significant impact on the body’s ability to carry out its intended functions. One of the most important calls I get as a midwife is right at that early stage when an expecting mother would typically be admitted to the hospital. They’re usually extremely anxious and a little scared because they know the baby’s on the way, and they want to know what they should do.

Premiere: What do you tell them?

Briana: Relax, go about your normal day as best you can, keep moving, and call back when you experience a few specific milestones. There’s absolutely no need to rush to a hospital prematurely and get put in a bed, but that’s our healthcare cultural paradigm. Letting women know what’s normal and giving them permission to experience it goes a long way.

A lot of what I do is easing fear. Unquestionably, there's a lot of fear around birth, and with a little education, knowledge, support, and encouragement, women can do incredible things they never thought they could.

Premiere: What is unique to the care provided by a midwife?

Briana: Once you've identified that the baby is healthy, the electronic fetal monitor comes off. Most midwives recommend intermittent monitoring. It automatically frees up the woman to be able to move around so she's not tied down by those monitors if it’s not medically necessary. Also, experiences like hydrotherapy are not typically seen in physician-led care, but they can be incredibly soothing.

One of the key differences in approach is the use of medication. Pitocin, for instance, is synthetic oxytocin, and it accelerates the birthing process. It’s very commonly administered as a matter of standard practice, but a woman’s body is already producing oxytocin in levels that are attuned to her natural birth process. If it’s medically necessary a midwife absolutely supports its use, but it doesn’t make a lot of sense to use it proactively. Midwives look at labor and childbirth as a life event that needs to be closely monitored, not actively managed.

Premiere: What insights can a midwife offer to nursing staff in a typical hospital setting?

Briana: I would tell them women are stronger than we give them credit for, trust their natural  processes, and support the innate capabilities of the human body. After all, birth is a miracle and we’re made to do it! After 15 years, I'm still in awe of what we’re capable of.

I’d also like to see the conversation about natural labor shift; there’s an ongoing narrative that natural labor is only for people who don’t believe in modern medicine at all. It’s unfortunate, because placing a premium on physiologic birth should be the standard of care for all women. It’s not about ideology. It’s about outcomes. 

Premiere: What have you enjoyed about working with Premiere?

Briana: Even when I was involved in nursing education, I never had to create a course or develop a curriculum. The classes I taught were already designed, and building my own content from the ground up was a fantastic opportunity to give some of my experiences with physiologic birth a voice. It was great to work with Dr. Arbour again as well, and her mentorship was extremely valuable. 

Premiere: Last question: is she Megan now, or will she always be Dr. Arbour to you?

Breana: (laughing) She’s Megan when we’re working on our courses together, but she’ll always be Dr. Arbour!

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