The Midwife

Interview with Salli Gonzalez

As you know, one of my recent areas of focus has been Cartel Medicine’s interventions into Pregnancy & Childbirth:

1.    Cesarean (C-section)

2.    Interview with Jennifer Margulis

3.    Ultrasound

4.    Delayed Cord Clamping

5.    Unassisted Childbirth

This interview is a positive sixth addition to the series.

I’m very grateful that Salli agreed to this exchange, as I wanted to get a current perspective from a practicing midwife.

I got a lot out of this interview, and a highlight for me being her answer to my cord clamping question (Q4).

With thanks to Salli Gonzalez.

Central Texas Birth Center: Clinical Director, Owner

(Soon to be Haven Birth & Wellness)

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1. Salli, can you please tell us about your background and what led you to become a midwife and advocate for natural birth?

I was a mother first, having had my first baby the typical hospital route in 1984. The conventional way included, IV, medication for pain, Pitocin and ultimately a forceps delivery. My daughter and I were both healthy and survived our first year. I got pregnant with our second child and by then I felt like I needed to be more proactive in my own care, instead of having things done to me. I had this second daughter in a birth center in 1985, without any intervention aside from them breaking my water at 8 cm to speed things along. I ate and drank in labor, I walked around, I had my support team with me. I felt very empowered because I was able to make choices based on my own understanding. Her birth propelled me toward wanting to tell the world that birth doesn’t have to be horrible.

The birth of my second daughter also opened my eyes to how much we depend on our “professionals” in making other health decisions, including foods we eat, and supplements we take, whether or not to medicate or even seek their help. I learned that I truly was capable of making health decisions for my family and began to learn to treat them naturally using herbal remedies and homeopathic remedies. I wanted to mentor other families to let them know that they too could advocate for themselves, whether in birth or in raising their children. This eventually led me to teaching childbirth classes, becoming a doula and ultimately after many years of raising my kids to become a midwife.

2. How has your personal experience giving birth to four of your own children at home shaped your approach to midwifery?

All my births have shaped my perception of birth, but my homebirths allowed me to experience the faith and trust of the human body, the female body, and what it is capable of. My first homebirth was a breech baby. We didn’t know he was breech until a week before he was born. I had to decide whether or not to stay at home in a very short period of time, Since I had never needed to explore this option, I got on the bus with my two tiny daughters, and we went to the downtown library. I checked out a stack of books and quickly did my own research and discovered that my baby and I had a very good chance of having a successful homebirth. I knew that if I instead walked into the hospital in labor with a breech baby that it would be an automatic c-section. The birth was beautiful and quite fast, my midwife arriving shortly before my son was born. Each subsequent homebirth helped me to shape my own needs and wants that I preferred in birth. I discovered that I did not like a lot of distractions or talking in the birth space, and I try to have a similar approach with my birthing mamas. I also try to instill confidence in these mamas, helping them realize that while birth is a monumental physical event, they do have the power and the strength to get through it.

3. Can you describe the environment and birthing spaces at your center and how they promote comfort and a family-friendly experience?

Creating a birth space whether at home or in a birth center is really more about a psychological and spiritual approach. It takes a certain amount of faith to trust the birth process. I feel like we trust the process of birth and we all believe that women were created to give birth. Obviously, there have been some along the way that have had to transport to the hospital, but the majority of our mamas continue their labors to have their babies in our facility or at home. Our facility is homelike, the space, so I’ve been told many times is peaceful. But I also think that our staff has confidence in the birth process and can impart that peace to our clients. We do not limit the amount of family that can be present in the birth space, but we tell our clients that birth is not a spectator sport, and all members of the team should be there to help and not to entertain the mama and distract her from her labor process. The team the mama chooses should also be 100% comfortable with her choice of where to birth, since any fear can hinder the mama’s labor process.

4. There is some debate around the optimal timing of clamping the umbilical cord after birth. What are your thoughts and practices on this?

We have a strong opinion about this, as a matter of fact. Most often, we will deliver the placenta while the baby is still attached to the cord. We put the baby immediately skin to skin with mama and put a warm towel over both of them. We will then quietly check on both for the next few minutes while mama and baby are meeting each other for the first time. Eventually the mama will tell us that she feels pressure and she delivers her placenta. At that time, we will offer to clamp and cut the cord. Fifteen to 30 minutes will have often gone by at this time. The cord is white and limp and no longer pulsing. The blood in the placenta is not the mother’s blood, it’s the baby’s blood. The baby should dictate how much of that remaining blood he will need after he is born, it’s always the right amount.

5. The administration of antibiotic eye ointment to newborns is a standard practice in hospitals but less common in out-of-hospital births. What is your approach and why?

Every mama that comes into our care gets routine lab testing which checks for sexually transmitted diseases. Chlamydia and gonorrhea may cause blindness in the baby if left unchecked. Since our mamas usually test negative and have the option of treatment if they test positive, we are confident that babies don’t need antibiotic ointment in their eyes. We do offer it though, since our state licensing requires that we do. We give informed consent, and many will refuse the prophylactic treatment.

6. Childhood vaccination can sometimes be a sensitive topic. How do you navigate those discussions with parents if and when they arise?

Most of our clients seek our care because they have done their research and want a more holistic approach to birth and child rearing. Like me, their road has led them to question all the routine interventions done in the medical paradigm. We have our own strong opinions about vaccination, and we don’t vaccinate in our facility. If they ask us which vaccine is safe for their baby, I will tell them that no medication can be inherently safe for anyone and to look into the ingredients list and the vaccine inserts. I will direct them to medical practitioners that have done the deep dive into vaccines and their side effects. One of these doctors is Paul Thomas, who produces the show, With the Wind, Doctors and Science Under Fire. He co-wrote the book, with Jennifer Margulis, called The Vaccine Friendly Plan. We have several other books in our library that they can use to do more research, including Miller’s Review of Critical Vaccine Studies, by Neil Z. Miller and Dissolving Illusions by Suzanne Humphries, which covers the history of vaccinations and includes many facts about vaccinations harms. At our clients 34 week prenatal visit, we give out a packet that has information sheets on parents’ options around vaccination, vitamin K, and circumcision.

7. You mention offering herbal remedies and homeopathy as part of your midwifery services. Can you share more about how you incorporate these modalities and what benefits you've seen for mothers and babies?

We are blessed to have an herbalist on our staff at our birth center. She distributes her handmade products all over the midwifery community. She is a wealth of knowledge and has a remedy for virtually anything pertaining to health in pregnancy and parenting. We use some of her remedies to calm and anxious mama that has trouble sleeping. We offer iron supplementation in the form of an herbal syrup that is made up of herbs and food. There is a colic remedy that helps the baby that has colic. As well as lactation support herbal remedies. In labor, there are remedies that can enhance labor or help a mama rest. We have liver support tinctures that have shown to lower blood pressure as well. Homeopathic remedies are also occasionally used in our practice including those that encourage a baby to turn, enhance a labor or calm and anxious mama. Arnica can help a baby that has had a difficult birth and there are other remedies that can help a baby transition into the outside world.

8. For women who may feel fearful of natural birth or are attracted to the convenience of scheduled c-sections, what would you say to help inform and empower them?

I would never try to convince anyone to take the natural route unless they are already exploring this option. However, if they are keenly interested but don’t know where to start, I can give them lots of information about natural birth and give them examples of my own personal experience and what I’ve seen in birthing mamas over the years accomplish. I love it when women discover their own power in birth and realize, while birth can be hard, and huge strenuous workout, they can and do it. I do encourage them to read some of the books we have in our library about natural birth, I encourage them to take childbirth education classes and gain the tools to achieve and natural birth. One of my favorite books for those that are still on the fence about the natural birth choice is Henci Goer’s book, The Thinking Woman’s Guide to a Better Birth. This book gives the pros and cons of each of the interventions in birth, and it is very well researched.

9. What has been your experience working with women who have had a previous c-section birth and are now seeking to have a natural birth, a VBAC (vaginal birth after cesarean)? What specific preparation and support do you offer to help them achieve a successful natural birth?

I have quite a bit of experience with women that are planning a VBAC. Our practice has some good statistics, I would say 80% of our prospective VBACs manage to give birth with us. The support we give is similar to our care of anyone that is birthing. These women need to process their previous births in our visits, and we give them encouragement and advise how to avoid the things that may have led to their c-section.

10. In your classes and workshops, what are some of the key things you teach to help mothers and their partners feel prepared and confident for natural birth?

I no longer teach childbirth classes since I’m in a busy practice, but I do encourage the couple to take childbirth education. In these classes, the focus should be on the tools that may be used to get a natural birth, such as positions changes during the labor and pushing in an upright position. The couple should focus on learning slow relaxation breathing which during the labor, will facilitate her going into her parasympathetic state of mind. The couple should be able to move through their labor with confidence, and I think being informed through a good childbirth class gives them the tools to do that. We have referrals for these types of classes in our community.

11. What are some of the natural comfort measures and techniques you find most helpful for women coping with labor, and how do you help partners support the birthing mother?

Relaxation breathing is the most important one. Upright positions in active labor are so helpful. This may include sitting on a palates ball or sitting backwards on the toilet. Teaching the dad or the doula counter pressure on the hip bones or on the sacral area are some good techniques. Keeping her well fed and hydrated is also one of the partner’s jobs. The one thing that I tell the dads is that all he has to do is love her and believe in her. Their eyes light up, and they say, “I already do that!” It doesn’t have to be complicated at all. Once a couple finds this out, they move through their labor with confidence and ease.

12. As a midwife attending home and birth center births, what challenges do you face in terms of liability insurance or working within the maternity care system in general?

We have worked with some really great hospitals and others that refuse to care for our clients. We try and stick with the more receptive facilities where we know the client is going to get the best care if we need them. We are not required to carry malpractice insurance.

13. Why do you think there has been a resurgence of interest in out-of-hospital birthing options like home and birth center births in recent years?

I think the last four years have opened many eyes to what the medical community is doing and has been doing for many many years. At first, women were told that they couldn’t have their partners with them, and they had to wear masks. Our own clients put the word out that we didn’t require any of that. Our business surged that year. It’s been at a steady pace since then. I’m grateful that we can offer the space for women and their partners to choose the care they are looking for and not be forced into complying with non-sensical mandates.

14. If you could change one thing about the current maternity care system to better support natural birth, what would it be?

I think we need more people to shout this option from the rooftops. I try and get our own clients to share their stories whenever possible. That is the best testimony. Consumerism is what changes the paradigm. Women need to ask for it from their practitioners. I can support them in their endeavors, but the consumer needs to make these choices themselves. Education is the key. Social media has been a great avenue for education in natural birth, natural parenting and healthy lifestyle changes.

15. What are you currently most focused on in your work as a midwife and birth advocate, and how can people best stay in touch with you and your important work?

Currently I’m working on enhancing my skills as a midwife. I’ve been blessed to be able to offer my services to twin and breech mamas. Every year I take a seminar or two on breech and twins. Breech Without Borders holds these 4 day seminars all over the world. I love learning from the seasoned midwives and OBs that have been in the field and doing this work for decades. I can be reached at:

salli@texasbirthcenter.com and also at

salli@newhopemidwifery.com or at 830-556-3404

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