Modern Midwifery

Houston Methodist Willowbrook Hospital offering hospital based midwifery care

Houston Methodist Willowbrook Hospital is one of Northwest Houston’s first hospitals to offer midwifery services for women seeking high-touch, low-intervention prenatal, obstetric and gynecologic care.

The midwifery program provides a home-like, birth experience in a hospital setting. It appeals to women seeking a more natural birth with a variety of pain management options. The program’s certified nurse-midwives, Rebecca McKimmey and Amy Perilman, are advanced nurse practitioners with master’s degrees and advanced medical training. The midwives write prescriptions, read medical tests, but practice using a holistic approach.

“Houston Methodist Willowbrook Hospital is one of the few hospital-based midwifery care programs in the city,” said Keith Barber, CEO of Houston Methodist Willowbrook Hospital and senior vice president of Houston Methodist. “We have added midwifery services to meet the evolving needs of our community in Northwest Houston and Tomball.”

McKimmey and Perilman, who have a combined 25 years of experience in women’s health, focus on overall lifestyle and offer women and their families lifelong individualized care, education, counseling and support. They provide services, including family planning, prenatal, postnatal and menopause care, and help women become more involved in their health. The midwives understand the uniqueness of every woman and each birth. They build relationships with every woman to provide the care she wants and needs.

“Our philosophy really is our foundation,” Perilman said. “We see ourselves as partners in care, and, when you approach it like that, it’s a very different outcome. You empower the woman, and, when you empower the woman, the whole family, I think, is healthier.”

Relationship-building starts at the first appointment. McKimmey and Perilman get to know each patient, and most obstetric and gynecological, or OBGYN, appointments last 30 minutes to an hour. Midwives are primary caregivers, so patients don’t require a family doctor or OB oversight, unless complications arise.

“Just taking that time to see them as an individual person and not using a cookie cutter approach – I think that you build trust when they see that you care about what their opinion is,” Perilman said. “I really like to think of it as we’re trying to reshape the childbirth experience for women and individualize it for the mom.”

The midwives explain basic care, including tests and nutritional information, and counsel women, especially expectant mothers, on emotional components to ensure healthy pregnancies. They book first visits with patients around 10 weeks. From there, the midwives visit monthly to 28 weeks, biweekly to 36 weeks and weekly until birth. Expectant mothers bring their birth plans and discuss needs and wants during these visits.

“We don’t try to change their mind,” Perilman said. “We will guide them with options to know that labor is dynamic, and, if changes are needed at any point, we can support them along the way.”

McKimmey and Perilman offer holistic pain management options, including hydrotherapy, essential oils and massage therapy. They also practice techniques to create comfort, such as wireless vital sign monitoring, allowing mothers to change positions and more freedom of movement. The midwives encourage mothers to make their labor rooms feel home-like and more personalized. They educate and provide tools each mother can use to fulfill her birth plan.

“There is no secret that labor is painful,” McKimmey said. “But women are really strong, and, when they’re educated about childbirth and prepare mentally for it, they are really successful.”

The midwives encourage additional emotional support from a doula — a woman trained to assist another woman during childbirth — who becomes part of the birthing team.

“We love doulas,” McKimmey said. “We think they’re a great part of the team. It’s been shown to be a benefit for moms to have that one on one support,”

The individualized care, education and tools the midwives provide ensures birthing preparedness and reduces medical intervention need. McKimmey and Perilman let nature take its course, unless complications arise.

“We very much have an evidence-based foundation to our practice, and, as such, we respect the normalcy and safety of pregnancy,” McKimmey said. “We don’t see it as an illness that needs to be managed,” she said, adding that unnecessary intervention can increase chances for cesarean sections, or c-sections, and other actions.

However, McKimmey and Perilman have 24-hour access to Houston Methodist Willowbrook’s doctors, surgeons and specialists, if complications arise. They assist during c-sections, stay for skin-to-skin contact between mother and baby and follow the mother’s post-birth plan.

Houston Methodist Childbirth Center at Willowbrook operates a level II neonatal intensive care unit, or NICU, with neonatologists provided by Texas Children’s Hospital. Houston Methodist Willowbrook’s maternity care team works with the midwives, who remain with their patients in the labor and delivery or operating room. McKimmey and Perilman say their patients trust them to provide care they need and want.

“We have a relationship with the women, so, if something does become complicated or something arises during prenatal care or labor time, they’re willing to partner with us and change that plan for safety,” Perilman said.

Patient care continues after birth, ensuring seamless transition from hospital to home. A six-week mom and baby follow-up program called fourth-trimester care, or couplet care, addresses lactation, diet, exercise and emotional well-being. The midwives help new mothers return to a healthy weight, re-establish a healthy sex life and adjust to a new family dynamic to reduce chances of developing post-partum depression.

“If a new mother is having lactation issues, it looks really different, if you address that at four days versus waiting six weeks when she’s already frustrated and now not even open to the idea,” McKimmey said. “I just think, overall, you’ll have a well-adjusted mom that’s able to take care of her new family.”

The midwives provide individualized patient care to women with family and community growth in mind.

“My favorite part of what I do is participating in a woman’s journey to grow her family because, at the end, if we have healthy families, we have a healthy community,” Perilman said. “It never ceases to amaze me. No matter how many births I attend, when that little baby comes out and is placed on the mom’s chest and they’re now two separate beings, it’s amazing. It’s just so powerful to watch a family be born. It’s one of the most awesome things we get to do.”

To schedule an appointment, call 281.737.2500 or visit houstonmethodist.org/willowbrook.