Changes at H&H

I am writing with a few updates from Hearts and Hands Women’s Care.


I began this practice in 2011 to explore the possibilities for out of hospital birth with a Certified Nurse Midwife in southern New Hampshire. While many paved the path before me, at the time I started there were none in active practice. With baby Dylan at my hip (and later Nora), I set up in Peterborough, did many meet and greets – with women, families and local providers – and, birth by birth, built up to what Hearts and Hands is now in 2019. During these years I witnessed a whole little community grow, and in that community I found my skill as a birth advocate, and an advocate for women in their health as a whole. I always believed in women, I believed they should access to safe births with safe providers, and I most fiercely believed in out of hospital birth. After all, that is where I was born, and where both my girls were born as well.  

This has all been my every day, and despite many attempts to trial ways to get the practice to grow, I have come to realize that I cannot get it to grow beyond a one midwife show without directly and assertively lining myself up against other local providers. To get this far, I have worked hard to respect existing local midwives, MDs and nurses, and I do not want to jeopardize this as we are all in this to care for the women of our region, all in our own scopes. I never wanted to work alone for a whole career. I had hoped to build this community to support a two midwife practice, but with three years in a row at overly-full-time-one-midwife, I have decided it is time to make a shift.

What this means for Hearts and Hands right now is that we will continue to offer the same high level of evidence based, honest and social care, but only to return clients. This means that anyone for whom I have provided prenatal and birth care in the past can return to care with Hearts and Hands, but we will not be taking any new families into care. This will create wind-down of the practice so I can take stock and explore what next steps I can take as a midwife and birth advocate.

As many of you know, I have had the privilege of working with Theresa Small, CNM, since October 2016. Theresa has attended many births by my side in addition to her own 15+ year career in support of women and birth. While a dream practice would be the two of us flying about in our SUVs catching babies one stop at a time, Theresa has offered to help step in to share the care at Hearts and Hands while I explore other work in the greater Monadnock Region and she keeps up her work and advocacy for midwifery at St Joe’s. Hearts and Hands will become a collaborative of providers sharing care responsibilities using the model I have set up over these years. We will still attend visits for care (including pregnancy related and well women’s health, annual exams, birth control, etc) at the Peterborough office, and share the on call schedule for births.

This has not come as an easy decision for me, but I feel a shift in my ideas of work life balance that I need to respect and explore. As I began to recognize this shift in my heart, and feel all the related feelings, the thing that kept coming up for me over and over is that, no matter what version of work I choose next, I will always be a midwife, I will always be with women.

I am writing this email to you all since word of mouth has been my greatest referral base. I will update my website etc, but also need help passing on the word that Hearts and Hands is taking a break on growth and not scheduling birth consults with new families at this time. Women still have choices here in southern New Hampshire, and I trust they will find those choices and be part of the communities that feel like the best fit for them for the years to come.

I will share an update on my next steps as space in my life opens up with fewer births at Hearts and Hands. Maybe I will write that book about using a Cooperative Family Model. Maybe I will find a hospital position where I can support and serve women with compassionate pregnancy and birth care – after all, so many “midwifey” practices are now accepted as standard of care (support for vaginal births, delayed cord clamping, skin to skin, quiet calm births, shared decision-making), maybe I will fit right in. Who knows what the future holds?


Whatever these next steps will be, I am so grateful to everyone in the extended Hearts and Hands family for all we have shared over these amazing years. Thank you for being a part of this special community and for inviting me to be with you and your growing families along the way.