Today we’d like to introduce you to Julie Gorenc.
Hi Julie, so excited to have you on the platform. So before we get into questions about your work-life, maybe you can bring our readers up to speed on your story and how you got to where you are today?
I have been a midwife since 2000. I was an attorney but loved my maternity experience so much that I went back to nursing school and then midwifery school to become a Certified Nurse-Midwife. For many years, I worked for physician-owned and later hospital-owned practices and attended deliveries in the hospital setting.. In 2015, a colleague and I opened our own practice so that we could practice true midwifery care. At that time, it was required to have physician collaboration which we initially had for over a year, and we continued to attend hospital deliveries. Thereafter, our hospital closed its labor unit, we lost our original collaborative physician, we gained and later lost other collaborations because true midwifery care is not supported, and we found ourselves verging on closing our practice. We were able to attend deliveries at the local birth center for a couple of months which opened our eyes to out-of-hospital birth. We knew a homebirth midwife and reached out to her for more information. She was excited to help us make the transition to homebirth, and we have never looked back. At that time it was still required to have a collaboration agreement (this is no longer the case) in order to practice as a Certified Nurse-Midwife. Because I did not have a collaboration agreement, I chose to pursue the Certified Professional Midwife designation. I took and passed the national exam and was able to continue to attend deliveries in the home, which I continue to do to this day.
Recently I wrote a book! The longer I attend deliveries, the more I believe in the normalcy of birth. I wanted to write a handbook of sorts that would help people to see this. The book is titled “Some Babies are Born at Home – A Parent’s Guide to Fearlessly Responding to an Imminent Birth Experience”. The purpose is to impress upon people that birth of a full-term healthy infant is not an emergency! The book is something all pregnant women should have at their bedside and both the mother and father should read well before the due date. There are numerous stories of babies being born in vehicles – which is not safe! This book provides confidence to respond if there is not time to drive to the hospital or for the ambulance to get there, or if your midwife is on the way for a homebirth but misses it! It was beautifully illustrated by one of my client’s who typically illustrates children’s books. Thus it was purposefully created for the family in mind.
Can you talk to us a bit about the challenges and lessons you’ve learned along the way. Looking back would you say it’s been easy or smooth in retrospect?
Smooth – no way!!! Here is a listing of the struggles I have been through in the past 10 years since opening my own practice:
1) Lack of respect and understanding of the midwifery profession – which continues to this day
2) 10 years ago, at the time I was trying to pull away from being owned and managed by physicians, the laws were very restrictive – as a Nurse-Midwife, you were required to have a collaborating physician AND malpractice insurance in the state of Kansas
3) Unless you were in a practice with other physicians who owned and managed you, finding a physician to sign a collaboration agreement was near impossible, for many reasons.
4) Malpractice insurance is expensive – we were even cancelled by a company that was happy to insure us when we delivered in the hospital, but not when they discovered we attended birth at home (the safety of homebirth with EXPERIENCED ATTENDANTS is supported by evidence)
5) Collaboration and changing hospitals:
– our first collaborating physician cancelled when the hospital labor unit closed (after about 1 year)
– our next collaborating physician cancelled most likely after she was pressured by other physicians to do so (after about 1 year)
– while 2 CEO’s of local hospitals wished to have their employed physicians collaborate with us because it would obviously bring business to their labor units, the first group refused and the second group backed us for 1 month before refusing to continue to do so (and not only berated us at their monthly meeting for our non-interventive practice style but also one of them yelled at me in the corridor of the labor unit for preforming intermittent monitoring which he did not agree with; they also forced me to pay nearly $900 to get a DEA number, knowing full-well they were not going to collaborate with us, and I had to sue them in small claims court to get this money back!)
– oh, and all the while, there was a law called “The Independent Practice of Midwifery Act”, which allowed for Nurse-Midwives to practice obstetric care without a collaboration agreement (but NOT gynecology care…) BUT because the regulations had never been devised, the law was never implemented!!!
– finally, while too late for us (because we had already become Certified Professional Midwives) Kansas did away with collaboration agreements for nurse practitioners, including midwives.
– oh, and insurance reimbursement is a whole other story!
– for the first few years we took insurance and we were miserable – they never paid what they should, we spent more time on the phone with them than actually caring for our clients, they would take money back on a whim – we either had to close our practice or go to a cash business
– between losing collaboration, changing hospitals, dropping insurance – we were in a continuous state of building a practice, losing a practice, rebuilding a practice, and losing it
– we went through 4 collaboration agreements and 3 hospitals in 3 years, we dropped insurance, we transitioned to a homebirth practice – all in all I would say it has been challenging!
As you know, we’re big fans of Midwife Partners in Women’s Wellness/Midwife Partners Homebirth. For our readers who might not be as familiar what can you tell them about the brand?
We are 2 Certified Nurse-Midwives and Certified Professional Midwives who attend homebirth. I have been practicing for 25 years and my partner for 20 years, thus we have a combined 45 years of midwifery experience. We began our careers in the hospital setting but have been a homebirth practice now for about 8 years. We typically attend births together.
I am proud that we are non-interventive – that we believe in normal, physiologic birth. I believe that women’s bodies were made to grow and birth their babies. I believe in patience and watchful waiting, while at the same time being alert for indications that all may not be normal. I am respectful and understanding that there may be times when a physician’s skill and a hospital setting may be warranted. But I also believe that for normal, healthy women, attempting to birth their babies at home can provide the most beautiful and memorable birthing experience and that even in the event of a hospital transfer they are more likely to have a vaginal delivery. I believe that fear in obstetrics has hugely contributed to an outrageous cesarean rate of 33% in our country. I believe that homebirth care removes the fear factor and that is why we have such great outcomes.
Our website: midwifepartners.net – gives a very comprehensive overview of us and our practice.
What’s next?
We just moved into a new office space that we are very proud of. When we first opened our practice we leased an office space for one year. We then found a wonderful office that was very homey but after 5 years we decided that due to the changing nature of our business towards homebirth and away from accepting insurance and thus having less clients in both obstetrics and gynecology, we would downsize. We moved into a yoga studio which also housed other women-specific services. But after over 2 years there we were ready to have more space and more of our own brand. Our new office has a reception area, 3 exam rooms, and a bathroom. We are so excited!
Contact Info:
- Email: [email protected]
- Instagram: midwifepartnershomebirth
- Facebook: Midwife Partners in Women’s Wellness
