Kathryn Dewar, a midwife and lactation consultant based in Kingfield, carefully checks a newborn’s vitals during a homebirth. Dewar shares her journey, reflecting on the challenges and rewards of midwifery, as she works to empower families and advance maternal care in the western mountains region. Submitted photo

KINGFIELD — In the heart of Maine’s western mountains, homebirths are more than a choice, they’re a deeply personal and intimate way to welcome new life. Kathryn Dewar, a Licensed Midwife [LM], Certified Professional Midwife [CPM], and International Board Certified Lactation Consultant [IBCLC], is dedicated to making this option accessible through Moonstone Sunrise Midwifery and Lactation in Kingfield.

Home births have been growing more popular across Maine, especially since the pandemic. In 2021, 323 people gave birth at home in Maine, an increase from the 2017 number of 227 home births, reflecting a growing embrace of this timeless tradition.

Dewar’s journey into midwifery began in Vermont, where she became licensed in 2019. However, her path to midwifery started years earlier during her own pregnancies. “I traveled 45 minutes for prenatal visits that lasted a total of five or ten minutes,” Dewar said, reflecting on her first pregnancy in rural Maine. “I was asked if I had questions and I did, but I didn’t have the language to ask them. It felt like I didn’t have permission to ask.”

That changed after she moved to Portland, Oregon, during her third trimester. There, at a stand-alone birth center, Dewar experienced a profoundly different approach to care. “My first prenatal appointment lasted over an hour,” she said. “I was asked what I thought about the different newborn procedures. That was a light bulb moment: I can have opinions and questions about the care of me and my baby.”

Those experiences inspired her to become a midwife and later, a lactation consultant. “Midwifery called to me,” Dewar said. “I wanted to provide the care I had been so desperately wanting.”

Postpartum care is where Dewar believes midwifery truly stands out. A typical midwife will see their client six or more times in the first six weeks postpartum, with visits at 24 hours, three days, one week, two weeks, four weeks, six weeks and an optional eight-week visit. “Most of the postpartum visits occur in the client’s home,” Dewar explained. “Both parent and baby receive care, as they are seen as a dyad or unit. As a lactation consultant, I offer extra lactation care visits to my midwifery clients as needed. In general, all lactation visits occur in the home whether or not they were a midwife client.”

While training at Birthingway College of Midwifery, Dewar was also inspired by Ina May Gaskin’s Spiritual Midwifery and the documentary The Business of Being Born. “Ina May shows that pregnancy and birth are largely normal processes that work well when a birthing person feels safe and supported,” she said. “The Business of Being Born revealed the pitfalls of standard maternity care and highlighted the need for more birth options.”

In her practice, Dewar emphasizes the importance of informed choice. “When you are making a decision about your own health care or your baby’s health care, you need to be informed of the risks, benefits and alternatives to each procedure, screening or treatment,” she said. Dewar uses an electronic health record system called Client Care, which allows her to provide informed choice documents with attached resources. Appointments typically last at least an hour, and those involving lactation education can take up to two hours.

Dewar’s midwifery journey led her to Maine, where her practice has steadily grown, but it is not easy to predict. “I had a busy year in 2022 and 2023 was only four births,” she said. “This year, I have been to about 20 births.” Her work includes assisting other midwives, attending births as a doula and providing lactation support.

Living and working in rural areas has presented unique challenges for Dewar. “The challenges revolve around access to referral services like labs or imaging, having a second pair of experienced hands at births and loneliness,” she said. “Most midwives prefer to work in pairs; three midwives at a birth is pure luxury.” Due to Maine’s regulations, having a second licensed midwife at every birth is not required. “Ideally, I would have another licensed CPM at all my primary births, but that’s not always possible,” she added.

Despite these challenges, Dewar appreciates the opportunity to connect with families in meaningful ways. “Home birth offers an opportunity to work closely with families I may not interact with on a regular basis and go down roads, literally and figuratively, I’ve never traveled,” she said.

Lactation consulting has become a cornerstone of Dewar’s care. “The two keys to lactation success are education and support, with support being the most important,” she said. Dewar emphasized that feeding challenges with a first baby often improve with subsequent children. “If you have to mix-feed, it’s not a failure,” she said.

She is also passionate about educating younger generations about midwifery. Dewar has plans for a children’s book: “I have an ABC book in mind, ‘M is for Midwife’, to explain what a midwife does,” she said. Recently, she introduced third graders to her work, teaching them how to identify a baby’s position through palpations. “I don’t want people to have to search for midwifery care due to trauma,” she explained. She is hoping some of the children remember these discussions as they get older.

Dewar acknowledges the significant personal sacrifices midwifery entails, including a period when she went 10 years without a vacation. Despite these demands, she finds the work deeply fulfilling.

Looking ahead, Dewar is focused on improving collaboration among health care providers. Her program, Perinatal Transitions, aims to streamline communication during hospital transfers. “My goal is for people to feel empowered in their birth experience,” she said. Reflecting on her personal journey and the importance of balance, she added, “I find peace among trees and the divine on mountain tops. Radical self-care is imperative for caring for others. When I get home from an all-nighter or long birth, there is a franticness to fulfill all the needs: food, rest, showering, connection with my family and friends and movement. I live close to trails and a river. Beauty abounds.”

For more information about Kathryn Dewar’s work, visit Moonstone Sunrise Midwifery and Lactation, located in Kingfield or online at www.moonstonesunrise.com.