Follow Arleen’s journey through a high‑risk pregnancy as she finds support, respect, and a natural birth experience with MetroHealth’s midwifery and doula teams.
Published March 7, 2026
A Safe and Natural Birth Plan at MetroHealth
Arleen Crider uses the word “traumatic” to describe the experience of the medical care she received during her first pregnancy, in 2004. Not because of the outcome (she gave birth to a healthy baby in December 2004), but because of what she later said was the loss of agency over her body.
At the time, Arleen was being treated at MetroHealth for a blood clot in her leg that had gone undetected at another hospital. During one of her follow-up visits to MetroHealth, a blood test confirmed she was 11 weeks pregnant.
Arleen’s doctors switched her from oral to injectable blood thinners that were safer for her to use during pregnancy. The pregnancy was considered high risk. That meant more prenatal visits and being connected to an internal fetal monitor during labor.
Doctors told her she would need to be on blood thinners for the rest of her life. But when it was time to refill her prescription six weeks later, she skipped it. Instead, she kept a close eye on any signs – achiness and pain – that might signal a clot. She stayed active and hydrated, modified her diet, and adopted a plant-based anti-inflammatory supplement routine.
Arleen stayed off anticoagulants for the next 21 years. In that time, she forged a career in nursing as a Licensed Practical Nurse with expertise in nursing informatics, holistic nursing and complementary therapies.
Because of her health history, Arleen vowed that she would never have another child.
A Change of Plans
She changed her mind when, at age 39, she found out she was pregnant. Aware of the challenges facing maternal and fetal health in the United States – especially the disproportionally high infant and maternal mortality rate for Black women – Arleen contemplated going outside the country.
Instead, she searched for a place where she could have her pregnancy, labor and delivery on her own terms, with as little intervention as possible.
That search led Arleen back to MetroHealth and its Midwifery Program.
Arleen was 26 weeks pregnant when, in March 2025, she met Katie Lamb, APRN-CNM. A midwife for 20 years, Lamb joined MetroHealth’s Midwifery Program in October 2024.
The two women reviewed Arleen’s medical history. Her previous treatment for the blood clot made her pregnancy high risk. Lamb needed to consult with her maternal-fetal medicine (MFM) colleagues, experts in handling high-risk pregnancies.
Arleen then started working with Birthing Beautiful Communities, a community-based doula program dedicated to reducing the infant and maternal mortality rate in Cleveland’s Black population.
Doula Tar’Ra Troutman helped Arleen craft a birthing plan. It incorporated her nature-based and spiritual-based ideologies while carefully considering her high-risk situation. Troutman also accompanied Arleen on several of her prenatal visits.
Honoring Her Choice
Mae-Lan Winchester, MD, an OB-GYN and MFM specialist, joined Arleen’s care team. Concerned about Arleen’s history of blood clots and advanced maternal age (39), Dr. Winchester recommended anticoagulants. Arleen declined. She was living a clot-free lifestyle and took natural supplements to prevent blood clots.
“It’s possible that one could have developed, but I’ve never needed to come in for treatment,” she said.
With that in mind – even with anticoagulants being the standard of care – the MFM team honored Arleen’s choice. Due to her age, Arleen agreed to extra ultrasounds to closely monitor the baby’s growth. She was relieved to find that her new MetroHealth care team respected her birthing plan.
After touring MetroHealth’s Birthing Center a few weeks later, her excitement about delivering there grew.
A Successful Delivery
Arleen’s 39-week visit on June 20 was with Amy Lowell, APRN-CNM, who launched MetroHealth’s Midwifery Program 12 months earlier.
Lowell broached the topic of scheduling a labor induction. Even though it ran counter to her birthing plan, Arleen relented and chose July 1 as the date. Hours later, she was in the beginning stages of labor.
After laboring at home the next morning, Arleen arrived at MetroHealth Medical Center around 2:30 p.m., already 8 cm dilated.
Arleen settled into a birthing room. She began to create a welcoming environment for her baby. Her doula brought tools, including tuning forks for sound baths, and a cooler to store the placenta.
“All of a sudden, I looked up and there were tons of other people in the room,” she said of her care team, Lowell among them. On call that day, she answered a page to come to Arleen’s room.
“They wanted to witness an amazing birth,” Arleen said.
The mood remained quiet and calm as Arleen incorporated hypnobirthing – a mind-body holistic approach to laboring that focuses on breathing technique and mindfulness practices – into her labor.
As labor progressed, Arleen shifted to her hands and knees. After a practice push, she took two more pushes. Her baby – 6 lb., 11 oz and 19 inches long – arrived at 5:16 p.m.
Healthy Mom, Healthy Baby
Afterward, Dr. Lowell and Dr. Lee made sure Arleen didn’t begin bleeding once the placenta was delivered. In the end, everyone got what they wanted – healthy mom, healthy baby.
“They acted immediately to take care of me,” Arleen said. “I was relieved to be able to trust completely in my care team in the same way they trusted me to make the right decisions for myself.”
“There was a lot of transparency,” Dr. Winchester said. “Knowing what Arleen’s end goal was and how she wanted the birth to go, we had a clear path to what she wanted.”
Lowell and her team of four midwives balance the fine line of being mindful of recommendations for high-risk pregnancies and giving women as much control as it is to safely do so. What is most important, she says, is that the patient gets the right care.
Since then, Arleen and baby Arlo have kept up with their schedule of pediatrician visits. At his six-month check-up, after months of slow weight gain, baby Arlo weighed 14 lbs., 11 oz and was 26 inches long. Pediatrician Lynn Milliner, MD, was very pleased with his progress.
“It was really important for me to have my nature-based pregnancy, labor and delivery on record and documented,” Arleen said. “I chose to do that by showing up as an active participant on the interdisciplinary team of professionals taking care of me.”
“At a time when the validity of nursing professionalism is being brought into question, I’m grateful to be able to take what I’ve learned throughout my journey and give it back to other moms and nurses in my community.”
For more information, visit Pregnancy Care or call: 216-778-4444.
A Pre-Birth Pediatric Virtual Visit offers the opportunity to connect directly with a pediatrician before the birth of your baby. Call 216-778-1010 to request an appointment.
