Tonya Diggins, nurse midwife for Perham Health

Tonya Diggins, nurse midwife for Perham Health

“When developing my midwifery practice in Perham, it was important to me to be able to provide water labor and water births,” said Tonya Diggins, nurse midwife for Perham Health. “It has been an amazing opportunity for all patients to have water labor or water births as an option in their childbirth  experience!”

Diggins joined the Perham Health medical team in November of 2017, after moving from Montevideo, Minn. Along with fellow providers, Dr. Ilene Reed and Dr. Kailey Witt, provide water births as another option for pregnant patients.

Each birthing suite at Perham Health has its own spacious birth tub, which is wider than a standard bath, so that a laboring women can move easily while keeping her abdomen immersed in the warm water. The tub is situated with one short end against the wall, so providers, nurses, and labor coaches can be as close as needed. Women may labor or give birth in the tubs if their pregnancy is uncomplicated and at term.

Each birthing suite at Perham Health has its own spacious birth tub, which is wider than a standard bath, so that a laboring women can move easily while keeping her abdomen immersed in the warm water.“Water labor involves immersion in warm water in a birthing tub during established labor,” Diggins explained. “The benefits of water labor and water births include a reduced perception of pain, freedom of movement, decreased energy expenditure, providing the mother a sense of comfort and calm, and decreased interventions.”

According to Diggins, once the baby is born, the provider, mother or birth partner can help to guide the baby gently, face first to the water’s surface. The feeling of air on the baby’s skin and change in temperature then triggers baby’s breathing reflex.

“Water labor and water birth improve physical and psychological outcomes for the childbearing woman, as well as empowers women and facilitates holistic, individualized, woman-centered care, Diggins adds. “Water labor and birth promotes increased satisfaction with the whole childbirth experience.” Since beginning to offer water births in 2018, Diggins has had patients who transferred to Perham Health because they wanted the option of having a water birth delivery. These have included several patients from her former practice who decided to make the two hour plus trip to Perham to have Diggins deliver their babies.


Austen, Trisha and Cole’s fifth child, born in October of 2018, was the first water birth at Perham Health.  The family, which lives near Granite Falls, Minn., decided on the destination delivery to have Diggins deliver baby Austen at Perham Health and for the option of a water birth.

Trisha had delivered two of her four children with Diggins in Montevideo, after seeking a provider who was in-tune with birth being a natural, mom-driven experience. “From the second I met Tonya, I knew that she was who I wanted to be with for the rest of my pregnancies and deliveries.” Trisha’s prenatal care was coordinated between Diggins at Perham Health and another midwife in Montevideo.

“I wanted a water birth so bad,” Trisha said, but that wasn’t an option in Montevideo. “That was one of the big things that Tonya made sure to point out when I came up to Perham the first time was, ‘Look at these tubs!’”

Cole had been somewhat hesitant on the destination delivery plan, Trisha recalled, especially with the three-hour drive it involved. His mindset changed when he went along to the 36-week checkup in Perham with Diggins. On the drive home from Perham that night, he was like, ‘Okay, we’re going to make this happen. We’re going to get you to Perham.’”

Trisha and Cole returned to Perham when she started having contractions on Wednesday of week 37. Trisha spent much of Thursday reading and walking loops around the hospital, in hopes that the activity would help her labor advance without medication.

Trisha continued to read while laboring in the birthing tub, changing position or getting out of the water to move around every hour or so. “I was in and out of the tub for a lot of the labor – so that I knew how it helped with pain relief and relaxation for the early stages of the labor,” she explained.

Tonya with Trisha and the three girls that she delivered (Austen, Aubrey, and Aurora); when the family came to Perham for one of Austen’s early well checks. Photo provided by Trisha Massmann.

After time in the tub, Diggins suggested moving to the bed to use a birthing ball for a while. After using the ball, conditions were right that she felt it was a good time to break Trisha’s water. “That brought on really, really strong contractions,” Trisha said, and she felt like she needed to get back into the birthing tub soon.

It took a bit of experimenting to find a comfortable position, but once she did, Trisha was ready to push. “I remember that I could pause and wait for the each contraction. It wasn’t such intense pressure that I felt like I needed to just push-push-push which is what I had done with my other labors.”

Once baby Austen was born, Trisha held her while Cole cut the cord, and they moved out of the tub.

“I was so impressed with how much the staff at Perham supports the golden hour after delivery,” Trisha said of the practice to give mothers and their newborns a chance at uninterrupted time for at least an hour immediately after birth for skin-to-skin contact, mother and baby bonding, and successful breastfeeding.

“I am just so thankful that between Montevideo and Perham that we were able to coordinate that,” Trisha said of her destination delivery. “Because I couldn’t have asked for a better labor and delivery experience than what I had.


Emmy and Jake, who live near Clarkfield, Minn., also decided to follow Diggins to Perham Health for a destination delivery water birth. Their fifth child, Etta, was born in Perham in September of 2019.

“We met Tonya for the first time in 2013, when we were expecting our second child,” Emmy said. “We definitely knew very early on that Tonya was the type of provider we were looking for.”

Emmy was interested in learning more when Diggins mentioned water birth in Perham as an option for delivering Etta.

“We have never had that option during any previous deliveries,” Emmy said. “I have spent time laboring in the tub previously, but I liked the idea of being able to stay submerged in the soothing water during the actual delivery.”

Their family traveled to Perham on a Thursday and settled in at a hospital-owned home for a night. The next morning, everyone moved to one of Perham Health’s birthing suites.

“We started the induction process, and our daughter Etta was born in the water later that evening,” Emmy explained. “Our two oldest children were able to be there for the birth, and it was a really special night for our family. Knowing that our oldest son loves all things medical, Tonya even allowed him to cut the umbilical cord! We loved our experience with a water birth at Perham Health.”

“She not only has provided our family with excellent medical care, but also has truly nurtured my journey into motherhood,” Emmy said of her experiences with Diggins. “Tonya is incredibly skilled in answering all of our questions while also empowering us to trust our parental instincts.  We feel so grateful that she has delivered three of our babies. It’s a wonderful feeling knowing that your provider will be with you every step of the way during the birthing process.”


“It has been a humbling experience and I feel truly blessed to be able to continue the continuity of care with my former patients and their families,” Diggins said of her destination deliveries. “Perham Health has a positive culture and progressive attitude and aided in the facilitation of water births. It is a team effort from all in Perham to allow this to happen.”