I moved from an OB to a midwife and it was the best decision I ever made.
If you’d asked me fifteen years ago if I would consider going to a midwife I would have laughed in your face. I knew a girl growing up who wanted to be a direct-entry midwife and the idea of her attending my birth was enough to put me off midwives for a good long while. )
My first baby was born early, two days before Christmas. My water had broken at 2am, we arrived at the hospital at 3am and I had an epidural. By 7am I was pushing and he was born at 9:30am. But there were things about the whole experience that bothered me. I didn’t like that my OB blew through appointments; it wasn’t unusual for him to spend a total of five minutes for my checkup. I felt like I had to write down a list of questions in advance because if I didn’t, he’d leave before I could formulate a thought. The birth itself was modern routine: epidural, pitocin, screwing a monitor into my baby’s head while he was still inside me. It was too much. I didn’t like the epidural, I couldn’t feel what I was doing. The doctor announced after two hours of pushing that I could have my choice: forceps or a c-section. I was mad. I had more in me. After the birth (and after I was given an episiotomy I didn’t want,) I was left alone in the room.
Even after a reasonably good birth experience with my son, I decided that I would change the things I didn't like about it by changing my doctor. In fact, I gave up my doctor. I decided that a midwife might be more my style.
I was also aware of the history of midwives; I understood how those women had been pushed out of the delivery rooms in favor of doctors with medical training--essentially medicalizing the birth process. Putting women under general anesthesia (like Erica’s grandmother,) and then feeding their babies evaporated milk and corn syrup all in the name of modern progress. Modern OBs have come a long way, but they are still incredibly busy and some are incredibly unwilling to wait for the process--favoring control and routine over specialized needs.
I am very aware that women used to die, like, a whole lot more than they do now. I also know that c-section rates approaching 30% is absolutely ridiculous. When my OB threatened me with a c-section after two hours of pushing, I knew our relationship was over. I could have gone much longer, but he was eager to make his appointments.
Our confidence in the ability of our bodies to do as they were designed has been undermined. I wanted something different. I wanted to be heard.
I decided the least I could do was to meet the midwives to see more of what they were all about. I went to the website of a clinic I'd heard about and actually found a picture of a friend of mine who is now a practicing midwife.
What I learned at my midwife appointment:
1. My midwife is an R.N., who has an additional medical masters degree in midwifery, making her a nurse practitioner, is licensed by the State and board certified.
2. Midwives can deliver in the hospital and some also have OBs attached to their practices for high risk cases. This was important to me. I am not into home birthing, you can have one if you want one, but I don’t want one.
3. While my state's average c-section rates are nearly 25%, my midwives are at 8%. EIGHT PERCENT. Even the OBs attached the the midwife practice, they get the higher risk cases, are only at 12%. This is a significant difference, and a statistic that you have a right to know from your medical provider. Some states have c-section rates of 40%. That's medical malpractice.
4. Whatever the mom wants, goes. Epidural, sure. No medication? Sure. Change your mind in the middle and need something, anything? OK. Move around, take a walk, hop in the tub, why not?
5. No routine anything: significantly lower rates of episiotomies with none being done just because, less 'tearing', less internal monitoring by route (that thing were they literally screw a cord into your baby's head while he's still inside you).
6. How about a health care practitioner who LISTENS to you. I spent half an hour talking to my midwife in addition to my physical exam. My OB had, at most, ten minutes to spend for everything. I have a family history of gestational diabetes. Although my OB knew this, he didn't test us early to catch a problem. My midwife had three tests scheduled to monitor me along the way.
7. Less scaring you, more empowering you. When I communicated my concern about weight gain, because my OB had scared me so much, the midwife said, “Well, the body has a remarkable way of taking care of that.” I gained 20 pounds less with my midwife baby than with my OB baby.
8. The midwife told me that I can be the first to hold the baby and I can hold it for as long as I want. "You did all the work, you should be able to hold it as soon as possible." Sounds like a simple idea right? Well, when my first baby was born they took him away, cleaned him, suctioned him, wrapped him up, showed him to me, and then removed him from the room. Everyone else followed. I was left alone. Totally and completely alone. "I guess I'll take a nap,"I thought, and promptly did. I didn't get to even hold the kid for probably 45 minutes. I didn't realize how much that bugged me until she mentioned their Mom First philosophy.
9. A belief that birth is a natural process that we can make easier and less painful by honoring the process. Moving, applying pressure, using gravity, all ways that the midwives used to make my labors more comfortable and productive.
10. Fewer invasive techniques. I was far less likely to undergo the “cascade of interventions” that so often leads to c-sections: induction, pitocin, slowing of labor, baby distress, panic, cut you open. And if you’re trying for a VBAC, sometimes a midwife practice are the only providers who will help you.
11. Inductions are risky, get a provider who doesn't take them lightly. My midwives didn’t recommend inducing for no reason. Even after I was 10 days late with my second they weren’t in a panic. A due date is an approximation, not a deadline. Once I was admitted to the hospital, that baby arrived in 45 minutes.
12. A better experience for me and my baby. I felt like moving from an OB to a midwife was simply an overall better experience for us. I was more connected to the process and had far more enjoyable labors.
I urge my friends and family to see a midwife first. It's an option you should look into because you have a say in how your baby gets here. Maybe you’ve got a great OB, maybe they are the best ever, but as for me and my babies, I’ll take a midwife.
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