BlogHer - There's more to birth than doctors - Comments

I had my first two children

Deaf Mom — Thu, 03 Apr 2008 07:33:31 -0500

I had my first two children via cesarean and I spent some time looking for a midwife to attend a HBAC (Homebirth after cesarean) with my third. I received a referral from a well-known VBAC author but surprisingly, I ended up being induced with Cytotec at home by the midwife she recommended (and another midwife who attended also). It took me three long years to deal with that anger and confront the midwifes.

I was really fortunate to be a doula at a friend's home waterbirth (she also had two cesareans)-- which turned out to be an incredible healing process.

Karen "Life is too short to pout all the time." A Deaf Mom Shares Her World Hands & Voices

Much prefer a midwife

religiarchy — Wed, 02 Apr 2008 19:01:59 -0500

Great post.

When I had my second baby while living in Norway, I never once saw a doctor. Prenatal to being discharged after the birth, never saw one.

It's the way they do it there. They have half the infant mortality rate of the US, and even less cost per capita for healthcare expeditures.

I'd absolutely use a midwife again and regret having the intrusive, made-for-doctor-convenience birth experience I had the first time!

Kim Mance
Religiarchy.com

religiosity+patriarchy+oligarchy=religiarchy

I had a very satisfying

LizaWasHere — Wed, 02 Apr 2008 16:08:15 -0500

I had a very satisfying experience with my first pregnancy, going to a practice that was jointly midwives and OBs. They didn't do home births, but I still got the highly personalized care of MWs for all of my prenatal visits.

In the end, 36 hours after my water broke, I ended up having a c/s. But it was attended by both one of my MWs and one of the OBs in the practice.

Liza
Founder & Coordinator, LesbianFamily.org
Personal Blog, LizaWasHere

Amy, I Added Business of Being Born to my Netflix Queue...

Vered — Wed, 02 Apr 2008 15:18:49 -0500

It does look interesting. It is probably too late for me - I had both my daughters at the hospital, with pitocin and epidural. Both births were fast and easy so I can't say I regret anything. And no more kids are planned in this family. :)

But the subject is interesting, and the movie trailer was fascinating.

Will you do the explaining when my grumpy husband wonders how come I ordered "THAT" on Netflix instead of the usual male-acceptable selection? :)

Vered DeLeeuw
www.momgrind.com

midwives were the best choice for me

laurie — Wed, 02 Apr 2008 15:12:36 -0500

I planned two home births had to move to the hospital both times. The transfer to the hospital went smoothly and my midwives worked really well with the hospital doctors.

Of equal importance the care I received from my midwives from the moment I was pregnant until 6 weeks post-partum was thorough and caring. My appointments lasted as long as I needed them to and my questions were answered in detail. My midwife also saw me on very short notice when I had a bout of ante-natal depression (at her home, in the evening) and referred me to a massage therapist and a family therapist (she also got me to start taking short walks every day). It all helped so much.

Can anyone say that they got this kind of care from their obgyn?

laurie
www.notjustaboutcancer.blogspot.com

Midwives and home birth

Liz Henry — Wed, 02 Apr 2008 11:43:03 -0500

I switched from an OB to a midwife halfway through my pregnancy, after talking to some women who did home birth & after reading Henci Goer's book "A Thinking Woman's Guide to a Better Birth". I think reading it would open anyone's eyes to the way that medical intervention causes a cascade of more medical interventions that then become "necessary".

My own labor went quite well and I was very happy with home birth. There is nothing like being comfortable in your own home, being able to walk around and live normally, having privacy, and I have to say, avoiding the dehumanizing experience hospitals impose. I was not hooked up to monitors with my mobility limited that way. My dilation wasn't micro-analyzed or tracked. During pushing & delivery stage I had oxygen to help me out. Then... there I was at home with my perfectly healthy baby. I got up an hour later and ate all the leftover Thai food in the fridge.

In a hospital, who knows what would have happened. Fetal monitor, wouldn't have been able to get up from bed, stressed and harrassed and on display, having to give birth on my back (silliest position for it ever, other than standing on one's head). It loads the deck against an uncomplicated delivery.

It was when I asked my OB what her rate of cesarians was, and she tried to evade the question, and then it turned out to be something like 35%, and she could not explain why, that I decided to avoid a hospital birth if I possibly could.

-----------------

Liz Henry

lizzard@bookmaniac.net

Badgermama - personal & mommyblog

http://liz-henry.blogspot.com - Poetics, feminism, & tech

BOBB

Amy Gates — Wed, 02 Apr 2008 11:02:11 -0500

Vered,

I think you'd find "The Business of Being Born" really interesting. Hope you'll consider seeing it. :)

Amy
Crunchy Domestic Goddess
BlogHers Act contributing editor

Great question

Amy Gates — Wed, 02 Apr 2008 10:58:41 -0500

This is a great question, Vered, and one of the misconceptions that I think many women have about midwives.

I've written a few posts already about midwives, home birth, hospital birth, etc., some of which include statistics.

The Big Push for Midwives: http://www.blogher.com/big-push-midwives

Midwives, home birth proven safe, contrary to ACOG's false assertion:
http://www.blogher.com/midwives-home-birth-proven-safe-contrary-acogs-false-assertion

US Mothers are Dying. Why don't we know that?
http://crunchydomesticgoddess.com/2008/03/18/us-mothers-are-dying-why-dont-we-know-that/

And yes, high risk women should definitely have a doctor and go to the hospital. But women who are in are in low-risk pregnancies can have a safe birth at a birthing center or at home with a midwife.

"Planned home birth for low risk women in North America using certified professional midwives was associated with lower rates of medical intervention but similar intrapartum and neonatal mortality to that of low risk hospital births in the United States."
http://www.bmj.com/cgi/content/full/330/7505/1416?ehom

Amy
Crunchy Domestic Goddess
BlogHers Act contributing editor

Thank you for your comment,

Amy Gates — Wed, 02 Apr 2008 10:47:08 -0500

Thank you for your comment, Lilmommy. I've read about the Bradley Method and am glad that you had satisfying births with it.

Hiring a doula is a great idea. :) I wrote about the benefits of doulas in a previous BlogHer post here: http://www.blogher.com/birth-doulas-make-difference

There are definitely supportive, wonderful doctors out there, but I wanted to make the point that doctors aren't the only option a woman has.

Amy
Crunchy Domestic Goddess
BlogHers Act contributing editor

I always assumed that OBs lowered mortality rates

Vered — Wed, 02 Apr 2008 09:13:27 -0500

"Throughout most of the world, and most of history, women have labored and birthed with midwives".

True, but I always assumed that throughout most of the world and most of history, women and babies died during labor and birth in much higher rates than since OBs entered the profession.

You say that a home birth with a midwife is usually just as safe as a hospital birth (I assume you mean that women with high-risk pregnancies should go to the hospital to give birth). This is encouraging and interesting. Do you happen to have statistics?

Vered DeLeeuw
www.momgrind.com

Midwives and Dr

lilmommythatcould — Wed, 02 Apr 2008 07:34:28 -0500

With both of my children my Drs. were very supportive, and I had two successful natrual births. check into The Bradley Method this is the method I used and it has a very high success rate. Even if you are comfortable with your Dr. or insurance will not allow midwife, some won't, check into a doula- who is more there for moms comfort while she labors.

There's more to birth than doctors

Amy Gates — Wed, 02 Apr 2008 00:07:04 -0500

It seems odd to me now that there ever was a time in my life when I didn't have much knowledge about birth or birth care providers, but when I became pregnant with my first child that's exactly where I was at. I knew that I wanted to try for a natural birth, but I didn't know much more beyond that. And so I found myself an obstetrician since that was what "everybody" I knew did. I didn't have any local mommy friends at the time to offer up their recommendations, so I made my decision on an OB based on the experience a coworker and his wife had. He told me that their OB had let him catch the baby, and since that was something my husband Jody and I had talked about wanting to do and seemed pretty open-minded to me, I figured we would give her a try.

While I don't recall interviewing this obstetrician per se, she seemed nice enough - though in retrospect her bedside manner was seriously lacking - and she seemed OK with our plans to have a Hypnobirth. In fact, with a few minor exceptions, she agreed to all of our desires on our birth plan and we figured she'd be a good fit for us. After all, she was saying all the right things, so we had no reason to doubt her. Little did I know that when it came time for me to give birth, all bets would be off.

When my time to give birth arrived, my OB's true colors came shining through and, when reflecting on the experience several months afterward, I felt violated, disrespected, upset, duped and resentful. Yes, I had given birth to a healthy baby which is ultimately what every woman hopes for, but I believe the process and birth experience matters too and mine was seriously lacking. I was left wondering, could there have been another way? A better way?

Back up a few months to the Hypnobirthing childbirth preparation classes my husband and I attended, where I learned of a couple expectant mothers who had plans to have a midwife at their birth rather than an OB. At the time I didn't know much about midwives - who they were, what they did - and was happy enough with my OB, so I didn't bother finding out more information. For example, I had no idea that there was a difference between the type of care a midwife provides and that of an OB. I didn't know what kind of training or schooling a midwife might have. I didn't know that there were different types of midwives. I didn't know if midwives attended births in hospitals and/or birthing centers or just at home. I really didn't have a clue and I have a feeling that I was certainly not alone in that regard.

Here in the United States, giving birth in a hospital with a doctor is the norm. Yet in the majority of cases a midwife-attended birth in a birthing center or at home is just as safe. However, many women have never heard of midwives or what they have heard is often full of misconceptions.

It wasn't until I had given birth to my daughter, officially joined the "mommy club," and made some mommy friends of my own that I began to hear more and more about midwives and learn about the role that they play in helping women prenatally, during birth and postnatal.

I was fortunate in that one of my best friends ended up deciding on a midwife-attended home birth for her second child. She had such a wonderful experience that when I was pregnant with my second child, I decided to leave my new OB (even though she was a far cry better than my previous one) and have a midwife-attended home birth as well.

Thankfully, the word is slowly getting out and more people are learning about the value and importance of midwives thanks to Ricki Lake's documentary "The Business of Being Born," which I highly recommend all women and their partners see. It's available on Netflix.

Here's a bit more about midwives to help clear up any misconceptions.

What is the role of a midwife?
According to Midwives Alliance of North America, "Midwives are trained to provide comprehensive prenatal care and education, guide labor and birth, address complications, and care for newborns." You can read about the different variations of midwives at MANA.

Why choose a midwife?
"Throughout most of the world, and most of history, women have labored and birthed with midwives. It is only in the last few decades that it has become common in the U.S. to birth in a hospital setting with a doctor. Being pregnant and giving birth are normal life processes for which a woman’s body is well-designed. Midwifery care has been proven to be a safe and nurturing alternative to physician-attended hospital birth." - MANA

How does the care of a midwife differ from that of a doctor?
Midwives practice using the Midwifery Model of Care which is based on the fact that pregnancy and birth are normal life processes. This is a fundamentally different approach to pregnancy and childbirth and is in stark contrast to the standard Medical Model of Care.

The Midwives Model of Care includes:

monitoring the physical, psychological and social well-being of the mother throughout the childbearing cycle
providing the mother with individualized education, counseling, and prenatal care, continuous hands-on assistance during labor and delivery, and postpartum support
minimizing technological interventions and;
identifying and referring women who require obstetrical attention

The application of this model has been proven to reduce to incidence of birth injury, trauma, and cesarean section.

The women I know who have experienced both the medical model of care and the midwifery model of care prefer the midwifery model. Personally, when I saw my midwife for my prenatal care I felt like a real person, rather than just a number (which is how I felt at one OB's practice, that I left I might add). I loved that my prenatal appointments with my midwife lasted an hour at a time and never felt rushed. I loved that I formed a bond with my midwife and that she knew me (and my daughter who accompanied me to all of my prenatal appointments) before I gave birth.

MamaAudrey at Deconstructing Motherhood remarks about her decision to go with a midwife and birthing center instead of a doctor and hospital:

I felt like I was in control of my pregnancy at the birth center and that my voice was important. At my doctor, I felt like just another number with a voice that needed to be silenced when heard. Thus began my prenatal care with nurses and midwives.

Mary at My First Pregnancy Ever agrees that there is a big difference between the two models of care.

And I think I can now rant about why I love my MW better than my doctor already. I went to my doctor on the 7th and saw the MW on the 9th. Both were very nice to me but you can so see the difference in their scope of practice.

She goes on to compare and contrast the two visits.

Ultimately the decision on who to have attend her birth is up to the mother, but it is my hope that women might learn from my mistakes and do their research ahead of time. Interview more than one doctor and/or midwife until you find one that is right for you. Knowledge is power.

Blogs by Midwives:
Close to the Root by Kneelingwoman
Navelgazing Midwife
The Journey of an Apprentice Midwife
Homebirth: Midwifery Mutiny in South Australia
Midwife: Sage Femme, Hebamme, Comadrona, Partera
Meconium Happens

Contributing editor Amy Gates also writes about attachment parenting, activism, green living and photography at Crunchy Domestic Goddess.