There's more to birth than doctors

BlogHer Original Post

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.

Related links:
Midwives Alliance of North America
The Big Push for Midwives
Citizens for Midwifery
Midwifery Today
Motherbaby International Film Festival
The Business of Being Born

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.

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