Is a Midwife the Right Choice for Me?
When many women think of having a baby, they never even consider a midwife or a birthing center. Most births in the United States happen in hospitals under the supervision of an OBGYN and slew of nurses. We’ve all seen the TV shows with the doctor covered head-to-toe in scrubs and a woman with legs in stirrups while a team of nurses hang around yelling "push, push!". Many women don’t even realize that they have an alternative to this scenario, which is really too bad! What if you want to have your baby in a more natural setting, away from bleeping machines and florescent lights? Or, what if you even want to have your baby at home? Thanks to a growing number of midwives, those options are both possibilities! But how do you know if a midwife is right for you?
Midwives-The Best Option for an Uncomplicated Pregnancy
Most midwives will screen you as a patient before they ever accept you. That’s because midwives, while skilled at assisting women in giving birth, are not doctors. If you have any complications during your pregnancy, your midwife will likely refer you to an OBGYN for more intensive care. Some of the conditions that preclude care by a midwife include:
2. Gestational Diabetes
3. Labor before 37 weeks
4. Labor after 42 weeks
5. Prolapsed umbilical cord
6. Fetal distress
7. Meconium in amniotic fluid (after water breaks)
8. Breech baby
These are all medical conditions that require close monitoring and care to ensure the best health of mother and child. However, the vast majority of women have uncomplicated pregnancies and deliveries and qualify for midwife care.
But Is a Midwife Right for Me?
Well, you’re going to have to ask yourself what kind of care you want during your pregnancy, and what kind of delivery you want. The first and foremost concern, for most mothers at least, is the lack of narcotic pain relief and epidurals. Birthing centers and home births do not feature boost of Fentanol with an epidural chaser. Instead, women rely on alternate means of pain management such as massage, self-hypnosis, and water therapy. If you desperately want narcotic pain relief or an epidural than a midwife is probably not the right choice for you. In exchange for losing the drugs though, you get a lot more freedom during labor and delivery. Unless you test Group-B Strep positive then you likely won’t have to have an IV, you won’t be constantly connected to fetal monitors, and the midwife will probably let you move wherever you want and be in whatever position you want during labor and delivery. The bath is also a great option in most birthing centers, and many midwives are thrilled to assist in water births. In general, most regular appointments with your midwife will feel more like friendly conversations about you and your baby, and midwives also tend to schedule longer blocks of time for their patients. Some even make house calls!
Another benefit of choosing a midwife is undeniably the cost. While a hospital birth alone can cost upwards of $20,000.00 (for a vaginal birth with minimal complications), a midwife will cost about a quarter of this for the entire pre-natal care and delivery. Imagine how much money we could save in the healthcare system if more women chose midwives!
An Inside Look at Midwifery, I Really Enjoyed This!
But, What if Something Bad Happens?
Having a baby with a midwife is not like giving birth in a barn. Midwives have medical training and know how to act, and quickly, in the unlikely event something goes wrong. Midwives stash or carry all sorts of medical equipment including oxygen for mom and baby, drugs to reduce postpartum bleeding, sterile instruments for cord cutting and clamping, IV fluids for mom and antibiotics if needed.
Types of Midwives
In general there are three types of midwives, lay midwives, Licensed Midwives, and Certified Nurse Midwives. Certified Nurse Midwives have both a nursing degree and a license as a midwife, and most of them work in hospitals. Licensed Midwives have a license from the state to practice as a midwife and meet certain guidelines to do so. Currently 24 states provide midwife licensing. Finally, lay midwives are women who have entered the profession through self-study, apprenticeship or some other informal means.
Helpful Links and Midwife Registries
- Midwives Alliance of North America
Midwives Alliance of North America (MANA) is an organization of midwives and midwifery advocates.
- The North American Registry of Midwives
The North American Registry of Midwives (NARM) is the certifying organization for midwives that recognizes multiple routes of entry into midwifery and includes verification of knowledge and skills and the successful completion of both a Written Exami
My Experience with a Midwife
Of course, why would I go on about midwives unless I enjoyed their services myself? About halfway through my first pregnancy, I decided to switch from an OBGYN to a midwife. I did so for many reasons, primarily of which was that I wanted to stay the heck away from the hospital during labor and delivery. I HATE needles, I hate monitors, I hate florescent lights and stirrups and shiny tiled floors. Don’t even get me started on the antiseptic smell. I knew a midwife would be a better choice for me too because I wanted to avoid narcotics and an epidural.
My midwife, Laurie, is a gentle soul with a soft voice. When I toured the birthing center the homey suite with a gigantic jetted tub and shower looked to me like the perfect place to give birth! For the next several months I grew very round and very excited to have my baby in such a wonderful place. And then... I just kept on being pregnant. Week after week my little bear stayed put, until finally, at 42 weeks, my midwife threw in the towel. Where did I end up of course? Right back in the hospital where I didn’t want to be! I was tethered to an IV and two belly monitors, and I couldn’t roll over without having those things adjusted. The labor inducing drugs made my contractions really strong and I caved after having to lay flat on my back for 15 hours and got an epidural. Though the doctors and nurses were unbelievably sweet and competent, you bet your sweet bippy I’m going back to the birthing center for round two, hopefully with a baby who comes out on his own this time!
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