Birth Series - Part 2B; Midwives and Doctors and Doulas, Oh My...Opinion!

You didn't think we would talk about doctors and midwives and doulas and not include my opinion, right?! I want to take a quick minute to continue the discussion about care providers and how to find the one that's right for you.

I had a unique situation where I saw a perinatologist weekly for the last 3 months of my pregnancy as well as continued care with my midwife. I had one foot in both the medical and the natural realm. For me, every time I left the medical office, I was worried or scared or in some cases, insulted. I'd then talk to my midwife and she would make me feel better. For example, when my perinatologist declared that my baby was huge and that I was gaining too much weight (which I WASN'T because 30lbs in 35 weeks is NORMAL!), my midwife told me that some women have big babies and that my body might just grow babies that way. She also didn't weigh me that's the little things, people! A doctor looks at numbers and charts and "normal" growth patterns but every woman and every baby isn't the same. I am not a number on a chart, I am a person. A midwife looks at the woman first and determines actions based on that. There's a trust that women have been birthing babies for thousands of years, who are they to come in and tell them to do it differently?!

Having a midwife is personal; I've cried in front of my midwife, we've talked about my mental and emotional well-being, all without judgement. She listened and reacted with kindness and understanding. I've frantically texted her random concerns and she's always gotten back within a few hours. She became a trusted confidant and member of our growing family. It was all those small, personal touches that made the experience unique. A doctor is not going to normally offer you that environment or that experience. One mother told me that she got so upset that her doctor spent the majority of their appointment time talking about his upcoming vacation, she told him that if he was only going to give her 15 minutes for the appointment then they were going to spend it talking about her.

An OB/GYN is a surgeon first - they're trained for high-risk pregnancies where surgery is most likely an outcome. During their residency, an OB/GYN must attend 200 spontaneous vaginal births but they also need to attend 145 cesarean sections as well as SEVENTY hysterectomies. Let's do some math - if a hospital trains just 10 residents throughout 4 years, with each hysterectomy being assisted by 2 residents at a time, that means that a hospital has to perform at least 87 hysterectomies a year. And that's a hypothetical low end! Kinda makes you feel like you might end up being a practice subject. Midwives are trained in knowing the difference between low risk and high risk and when a pregnancy or birth becomes high risk, that's when transfers happen. In those cases, you know that the medical intervention was necessary, not just because the hospital wanted to get it's training in for the day. 

I was speaking with a mom the other day who labored at home beautifully until she was 6 cm then went to the hospital. This interventions started immediately - she had to get her IV placed twice because they messed up the first one, she kept getting tangled in the cords and was concerned because her IV was causing her pain. She then received an epidural only to have the doctor come in shortly after and proclaim that her labor had slowed and he wanted the baby born so he suctioned the baby out. She had only been given 10 minutes to push...her epidural hadn't even started working on one side of her body! Of course her labor slowed - she was getting angry and frustrated with the medical interventions like the IV and not focusing on birthing her baby. I pushed for an hour and a half, focusing on no one but myself and my baby. My midwife gave my body the time and the space to push a human out of it. It took almost 10 months to grow the baby, let's give more than 10 minutes to get him out! The whole time I was telling the other mom about my birth experience, she just kept saying "I didn't even know that was an option!" A little bit of research could have saved this mama a lot of heartache.

A midwife will use machines just like a doctor does, however a midwife is trained to listen and respond accordingly while a doctor will pay more attention to charts and readouts. During labor the only intervention I had was my midwife listening to Baby's heartbeat on the doppler occasionally and some oxygen. I hated being hooked up to the awkward fetal monitor during my perinatologist appointments. A fetal monitor is often used during the entire duration of labor with a doctor and is only one of multiple interventions.

Mamas - you have to remember that you have choices and YOU are the mom. Speak to your care provider about how you want the birth to go and get facts. With both a midwife or a doctor, conversations have to take place where you get answers. I knew a mom that said she felt uncomfortable talking to her doctor about their intervention history so she never inquired. This person is staring at the business end of your vagina and you don't want to ask what they tend to do with it?! ASK!!!! YOU ARE THE CLIENT! Making decisions while giving birth is the first real decision you'll make as a mother - you can't be bashful or intimidated and if you're feeling that way around your care provider then maybe you should consider switching. You're supposed to both be on the same team. I know a mom that switched doctors 8.5 months into her pregnancy! She said she felt uncomfortable with her first doctor and when she met the second one, she just KNEW he was meant to deliver her baby. FOLLOW YOUR INSTINCTS! 

I'm an advocate for safe birth. Do I think you should consider birth (home OR hospital) with a midwife? Absolutely - my experience has zero regrets and unfortunately I can't say that I've heard the same about doctor assisted births. Do I think you should consider a home birth if you're a high risk pregnancy? Absolutely not! If you are high risk and a midwife says they'll take you on for an out of hospital birth - RUN! There are some births that should happen with hospitals. But again, you have choices - many hospitals work with midwives who will be able to provide you personal care with a back up medical assistance. ASK! Ask your doctor if they would consider working with a midwife and visa versa. Find the fit that's right for you!

I had people BEG me to give birth with a doctor. But I was a low risk pregnancy and didn't want any medical interventions and doctors are trained in medical interventions in emergency situations. My perinatologist told me 5 days before my due date to schedule a C-section immediately based on the numbers on the ultrasound (which we all know become less reliable the longer the gestation). My midwife negotiated and it went to allowing me 4 days to get Baby out naturally, which is what happened. If I wouldn't have questioned my doctor, I would have not only had an unnecessary surgical procedure but would have had a birth I would have regretted. I'm so glad I listened to my body and gave it the opportunity to do what it was supposed to.

Finally, you have to remember that doctors and midwives are people too. Are there horrible midwives? YUP! Are there amazing doctors? YUP! If you feel more comfy with a doctor, go with one! More comfy with a midwife, then that's who you should birth with. The most important thing is that you do research, you ask questions, and you feel like should you birth with that person, they'll put you and your baby first.  

Tomorrow we'll be finishing up this series talking about doulas and how they can help not only during your birth but also postpartum!

Did you "shop around" for a suitable birth care provider? If not, do you regret not getting more info?