I'm going to a MW instead of OB, what do I expect?

[anotherpeanut]

Okay I know this is kind of a dumb question but should i expect anything different when seeing a midwife? i've always only seen OBs (but that wasn't going to get me anywhere close to a VBAC) so I decided to explore this option intead (it's a mixed practice). I initially see a mw and then can decide from there how i want to proceed. Thanks!

[kltroy]

For prenatal visits you can probably expect:
1. More time spent with you per visit
2. More of an interest in you as a person, and of your whole body health
3. Depending on MW, less pressure/discussion about prenatal testing, or a more flexible attitude towards it
4. More education on health, diet, etc that can help you have a healthy pregnancy.
5. More natural and alternative options (for example my MW has a regimen of echinacea and vitamin C and acidophilus that she swears by for keeping you Group B Strep negative right before the birth)
6. The assumption that you are normal, healthy, and capable of birth unless evidence presents itself to convince her otherwise

For the birth you can expect your MW to be there for most or all of your labor and birth, better labor support, more flexibility to have the birth you want, lower rates of intervention (more likely to sit on her hands so long as everything with the baby looks good), more alternative options (water birth, alternate positions and/or locations for birth etc), more likely to let you take the lead on how you want your birth, .... am I missing anything here, ladies?

[blessedwithboys]

a midwife cant give you a csec!

[meganmarie]

The biggest difference between my midwives vs. my OBs was that the midwives never, ever kept one hand on the office doorknob while asking me if I "had any questions".

[ShwarmaQueen]

IMO, the biggest difference between MW and OB care is that most MWs put way more responsibility on the mother to take care of herself by preventative measures. Diet, exercise, supplementation, etc. are all in the hands of the the mom, and what she does heavily influences the outcome of her pregnancy.

[DocsNemesis]

It totally depends on the midwife, honestly. I'd assume since its a mixed practice, its a CNM? That's fine, they just can't be quite as flexible as lay midwives.

Anywho, I saw CNM's with my 2nd, after an OB with my first. It was a practice with 5 CNM's, who I saw randomly each time. The first thing I noticed was that while some of them were great and I really liked them, others were much more medicalized than I wanted and honestly, I would've taken my OB over one particular midwife. She was horrible.

I noticed that with certain things, some of them seemed to be very open, and also that those same midwives were much more trusting of my feelings/thoughts. The other (2, I think?) were much less trusting and were not very flexible on tests and such. One outright said I didn't know what I was talking about and should trust her since she's the one with training. -_- I do NOT appreciate being talked to like that.

Every midwife does things their own way. With the CNM's, everything was very similar to the OB, procedure wise. Pee in a cup when I got there, do BP immediately, everything was in an office. Cervical checks were on a bed with those foot thingies. That doesn't mean every CNM practice is the same way, but that's what I'd expect. However, most midwives spend a lot more time with you and hopefully have more faith in your body than most OB's. Again, most. Remember, if they seem to be lacking faith that you can do this or seem to treat you like an idiot, you can always go back to looking for a new care provider!

The CM's I used for my last 3 did everything in the birth center birthing rooms. Both them and my new midwife (my old ones can't do VBAC, sadly) had moms just pee on the little test stick ourselves and read it ourselves. Its not hard. And honestly not peeing in a cup was sooo nice, lol. We then sit down and talk for a bit, then BP and heart checks were done on the bed (or on the exam table at my new midwife-like I said, everything vary's so much!). They then palpated to feel where the baby was and check size. The OB/CNM's just did measurements, never felt around. Then we usually talk some more and such. Cervical checks are almost never done at either place, but if they are, its on the bed. Nice and comfy. They also never questioned my declining certain tests and when I'd ask their opinion, they'd let me know without trying to scare me into something. For instance, with the GD testing they gave me the pro's and con's and went over risk factors. I only have one-being slightly overweight-and they didn't see that as being a big enough factor.

Again though, every care provider can vary so much from another. Just because one person is an OB, another a CNM, another a CM-really doesn't mean anything in itself. There are great people of all provider types, even OBs-though they seem to be few and far between, lol. Your CNM's may do things more like my CM's did-or maybe a combo, or maybe nothing at all like them.

Hopefully whatever happens, it'll be what you're looking for and you'll get a real shot at your VBAC!

[AlexisT]

My experience with mixed-practice based CNMs is that they work a little more like an OB, and tend to have more conservative policies. This does NOT necessarily make them mini-OBs (though I think that if someone wanted to work like that they might be attracted to a mixed practice, IYSWIM). They do tend to be less rushed, but no hour long appointments. Because they work more closely with an OB they may have more constraints placed upon them (they may be required to risk out patients earlier, for example). Overall, the approach is a little more medical, though they ARE still midwives.

I think the only way to know how a particular MW works is to ask her. There's just too much variation.

[catspage]

I also went to a mixed practice for my VBAC. The midwives operated in the same manner as an OB, but they did spend more time with me when answering questions.