What does the apprentice do at the birth?

[jennica]

So, I am having a homebirth in July. My first birth was very traumatic and resulted in PTSD. I want a very private hands-off experience this time around and believe that I found a midwife who will hopefully honor my wishes. Of course when I interviewed it was just her, and now when I go to appointments her apprentice is there too. I think it is fine that she has an apprentice, and that her apprentice will be at the birth (I really feel it is safest that way). This last appointment her apprentice palpated my belly and tried to find a heartbeat. I was fine with that I guess, but it made me start to wonder about what her apprentice will do at the birth. I really don't want any interference aside from periodic heart tones taken, and honestly I don't even want to see the apprentice or know she is there unless there is an emergency where her assistance is required. I want to see very little of the midwife as well, and we discussed the possibility of her being in another room during the birth. I'm wondering how I can tactfully bring this up at my prenatal with the apprentice sitting right there? It feels awkward to start talking about how I don't want her apprentice to touch me at all or even see her during the birth when she is a very pleasant person and I have nothing against her personally and she will be sitting right there as I talk about this. But, I really just don't want two people doing things to me during the birth. It is really difficult for me to submit to any type of procedure done to my body - even when they were trying to find a heart beat at my last prenatal I was getting very antsy and very close to telling them to please stop. I am afraid I will feel ganged up on if two people are attending to me during the birth instead of just one. I should note, I'm expecting a fast birth, Ds's was 6 hours from first contraction to birth and I really feel it was lengthened by a great deal of interference from the hospital staff. My guess is that this birth wont be any longer than Ds's and could be shorter. I could understand if I had a really long birth that the apprentice and midwife might need to tag team it a little bit to stay rested, and though that is always a possibility, I think the chances of that happening are very slim. So, I don't think it is unreasonable to just want one person attending me, but how do I tactfully ask for this?

[feminist~mama]

I think what you just said was fine! Asking what their expectations are and outlining yours is a great idea, especially since you've already had this conversation about hands-off once. I feel like having this conversation with the apprentice ensures that everyone is on the same page and is a really good thing!

Best of luck with your birth!

[matthia]

I agree with the pp. Remeber that the apprentice is there to LEARN, so as far as her being the one to do routine procedures at your prenatals, this is a way for her to gain experience under the observation of a professional. I had a very scary hospital experience just a few days ago (at 22weeks) and my MW and her apprentice both came at 2am and stayed until I was ready to sleep, and both showed up the next day. I was really happy to have two people there because it meant when one was tracking down the OB or scheduling some tests, the other was sitting with me and DH or explaining a procedure or answering questions, or bringing me juice.

Now, that being said, part of her becoming a MW is learning how to deal with ALL Situations. You said you've already spoken with your MW about being hand off, I think that it is totally acceptable, even preferable, to bring it up again at your next appointment. It's better for you to explain your reasoning to someone than to have a "crazy hormonal pregnant moment" (that's what I call mine) in her face without her expecting it. Not that I'm saying you will do this, but everyone has bad days and labour is no fun at all, especially when you're not getting what you want. They're there to make this experience the best one it can be for you, if that means sitting in another room doing crossword puzzles for 6 hours and then leaving without seeing you more than once or twice, then that's what it needs to be.

[olstep]

I would expect a midwife to let me know during the INTERVIEW about her having an apprentice. Call me selfish but I do not want other people to practice on me.
I'd talk to the midwife on the phone, ask about possibility of having my next prenatal visit without the apprentice and discuss the issues I have.

[jennica]

Originally Posted by olstep

I would expect a midwife to let me know during the INTERVIEW about her having an apprentice. Call me selfish but I do not want other people to practice on me.
I'd talk to the midwife on the phone, ask about possibility of having my next prenatal visit without the apprentice and discuss the issues I have.

I'm pretty sure she told me at the interview and I expected her to have an apprentice there, so that part didn't upset me. It's a little odd to have this person you never met at your first prenatal, but I'm getting used it. I just don't particularly like the apprentice looking for the heartbeat, then the midwife looking, when I'm so hypersensitive. I'd really rather the midwife just does all that stuff, instead of having it done twice. My biggest concern is the birth, and also trying to figure out how to have this conversation. A phone call might be a good idea, because then the apprentice wont be right there listening and making me uncomfortable. I'll just have to think about it for awhile to really know what to say.

[phoebemommy]

With my first birth I had a bad apprentice experience. It was the apprentice's last birth before her license, so she was "in charge". She didn't do anything truly horrible, but from the moment she arrived (while I was pushing) the very calm vibe in the room got hijacked by her coffee'd-up hyper energy. She wasn't shy about foisting perineal pressure on me (this hadn't been discussed and wasn't necessary), was all up in our business pressuring me and the baby to breastfeed before he was ready, and my biggest gripe, threw me to the floor from the toilet at one point when she thought I had dumped a bunch of blood so she could shoot me up with pitocin (my complaints -- I was perfectly coherent and clear headed so I didn't need to be thrown roughly to the cold bathroom floor, my midwife had said I would be given herbal treatments first for bleeding, and finally, I thought and still think it wasn't really that much blood).

The thing is, I could have anticipated that I wouldn't like her there. I liked her a lot as a person, but I could tell she had a bossy, hands-on style. I assumed that because my midwife has a very different style, that the apprentice would be adopting my midwife's style. I've talked to my midwife about it this time, and she apologized for letting things happen the way they did. But I'm being very clear in my birth plan this time about my expectations for everyone there.

You're very smart to be thinking about this in advance. From everything I understand, it's pretty standard (and smart!) for homebirthing women to dictate who can be in the room and touching them. That's why you're homebirthing. And your midwife and apprentice will, I think, understand and not take it personally. When I talked to my midwife about my concerns, I did it one on one without my husband (who just didn't get why the apprentice bothered me so much) and without her new apprentice in the room.

[Belle]

I hired our midwives without meeting their apprentice. There were the two of them and I met their apprentice later. She did most of the prenatals with the two senior midwives in attendance. During the birth all of them were hands off. I think they checked the HB with a doppler once or twice but that's about it. One of the senior midwives had a cold so she stayed away from me and the baby and took notes and pictures. The apprentice actually caught our baby. Dd2 had a double nuchal cord so she unwrapped her from the cord while still under the water and handed her to me. After the birth she expressed concern that we might be disappointed that we didn't catch the baby ourselves. We weren't that set on catching so it didn't bother us much.

I think that we clicked better with their apprentice than we did with the senior midwives.

That said, you really should be comfortable with everyone there. Not just at the birth but if you are feeling overwhelmed during prenatals let them know what you're feeling.

[jennica]

Thanks for all the advice, it is really helpful. I think part of the issue is that the room is really small, and when Dh and Ds are there it is crowded and I get overwhelmed, so am more sensitive to people touching me. Also, I'm just sensitive to that now because of the past traumatic experience it comes up a lot at any type of body work/medical appointment. I do really like the apprentice, she is very gentle and respectful towards me. I don't have any personal issue with her at all, this is totally about me and my issues with the trauma and PTSD and the unique needs that creates for me. I just don't want her to take it personally because it is nothing personal at all. I will probably call my midwife and talk to her about this issue. We have talked a bit about the birth trauma, but haven't really had any in depth conversations about it yet. It might be a good way to open up that subject and start talking about it.

[olstep]

Originally Posted by jennica

I do really like the apprentice, she is very gentle and respectful towards me. I don't have any personal issue with her at all, this is totally about me and my issues with the trauma and PTSD and the unique needs that creates for me. I just don't want her to take it personally because it is nothing personal at all. I will probably call my midwife and talk to her about this issue.

I think you phrased it really well. But I would not do it over the phone. It is always better to discuss delicate subjects seeing each other eyes. Of course, if it doesn't make it more stressful on you.

[MidwifeErika]

You could always call your midwife and arrange your next prenatal without the apprentice so that you could comfortably discuss this all with your midwife.

[ginapueblo]

Originally Posted by MidwifeErika

You could always call your midwife and arrange your next prenatal without the apprentice so that you could comfortably discuss this all with your midwife.

Ditto. Or just have this conversation with her on the phone. I am sure she would want to know if you had concerns.

[phathui5]

There were two apprentices at my last birth. They:

- hung out and talked with me and dh
- massaged my back
- went out and got us snowballs when I asked
- suggested getting in the shower near the end of labor
- helped the midwife at the end
- came back and weighed ds for me when I thought he was sleeping too much and not eating enough

[Paige, CPM]

You could also email your midwife with your concerns and ask to talk to her about it. Either put details in the email or save them for your conversation. Either in person or on the phone...whichever you request via the email.

Good luck! Let us know how it goes.

[lunarlady]

I actually had the reverse situation for my last birth. I hired the apprentice as my midwife, but had to have the other supervising midwife at the birth. I only met her twice before the birth, so I was a little nervous about it. But it was fine. She checked the heartrate one time, and told me to try to breathe deeply another, and that was about it. Neither of the midwifes touched me very much during labor. I didn't want anybody (even DH) touching me, and so they didn't. I think I had two internal checks, they checked the heartrate via doppler about every 1/2 hour, and other than that and helping prop me in the positions I wanted, the whole thing was pretty hands off. Just make it clear what you want, and I think you will be fine.

[GoldmanBaby09]

I felt really similar to the OP about this when I had my birth last year. I met the apprentice in the very beginning then had a long stretch of prenatals without her there and then she popped back up in third tri when I had almost forgotten about her. I didn't ever really feel like I clicked with her and was very nervous about having her in my birthing space. I considered asking my midwife not to have her at the birth, especially since I planned to labor in our bathroom, which is not huge. But my mom (who is a mw) reminded me that the apprentice often isn't there for the mother, but for the midwife, to help with equipment and be another set of hands and eyes as needed. Obviously you want to be comfortable, but I felt a little better knowing that the apprentice wasn't going to really be bothering me. Once I was actually in labor, I could have cared less if she was there. In fact, when I was pushing, I really wanted to be able to see the baby's head so the apprentice ended up holding my make-up mirror in a very awkward position for a long time so that I could see as I pushed. I ended up being very thankful for that extra pair of hands to help me with that particular motivation.

[Eresh]

I may be reading wrong, Jennica, but it doesn't seem like you have a problem with the apprentice. You have a problem with how some aspects of your appointments are going and you're concerned about the same issues cropping up when you're at your most vulnerable during labor.

I think you should be as specific as possible with your midwife about the discomfort you have being in a small space with so many people and being touched repeatedly. You should definitely not "suck it up" during prenatals since that will make it impossible for you to relax and trust your mw during labor. I think it would be very reasonable to work out measures that would make prenatals easier -- maybe fewer people in the room or maybe move to a larger room if that's possible, have only the mw or only the apprentice perform a given exam (depending on the level of the apprentice), fewer exams that involve physical touching, etc. At the same time you can establish expectations for how things are handled during labor. I do not see that laying out your concerns and expectations would be offensive to the mw or the apprentice but if you're more comfortable talking one-on-one with the mw, then that would work fine too, I think.

[Baby_Cakes]

At DD's birth, the apprentice did most if not all of the heart tones, sat by my side, stroked my leg, encouraged me, and also did my sutures at the end. My actual midwife didn't do anything really, except for a few internal exams.

I hadn't even met the apprentice until the day before, but she turned out to be such a loving and compassionate person at Nora's birth.

I guess my point is that you may want to discuss her being present NOW before its too late. While I loved Becca and her role in my birthing experience, if I were to have had a problem w/her being there when it was too late to say anything, that would have been really annoying.