I delivered last summer with a midwife and overall had a good experience, but there are still some things that bother me. Im hoping to discuss these with my midwife later on, but i was hoping you guys would have some advice for me.
Background on me: Im a GP whose practice consists mainly of pregnant women and babies. I attend deliveries almost weekly, i've been in the room to welcome babies several hundreds of times. however, I have a non-medical attitude toward birth.
DH and I chose to go with a midwife with our first kid because
1- I wanted a natural delivery
2- I didn't see the need to see an OB for 10 minutes appointments. I could do the whole check up myself (BP, urine test, heartbeat, labs, etc) I felt a midwife would be able to help me more with the other aspects of being pregnant and becoming a parent
3- I wanted to include DH. He's not a physician, and I knew that if i saw an OB, we would "doctor talk" and he would feel excluded
4- I wanted to be a woman, a mom, while in labor. Not a doctor. I wanted to step out of that doctor's role and let someone else take charge. It's hard to explain, I still wanted to be in control, but I didnt want to spend my time looking for decelerations on the monitor, or plotting cervical dilatation on a useless curve.
We got 1 and 3. I never clicked with my primary midwife, I thought she was cold and judgemental. I was hoping she wouldn't be on call when i went into labor (they work in pairs, I had a secondary midwife who took calls ever other weekend) This was in canada, where there is a severe shortage of midwives, so switching was not an option. I never got to choose who my midwife would be, I was just assigned to her (or her to me...) Thankfully, it was my secondary midwife who was on call when i went into labor. I liked her a lot more.
BUT, because I had only met her twice, we didn't really know each other. She was way more proactive in labor that I would have wanted her to be. I didn't say anything because I was in my bubble and didn't quite realize what was going on, and also because I was afraid of being "the doctor". I trusted her and figured that if something felt really wrong, I would say something, but if it just felt like something I would have done differently but that her way and mine would both be right, I would not say anything.
I got to the birthing center at 8am, 4cm dilated, coping really well with the contractions. I had no pain at that point, and slept through some contractions.
I went in the tub, but the water was too hot and I started feeling unwell. My blood pressure dropped, my heart rate went up and so did the baby's. She thought the baby was having an irregular heartrate, but I could tell she was just going back and forth between his and mine (my heart was beating so hard I could feel my pulse in my head, it was easy to know which rate was mine) However, MW didn't really believe me, she was super nervous, and asked another MW to come check. By that time, I had been lying down and felt better, so the heart rate was back to normal.
MW came in at 11am, checked me and said I was now 6cm, and said she'd like to rupture the bag. I didn't see a need for it, but no reason to refuse either, so she did.
A few hours later, she came back to check me again, still 6cm. I was shaking and nauseous and my body was doing funny things (like trying to push....) I felt I was in transition, but when the MW said my labor stalled and I needed to be transfered for augmentation, I figured I must have been wrong about it. She also heard ONE variable deceleration (those are usually not a sign of distress). I hadn't felt the baby moving for a couple hours, but that was not unusual as I had an anterior placenta and would only feel him in the evening. So the midwife was really worried.
When I got to the hospital, I was 9+ cm, pushed soon after and baby was born after an hour of pushing, no augmentation required.
In retrospect, I feel like my midwife was way to cautious and im wondering if it's because I intimidated her as a physician. Many of my friends delivered with her and did not have similar issues. Im starting to wonder if she had been looking for a reason to have me deliver in the hospital from the start (did she rupture to see if i had meconium, which was a reason for transfer as per their protocol? Why did she consider a single variable decel a reason to transfer? I looked at her notes at my follow up visit and there was nothing in writing that justified a transfer. She had moved to a different practice in another city between my delivery and my post partum visit, so i never got to ask her)
All this to say... I don't know how to approach my next labor. I feel I should have trusted my instinct and refused to be transfered. But at the same time, I clearly remember my brain not functionning 100% and feeling really fuzzy at some point, i know my judgement was not optimal (ah, those endorphines...)
I want to be involved in my own delivery, but I don't want to take over. I don't know how to balance those two things...
Any advice? (sorry for the novel length post)
Background on me: Im a GP whose practice consists mainly of pregnant women and babies. I attend deliveries almost weekly, i've been in the room to welcome babies several hundreds of times. however, I have a non-medical attitude toward birth.
DH and I chose to go with a midwife with our first kid because
1- I wanted a natural delivery
2- I didn't see the need to see an OB for 10 minutes appointments. I could do the whole check up myself (BP, urine test, heartbeat, labs, etc) I felt a midwife would be able to help me more with the other aspects of being pregnant and becoming a parent
3- I wanted to include DH. He's not a physician, and I knew that if i saw an OB, we would "doctor talk" and he would feel excluded
4- I wanted to be a woman, a mom, while in labor. Not a doctor. I wanted to step out of that doctor's role and let someone else take charge. It's hard to explain, I still wanted to be in control, but I didnt want to spend my time looking for decelerations on the monitor, or plotting cervical dilatation on a useless curve.
We got 1 and 3. I never clicked with my primary midwife, I thought she was cold and judgemental. I was hoping she wouldn't be on call when i went into labor (they work in pairs, I had a secondary midwife who took calls ever other weekend) This was in canada, where there is a severe shortage of midwives, so switching was not an option. I never got to choose who my midwife would be, I was just assigned to her (or her to me...) Thankfully, it was my secondary midwife who was on call when i went into labor. I liked her a lot more.
BUT, because I had only met her twice, we didn't really know each other. She was way more proactive in labor that I would have wanted her to be. I didn't say anything because I was in my bubble and didn't quite realize what was going on, and also because I was afraid of being "the doctor". I trusted her and figured that if something felt really wrong, I would say something, but if it just felt like something I would have done differently but that her way and mine would both be right, I would not say anything.
I got to the birthing center at 8am, 4cm dilated, coping really well with the contractions. I had no pain at that point, and slept through some contractions.
I went in the tub, but the water was too hot and I started feeling unwell. My blood pressure dropped, my heart rate went up and so did the baby's. She thought the baby was having an irregular heartrate, but I could tell she was just going back and forth between his and mine (my heart was beating so hard I could feel my pulse in my head, it was easy to know which rate was mine) However, MW didn't really believe me, she was super nervous, and asked another MW to come check. By that time, I had been lying down and felt better, so the heart rate was back to normal.
MW came in at 11am, checked me and said I was now 6cm, and said she'd like to rupture the bag. I didn't see a need for it, but no reason to refuse either, so she did.
A few hours later, she came back to check me again, still 6cm. I was shaking and nauseous and my body was doing funny things (like trying to push....) I felt I was in transition, but when the MW said my labor stalled and I needed to be transfered for augmentation, I figured I must have been wrong about it. She also heard ONE variable deceleration (those are usually not a sign of distress). I hadn't felt the baby moving for a couple hours, but that was not unusual as I had an anterior placenta and would only feel him in the evening. So the midwife was really worried.
When I got to the hospital, I was 9+ cm, pushed soon after and baby was born after an hour of pushing, no augmentation required.
In retrospect, I feel like my midwife was way to cautious and im wondering if it's because I intimidated her as a physician. Many of my friends delivered with her and did not have similar issues. Im starting to wonder if she had been looking for a reason to have me deliver in the hospital from the start (did she rupture to see if i had meconium, which was a reason for transfer as per their protocol? Why did she consider a single variable decel a reason to transfer? I looked at her notes at my follow up visit and there was nothing in writing that justified a transfer. She had moved to a different practice in another city between my delivery and my post partum visit, so i never got to ask her)
All this to say... I don't know how to approach my next labor. I feel I should have trusted my instinct and refused to be transfered. But at the same time, I clearly remember my brain not functionning 100% and feeling really fuzzy at some point, i know my judgement was not optimal (ah, those endorphines...)
I want to be involved in my own delivery, but I don't want to take over. I don't know how to balance those two things...
Any advice? (sorry for the novel length post)
Not about laboring, but about standing up to the hospital staff. I was like "yah, okay, whatever..." about everything, because I just wanted to be left alone. Luckily, dh and my doula would stop and ask "What are our other options?" etc. So, I understand how it happens that you are in that labor bubble, highly suggestible, and just kind of go along with everything.
Don't be afraid to refuse something that's not necessary just because you don't want it. You don't need a "better" reason. It is not your job to make your caregiver feel more comfortable or less threatened or what have you. Cooperating in every way with your mw obviously did not make her any more comfortable with the situation, so what did it gain you, really, except an unnecessary transfer?
