Question for CNM's who do hospital deliveries....

[Jynuine]

I have a question!

I've had 5 CNM hospital births, and they were at 5 different hospitals with different expereinces. Now that I am the experienced mom who births like she is at the spa (yeah that's me) I feel like I'm kind of swept to the side and not tended to by the MW, basicly left to the nurses. My last 2 were like that- before that the midwife I had was a bit whacko so, she has an excuse.

My question is this:

Is it unreasonable for me to expect that my midwife would be tending to me throughout the labor at least off and on and not just run in for the presentation, such as an OBGyn would do? I don't want to be TOTALLY selfish... I know she might have other clients who are newer at this or having tougher labors than I might be, but I DO want to sort of feel like she is mine, too?

My last midwife only gave me one to two words of encouragement as she rushed in and was dressing for presentation and didnt even touch the water. 2 nurses and a training midwife all but dove in (which I thought was a tad over the top) for my last birth and I just want to know if it's unrealistic to think that in this next waterbirth the midwife might spend a little more time with me during labor?

If I'm not being unreasonable I was thinking of putting that in my birthplan. Thanks for your help!!!

[thepeach80]

It's something to talk about during pregnancy and maybe find out what was going on w/ the last births. The last birth I was at was w/ a CNM and she was there most of active labor. She did have another mom in labor so she did have to go back and forth but her and the student were very accessible even though mom was having her 2nd baby.

[Peony]

It depends on how their practices are set up. If they are seeing patients in the clinic and are the on-call MW for births that day then they aren't going to be able to sit around around for hours. Other practices allow for more time with the patients. Those are things that would be wise to ask when selecting a practice, and if it isn't feasible or if you really want someone with you, maybe hiring a doula. 

[kltroy]

It very much depends on the practice, and on how busy they happen to be that particular day.  Even within one particular practice that I know of in my area, there is generally 1 CNM who is in the hospital at any given time.  Often, they have one laboring woman, and then that mom gets constant attention.  Sometimes they  have 2 moms, in which case the CNM needs to split her time between the two of them.  Some CNMs will structure their practice so that they do not have overlap in EDD (especially those with a solo practice), in which case you can expect to see your CNM most of the time you're in the hospital. 

I agree with the PP - this is something that you should ask.  You might consider phrasing the question to ask roughly how much of the time a CNM is in the room with you during labor after you've gone to the hospital.  How many patients do they typically have at once in labor?  Should you have a doula with you too, or does the CNM expect to fulfill that labor support role herself?

[Wittyone]

Just chiming in to agree with what the other posters have said - ask your midwife :)  In the practice I am with I do not have to run back and forth between the office and the hospital, if I am on call I'm only in the hospital.  HOWEVER, sometimes I only have one mama and can labor sit as much as needed.  Othertimes all six rooms are full with my patients and then I am spread pretty thin!  Unfortunately the census on labor is impossible to predict, so if you have the option of a doula and it's important to you to have some one continuously or frequently present, I'd recommend the doula.  Our hospital has a volunteer doula program, with doulas who will provide free labor support for anyone who wants it.  Because they are volunteers there are times when we have a gap in coverage, however it's a great service.  Maybe ask about something like that as well...?

[Wittyone]

Oh, just another thought when I re-read your post about your last birth and the student midwife diving in but the midwife not touching the water...when I am working with an experienced student I don't have my hands on either.  I am required to be present for the birth but the student is generally "catching" unless there is a complication.  If that was the case it probably would have been nice for you to know ahead of time though!

[CEG]

It completely depends on the type of practice.  My last job was a busy private practice with docs and midwives.  The midwives were hired by the docs to essentially do the uncomplicated deliveries so the docs could do surgery.  So it wasn't set up or designed to provide midwifery style care.  Most of the patients were looking for inductions and epidurals but they loved having the midwives deliver because we had better bedside manner and tended to be able to talk with them more.  But someone looking for a true midwifery style experience would have hated it.  But we typically had 3-5 vaginal deliveries and 2 or 3 c-sections to first assist at per 24 hour shift.  It just wasn't possible to provide more intense care.  The key is knowing what style of practice you are getting into.  I would be more comfortable with an independent miidwife practice (i,e, not hired by docs to fill a role) but they are few and far between where I currently live.