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Questions about homebirth midwifery care

post #1 of 7
Thread Starter 

I've been having appointments in my own home with my midwife since I was 8 weeks pregnant, now we're starting to see her more frequently every 2 weeks starting this monday, and then every week at 37 weeks.

 

I know that if I were going with a traditional ob/gyn I'd be getting pelvic exams regularly and lots of testing~ do homebirth midwives do any sort of physical pelvic exams later on in the pregnancy (to check cervical dilation??) or is it super hands off? What about group B strep test? I figure that's something I can do myself.... I pee on a little stick every appt that checks glucose/protein in urine so I'd assume she'd just let me swab myself too.

 

just curious...... don't really feel like asking her.

post #2 of 7

My midwife doesn't do pelvic exams unless there's a reason to. She doesn't feel that checking my cervix will tell her anything, some women are 2 cm dilated a long time, others become 2 cm dilated and are holding a baby in a few hours.

 

I'm not sure what she does about the GBS test, I hope I can do that myself it seems awkward lol. I've read a lot of midwives will have you do it yourself. If I understand correctly, you swab your vag and your butt...not rocket science. I will probably ask to do it myself if not.

 

It all really depends on your midwife, but I'm sure you have the freedom to decline whatever you wish.

post #3 of 7

My midwives did not do pelvic exams unless requested. Even if you were 4cm dilated, if you aren't having contractions it doesn't mean a whole lot. My midwives did not test for GD because I was showing no signs of it (i.e.-glucose in urine, measuring large) and have no risk factors. They would have ordered the test if I wanted but I declined. I did do the GBS test. I swabbed myself in their office and they sent it off for the results for me. Other than that, I just did the standard 20 week ultrasound and that was it.

post #4 of 7

We offer moms GBS testing and they can have it done if they want to know, or fill out a form to decline it if they don't. As far as vaginal exams, I don't ask unless we're concerned about preterm labor. Sometimes moms will ask us to check and after explaining to them that it doesn't really mean anything unless you're having contractions, if they still want to, I'll do it.

post #5 of 7

my first midwife did one pelvic...and then yeah told me it doesn't mean to much. she checked for gestational diabetes, anemia...there might have been swabs that i have forgotten about. She is a cnm

 

my second midwife didn't do pelvic exams, she tested for anemia and gd...I don't remember if she checked for broup b strep. she was a cpm.

 

it really depends on the midwife, i'd say just ask yours. Most midwives encourage questions, it's one of the great things about midwives...they don't treat you like a birthing cow ;)

post #6 of 7

Like the others said, it really depends on your midwife, so ask! But ever more than that, it depends on you and what you want!

 

With my last, I only had one cervical exam the entire pregnancy. That one was done early in labor just so the midwife could make sure she felt a head and not a butt. Other than that, there's not much reason for them. It's just introducing new bacteria up there that doesn't belong to you or your partner. The GBS test is just a swab and doesn't require an exam.

 

I'm 30 weeks now and plan to do the same. Just one check early in labor and that's it. 

 

But if for some reason you just really want to know what's going on in there, you can of course request that your midwife do one. Like the others said, they don't mean much. A woman can walk around completely effaced and a little dilated for weeks before labor actually begins. Similarly, a woman can be not effaced or dilated at all and have a baby in her arms the next day.  

post #7 of 7

My midwife offered exams starting around 36 weeks (which I accepted, although I knew they weren’t a very accurate measure, I thought it was good to have that information as we were nearly 2 hours away from the birth center and I wanted to know for when labor began whether I might already be fully dilated or not so as to have an idea of how quickly things might progress – as it was, I was only 2 cm and 50 percent effaced in my first check in labor). But it was always an “offer” – it was made clear that it wasn’t a very accurate measure of when the baby would arrive and I was always told that I could decline the exam if it made me uncomfortable or if I just didn’t have any interest in doing it.

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