In general, I think US culture tends to think of doctors as miracle workers who can solve all problems, and if you see one (for whatever reason) you won't die. Ditto for being in a hospital...as long as you're there, you won't die.
A car crashes, and people inside are gravely injured and they die on site, no one's suprised...but jeez, if they make it to the HOSPITAL with docs, then it can be 'suprising' if they don't make it........I'm just trying to make a point about our culture.
Our culture is very superstitious when it comes to pregnancy...have an ultrasound...that's what will ensure a healthy birth? Be in a hospital? Always, every time, THESE are the things that will make pregnancy and birth safe?
Sometimes, yes, always, no. And it's pondering these bigger ideas that deciding to homebirth is all about.
So, naturally, when a woman contemplates going to a midwife rather than a doctor, she is going to question that decision very carefully.
I guess I might think of seeing a midwife as like being a kid and having parents. When you're sick, as a child, your parents take care of you, help you, and if necessary, have the life experience to know if you need to see the doctor or go to the hosptial.
No one thinks the children of NON doctor parents are doomed to death; if the child's health changes in a way that it is beyond the parent's scope of knowledge, you go see someone who knows better.
The same is true for the homebirth midwife. Like a mom, who's seen a few colds, a homebirth midwife has seen a few pregnant ladies. If she sees something about the pregnant woman that is not 'normal' compared to what she's seen and studied, she'll send that woman off to see someone who knows more.
Phoebe, you say you wish you had a guarantee that you'd know whether or not you'd need to be transferred to the hospital in the middle of labor for an emergency or not...
...I think you can probably get a pretty good guarantee from your midwife. As I have learned more about homebirth and birth, I have learned that there are few 'rush to the hospital' emergencies.
In fact, the most likely 'rush to the hospital' emergency would be post-partum hemmorage, which happens after labor anyway...and only if it takes more than 45 minutes/an hour to get to your nearest hosptial, I wouldn't freak out about it too much.
From the three homebirth midwives DH and I interviewed, in their experiences, the most common reason for a transfer to the hosptial during labor was a tired mom....an excited mom, who once labor started, didn't sleep....was too excited, didn't drink enough fluids, the hours pass, her labor keeps her awake because it's so thrilling, and after a day of this, mom gets tired...and needs to be rehydrated w/ IV fluids...they go to the hosptial, she perks up instantly with that speedy rush of H20 and glucose, pops out her baby, and wishes DANG, I couldda done this at home!
Personally, I think laboring at home w/ midwives is safer than the hosptial. When I think of another 'complication' during labor, a slowing of the fetal heart rate, I would rather that a midwife, with a fetoscope against my belly every 15 minutes discovers it, rather than a faraway L&D nurse at the nurses station who sees the info on the montior.
I too have been seeing a CNM at a clinic in addition to my homebirth midwife. My CNM is supportive of my homebirth choice and is happy she can provide continuity of care should I decide to go to the hosptial. At 36 weeks, I just got my hemoglobin tested there, and I had some inital bloodwork done w/ my CNM at the beginning of my pregnancy.
I have been suprised at the support people have for my choice to birth at home...from my hairdresser to my dentist to my inlaws to this CNM I'm seeing! You may find this to be true for you, too!
But that;s another story.
