how to answer "why a midwife?"

[flitters]

i'm expecting my first baby and the questions are starting to come in about how i decided to get my care from a midwife and why i want a homebirth. most everyone has been very supportive (and i'm thrilled dh is confident in this choice). however, there are two people with whom i want to be extra careful when i explain this choice.

one is my MIL who was a labor and delivery nurse for about 20 years and had an emergency c-section with her second child because the monitor showed fetal distress... dh says she knows several wonderful midwifes but is going to have reluctance (and doesn't understand exactly what midwifery care is from her suggestion, "be sure to get a midwife who can give you an epidural because they can be really good in labor.")

the other person whom i want to understand my choice is a very good friend who a doctor is in her second or third year of residency with an obstetrician dealing with high risk pregnancies. i don't want to be offensive but i do want to be clear.

in response to her question, "how did you decide to go with a midwife?" here is what i wrote:


...

as for going with a midwife, that's a bigger question. also on that topic, i'm also planning a home birth - the two kind often go hand in hand. before i go into it more, i just want to clarify that i think in general, ob's offer excellent care and are absolutely neccessary in pregnancies with complications. it turns out though, that it's hard (really, really hard) to find an ob that really advocates natural birth
even for healthy pregnancies.

anyway, i made this decision after about two years and a lot of research and reading (easily over 2 dozen books - i'd happily send a list or some links if you're interested). in short, the midwife model of care centered
on natural birth without unneccessary medical intervention is safe and a better match for my philosophies. care from a midwife is actually more likely to reduce the risks than add to them. home births with a midwife are statistically as safe as obstetrical deliveries of babies from similarly healthy pregnancies and controlled studies have shown home-birthed babies are healthier (higher apgars, reduced infections, less
frequent need of resuccitation) and their mothers have fewer complications. my midwife will do a lot of screening over the next months and if anything comes back questionably (or if the baby is born
prematurely or postdate) i will be sent to an obstetritian who can handle complications. i think what it really comes down to is that for a woman with a normal pregnancy, the best birth experience will be where the mother feels most comfortable and most confident with her (properly trained) care-giver, whether at home or in a hospital, by a midwife or an
obstetrician. now i just hope that my pregnancy is healthy so my baby and i can experience a natural, gentle birth.

...

i would really appreciate any feedback on how to make this better!

thanks in advance!

:D

[~Megan~]

I think its reads well. Is sensitive to their feelings, etc

I would, however, capitalize as necessary.

[Irishmommy]

What you wrote is fine, but my usual answer is because I and my baby are safer at home with a mw than in a hospital with an ob. And that I like more than a 5 minute prenatal checkup every time.

[TurboClaudia]

I think what you wrote to your friend the ob is well thought-out and sensitive to her background. I, too, have anticipated this question -- my partner's father is a surgeon and we have many friends who are "mainstream" (i.e. here that means ob-seeing, epidural-birthing, etc.) -- but I have been very careful to say as little as possible to any of them about my choices. I don't want to sound as if I have to defend our choice: it is our choice and it is not open for discussion.

My question to you: have your mother-in-law and your friend asked why you are not considering care from an ob? Because if they have, you could reply with a question to them: what do you think an ob would offer me? (said in a very curious way...)

From the situation you described, I don't even know if asking that question is appropriate, but it certainly would give you insight into what they believe is/may be lacking in your care.

warmly,
claudia
mama-to-be in late spring 2004!

[stafl]

I agree that what you wrote is very well thought-out and I wouldn't change a thing.
But in my experience, anyone who really thinks hospital births are better won't be swayed by even the best arguments and facts.

I would like to warn you against defending your choice to anyone who objects. It isn't their choice to make, and it isn't your place to educate them about it. Pregnancy is a very emotional time, and getting into a debate over your chosen care providers and birth setting will only upset you and won't change their opinions one little bit. Hopefully your friend and MIL will be supportive of your choices (whether they agree with you or not) and you can just ignore my advice. ;)

[flitters]

thank you all so much for your input. i think i'm going to send it along to my friend pretty much as it is. i'm really hoping just to continue the conversation and not to start a debate or anything... i really don't want my response to sound like a defensive statement because the question was by no means offensive.

i believe my friend really will have an open mind about this - she is very nonjudgemental and actually was asking because she wants to get a broader idea of the different kinds of practices out there for when she finishes her residency. i want to be clear in my response, but absolutely not aggressive.

neither have explicitly asked why i'm not going with an ob, but i suspect my MIL will slowly become more vocal about how she feels (incorrectly) that my choice is not as safe as a hospital birth... maybe when that happens i'll just start sending her books. i hope she surprises me though. it doesn't matter either way, but it would be nicer to have her support than her unbased nagging worry.

as for capitalization, i believe it is very important in business and formal emails, just like spell checking. for casual notes between friends i don't think it matters. and although the subject is very personal, the tone is still casual and i want to maintain that.

thanks again for all of your feedback!

[KeysMama]

I am really sorry you have to defend your choices. You would never have to defend wanting a hospital birth, or epidural , or even a voluntary c/section now adays!

I think your letter is fine too, but am also concerned that whenever a mom offers up a defense, it leaves her open for more arguments. Maybe not, I hope not!

I basically leave it at this: In order to reduce maternal and infant mortality, The World Health Organization, and Healthy People 2010 in the US NOW recommend Doctors for sick women and Midwives for healthy ones. Period.

[momto l&a]

how to answer "why a midwife?"

I have always just turned the question back on them by asking something like 'why not use a midwife' or 'why have a hosptial birth?' They usually end up sputtering something that makes no sence.:LOL They realize they know less than you do about birth options.

[flitters]

I just wanted to share that we have now told all of our close family that we are planning a midwife attended home birth and they are all very supportive! I think it helped to have so much safety related information on the tip of my tongue to answer the question which proved inevitable, "You are going to give birth in a hospital, right?" I am a bit surprised and very happy that nobody even discouraged or questioned me in the slightest after I gave them the answer. It wouldn't have made a difference in our choices but I'm delighted to have their support!

My mom is particularly excited about our plans for a water birth.

I feel very lucky!

[momsgotmilk4two]

I have answered that question by explaining that I really like the care I recieve from my midwife. The fact that our appts. are not rushed, she takes the time to just sit down and talk to me. I get much more personalized attention than I did from my OBs. Also, what appeals to me is that she will be with me throughout my entire labor, not just for 15 min. of pushing and maybe a brief check before that. I feel like we're really getting to know each other and develop a relationship that will be a big help during the birth.