Question for those with Midwives

[newlife]

Okay, I just thought about this. If you have a Midwive, you don't get ultrasounds right? And you know at the beginning of pregnancy, a lot of blood work is involved (with a doc) ,so what about a midwife. I know that sometimes traditional medicine can sometimes be intrusive, but what about all of the advantages it brings? As far as your pregnancy (not labor and delivery) is concernced do ya'll think it is safer to have a midwife? Or maybe I am wrong do midwives have these things at their disposal, if so please describe?

Thanks ya'll.

[plantmommy]

Depends on if you have a CNM or a LM or what have you, as well as the particular midwife, and what you want.

With dd, I did have most of the bloodwork done, but no U/S. This time, using the same midwife, I chose to use old bloodwork but did have an U/S. My midwife is a CNM, so she can draw the blood and send it to the lab, etc., and for U/S she wrote me a prescription to take to the closest radiologist, since I live in a different state than she does, now.

The thing is, with my midwife, we discuss each of the tests, weigh our options and I decide which tests or procedures, if any, that I want. Sometimes she recommends something, but it's always open for discussion, and it's always my call in the end.

Also, how exactly the tests are done is open for discussion, too. For example, take the GD test, which, with an OB, you have to drink thise vile liquid that is LOADED with sugar on en empty stomach, which made me feel ill, then sit and wait for an hour or more before the blood draw. With dd, before the test my midwife said to make sure I ate a nice, big breakfast. That would give a more accurate and realistic test reading, as well as being easier on my body. This time, I'm forgoing the test altogether. There's simply no marker for gestational diabetes here, and I see no reason to test for it.

I think in essence, that's the difference. My midwife realizes that my body is unique, my pregnancy is unique, and I'm not just like anyone else. There's no reason for me to be routinely tested for anything, because my pregnancy is not a routine.

[plantmommy]

Oh, I forgot to answer one of your questions!

YES! I think it's safer. Who's going to know you better, and be more aware of any changes going on with your body, besides yourself? An OB who you see for maybe 10 mins. max every month, or a midwife with whom you spend an hour or more at each visit? Last month, for example, I gained no weight. My midwife looked at me long and carefully, and palpated the belly, and said that's fine; I look great, totally healthy and the baby is growing. It works out because I weigh the same now as I did at the same point during my last pregnancy, despite going into this one about 10 lbs heavier (on a 5'2" frame). If I'd kept gaining at the same rate, it would likely be more than I need to gain.

With an OB, if you gain more during a particular month, it can be an issue, or if you don't gain during a month, it can be an issue. With my midwife, we're looking at the whole picture of ME and MY pregnancy, which is unique.

[Patchfire]

The midwife we've chosen (a CPM) basically 'sends' her clients out to whatever doctor that the individuals' insurance will pay for, to get initial bloodwork done - CBC, rubella titers, STD tests, et cetera.

As far as ultrasound - there are no proven benefits to routine ultrasound, and some possibility that it might not be as safe as claimed.

Essentially, most midwives - and here I am only talking about CPMs or other direct-entry midwives - use the medical system very rarely, but when a problem is indicated, they refer care.

Now, with CNMs, which is what we used with dd, they had access to everything a traditional OB practice would, because they practiced 'under' an OB - meaning we got the full range of technology - blood draw, offered AFP (but declined), routine ultrasound (which discovered a 'low-lying placenta' - not a surprise, at 18w, but then they INSISTED on a second u/s at 36w to make sure I didn't have previa. Despite the utter lack of any symptoms of it.), GTT at 28 weeks (gross!), et cetera.

You might want to read The Thinking Woman's Guide to a Better Birth which talks about some common technologies. There are other books as well, but of course I can't think of their names at the moment!

Good luck finding what works for you!

[newlife]

Thanks ya'll. And we're the same height Plantmommy.

[georgia]

Here's a great link: http://midwivesmodelofcare.org/

In a nutshell, for me, it's ALL about philosophy. Either pregnancy is to be treated as an illness---just waiting for something to go wrong or it's seen as a normal and wonderful part of life. Take your pick :thumb

Best wishes w/ your pregnancy!

[ekblad9]

My midwife just happens to be affiliated with my homeopath/dr. So I'll go to him for initial blood work. Other than that, I won't do anything. I may do an ultrasound but again, I can go through my doc for that.

I have had five hospital births and attended on homebirth. I can tell you without a doubt that homebirth is way safer and better in all ways. In each birth that I had in a hospital I was almost killed or the baby was. :eek I'll never go to a hospital again.

[supersarahmommy]

Okay, I just thought about this. If you have a Midwive, you don't get ultrasounds right? And you know at the beginning of pregnancy, a lot of blood work is involved (with a doc) ,so what about a midwife. I know that sometimes traditional medicine can sometimes be intrusive, but what about all of the advantages it brings? As far as your pregnancy (not labor and delivery) is concernced do ya'll think it is safer to have a midwife? Or maybe I am wrong do midwives have these things at their disposal, if so please describe?

Thanks ya'll.


Now, I didn't see my midwives until later (after 3 months--beginning of 4th) on because I was being monitored by a specialist (who wasn't an OB) because of a prior miscarriage and prob with polycysts. However, I have had one ultrasound to determine that all the organs developed well. My bloodwork was tested in the beginning. I also recieved a glucose screening. I opted out of amniocentisis, but it was offered. Also, genetic counseling (I believe that is what she called it) was offered because my bro had some thyroid probs (but, opted out because he is fine imo and he is the only one in our family and it wouldn't change anything in my pregnancy). I will be most likely this Thurs. getting my my strep B test, but i am not sure if that will change because my plug came out two weeks ago (from today! :)).

I don't feel like my treatment is any lesser or unsafer (a word I made up :)) than when I was with my doctor. ANd actually the doctor before my last (which was my mom's OB) wanted me to take a diabetes medicine while pregnant (glucophage is the name) because of my polycysts. That is why i switched to a specialist and he said how ridiculous that was and my midwives agree.

Feel free to ask any ?s if any of this does not make sense.

Also, there are many other benefits to seeing a midwife, and if you really want to know... just ask. But, I won't take up too much more room on this thread for now. :P

[wtchyhlr]

Actually, my midwife has an ultrasound machine. And offers all the same testing as an OB, but with informed consent.

~ Joy

ps. She's an LPM, not a CNM

[3 little birds]

M licensed midwives draw blood and can use doppler as well as order ultrasounds if I desire.

I had one hospital birth and one home waterbirth. I will never go to a hospital for childbrith again without cause (emergency).

[oceanbaby]

My midwife (who is not a CNM), does all the same blood tests that my OB had done. I have the option of declining them if I want, but since I don't have a problem with them, she came to my house, did the blood draw herself, and sent it off to the lab. I did have an ultrasound done as I was seeing an OB before I switched to a midwife. However, my midwife prefers that I preregister at the backup hospital (mainly to preserve the good working relationship they have with that hospital and homebirth transfers), and once I do that I can certainly opt to have an ultrasound done with them. Even without doing that though, I believe my midwife can refer me to someone to get an ultrasound if I want it.

I do believe that my prental care with my midwife is much more thorough, and therefore more safe, than it was with my OB. I really liked my OB - I have no complaints about him, I had the birth I wanted with my first son, and he was much better than previous OB's I'd seen. But he still wasn't as thorough as my midwife is. I believe she'd be more likely to catch something that he would be, simply because she spends more time with me and asks more questions.

[Kristeen]

I live in Alberta and my midwife is funded through the Provincial government because I am attending a kind of 'pilot project' model of care (First "Birth Centre" type place of it's kind here...). The "Birth Centre" happens to be located in a small town hospital (very near my big city) . I had all the bloodwork done, but it was optional. The program routinely sends women for an u/s at 20 wks (same as most OB's here) but I opted out of that. I am not convinced as to the safety of ultrasounds. My midwife also has a doppler at her disposal which I was asked if I wanted used on me.

My first preference would have been for an unassisted homebirth (but everyone around me would have FREAKED). My second would be a midwife assisted homebirth, but unfortunately, money was a factor for us and the way the Birth Centre is run makes me very comfortable with the whole experience (hospitals SO do not bother me-- I just would have preferred the privacy and convieniece of being at home since I REALLY don't see birth as a medical event).

[Mom2baldie]

I am having a midwife-assisted homebirth and have also had bloodwork taken (CBC), as well as a sonogram at 10 weeks gestation after experiencing quite a bit of bleeding for over a month. My midwife does the bloodwork herself, then sends it to a lab and for the sonogram I was referred to an OB. She also offers all the routine prenatal tests that you can get with an OB (afp, GD, routine 20 week sono, GBS), but I have opted out of all of them so far, so Im not sure if they are done differently or what...

Since I can have all of the tests that traditional medicine can offer with my midwife, Im not sure what advantages Im missing out on by going to her instead of seeing an OB. After all, I get truly informed consent with her, I am never pressured about anything, I am never looked down on because of the choices I make, my appts are all at least an hour long and we talk about my emotional health, as well as physical health, she is concerned about more than weight gain and blood pressure... I feel very comfortable with her and the care I recieve from her. If she thought there was a problem prenatally, I would be referred to an OB, so that takes care of that.

I think that prenatal care from a midwife is healthier because they pay enough attention to you that they can often spot a problem in advance and help you make changes to hopefully prevent the problem from getting worse. They can also offer more holistic and non-invasive solutions to said problem than an OB can. This has been my experience anyway, after having 4 pregnancies and 3 different care providers: my midwife, an OB and a family practice MD. I will never go back to an OB. With my midwife I feel like someone important, instead of "just another patient".

[oceanbaby]

I think that prenatal care from a midwife is healthier because they pay enough attention to you that they can often spot a problem in advance and help you make changes to hopefully prevent the problem from getting worse. They can also offer more holistic and non-invasive solutions to said problem than an OB can.
Exactly!

[candleofthought]

you don't need anything to special to draw blood, except practice. I was an in house lab tech for 2 yrs.
My midwife is an LM and she does all my labs in my living room :) and drops them off at a lab my ins company covers and they fax the results to her.
she also did my strep test in my home, in my bed :) and my gest diabeties test in my home.

We decided to have an u/s , my midwife ordered it at the local hospital of my choice, I went in with dh and dd a nice u/s tech did it and my midwife got the results by the end of the week. and my insurance covered it.

I think the best part about having a midwife is the home visits, she's been visiting me for 9 months and now every week, in my house. So come time to deliver, she knows where everything is and we are all pretty comfortable. Especially dd, knows who she is and all about whats going to happen.

Midwifes are usually regulated and are required to do/offer the standard testing throughout the pregnancy.
I would not want to be in the hospital to birth a healthy baby, when I can do it right here in my own home.

[momto l&a]

When I first started going to my mw (5 years ago) she had you go to a dr to get the intial bloodwork done unless you already knew what blood type you are. I had gone to one visit with a dr so I had all that info.

Now days for her first timers she can do all the draws in her office.

If she saw reason to have an u/s she has a Dr that kinda backs her up, other wise you can go to whomever you please for the u/s.


I go to a mw because of the care I get. I never got that kind of attention or time with a dr.

IMO theres nothing like a hb. Dh and I have never had a hospital birth but dh says hb is the only way to go for us and I so agree. No hurry to get to the hospital and having to put up with all the stuff that goes on there. I just stay in the comfort and familar surroundings of our own home and get waited on hand and foot. My mw and her helper have nobody else to care for but me. :thumb

Should there be an emergancy my mw has been trained to pack a mother and baby up for Life Flight and to direct Lifeflight to our location. It would take much more time to go to our local hosital have them get a dr in, then decied to call Lifeflight.


Birth is an event not an illness, thus IMO theres no need to go to a germ ridden hospital