Student midwife at the birth? - Mothering Forums

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#1 of 25 Old 12-03-2010, 03:36 AM - Thread Starter
 
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I don't know what to do...  My midwives have recently taken on a midwifery student, I met her for the first time this week at 36 weeks.  They asked me if she could attend my prenatal visits and my birth.  My first instinct is to say yes because I know how important it is for her training.  BUT, when I stop to think about what I want for my birth, Im not sure it includes her.  And that makes me feel pretty bad...

I was planning on keeping everything really low key.  DH and I only, with the 2 midwives (we love them and get along really well).  DS will be cared for by another student midwife who offered to do it for free if we agreed to let her witness the birth if DS was sleeping (that was before this new student ever came into the picture).  She's super nice and I would love to have her with us if DS doesn't require her attention, even though I feel like it's starting to be too many ppl.

The new student is super nice too, but in a different way.  She's full of energy, much more outgoing.  At the prenatal visit, I think she talked more than the main midwife.  That's great, but Im not sure that's what I want at the delivery.  I like the mellow personalities of my midwives and the first student. 

Also, our bedroom isnt super big, and Im worried about the space being too tight for the 6 of us once the pool is in there.

She's in the early stage of her training (not sure of the details) and would be mostly observing, maybe taking pictures for us if we wish, hand stuff to the midwives if needed, and help with the clean up. 

I don't know what to say.  I would like to help and give her an opportunity to learn, but at the same time I don't want to feel like she's invading because she's more energetic/outgoing.  I also don't want to be rude and ask her to sit in the corner and be quiet, and I know I won't have the guts to ask her to leave the room if I find her energy distracting.  

At the same time, Im looking back at my first birth, and I was so high that I really didn't notice who was in the room once I hit transition.  DH says a second midwife came in, and I have pictures to prove it, but I have absolutely no recollection of it.  (until transition, it was only DH and I, with the midwife popping in once in a while for a HB check).  So maybe that won't even matter???

Im not sure how to address the issue, and I have to figure it out before the next prenatal visit so my midwives can ask her to be there (or not).   Maybe she was the way she was only because she was nervous as this was our first time meeting?  I wish she had been part of the prenatal care from the start, I would like to get to know her better before deciding...  But I don't have much time, and I don't want her to waste her time coming to more prenatal visits if she won't be able to attend the birth... 

 

Advice please??

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#2 of 25 Old 12-03-2010, 03:53 AM
 
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As a student midwife, I can tell you that I have never been offended when my presence was not desired at a birth. This is YOUR birth, and I'm sure your midwives will understand your reservations. Please don't be afraid to speak with your midwives. Also, I sincerely hope that you do not feel guilt about not wanting a student in attendance. I will be hoping that you will have the birth you desire.

 

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#3 of 25 Old 12-03-2010, 04:35 AM
 
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totally agree with PP.  

 

This is your birth, you only get one chance, and the SM will have more opportunities.

 

My preceptor has had clients that made it expressly clear that they didnt want anyone "extra" at their birth, and even though its a little disappointing, I really appreciated their honesty. There have been clients that didnt want me around at all, and clients that wanted me for prenatals only.  Most recently I went on call for a client who decided to tell my preceptor (in labor) that she didnt want her to call anyone else (me) to come to the birth. I understood, but was still a bit peeved. It takes a lot to be on call. I rearrange my entire month that clients are due so that when mom goes into labor I am prepared to be available. It would have been courteous and much appreciated to have some honestly from this couple, even that it was a possibility that they weren't "feeling" me and would prefer my preceptor only. I dont  look back and think my time was completely wasted by going to all their prenatals etc, because Im always learning, but yeah, I would have really really appreciated the heads up. Student midwives have lives and families aside from their apprenticeships too yk?


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#4 of 25 Old 12-03-2010, 04:53 AM
 
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2 midwives and 1 student is already plenty, if not too many 'helpers' at a birth, IMO.  I just don't understand this idea of having a whole committee attend a family!  Anyway, you are already allowing 1 student to be present, you don't need to ok a 2nd student.  Honestly, I don't even like the idea that they would ask you to allow a 2nd student.  Birth is for families--the idea of the helpers outnumbering the family is repulsive to me.  IMO, the more midwives/helpers you have, the more the birth becomes 'theirs' instead of 'yours'.

 

Dont' feel bad about politely telling them no, on the 2nd student.

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#5 of 25 Old 12-03-2010, 05:13 AM
 
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You're already having a student.  You don't need to have 2.  It's a homebirth, not a teaching annexe!

 

Having said that, WRT the worries about chattiness, we had a student MW at our most recent birth, i'd never actually met her, my MW met her when she was lecturing and she lived around the corner so my MW asked permission to invite her which worked out great.  She turned out to be very chatty and friendly, but i never knew that until much later because when she arrived and i was IN labour, she behaved just like my MW, they whispered as few words as possible to one another and spoke to me only when they had to (not ignoring me, but letting me get on with it).  So that might not be worth worrying about.

 

But in general terms, i only had one MW, her back up was 45mins away and my active labour was 55mins (and i didn't call my MW to attend until it began so she was only there for 40mins before the baby came) so having the student there was helpful to MY mw - she wrote things down for her and passed her stuff.  In addition there was me (of course), DP and my dad (who sat on the stairs and watched through the open bedroom door) and the 2 mw's, so it wasn't too crowded.  I definitely wouldn't have wanted to add MW's back-up, DD (she was with XP) and another student to that mix!

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#6 of 25 Old 12-03-2010, 07:04 AM
 
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Say no & do NOT feel the least bit guilty!

Aside from the fact that you already have a lot of people AND you don't have a lot of space, this isn't a lot of time to get to know this student! Clearly, you're not feeling great about it (totally understandable) so say no! That's not long enough at all, IMO, to feel adequately comfortable with her prior to birth! Any halfway decent MW will totally understand that! it's the whole concept of sphincter law! Just because you've met her for a couple prenatals doesn't quite move her out of the territory of "stranger" - that's just not long enough, IMO.

 

Do NOT feel guilty! There are enough other clients - clients she can get to know much earlier in the process so that it's appropriate for her to attend their births.

 

Say no! Don't hesitate & don't feel guilty. I agree with Ms. Black that it's actually a bit inappropriate for them to have even asked this late in the game. I find it a touch rude for them even to have asked, honestly.

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#7 of 25 Old 12-03-2010, 04:31 PM
 
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In the situation you described, I think I'd politely decline. It's pretty late in the game, you don't feel at ease with her and you already have a student midwife who will be attending.


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#8 of 25 Old 12-03-2010, 06:08 PM
 
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I agree with the others. You are already 36 weeks. I am sure there are other women who will have more time to develop a rapport with her and won't mind the extra presence.


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#9 of 25 Old 12-04-2010, 11:43 PM
 
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FWIW, the first student midwife was "hired" as a "sibling doula" by the family. If the sibling is sleeping then the student can watch. Her role is completely different than what a student does.  

Quote:
Originally Posted by MegBoz View Post

 I find it a touch rude for them even to have asked, honestly.


Can you elaborate on this a little? "Rude" seems a bit strong of a word, and I'm not fully understanding how just asking could be rude.

 

I haven't had many students work with me, but I always caution them that clients that are due soon may not want them at their birth. And most students are very much like the previous poster-their feelings aren't hurt and they understand.

 


 

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#10 of 25 Old 12-05-2010, 12:28 AM
 
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I had a student midwife at my birth and it was no big deal, I didn't mind at all but I wouldn't have hesitated to ask that she not attend if I had felt differently. I do, however, wish I had been able to ask that the midwife's assistant/doula not be there but she had to be because she wouldn't attend a birth without herself and another fully trained assistant there and the student didn't have the proper training to act in that capacity yet. It was worth it to have the woman I wasn't as comfortable with there because it kept me from having to birth at a hospital with a 40+% c-section rate. What if you agreed to have the student there with the understanding that you may ask her to be in another room for much of the labor and birth. Who know, you may like having an extra set of hands around?

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#11 of 25 Old 12-05-2010, 07:35 PM
 
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There were 2 student mws at DS birth and without them, the experience would have  been tooootally different (and not in a key way). They helped DH know how to help me, having both been through natural labors/delivery themselves. THEY WERE KEY TO OUR SUCCESS. The MW was pretty handsoff, which is what we wanted as well, but she was also focused on DS heartrate since it was finicky at times. Their uplifting encouragement, the constant attention- seriously, one would bring the cup of water while the other was putting a cold compress on my forehead, they both told me constantly how wonderful a job I was doing and whispering encouragment when I was at my breaking point and crying (in transition). I'm so grateful for those ladies and I will be forever indebted to them! I really wouldn't have lasted without them (my labor was soo intense for 5-6 hours)!

 

So needless to say, I say go for it! 


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#12 of 25 Old 12-05-2010, 09:52 PM
 
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 I am trying to decide about a similar situation. My midwives want to have their birth assistant attend my birth. She is almost a midwife herself (about to take her exam) and has worked with them before. I just met her at my last prenatal because she actually lives out of state now, but has returned to help them. I feel kind of unsure because I just met her and haven't had the chance to get to know her and I have shared emotionally so much with my midwives over the course of the pregnancy. Our house is also very small. On the other hand, I can see how it could be an asset to have her there. She said she can sit in another room and read if I don't want her in my space. So I think I am probably fine with it, but you should do what feels right to you. I think that for me, if she knows that I may want to be alone, and how to act at a birth (which I am sure she does not being brand new) than I am okay. I have also been thinking maybe I'll really like having another person, if she can kind of take the role of doula and be encouraging and maybe take some pictures for us.


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#13 of 25 Old 12-06-2010, 08:31 AM
 
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Quote:

Originally Posted by jengacnm View Post

Quote:

Originally Posted by MegBoz View Post

 I find it a touch rude for them even to have asked, honestly.


Can you elaborate on this a little? "Rude" seems a bit strong of a word, and I'm not fully understanding how just asking could be rude.

Well, perhaps 'rude' is indeed a little strong. But let's bear a few things in mind:

1. HB MWs make an effort to make a true connection with clients. They don't just check fundal height, fetal HT, etc. & send you on your way. I think it's fair to say the vast majority really work to develop a strong connection - to really get to know the clients & have a good rapport & sense of trust.

 

2. Again, I think it's fair to say the vast majority of HB MWs really understand & respect sphincter law - that concept that our sphincters are shy & don't open too well in front of strangers, bright lights, pressure (being yelled at, etc.)

 

So given these 2 things, given having spent many months getting to know the client on a deep, personal level, it really strikes me as insensitive & inconsiderate to say, "Hey, can we also bring along this other person who you only met one time (and who is therefore still a 'stranger')?" Bearing in mind that 37W is full term, so it's totally conceivable that the OP could only have met this student the one time.

 

Perhaps I was doing too much projection of my own feelings & that impacted my judgment here. But I've told my MW & her asst repeatedly that I enjoyed laboring alone with DS & want to be left alone as much as possible. So for me, if they said, "Hey could, we also bring this new person along?" to me at my 36W apt, I'd be ticked off & consider it a rude, inconsiderate request.

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#14 of 25 Old 12-06-2010, 04:20 PM
 
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I had a homebirth with 2 midwives (my midwife and her partner) and THREE student midwives, plus our birth photographer. And it was AMAZING. Each of them helped out in their own ways and they all have different personalities but in the moment I honestly wasn't even paying them any attention. My midwife was the main one who spoke with me and provided the most verbal support to me face-to-face. The others were just doing other things like getting tea, helping me sip Recharge in between pushing, massaging my scalp and squeezing my hand while my midwife sutured my tear after the birth...

 

I didn't meet one of them until late in my pregnancy, but to be honest it didn't even matter. I agree, it's your right to choose, especially if your midwife gives you the option, but my midife never did -- she is one of the only CPMs in our state who takes on apprentices and it is never even offered as a choice, it's clear from the get-go that her students are integral to her practice. And I think both client and midwives benefit.

 

BUT, again, it is your choice and I understand your feelings. I just want you to know that hubby and I live in a 500-sq foot apartment and we had a birth team of FIVE and I honestly only think it added to the awesomeness of the event (And I'm not someone who likes to have lots of people around or anything like that).

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#15 of 25 Old 12-06-2010, 04:21 PM
 
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Also, it's really important for student midwives to get experience so future generations of women can go on to have awesome homebirths too! :-)

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#16 of 25 Old 12-06-2010, 07:27 PM
 
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I think it is completely fair to ASK, and in the asking is the expectation that the answer could be yes or NO.
I actually think it is pretty weird to have a student hired out to be separate support, that would probably not fly too well in our practice, we generally need the student, and if for any reason there were 2 labors at the same time or back to back not the best division of labor. On the other hand off we generally go with the flow and what ever needs to be done, playing with a child, and moving back and forth into the room to take heart tones I have certainly done... Even with one or 2 of us sleeping. I have also been called in last minute to cover and can be fine with that and certainly can build a connection in labor with a mom. Granted I feel more comfortable meeting moms more than once before labor. Not all home birth midwives are as one on one as stated some of us practice in small groups and although we may pretty much be the primary attendant for a particular client, it could also be that the midwife who assists a mom at the moment of birth may be who ever is closest .
And to restate if they did not want the additional student to be optional they would not of asked if it would be ok.

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#17 of 25 Old 12-06-2010, 07:41 PM
 
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My personal opinion is from my own experiences so take it with a grain of salt.

 

I say, be upfront at your next appointment and say everything you have written here. Let them know how you feel. Possibly that you will decide the day of labor depending on how your relationship evolves. As MW's i imagine they would be extremely ok and appreciative with your frankness. And it also leaves it up to you so that you always feel that you are controlling your birth, which to me is most important.

 

My experience: I transfered to my last MW I think around 26-30 weeks (can't remember specifics) and she had a new apprentice which had joined her practice since my initial interview with her around 10 weeks (took me that long to decide to go for another homebirth after a very traumatic homebirth with my surrogacy). Initially, i was put off by her. She was extremely homebirth and couldn't understand (my words, not hers) why i'd ever want anything but a homebirth. But as the appointments went on and i dug in and let go and spoke my experiences, I started to really respect her as an individual and decided that i'd call my main mw but probably not the apprentice. My mistake was that i should have been forthcoming but i was still too raw from my last homebirth. And i didn't trust anyone.

 

Everything ended up working out in the end perfectly. I called my mw and they arrived about an hour before birth (was a fast labor) and i remember the apprentice showing up but not much more than that because her complete demeanor changed and i fell in love with how she served as a midwife. After the birth, we realized ds was having some breathing issues and a fever and so we decided to transfer to the hospital since there had been a lot of meconium in my bag of waters when it broke as i was pushing. It was wonderful having the apprentice because I know that my mw probably would have not been able to juggle everything it entailed. I hadn't even packed a hospital bag or anything. So the apprentice prepared me and cleaned up while my main MW cared for my DS and I. She stayed behind as my mw transported with me, ds and dh and she helped clean and then met us at the hospital. At the hospital i realized that we were a united front, and strength truly came in numbers as i was forced to take head on my fears of hospitals and combat my post trauma from my very first (and only) hospital birth and a life threatening hospitalization of my first dd. These 2 women have become more then mw's in my book, they are true friends and the experience that the apprentice gained from our birth and transfer is one that i believe will pay it forward to many hundreds of birthing women as she comes into her own practice. I am so glad that we allowed her to be there.

 

But this is your birth, your body. You get the final say and if it's not something you want, don't be afraid to say so.


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#18 of 25 Old 12-06-2010, 08:02 PM
 
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I had a student midwife attend and I really liked her and didn't mind her there.  Actually there were a couple other people I didn't realize would be there to help with some things on the side (didn't notice them most of the time.. they were more clean up or to offer more hands if necessary rather than the actual laboring and birth management) who I was more bothered by.. again, even though I didn't notice them much.

 

I think it is definitely okay to turn this student down.  Yes, they need experience but they will find experience somewhere.  You are already close to due and might just not be prepared to try to form a connection you might need for the kind of birthing experience you want.  I think if you are unsure and stressing about it, you should err on the side of caution and just not have the student there.  That way, you don't have to realize at your birth you don't want the student there and try to decide if you should ask them to leave or suffer through it or hope you can ignore it or whatever.  They aren't there so its a stress that doesn't exist at all.

 

Plus, you can always say when you go into labor 'hey by the way... its cool if you invite them.'  Its much easier to be polite about changing your mind if you say no now.

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#19 of 25 Old 12-06-2010, 08:30 PM
 
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Quote:
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 After the birth, we realized ds was having some breathing issues and a fever and so we decided to transfer to the hospital since there had been a lot of meconium in my bag of waters when it broke as i was pushing. It was wonderful having the apprentice because I know that my mw probably would have not been able to juggle everything it entailed. I hadn't even packed a hospital bag or anything. So the apprentice prepared me and cleaned up while my main MW cared for my DS and I. She stayed behind as my mw transported with me, ds and dh and she helped clean and then met us at the hospital. At the hospital i realized that we were a united front, and strength truly came in numbers as i was forced to take head on my fears of hospitals and combat my post trauma from my very first (and only) hospital birth and a life threatening hospitalization of my first dd. These 2 women have become more then mw's in my book, they are true friends and the experience that the apprentice gained from our birth and transfer is one that i believe will pay it forward to many hundreds of birthing women as she comes into her own practice. I am so glad that we allowed her to be there.

 

But this is your birth, your body. You get the final say and if it's not something you want, don't be afraid to say so.



YES us too. We had minor complications (PPH from retained placenta) and the student MWs stayed behind with DS who went to sleep while DH, MW, and I went in to the hospital (this was in the middle of the H1N1- I did not want to take him with us, or else they would have checked him in too). They were so kind and loving, I trusted them completely. They took pics of the exams being done by the other MW, and cuddled him while he slept. They cleaned up the mess from the birth (and I do mean MESS!), did laundry, and fed me when I returned. Priceless attention. 


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#20 of 25 Old 12-06-2010, 09:37 PM
 
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I don't like extra people at my births. I would say NO and not look back!

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#21 of 25 Old 12-07-2010, 06:42 AM
 
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Quote:
Originally Posted by ks3885 View Post

I had a homebirth with 2 midwives (my midwife and her partner) and THREE student midwives, plus our birth photographer.

<snip>

 

I agree, it's your right to choose, especially if your midwife gives you the option, but my midife never did -- she is one of the only CPMs in our state who takes on apprentices and it is never even offered as a choice, it's clear from the get-go that her students are integral to her practice. And I think both client and midwives benefit.

Whoa - OK, I can understand that it's a requirement that a MW have a student with her - and maybe even another midwife AND a student for a total of 3... but does she really not let you have any choice in the matter when it comes to having a birth team of FIVE??? Sure, some mamas don't mind and I'm glad it was so positive for you, but if I had to have a birth team of 5, NO WAY would I go with that MW. Even my hospital-based midwives were respectful of my desire to have a smaller birth team & said it was fine to have only a MW and a nurse in the room.

 

& I'm pretty sure a lot of mamas would have a problem with a birth team that large, so it would really surprise me if she didn't let any mamas limit the birth team to a max of 3, or at least a max of 4 if they desired.

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#22 of 25 Old 12-07-2010, 09:22 AM
 
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It has to be your decision for whatever you feel comfortable with. I am also a student midwife and  would never want to make a woman feel obligated. This student will have lots of opportunities ahead in her training, but if you think you might want her there if you get to know her better, don't worry about wasting her time with prenatal visits either. Every visit is good experience for her, and whether you say yer or no, be honest with your midwife about your reasons because that will help her learn. If, like you said, you are put off by her higher-energy personality, then she can get some feedback on how to tone it down a bit, or how to be less nervous. Or, perhaps she's really was just very excited to start her first placement... I know I was! Once again, don't feel obligated... she wouldn't want you to.

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#23 of 25 Old 12-08-2010, 08:31 AM
 
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In the situation you described, I think I'd politely decline. It's pretty late in the game, you don't feel at ease with her and you already have a student midwife who will be attending.


Agreed.  With 2 MW's and another apprentice... that would be too many folks for me.  Sounds like your gut has already made the decision! 


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#24 of 25 Old 12-08-2010, 10:46 AM
 
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I was never asked, but I'm sure if I had SAID "I only want you and one other person there" it probably would have been fine. She would have probably just brought her most senior student and her partner midwife, or maybe just her and her partner midwife. I'm sure some of her mamas do that, but I've never known any of them. All of us loved her birth team (I'm in touch with a lot of the mamas whose births my midwife attended). And we all agreed that her birth team rocks! They all played important roles, even if they were small, in my birth.

 

I'm also a student CNM, and I didn't have a problem with other student midwives being there. I'm also an L&D nurse, so I know that in hospitals so many people are in the room that you've never even seen or met before, so I guess I'm just used to it. Having 5 people, all of whom I'd met before, was awesome to me!  I'm sure your midwife is fine with you saying no, especially since she asked you! Don't worry about it. Everyone is different and many people choose home birth bc they want to have a limited number of people present. I just want to offer a voice saying that I had 5 people present and it was still extremely intimate, happened in my completely dark bedroom with just a flashlight, and could not have been a more empowering awesome experience.

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#25 of 25 Old 12-13-2010, 07:23 PM
 
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I think if she were more experienced I would lean more toward you having her there but since she's newer all the benefits of having an extra midwife are null so she would really just be just an extra body which you specifically don't want. So I say in your situation I would say no.


Harmony, mom of dd (14), ds (11), ds (4) and having #4 in June
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