"Hands Off" Midwife... means what now??? - Mothering Forums

Forum Jump: 
 
Thread Tools
Old 10-01-2005, 08:54 AM - Thread Starter
 
Spark's Avatar
 
Join Date: Nov 2001
Location: Prodromal Labor Island Ambassador
Posts: 11,190
Mentioned: 0 Post(s)
Tagged: 0 Thread(s)
Quoted: 0 Post(s)
So many times I've read posts or birth stories about "Hands Off" midwives. But it's used so frequently to describe 90% of MWs that I'm totally thinking it means very little now. MWs described as "hands off" have suggested transferring to an OB during pregnancy for variations of normal, vaginal exams during prenatals, all kinds of testing, stripping membranes, rupturing waterbags (to get things going), doing many cervical checks during labor, holding back the lip of a cervix, dictating positions to labor in, just plain interfering, etc, etc, etc.

I wouldn't consider any of those items as something a "hands off" MW would engage in and yet others do. The term "hands off" is so confusing now. It's like saying "That was a cute baby." because most baby's are merely by their existence. I don't think a MW is truly "hands off" though just by her existence, yet it seems others do think so.

What can we call a MW who comes to your house and sits in the corner and then performs a newborn check and postpartum check after the family has a good amount of time to bond? She's certainly not "hands off" since she didn't recommend transferring to OB care when labor stalled for 2 hours. So... what is she?

Spark and her four firecrackers.
Spark is offline  
Sponsored Links
Advertisement
 
Old 10-01-2005, 11:28 AM
 
alegna's Avatar
 
Join Date: Jan 2003
Posts: 42,826
Mentioned: 0 Post(s)
Tagged: 0 Thread(s)
Quoted: 0 Post(s)
Not sure what you're asking.... but I have found some MEDwives who claim to be hands off midwives, so I hear you on that...

I did end up with a true hands-off midwife.

sigh

-Angela
alegna is offline  
Old 10-01-2005, 11:42 AM
 
veggiekicks's Avatar
 
Join Date: Jul 2005
Location: Miami, FL
Posts: 570
Mentioned: 0 Post(s)
Tagged: 0 Thread(s)
Quoted: 0 Post(s)
I consider my mw to be pretty "hands off", but she did do a few VEs, listen to baby, and suggest position changes while I was in labor. Even though these things are a bit more "hands on", I consider her to be more hands off in that she ALWAYS let me call the shots (she would've stepped in if ds or I were in danger, though). A few of the VEs were at my request, some were her suggestion. It was her idea to listen to baby intermittently and same with the position changes (some positions I tried and some I didn't), but she was been fine with me declining any of these and sat back.

During prenatals she offered all of the testing to me and let me pick or choose what I wanted. She never offered a VE in prenatals, but would've done one if I requested.
veggiekicks is offline  
Old 10-01-2005, 12:04 PM
 
MamaTaraX's Avatar
 
Join Date: Oct 2004
Posts: 3,444
Mentioned: 0 Post(s)
Tagged: 0 Thread(s)
Quoted: 0 Post(s)
My midwife is known for being hands-off. She'll come to a birth and just be in the house, nowhere near you until you ask or after the baby comes out. That's part of the reason we hired her. That's a BIG reason why. She doesn't do VEs,unless requested. I even asked if she can *not* check FHT and she said "sure". She said she'd like to do one when she arrived but didn't need to do anymore unless something seemed amiss. She's happy to just be in the area in case she'sneeded. That's exactly what I think a midwife should be! Mine asks if I want any tests or anything and that's it. She asks just to bs sure, not to badger. The midwife I had for my2nd son's birth was hands-off too. When we arrived at the birth centre, I requested a VE and she did one. Otherwise, she didn't do any. She only camearound me when she sensedI needed it and it was exactly whaet I needed. She napped with my older son. She'd come andtalk with me or rub my body when she knew I needed it, but otherwise,nothing. I loved it and my husband was so impressed with that that he named the baby after her

Namaste, Tara
mama to Doodle (7), Butterfly (2), and Rythm (due at home 1/06)
MamaTaraX is offline  
Old 10-01-2005, 12:05 PM
 
MamaChel's Avatar
 
Join Date: Mar 2003
Posts: 1,211
Mentioned: 0 Post(s)
Tagged: 0 Thread(s)
Quoted: 0 Post(s)
my MW is pretty hands off. She did exams when I requested but otherwise left us alone. We had to go get her from her nap when I was ready to have the baby, she was downstairs.

As for your question.....I'd call her a wonderful midwife.
MamaChel is offline  
Old 10-01-2005, 01:44 PM
 
Undercover Hippie's Avatar
 
Join Date: Sep 2004
Location: The 'burbs
Posts: 2,205
Mentioned: 0 Post(s)
Tagged: 0 Thread(s)
Quoted: 0 Post(s)
My MW is truly hands-off as well. I never had a VE and the only "testing" she does is the pee strips. When she arrived at our house I was being supported by my doula and DH so she didn't even touch me until I felt pushy. Then she just supported me through my pushing as I needed/wanted (and wiped poop :LOL) but mostly she sat back until the baby's head was coming down and out. She really didn't get "hands-on" until it was needed when the placenta came out with a gush of blood.

So maybe the term "hands-off" MW is overused and is not as significant as it should be, but for a MW who truly is I agree with the PP:

Quote:
As for your question.....I'd call her a wonderful midwife.
Undercover Hippie is offline  
Old 10-01-2005, 03:04 PM
 
ZeldasMom's Avatar
 
Join Date: Sep 2004
Location: New York
Posts: 3,371
Mentioned: 0 Post(s)
Tagged: 0 Thread(s)
Quoted: 0 Post(s)
ITA that the term doesn't have a lot of meaning, and I've never heard it used outside of MDC. I think people use it as a kind of shorthand for "a good midwife" or "a true midwife" since there are some that work in a pretty medicalized way (for example, I had a midwife for my first birth who had many moms give birth on their backs : ).

In terms of choosing a birth attendant for myself my inclination is to not worry about labels and go more with choosing a provider that I feel good about. For me that means a provider who (a) reads professional medical/midwifery literature and practices in an individualized (it's a red flag to me if I hear a lot of "I have all my clients do X"), evidence-based way and (b) works in a collaborative rather than a controlling way. I want someone who sees her role as giving information, then leaving it to me to make the decision about what to do, and is able to step back and respect that decision even if she would have made a different one if she were the client. To me when people talk about wanting a "hands off" midwife what they mean is they want someone who perceives birth as a normal process rather than an inherantly medical process, and consequently lets it happen the way that feels right to the mama rather than stepping in and "managing" things when this isn't needed.

I just gave birth attended by a CNM who exclusively does homebirths and I thought she was awesome. I had no vaginal exams/cervical checks during my pregnancy or the birth, and things like being weighed/testing my urine at prental visits were optional. I found her very empowering, supportive, and "hands off" at the birth. Some people would dismiss her as a MEDwife just because she's a CNM. I get why they say this, since their training is more medicalized than the training CPMs get and most work under the supervision of an OB. Still, I think it's best to put some work into getting to know your provider and then judging how good of a fit her approach is with what you're looking for.

edit: one more thought about what it is to be hands off. IMO a midwife isn't necessary for a normal birth. I want a midwife present as an insurance policy in case something goes wrong. If it doesn't, I don't want her doing much.
ZeldasMom is offline  
Old 10-01-2005, 06:51 PM
 
MamaChel's Avatar
 
Join Date: Mar 2003
Posts: 1,211
Mentioned: 0 Post(s)
Tagged: 0 Thread(s)
Quoted: 0 Post(s)
Quote:
Originally Posted by ZeldasMom
I want a midwife present as an insurance policy in case something goes wrong. If it doesn't, I don't want her doing much.

ITA. My midwife becomes helpful when I don't stop bleeding after birth. (runs in the family, we know about it and by now are prepared to deal with it, no big deal) Otherwise, I prefer to be left alone.
MamaChel is offline  
Old 10-01-2005, 08:45 PM
 
Mrs Dimples's Avatar
 
Join Date: Apr 2004
Location: nak'ing the light fantastic
Posts: 1,971
Mentioned: 0 Post(s)
Tagged: 0 Thread(s)
Quoted: 0 Post(s)
I have never given birth with my MW, but she said in our interview that her preference is to be hands-off, unless the laboring mom wants otherwise. She said she would be perfectly happy to putter in the kitchen while I labor and catch the baby if I wanted.

All prenatal testing in addition to pee strips (which I do myself and read with her) is at my discretion although she seems pleased that I have declined all of it. She has lots of videos of UC in her library...anyway, I am confident that she will not turn into the dreaded medwife on me. I interviewed LOTS of people before I chose her, and although some of them professed to be hands-off, in the sense you are talking about, I had a fishy feeling.

I agree that we have a problem when people think that securing the servies of someone titled anything other than OBGYN is guaranteeing them some kind of warm fuzzy birth, or quality care. The letters CNM, CPM, or anything else do not a good birth attendant make. You have to do the homework, and be attentive, and KNOW WHAT YOU WANT. And don't stop until you find someone who will help you get it.
Mrs Dimples is offline  
Old 10-01-2005, 09:15 PM - Thread Starter
 
Spark's Avatar
 
Join Date: Nov 2001
Location: Prodromal Labor Island Ambassador
Posts: 11,190
Mentioned: 0 Post(s)
Tagged: 0 Thread(s)
Quoted: 0 Post(s)
So, it's not just me that see how "hands off" midwife means very little, then? It's like most people say it and mean lots of different things. When someone says that their MW is "hands off" I usually gloss over that in my mind, because it means very little IMO. Now, tell me that your MW won't do or say anything unless you ask or a major emergency is present and I KNOW what that means.

Perhaps it's a combination of MW's presenting themselves as "hands off" and clients feeling comfortable with the care they've received, even if the rest of us would not be that leads to the overuse of "hands off".

MrsDimples put it well when she said to fully investigate your care provider. Even if they call themselves "hands off", it could mean a range of things just like MDC mamas who use the term.

Quote:
Originally Posted by ZeldasMom
IMO a midwife isn't necessary for a normal birth.
: I couldn't have said it better!

Spark and her four firecrackers.
Spark is offline  
Old 10-01-2005, 10:57 PM
 
mwherbs's Avatar
 
Join Date: Oct 2004
Location: Tucson, AZ
Posts: 5,491
Mentioned: 0 Post(s)
Tagged: 0 Thread(s)
Quoted: 1 Post(s)
for me it is a willingness to do what parents want -- but there are always constrains of licensing-- here in AZ the protocols are written into the midwifery law- so even if something is outdated it is still required to do - referrals are prescribed by the state for many variations of normal- in these cases a midwife has no real choice in the matter. And she may reassure clients and even have a good back-up who will not create problems where there are none.
Additionally there is such a thing as "standard of care" in which you need to offer as a care provider-
------there is a wide range of what a consumer wants- 15-20 years ago none of the women I served would ever have an ultrasound, now a very high percentage of women I see expect to have atleast 1 ultrasound - it is the rare client that does not want this. and it goes the same for every procedure and test women/families pick and choose all sorts of things I would have considered more hands on-- but it is not my life or body so it is also not my choice to make other than to be aware of what is done and how to do it or who to refer out to.
mws I consider "hands off" will usually have/accept waivers for many things they are required to offer, they are patient and are often happy to just sit on their hands- frequently at prenatals there is plenty of time for you to talk not just listen(the birth stories they tell and enjoy are ones where they didn't have to do much)
mwherbs is offline  
Old 10-01-2005, 11:47 PM
 
Rach's Avatar
 
Join Date: Nov 2003
Location: New Mexico
Posts: 3,414
Mentioned: 0 Post(s)
Tagged: 0 Thread(s)
Quoted: 0 Post(s)
I consider my midwife to be pretty hands off.
She does have things that are routine for prenantal check ups, but I can refuse any of them at any time.
She has scheduled my prenatal checkups around my comfort level, instead of doing the routine 2 weeks, and then 1 week apart.
I'm 39 weeks and she has not mentioned once doing VEs. I asked how many she does during labor, and she says the most she's done is 4, and feels like that is a lot.
She prefers to have the fathers catch the baby, since it is their baby and they have a part in birthing too.
She wants to be called when contractions are 2-3 minutes apart, but will come at anytime the mom wants her.
I've asked what to do in case of transfer of care [such as after 40-42 weeks and a VBAC] and she says she will do whatever the mother wants, and prefers to do nothing if the mother and baby are well.
She also says, she tries to exhaust all options before transferring care, and that includes calling a fellow midwife to asses the situation for suggestions.
After the birth, she wants the mother and baby to bond for about an hour, and wants the baby to latch within that hour. She does her exams on the newborn on the mother's chest, and doesn't weigh or measure etc.. until the mom is getting cleaned up and into bed so the family can rest.
True, I have not birthed with her yet, but so far I am pretty confident that she is the right midwife for me.

heartbeat.gif heartbeat.gif heartbeat.gif

Rach is offline  
Old 10-02-2005, 12:38 AM
 
cathicog's Avatar
 
Join Date: May 2005
Location: Great Smoky Mountains TN
Posts: 1,551
Mentioned: 0 Post(s)
Tagged: 0 Thread(s)
Quoted: 0 Post(s)
Quote:
Originally Posted by Spark

What can we call a MW who comes to your house and sits in the corner and then performs a newborn check and postpartum check after the family has a good amount of time to bond? She's certainly not "hands off" since she didn't recommend transferring to OB care when labor stalled for 2 hours. So... what is she?
A good one. (or a well paid babysitter! )
I have found that just by listening, I can tell how mom is doing, and only the occasional fetoscope/doppler check on baby, especially if mom is feeling pushy. Other than that, I would go with what the mom wanted. Some just don't like to be touched at all...and I don't necessarily consider a 2 hr stall a bad thing. It could be the break the mom needed just before pushing. Especially if it is late in the evening/early AM, and she needed to sleep some before pushing...
cathicog is offline  
Old 10-02-2005, 12:54 PM
 
anonymommy's Avatar
 
Join Date: Aug 2004
Location: Georgia
Posts: 252
Mentioned: 0 Post(s)
Tagged: 0 Thread(s)
Quoted: 0 Post(s)
Some people have used the word "low profile" as in low profile midwifery ... one comes to mind but I am too fuzzy right now to giver her credit, although perhaps she deserves credit for the term.
anonymommy is offline  
 
User Tag List

Thread Tools


Forum Jump: 

Posting Rules  
You may not post new threads
You may not post replies
You may not post attachments
You may not edit your posts

BB code is On
Smilies are On
[IMG] code is On
HTML code is Off
Trackbacks are On
Pingbacks are On
Refbacks are Off