Can someone explain midwives to me? - Mothering Forums

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#1 of 7 Old 07-08-2006, 10:54 AM - Thread Starter
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I just told DH that I am now planning on going to midwives instead of an OBGYN and he just flipped! He told me he does not like the idea of me not seeing a real doctor. So now I do not know what to do. Maybe if I had more information on midwives it would help? Do midwives perform and read ultrasounds? I would like to have the one at around 20 weeks. How about if a problem arises, are there doctors readily available to help out? What if during delivery there is an issue and a doctor is needed is that possible?
Any other information that you could supply me with would be great since now not only do I have to change practices I now have to convince DH that seeing midwives are OK.


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#2 of 7 Old 07-08-2006, 11:25 AM
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Here's a pretty mainstream overview of midwives, for starters:
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#3 of 7 Old 07-08-2006, 12:14 PM
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For the most part, if you are giving birth in a hospital, the doctor is NOT in the labor room with you until the VERY END of the birth.... like literally until the baby's head is crowning. Before that the doctor monitors your labor via computers and monitors and it is the L&D nurses that are going to be there... so if your husband thinks having an OB is going to give you quality care, thats not true. If an emergency arises, the L&D nurses page your doctor to come.

Most midwives do bedside labor support, so you will have a trained professional in there with you while you are laboring more frequently than with a doctor. Some come in and out, others hang out in the room the whole time. Same as if you have a doctor, if an emergency arises, an OB will be paged. So actually having a midwife is SAFER because you are more likely to have a trained professinal in there with you not solely relying on computers and monitoring you from another building or whatnot.

Having a midwife will also lower your chances of cesarean and other complications because they are trained in the art of birth, not just surgery...

There is a quote out there that having a trained surgeon deliver your baby is like hiring a pediatric surgeon to be your child's babysitter... its overkill and not necessary. If their services are required, either way they are going to be paged.

Also, most OB's don't perform their own ultrasounds, they send you to ultrasound technicians for that. Same thing with midwives.
Also, midwives spend more time with you during appointments so they are more apt to pick up on subtle issues that might need to be addressed. To me its better quality care and safer to go with a midwife. Save the OBs for the true emergencies.
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#4 of 7 Old 07-08-2006, 01:40 PM
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Well, as an aspiring midwife, I'm a little biased, but the World Health Organization recommends that the majority of maternity care should be handled by midwives, NOT OBs, so I don't think I'm alone in my belief that midwives rock and are extremely safe.

Some webpages to check out:
ACNM - their site is extremely biased toward CNMs and their certifications, and basically ignore MANA and the existance of CPMs, but for information on nurse-midwives (the type of midwife you'll probably be seeing) they're a great resource.

MANA - a much more balanced look at ALL the midwifery options, since they're a group for all types of midwives. Their servers are wonky at the moment though, and they're expecting the site will be up and down "In early July".

Citizens for Midwifery - another good resource for learning about all different types of midwives. They promote the Midwives Model of Care, which is what makes midwives so great, but which unfortunately many CNMs are constrained against using by hospital policy. Here's their FAQ which addresses many of the questions your husband probably has.

For books, I highly recommend The Thinking Woman's Guide to a Better Birth by Henci Goer, Gentle Birth Choices by Barbara Harper, or, oh, any number of other good birth books.

OH! Marsden Wagner, MD (former member of the WHO branch for maternity and child care, I believe) just came out with a new book, called something like Creating Your Birth Plan. I recommend that one, too.
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#5 of 7 Old 07-09-2006, 11:31 AM
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Having birthed with a midwife and attended a birth as a coach with both a midwife and an OB, there's no comparison in quality of care. A midwife takes the time to know you, know your plans, and stays with you a huge chunk of the time you are in labor. SO if you need to try a different position, get up and move, need some coaching, encouragement, to discuss options,etc. the midwife is there for you. Most hospital midwives work with/under OBs and immediately page them if you need them. They also spend ALL their professional time doing prenatal and birth care -a s opposed to OB's who do a variety of ob/gyn services

Birthing with an OB, in most cases, works like this.
You go to the hospital, nurses set you up and then leave you alone for a while. A doctor "pops in", checks you vaginally, looks at any monitors, then leaves. The nurses stay with you for the most part, but may of may not give you any coaching, so if you and your DH don't notice that you may need to be moving around, change positions, etc, then nobody suggests it. You may end up stalling or something and not have the expertise to know how to address it. Also, if you are in labor during shift change - usually 7 am and 7 pm, but other times also, the nurse will leave and you will get a new nurse, even if you are in the middle of pushing. SO you may end up with a nurse you have no rapport with at a very intense time. Every hour or so, the doctor pops in, asks the nurse or maybe you how things are going, then leaves. Occasionally checks you vaginally. If she/he doesn't like how your labor is going, they may push meds like pitocin or push for a c-section, but won't stay int he room for longer than maybe 15 minutes, so don't actually obserrve your contractions, how you're handling them, what sort of support you might need. When you start pushing, the nurse will notify the doc, who may or may not come. THe nurse will watch you push, giving you some instruction (but without having the masters degree that midwifes have, just probably lots of experience witnessing births). When the baby is ON your perineum, maybe 2-3 pushes from coming out, the doctor will RUSH in, there will be a flurry of activity all the sudden, probably freaking you out a bit. You'll push out the baby. The OB will hand them off, deliver the placenta, congratulate you and leave. If you were in labor for 12 hours, you might see him/her for an hour or so. DOes that sound like excellent care to you? The OB who delivered my SIL's last child never even said her name.

A midwife will stay with you, give you QUALITY coaching, help you have the birth you want, and negotiate care dcisions with you. You will feel like you have an ally and advocate.

BTW - I've NEVER heard of an OB who performed or read the 20 wk ultrasound. They take a while - like 30 min. - and an OB is generally not going to take the time to do that themself unless it's a tiny little practice. You generally are sent to an ultrasound tech who takes all the pix and measurements, then passes that on to the OB or midwife - both of whom interpret her notes. When I was "late" and had to have non-stress tests and ultrasounds, my midwife did do those ultrasounds (to measure fluid). When my midwife didn't get the numbers I needed, she sent me to her ultrasound tech to give me another chance to avoid induction - I doubt an OB would have given me that chance.

Good luck - have your DH do some reading, and have him go to your first midwife appointment and ask the midwife questions. If he's not impressed, I'd be surprised.
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#6 of 7 Old 07-09-2006, 12:00 PM - Thread Starter
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Originally Posted by Yo Becca
BTW - I've NEVER heard of an OB who performed or read the 20 wk ultrasound.
Both my OB's (moved in the middle of my pregnancy) did the ultrasound themselves. I lived in both a large city and a small town too so I guess it just varies from practice to practice.

Oh and I'm really excited to try out midwives now. Though if I lived in the same town I did where I delivered DD I would still see my OB there. He was awesome and laid back and took all my requests into consideration. My only requests were, no c-section, and no cutting or tearing and I had neither. I'm sure some of it was luck but I had a great birth!
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#7 of 7 Old 07-09-2006, 01:03 PM
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With my last pregnancy, my DH was really against us switching to midwife care. I wanted to go in and meet them, so I brought him along and by the time we left he was more then comfortable with us have them do our prenatal care and birth at the birth center. This time around we're having a home birth.
Maybe take him with you to meet them and just go over their content of care.
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