Hi there! I'm new to this site. My husband and I are trying for our second child and I've heard from lots of different people that they swear by midwives. I don't know much about them though. I mean, I've searched the internet and have a pretty good understanding of what they do but I'm really looking for more personal info, testimonials and the like.
I'll start by saying what I'm looking for and maybe someone can help with some advice on the topic. Please feel free to share any midwife experiences that have swayed you one way or the other because I'm just really trying to absorb as much info about them as I can. With my first child I had a rocky pregnancy, no life threatening problems but my son was born via emergence c-section and the doctors could never really give me that much info as to why. I really feel like I was just along for the ride which is not at all what I wanted and certainly not what I want this time around either. I still want to see an OBGYN I think and I for sure want to give birth in a hospital but I really DON'T want another c-section. I was told by the doctor who delivered my son that I wouldn't necessarily have to have another one. Basically what's really important to me is to have a trained professional who is there for ME as much as he/she is there for the baby so that I don't feel so out of the loop. I want someone to be able to say, "hey wait, that isn't the only way!"
So, what do you think? Am I crazy? Is this something that a midwife would be better at or did I just have a horrible doctor the first time around?
hm, I don't know. A Doula doesn't have any medical credentials or anything. I don't really know much about the field I guess but it seems a little new-agey for my taste. No offense intended to anyone.
I think the PP meant a doula in addition to a doctor/midwife... a doula is there to support you during labor/birth - nothing new-agey about it.
Right, I figured that. I guess I'm just feeling like a doula would provide something more along the lines of moral support when I'm looking for a little more than that. Again, though, I don't know much about doulas.
I'm not in your area but saw the thread on the main page. How about looking for a nurse midwife? They work with an OBGYN (either in the same office or use certain OB's as backup). I had my first son with a nurse midwife in a hospital. The practice had two nurse midwives and two OBs. I have a friend who used a nurse midwife practice that had their back up OB's in another office. That way you get the care of a midwife with the OB backup if it becomes necessary.
I had an OB during my pregnancy and switched to a CNM (a registered nurse, who also went to midwifery school) who like the PP said, was in a practice with OBs, so if anything were to go wrong, there is at least one OB on call. This was also a hospital birth. You have the philosophy of the midwife but also the sense of security with an OB. I think it would be a great mix for you.
If you would like to get a better grasp of the subject, I would highly recommend watching the movie The Business of Being Born. It gives you a good introduction as to why many people choose to not have an OB. If you still would like an OB, I would get a doula as I see you are planning to have a VBAC. I am a doula (in training) and our purpose is to offer you with emotional and physical support as well as give you the information you need to make an educated decision. They are YOUR advocate, and looking out for you and your best interest.
Here is a great article...
Doula mom to Leo [7.11.10] and fiance to Jake.
Welcome to MDC!
I would certainly recommend (agreeing with a previous poster) that you and your husband check out "The Business of Being Born" for an outline of the cascade of interventions that can lead to a cesarean section--it gives a good overview as to why so many women are choosing midwives, in an easy to understand, non-threatening way. I know Netflix has it.
I chose a midwife because I believe that pregnancy and birth are a normal, healthy process, not an illness. I wanted someone who would listen to and respect my concerns and preferences, but would still be there in case my baby or I needed help. I wanted the freedom to have an intervention-free labor and birth, and my midwife was extremely supportive in achieving that end. I am fairly sure that with an OB I would have had a cesarean section, mostly because my baby was big. Instead, I had a wonderful vaginal birth, with the knowledge that if I had needed a C-section, it would not have been for lack of trying or my care provider's lack of trust in my body.
I think the best thing you and your husband could do is to sit down and interview a few different midwives and ask them about their care philosophies, and see if you are comfortable with what they have to say. In your position, I would be looking for a certified nurse midwife who works in a hospital setting, as a PP mentioned. Also, since you are planning for a vaginal birth after cesarean section (VBAC), you'll want to choose a care provider and hospital carefully, as some are more VBAC-friendly than others. Check out the International Cesarean Awareness Network (ICAN) and VBAC.com--she seems to have good, concise descriptions of how a midwife and/or a doula can help you achieve the birth you and your husband are striving for.
Good luck, and again, welcome to MDC!
Stay-at-home mama married to my best friend of 10+ years. Aspiring midwife loving parenting our beautiful Julian, born 5/24/09. Expecting a second bean in late July 2012!
Thank you all SO much for the info!! I will definately watch The Business of Being Born. Also, thanks for all the info about VBAC. You really have no idea how helpful it is! I'm glad to hear that there are midwives out there that work in an office with an OB on call. I don't have alot of friends who have had children so the only person I've been able to talk to at length is my mother and she was under the impression midwives only did home delivery so she wasn't much help. :D
Is anyone in the Toledo, OH area? This is where I am so referals would be very welcome!
Thanks again, ladies, for all your help!! Anymore stories and experiences are also welcome. I'm in high research mode! :)
There is the freestanding birth center (Mother's Own), but that isn't quite what you are looking for.
There is a Dar a Luz group run by Erin Marten-Snyder and an attachment parenting group run by Holly Allen. Both could probably put you in touch with other VBAC moms or at least find you some info about the midwives who could be helpful with a hospital VBAC. There is a pretty fair sized group of women who natural mother in the area.
Off the top of my head:
Associates in Women's Health with Cindy Parke. It is a midwife group that employs an OB. Not sure how often it happens but have met several women who tell the same story about scheduling the baby's birth especially if they want a VBAC. They are told that the OB will be out of town/off call near the due date and the other docs in the call circle are not nearly as supportive. So, to get your VBAC they suggest you have an induction near your due date to be sure their doc is the one on call. Other than that they do do waterbirth at St. Luke's and maybe St. V's.
The Toledo Hospital midwives (big group of 17-18 or so) also does VBAC's on an individual basis once approved by their docs.
Donna Augustine is in with Dr. Read and their record is pretty good also.
Hey Jessica. I am not in Ohio but wanted to weigh in on my experiences with midwives and doulas and why we made the choices we made. My first birth (my oldest daughter) was when I was 15! I had a traditional OB and while I wasn't subject to any interventions, it was certainly not what I would have wanted. I definitely felt, "along for the ride". So, when I got pregnant with my son 2.5 years ago, I knew I wanted something more participatory and I didn't want to be in a hospital. I looked around and found a Certified Nurse Midwife. She was an RN and had also gone through midwifery training. At the time, I was a bit leery of CPM's (Certified Professional Midwives, or lay midwives). Anyway, the birth was quick...the experience wasn't 100% what I wanted, but mostly that was due to the quick (2.5 hour) labor and birth and everyone scrambling. I was very thankful to be at home and have a midwife and my family present.
I don't know why but the Reply thing is giving me a hard time...so, this is a continuation from my last post! Anyway, for our third child, I decided to go with a lay midwife. She'd been the birth assistant at our 1st homebirth and was closer to me geographically, so we hired her. I couldn't have been happier. I shared with her that I was kind of disappointed with how fast and intense the birth had been. NOt that anyone could have changed that, but I told her how concerned I was that I basically labored and delivered by myself because everyone was scrambling to get ready. Anyway, she listened to my concerns and was sure to be very "present" for me at our last birth. She encouraged my husband to JUST focus on me, and not running around filling the tub and that kind of thing. She encouraged me to move, change position, breathe, feel the baby's head as she was crowning...everything that I would ever want out of birth. She was wonderful. I doubt will will ever have more kids, but if we do, I will ABSOLUTELY choose to have her present at our next birth. She was attentive to me AND what was going on with the baby. I don't think that OB's are all bad, there are truly some wonderful OB's out there. But, VBAC's are difficult to find these days. I know so many people that wanted a VBAC but weren't "allowed" to try. That is criminal, in my opinion.
I would really encourage you to look for a midwife if you are interested in a VBAC. Or, have a good hard conversation with your OB and really discuss your last birth, what happened, your wishes for your next birth.
Sorry for the multiple posts!
I wanted to add that you should DEFINITELY read "Ina Mae's Guide to Childbirth" by Ina Mae Gaskin. She uses some kind of strange terminology, but don't let that distract you. She is an absolute genius and very well respected both by midwives and OB"s around the world.
And I forgot to ALSO add that no, you are NOT crazy. I think that is a total failure of the modern medical system that we are left feeling as if we are not active participants in our own health. This is especially offensive when it comes to birth. Birth is an intimate act occuring between you, your baby and...nature/God/spirit...(whatever you believe in). Whomever attends your birth should respect that and do absolutely EVERYTHING they can to nurture that intimacy, provide guidance, assistance and be ready to assist when the two of you are having problems. But it is NOT their birth, it is NOT their glory.
That is what drives me nuts about most OB's. They really seem to view it as "their" event. Ugh.
Ok-apology. I re-read the OP and you are interested in an OBGYN and a hospital. I gotta say that I don't have much to add on that because it has been my experience that it is HARD to get away from the intervention/C-section/no VBAC thing at a hospital.
Still read Ina Mae, though. :)
No apology needed! You've given me great info and I love hearing about other women's experiences when it comes to the birth of their children. It's not something that I feel comfortable asking people about because a lot of people feel that it's private and I respect that. When it comes to the whole hospital thing, I just worry that what if something happened that we couldn't handle at home, you know? There was so much mystery when I had my first child, no one knew why he was in distress they just tell me that if he hadn't been born when he was he wouldn't have made it and that scares the hell out of me. Of course there was more to it than that but ultimately no one could tell me what happened and I DON'T want that to happen again. Also, I can't help but feel that if my OB had been paying more attention to me I would have gotten more anwers because I was surely asking questions.
I'm starting to worry that I won't have any luck with the VBAC. I really hope that's not the case.
Welcome! For my first VBAC, I actually hired a homebirth midwife to come to my home during labor, and then when I reached 8-9cm, she went with me to the hospital and advocated for me as my doula. The best way to have a successful VBAC, in my opinion, is to get to the hospital when you are well into labor so there is less time for medical intervention. Good luck!
Well, Jessica that is partially why I recommend reading Ina Mae's book. I think that for my husband and I, there is absolutely NO FEAR involved with childbirth. So, it was easy for us to choose homebirth because it is our absolute conviction that childbirth is NOT an inherintly dangerous process. But, I totally understand that it is common for people to have fear associated with it, particularly if you've had a scary situation in the past. And the Ina Mae book just makes the whole process seem...beautiful. NOT scary. Even the women that are having breech babies or twins...its all so beautiful and NOT scary. I love that book! :) I gave it to my BFF when she had her first baby. And she (jokingly) said that she was going to "reach for birth ecstacy". She sent me a pic of herself like, minutes before her baby girl was born. She was smiling. :) She was trying SO hard to achieve that...she walked into the hospital and delivered her girl in triage.
I just think that while there are definitely legitimate problems that can pop up, a lot of it is attitude and empowerment. Ya know?
So, if I were you, I would first schedule an appointment with the OB that delivered your last baby and ask some pointed questions. "Why did I have a c/s?" "What caused distress?" "What WAS the distress?" (low heart-rate, shoulder dystocia, etc.) I mean, you really can't know if there was something about YOU or your BABY or if there was something about what THEY did to you that caused this "distress" until you sit down and ask those questions. Its all about self-advocacy.
I think that once you do that, your new-found understanding of the situation will help eliminate a LOT of fear. Knowledge is power, right? Talk to some midwives in your area, go visit the birth center that someone mentioned. I mean, I just really firmly believe that the more you know, the better off you are.
I read somewhere the biggest difference between OB's and Midwives is Midwives listen. They trust you and your body to deliver a baby and trust your judgement about what is best for you, your baby and your family. With a good midwife, your prenatal visits will be at least 1/2 hour. She will spend time with you talking about what is going on with your pregnancy, how you are feeling about things (emotionally and physically) talk to you about what tests she recommends and why, what to expect from your labor and answer all your questions completely. With DS1 my DH had a million questions about everything and they were all answered patiently and throughly. We were never rushed.
I would add the other difference (which is related) is presence. Your midwife will be with you your entire labor. She will be the one monitoring you and the baby (interminttently) instead of a nurse who is generally checking in with the OB. She will notice problems before they become crises and step in with the appropriate response. Since the midwife is present, you can avoid continuous fetal heart rate monitoring which very often starts a cascade of interventions ending in C/S. I don't have sources on hand but a search of fetal heart rate monitoring or cascade of interventions-birth, should pull up more than you can read. :)
Also, you have a right (and responsibility to yourself) to find out exactly WHY you had a C/S with your first birth so you educate yourself to avoid (as much as possible) a second. You can ask for a copy of your records from the hospital and your OB. If you still have questions, set up an appointment and (nicely) demand an explanation from the OB. I don't mean to cause any hurt, but the fact that the OB won't tell you why a C/S was the only choice and that he is using the "we saved your baby" card is a huge red flag to me. You need to know this information so you can heal and have a better birth this time.
Even though this is your second birth, check into attending a Bradley (or Brio) childbirth class. You and your partner will learn soooo much.
Pam Cliff Malachi 5/08 Judah 5/10 Eden 8/12 Asher 8/12
You can't get a cup of tea big enough or a book long enough to suit me. ~CS Lewis
Thanks so much for all the great info!!!
Just to be clear, I did ask a lot of questions after my son was born. What happened was, I was sent to the hospital because my blood pressure was high. While there his heart rate slowed and we called a nurse in, she checked the machines and then left to talk to a doctor. My OB was out of town at the moment but they were a big practice so I had another doctor from the same practice that was on-call. The nurse came in and said that he was in distress and they were going to have to do a c/s. At this point I was really just afraid for his safety and felt that I shouldn't slow them down at all. Anyhow, once all was said and done I was told that for some reason there was no amniotic fluid when he was delivered. His blood sugar was low also. When I asked why all this happened I was told they didn't know for sure and they thought maybe I could have developed gestational diabetes after I had been tested for it. I asked a different doctor from the same practice the next day and was told the same thing. I really didn't do the research I should have done before choosing my OB and that's my fault, I really just didn't know any better (hence the thirst for knowledge this time around).
This is a great site. You guys have really helped me out a lot and I have begun to compile a great list of Midwives in my area that I will interview when the time comes. I'm really glad I have all you mothers to pester!
If you don't mind my adding to the thread, I may be able to fill in a few blanks for your questions about why the distress occurred. I'm a midwife and have worked on a large perinatology project with the NIH branch in Detroit.
I don't think the problem was gestational diabetes. It sounds more like you had preeclampsia. Or, did the docs do any testing MTHFR or Factor V Leiden? Both (MTHFR and FVL) cause micro clots in the placenta and decrease the available surface area for providing nutrients and oxygen to the baby. What you will see if this occurs early in the pregnancy (like around 20 weeks) is that the baby develops IUGR (growth restriction) so that it's at 10 % or less for its in utero growth curve. If itccurs later and suddenly, it may not cause growth problems at all. At the same time the decreased working surface area is incapable of the placenta is producing enough amniotic fluid so the AF levels are low. Put it altogether and the baby has trouble getting enough oxygen and the decreased AF makes a cord compression more likely. The type of decelerations that the nurse saw would give you a better idea of which cause was the problem. Decreased oxygen would be late decelerations occurring after each contraction. Variable decelerations occur on an irregular basis. The other complicating factor is depending on how high your blood pressure was, it may have been causing a problem called reverse end diastolic flow. What this means is that there was so much pressure from the blood entering the placenta from your circulation that it would hit the arterial side of the capillaries in the placenta and instead of gently oozing in and out would just shoot out the venous side without staying to drop off oxygen and nutrients. Think of filling a glass at the sink. Low pressure and the glass fills w/o problem. High pressure and it's likely to splash back out of the glass even though the glass is barely full.
It doesn't sound like you or the doctors had much time to sort out what was going on, but you may want to go back and ask if the did any of the labs for preeclampsia, MTHFR or FVL. If they haven't and the scenario I presented sounds familiar, you may want to ask them to do the labs before you become pregnant or get too far along. There are other labs that are standard when this happens.
Forgot to mention that the cardinal sign involving amniotic fluid with diabetes in pregnancy is that there is WAY too much of it.
You sound like you were very courageous in a very difficult situation. I applaud your willingness to sacrifice your body to make sure your child was safe. Doesn't mean you have to like the manner in which your child was born, but it certainly shows a lot of love for him.
Thanks so much, Mothercat! This is good info that I can print out and take with me when interviewing midwives and OBs this time around. I wonder if they would have done tests like that after the fact unless I requested them (which I wouldn't have known to do). I'll check into it for sure. Too bad you're not in Toledo :). Do you know any practices in Toledo to reccomend to me? I've been doing a lot of research and Dr. Terry Gibbs keeps coming up. It looks like he works in a practice with a lot of midwives too. Do you know anything about him? I've added him to our list of people to interview regardless, but maybe you have some advice.
I am in the Toledo area, but you said you were looking for a hospital based midwife and I only do birth center and home birth.
I know Dr. Gibbs. Used him as a back-up plan when I had my home birth almost 22 years ago. He was new to Toledo, but had worked with a group that did home birth in the Chicago area. Talked with him at one time about serving as consultant for my practice, but before we could get very far in the discussion he accepted an academic position in the area.
My understanding is that his practice style has changed a lot in 22 yrs. and is now very medically oriented. I did check the Prormedica site and see that he is in a consult only practice that focuses on menopause. Couldn't find any OB info about him on the Promedica site.
There are 2 other doctors on the Promedica list that I have worked with. Dr. Bishop is very kind, has a good bedside manner and very evidence based. The same can be said for Dr. Neuhoff. They are both technically very good and have treated our families , and myself, kindly and respectfully when we have needed to transfer to the hospital.
The list is here with the contact info: