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Conflicted about MW's Level of Involvement

713 Views 6 Replies 5 Participants Last post by  erin_brycesmom
With my last birth (first homebirth), we chose a midwife who was very hands off. I had a lot of prodromal labor-48 hours of contractions every 7 minutes-and I wished she had been a bit more supportive during that time in helping me figure out ways to speed things up. But actual labor (2cm-birth) was under an hour, and I did fine by myself with my husband around if I needed him.. the midwife didn't make it and my husband caught her. It was wonderful.

This time, I hired a different midwife but one who is cool with unassisted birth, so I knew she would provide whatever level of involvement we wanted (I want someone around, but maybe in the other room or something). We ended up having to switch to another midwife, and while I really like her and we get along and have a similar general philosophy, every time she mentions any sort of monitoring of me and the baby during labor, I internally cringe and find myself wishing that she'd show up right after the birth. I know it's important to check the baby's heartbeat and my blood pressure and whatnot, but I can't help wanting to avoid it if at all possible. I'm also worried that her monitoring will be distracting and make it harder for me to focus.

Has anyone else felt this way, but decided *not* to UC? How did it work out? I know it's kind of hypocritical to want to UC but only accidentally, but that's where I am right now.
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Have you discussed your ideas about her involvement during labor and birth? I think clearly expressing your expectations about her role, and hearing hers in return will give you a better idea of what to expect. I think most importantly, discuss if she would be willing to be hands off and really only get involved after the baby is born...because you can't really decide how you want to proceed, until you know what to expect.
Right, here's my personal take as a midwife...

I am all for UC, if that is what someone wants and is fine with taking that responsibility.

As a midwife I was trained and am hired to monitor to make sure all is well with birth, I don't care about catching, waterbirth or not, positioning... I can even be in the next room as long as I can come in and follow evidence based protocol for monitoring. I can be in the other room when the baby is being born as long as I can sit at the door and listen and if need be ask if all is well. If there are funky heart tones then I want to be in the room assessing at the time of birth. I do want my assist to be there for me in case of an emergency, but she can lay totally low, not be seen.

I can not see myself as being at a birth just in case something happens when the baby came out. Personally (and this is no judgment on you, because I can understand why you like your privacy) I am responsible as I am being paid to be an attendant and I have to think about my role if I failed to do it correctly and the consequences to baby, parents, my feelings, my ability to practice in the future, other midwives abilities to practice in the future and availability of midwives to a community of homebirthers who want midwifery care.

It is not that I don't trust birth, because we all know that most of the time we don't have to do much, but wouldn't you know it the one time I attended a birth and didn't do anything, that would be the time where maybe I should have.

I hope it is helpful to see this from a different perspective. Perhaps you can give your husband and yourself some training in order to do a UC and have your midwife come in case any of your monitoring seems off, something comes up.

I have gone to an unassisted because the parents decided after a long birth they needed support and were willing to pay our full fee. That worked out really well and we followed the above scenario, monitoring and being at the door when time of birth came.

Good luck with your decisions!
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Paige, I totally agree with you, and that's why I hired a midwife. I know that it's in my and my baby's best interest to have monitoring during labor and during pushing. While I don't judge anyone for choosing UC, and understand that decision, consciously choosing to UC is not for me. I want to have someone that I can look to for guidance. I don't want to have to make decisions about whether things are progressing normally or not. I know that I have a certain responsibility in the outcome when I choose to homebirth, but I don't want the responsibility of being the care provider as well. I just want to be in my groove and give birth, you know?

That said, since Fiona's birth went so well, and it was so wonderful being just me and my husband, I worry that having someone around will affect how I experience the birth. I guess what I'm asking is.. if anyone has wanted to be alone during birth, but still accepted the need for some monitoring.. how was it coping with monitoring when your need vs want were in conflict?
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This is so hard, you know I am having a baby in June or July and am so lucky that my midwives are also dear friends, I mean that is the reason we want to hb right, for many reasons but also the intimacy.

I hope you get to have a good heart to heart with your midwife about your experiences and what you want and hopefully you can come to peace with her and in your heart about your needs.
Talk to her about it. I don't like being touched, or talked to in labor, so I told my midwife that. She was present, but quiet and hands off. She checked heart tones, maybe once an hour, a watched from the other side of the room. Once she suggested changing position. My labor was pretty quick, so there wasn't much that needed to be done. But she was right behind DH as he caught DS. Though I'm sure we could have done it on our own, I felt much better working with a net. I am REALLY glad she was there afterwards. I got the worst case of the shakes I've ever had in my life, and probably would have panicked if she hadn't been there to reassure me it was normal, check my BP, and make tea.
I can relate to a lot of what you wrote except I did not want guidance from my MWs. We had gone back and fourth about UCing with that pregnancy and the one before. I ended up hiring my MWs but toyed around with the idea of not calling anyone for the actual birth or calling too late. It ended up being great. They did one fetal heart tones check when they first arrived and then none after that. This was fine with me. They did not do any monitoring during pushing and I am glad for that! They gave me what I asked for. They stayed mostly in the other room until my body began pushing on it's own. Then they watched from behind and didn't touch me. I asked my MW to help pass the baby between my legs since I was on all fours when I pushed him out into the water and she stepped forward and did. I was glad they were there as they provided a positive presence and did not interfere. Also, my placenta was very stubborn and took about an hour and half to come out and I was glad they were there simply because I think I would have stressed out some if not. I know it would have been find without them there but knowing myself, I would have focused too much on that instead of focusing on my precious new baby if they weren't there. And really, the MWs were totally laid back about which was great. It wasn't until about an hour after the birth (an hour spent holding, nursing and snuggling my baby) that they mentioned it might be a good idea to try some other positions to see about getting the placenta out. It was calm and non-stressful.
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