Clarification As To Why I'm Using A Midwife

Now that people know Dan and I have a midwife to get me through my pregnancy and labor, it has come to my attention that many people have a lot of misconceptions about what a midwife is. So many people have said:

• "Be careful." 
• "Make sure you also have an obstetrician because a lot of things can go wrong with a midwife." 
• "You should ask for references." 
• "You're doing a home-birth?"
• "You should have an OB because you're high risk due to your history."
• "It's dangerous to have a midwife."

I've realized that many people are misinformed about what a midwife does compared to an obstetrician. I want to shed some light on those differences. First, though, let me answer the questions from above.

• I am being careful. I've done a lot of research in the area of what is best for me and my baby. A midwife can perform all gynecological and obstetrical needs as an OB/GYN. The only thing they cannot do is perform a cesarean section.
• Our midwife, as all midwives, work with obstetricians in the event that intervention is needed. 
• I'm not going to ask for references and am sure I would not get any as patient/Dr. privacy would not allow. You would not ask your regular obstetrician or any Dr. for that matter for references. I met with the midwife, I liked what she had to offer, and I will be using her. A friend of ours has also known women who have used her in the past and are using her now as their midwife, so word of mouth is considered here. Our midwife has done over 750+ births so experience is not an issue.
• We are not having a home-birth. Our midwife will do both home-births and hospital births. We are opting for a hospital birth with the midwife and are going to a hospital that supports the midwifery model of care. 
• I want to clarify that even though I have had two miscarriages, I am not high risk with this pregnancy. The problems that I faced which caused my miscarriages have been taken care of with medication and surgery.
• It is more dangerous to have an obstetrician help deliver your baby because they are surgeons. Obstetricians are not trained to do normal births. Normal, meaning natural, little to no intervention. Unless you are a high risk pregnancy, a midwife is better and safer.

Now let's take a look at the Midwifery Model of Care:
Midwifery Model of Care by Judy Edmunds, Certified Professional Midwife

         OBSTETRICAL                                             MIDWIFERY

Focus on pathology, illness -------------------- Normal, developmental, social

Elevates "authorities" as experts ------------- Women's knowledge is valued

Woman is low in hierarchy --------------------  Egalitarian, peer relationship

Must enter doctor's territory ------------------- Midwife is a guest in her home (if home-birth)

Lack of familiar surroundings ----------------  Remains in familiar environment (if home-birth)

Strangers perform procedures ---------------- Midwife has become her friend

Women's positions restricted ----------------- Freedom to move as desired

Brisk, depersonalized schedule -------------- Ample time for relaxed visits

Awkward, brief communication -------------  Open, intimate two-way sharing

Unfamiliar language used often -------------- Simple, common vocabulary

Punitive, scolding, threatening ---------------- Empathy, support, encouraging

Professional distance maintained ------------ Close relationship is forged

Spiritual, emotional neutrality ----------------- Honors her personal feelings

Training emphasis: intervention -------------- Trained to preserve normality

Drugs offered for pain relief ------------------- Pain accepted, comfort offered

Some facts every soon-to-be parent should know:

• The United States has the second worst newborn death rate in the developed world
• Midwives attend over 70% of all births in Europe and Japan 
• Midwives attend less than 8% of all births in the United States
• The United States has one of the highest maternal mortality rates among all industrialized countries
• In the early 1900's in the U.S. inexperienced obstetricians began doing smear campaigns against midwives
• In 1900, 95% of births in the United States took place at home
• In 1938, half of all births in the U.S took place at home
• By 1955, less than 1% of births took place at home and remains that number today
• Induction in labor (pitocin and other drugs) increases the rate of cesarean section births
• Lying on your back to give birth makes it harder for the mother to use her stomach muscles to push which will increase the chances of an episiotomy, forceps, or vacuum to get the baby out
• Obstetricians are not trained in normal childbirth, they are trained as surgeons
• New York hospitals have some of the highest cesarean section rates in the country
• The cesarean section rate in the U.S. went from 4% to 23% in the 1970's
• Since 1996 the cesarean section rate in the U.S. has risen 46%
• In 2005 the cesarean section rate was one out of every three births

Ok, so here's an interesting clip from The Business of Being Born:

Why are doctors giving Pitocin to speed up the delivery when it clearly states on the warning label not to do so unless there is a medical necessity?

The warning on the Pitocin bag states:  WARNING: This medication is recommended to be used only in pregnancies that have a medical reason for inducing labor (e.g., eclampsia). It is not recommended for elective (voluntary) procedures or to make the birthing process more convenient. For additional information, consult your doctor.

I'm going on a rant here so I do apologize in advance. After so much research on this matter I have very strong feelings about the whole birthing process in the U.S. and I need to share my thoughts, especially when a lot of people have been making me feel like I'm doing something wrong for having a midwife instead of an obstetrician. Thank you to all of you who have not judged me and my decision, but have been supportive and want to learn about the differences. I appreciate it. 

It's a very stressful place for women to be in, because we are taught to trust doctors. How many times do we ever get that second opinion? When it comes to childbirth, women are meant to feel almost helpless. Like we need the interventions of the obstetricians to have a healthy birth. But the fact is, women have been giving birth long before there were obstetricians. So what's changed? Women's bodies are still the same, so why have I heard of doctors saying things like the baby's head is too big to have a vaginal birth? That makes absolutely no sense. These doctors are saying things like this to scare us. To make us get these cesarean sections to save time and speed up the delivery. I watch these baby shows, such as A Birth Story and Bringing Home Baby, and I want to cry. Birthing is portrayed as something scary. Something that we need drugs to get us through. It disgusts me. I get so upset, especially when I see healthy moms-to-be scheduling their cesarean sections for no good health reason. A cesarean section is major surgery and these women are opting for it because their doctors won't let them get past their due date. Or they are having cesarean sections because their doctor is scaring them into thinking that a 12 hour labor is harmful to the baby, when in fact, they just don't want to be there for another 12 hours until you deliver vaginally. The baby will come on it's own. You don't need to schedule it unless there is a medical necessity to do so.

Which brings me to my point, people are just not informed of these facts and what a normal birth is. We are brought up to believe that when you have a baby, you go to an obstetrician and give birth in a hospital on a bed. All the while hooked up to all sorts of machines with an IV in your arm so the doctors can inject you with drugs. Let me say that again: DRUGS!!! Drugs that we do not need and drugs that we may not know the effects of to our unborn babies until it's too late. We are told time and time again, "Do not take any medication while pregnant because it may harm your baby. If you need pain medicine, take nothing stronger than Regular Strength Tylenol." So why is it OK to take a much stronger medication during labor? There is not enough research for me to say, "Yes, give me all the drugs you have for labor because I know for a fact that it will not harm me or my baby." Fact is, if there's the slightest chance of harm, I will not do it. I don't even take headache medicine because I just don't like to take any kind of drug, pregnant or not. I'm not against pain medicine if it is something you absolutely need, especially in labor. But I do want women to know that opting for it right away because of fear that has been drilled into us almost immediately, is wrong. We are told over and over again that labor is the most painful experience we will ever have. I believe that women are going into labor expecting this and not wanting to deal with it so they ask for the epidural as soon as they get to the hospital. They don't wait to experience anything. Once you get that epidural, you will get any drug the doctor tells you that you "need." Why not? If it will make the labor quicker, you should do it, right? Why not wait it out and let your baby be born naturally, on his or her own time line instead of the doctor's? It's something that I will never understand because unless there is a medical need for you to labor quicker (baby in distress, mother in distress) then there is no need to speed it up.

So obstetricians are all about the interventions. Ask any woman who has given birth and I will guarantee that almost all of them, will say that they have had drugs during pregnancy. Then, out of those women, how many have had a cesarean section? The number may astound you. It's getting ridiculous and the only saving grace is having a midwife. For a low risk pregnancy, a midwife will be there to support the mother and get her through the most empowering day of her life: giving birth to her baby. This is not a feminist thing, like many will say. This is a woman's rite of passage, if you want to label it. Birth is an experience that I want to remember, something that I want to feel. I don't want to be dazed from drugs, I want to be aware of my body and what is going on. Most people will call that feminist or call a woman a hippy or out of her mind for wanting to feel the pain. Truth is, life is painful. There is no way around that. But if I can survive this pain and in the end have a beautiful, healthy baby to hold in my arms, the pain of that experience is welcomed and in the end I will be rewarded with a wave of natural oxytocin that will put me in bliss. Unfortunately, many woman don't feel that because of the drugs. The baby feels that bliss as well, but if the baby can't be near the mother's breast right after birth, that experience is lost. Obstetricians will have your baby taken from you almost instantly to be cleaned up and weighed. Midwives will encourage you to hold your baby for a while so you can bond instantly. Why is there a rush to clean and weigh? Oh, that's right, so the room you're in can be cleared faster for that next laboring mother.