Disclaimer: The following is not intended to be a bash against mothers who have chosen a different route than I. I am a firm believer that natural childbirth isn’t for everyone and I would never judge someone who chose to do things differently. These are my opinions based on both studies I have read and my personal experiences. Regardless how you choose to bring your blessing into the world, I rejoice for your growing family and gift from above.
I recently had a co-worker email me asking for hospital references as she is recently married and thinking about babies in her near future. She figured as a mother of five I would have the low-down on everything maternity. As it so happens, I am 11 weeks along with baby number six and struggling to decide on a location myself. My sister is also due the same week and I was surprised that around 9 weeks she already had her midwife and deliver location selected. She utilized the internet to find someone in her network with good reviews which is probably a pretty good route to go.
Anyway, the conversations got me thinking about what I wish someone had told me when I was expecting my first and knew nothing. I chose to stay with my family care doctor who also delivered babies and used the hospital he was affiliated with. I had a pretty standard first time delivery but if I could go back I wouldn’t do things the same. I delivered my second child in a military hospital with an OB in Mississippi. My third was with a civilian OB in a civilian hospital in Florida. My fourth was with a midwife in a birthing center (Mountain Midwifery Center – amazing and highly suggested to all). Due to insurance restricts I was unable to return to the birthing center and delivered my fifth by midwife at a hospital recommended by MMC. Now with my sixth I do not know where I want to go and here is why.
I wish I had been told that prenatal care is boring. There is nothing new or excited if everything is going as expected and you are a healthy woman. By the fourth child I found the monthly visit to be a pain in my butt and a hindrance to my schedule. Yes I’m feeling fine. No, I don’t have any questions. So this is exactly what I told my coworker. Prenatal care is pretty much the same. Find a location you like and work backwards to finding a provider you enjoy and supports your choices. And get a midwife not an OB.
Why am I so anti-OB you may ask? While I recognize there are perfectly lovely doctors out there delivering babies, I disagree with the entire doctor approach to pregnancy and delivery. I am not sick. I do not need a doctor. My body is doing something natural that it will do on its own with very little assistance from me. This is the view of a midwife. A midwife monitors and assists during labor and delivery helping a woman’s do what it is supposed to do. A midwife knows if and when there is something wrong or requires a doctor’s attention. Midwives have OB’s they partner with for the cases where medical intervention is necessary because sometimes it really is.
A certified nurse midwife holds master’s degree in midwifery. They are usually a nurse first with a bachelor’s degree and a few years as a nurse in a clinical setting before pursuing their midwifery degree. A CNM can prescribe medications including pain medication. Just like a doctor, they are licensed in all 50 states and insurance covers their care when you deliver in a hospital (some will cover all or part of birthing centers and mostly homebirths are not covered). Midwifes don’t just deliver babies. They can provide most forms of female care throughout your life including birth control choices like an IUD.
Why does it matter? It’s all about the experience. If you are more interested in just getting it done, then you probably haven’t continued reading my post anyway. Midwives take a patient-centered approach to pregnancy and birth. Appointments are longer in length as they really get to know you and your situation. They offer more emotional support and are more open to your choices for a birth plan. No midwife will ever encourage your to just lay on a bed and grit through the pain. They will help you move and express yourself in a fashion that assists movement of the baby. For example, did you know that high pitched screaming or whining is terrible while in labor? It closes your body up. Low pitched open throat moans on the other hand encourage your body to open itself up. For low-risk pregnancies, multiple studies found that midwife deliveries are much less likely to result in cesarean section. Epidurals are available through many midwives if you choose that route, but they will encourage more natural approaches to pain management that don’t risk you or your baby.
I had an epidural with my first child only. I fought through about 8 hours of labor on Pitocin before giving in and taking the epidural. I could still feel everything; it was just less sharp and focused pain. You can’t get up and use the restroom for hours afterwards without help or at all. My baby was lethargic and had some initial trouble latching to my breast. With my natural births, I was using the restroom unassisted immediately. My babies were alert and excited to nurse.
I am scheduled for a hospital tour tonight which I am partly dreading. I fear the typical “look how nice this facility is” sell. I personally don’t care if my room has a flat screen TV and a place for my husband to sleep and my own restroom. I can get that at any location. Yes the labor and delivery room here is huge…most of them are and I don’t really need all the space. Wow, the bed drops out the bottom and pops up stirrups for my feet to push…won’t be using that at all. In fact, my last two labors were not in a bed at all. I labored standing up for most of the time and even delivered my youngest in a standing position. It is not natural to deliver lying down and on your back is the worst. The birth canal and your pelvis gets pinched off and you are fighting gravity. If you want to see how we should be delivering, look at gorillas. They move around during labor but move into a squat for pushing and catching their baby. I delivered my fourth squatting in a birth tub catching him myself. When I delivered my fifth standing I also caught her (my midwife was behind me with her hands below mine so I wouldn’t drop her). These two positions were the most natural and I ended up in them of my own accord with no previous plan to be in that position. It just happened as I listened to my body and it worked better than any other positions I’ve ever delivered in.
So bottom line? Do your research. Read Ina May’s Guide to Childbirth. Learn about all your options. Prepare you basic birth plan and take the key parts with you to find a provider. If they are not willing to discuss your birth plan desires on the first visit, leave and find another. Be aware that you might change your mind once in labor, but having a provider that is willing to let you go how you feel is more important than I can state.
