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Old 10-31-2005, 06:30 PM   #1
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Why do so many people choose to go to a midwife?

I'm just curious. Here, in this area of Ohio, it's almost unheard of to not go to an ob and deliver in a hospital. I've heard so many women on this board though say that they see a midwife so I was just wondering what the pros/cons are to a midwife vs. an ob-gyn? And with a midwife, do you deliver in a hospital or out in someone's bedroom somewhere? I don't mean to sound ignorant, I just don't know.

 
Old 10-31-2005, 06:56 PM   #2
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Re: Why do so many people choose to go to a midwife?

I go to a military hospital and I see a midwife. I was told that during a first pregnancy and no past complications midwifes can be great because their appointments are scheduled to spend more time answering your questions, etc. I chose to go this route for that reason and also because I was prior military and the midwifes are civilians and the doctors and other staff are military members, which I rather avoid. We actually deliver in a hospital, like most people normally do, not at home or in a tub, or anything like that Actually when I go to the hospital a doctor will deliver because the midwifes are not usually on staff there. The midwifes are also in the same buildings as the doctors. For me and my experience there is basically no difference except the fact that my midwife speaks to my husband and I more personally and spends more time asking and answering our questions. This is just one perspective on midwifes. Some other women may actually give birth at home or go to a separtate clinic that is not at a hospital. I am from Iowa and not many people use midwifes or have at home births, so I understand where you are coming from.

 
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Old 11-01-2005, 02:07 AM   #3
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Re: Why do so many people choose to go to a midwife?

in the uk everyone has a midwife who they see regularly through their pregnancy at their gp practice.you only see the consultant ob if you are a high risk pg and the midwives deliver your baby unless high risk or complicated. in the uk midwives are highly trained and have lots of responsibility in fact if the child develops any problems before they are 18 the midwife is accountable if her actions were negligent. you don't have the same midwife deliver your baby that you see in the community at your gp surgery and you don't get to chose your community midwife but you can choose which hospital you go to. the midwife is definately a better option than seeing the gp.

 
Old 11-01-2005, 05:48 AM   #4
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Re: Why do so many people choose to go to a midwife?

With my first pregnancy I went to the regular ob and when I delivered, he wasn't on call so that was weird. The ob that I went to before doesn't do ob anymore - just gynecology. So, after trying to figure out who I'd rather see in the practice I chose a midwife because rather than spend 10 mins per appt. they spend 20-25 mins. She answers all of my questions without slowly moving toward the door and really explains everything and asks me how I am feeling! I can't remember my ob ever asking my how I was feeling! I just think she's great. I'll also deliver in a hospital.

 
Old 11-01-2005, 06:45 AM   #5
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Re: Why do so many people choose to go to a midwife?

In Dallas, most of the midwives don't have hospital privledges, so many of work out of a birthing center.

 
Old 11-01-2005, 08:03 AM   #6
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Re: Why do so many people choose to go to a midwife?

I'm originally from PA, and having a midwife is not considered normal practice up there. I always was under the impression they were just for more non traditional births in homes. I am now living in FL, and have been seeing a midwife, and she will deliver. I actually didnt really have a choice, its the normal procedure at the Doctors office down here. The doctor only steps in for complications, and everything else is handled through the midwifes (there are four of them at the office). At first I thought it was weird, but really its just like dealing with a nurse in a doctors office , only the midwifes seem alittle more knowledgable and take some of the responsibility off of the doctors. I will deliver in a hospital. Unfortuantely, I'm on medicaid and didn't have too many options as to where to go for my prenatal care, but from asking around it seems the most Doctors offices have midwifes down here!

 
Old 11-01-2005, 08:55 AM   #7
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Re: Why do so many people choose to go to a midwife?

The only dr's office that would take my insurance had midwives. I enjoy this alot more then my previous dr bc my midwife sits and talks to me as long as I need an ear! It's nice to have my dr ACTUALLY concerned about my pregnancy instead of pushing me out of the exam room.

 
Old 11-01-2005, 09:02 AM   #8
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Re: Why do so many people choose to go to a midwife?

We are choosing a midwife for many reasons. First, it's just much more personal, like someone else said in an earlier post. They are there for you, meeting with you, not waiting to get to the next patient down the hall. The whole practice and philosophy of midwifery is to comfort the mother and make her feel relaxed and at peace, to educate her about her body, her pregnancy, and the process of pregnancy, labor and birth.

Also, we feel like a lot of the "problems" that hospitals and doctors are there to help with or "prevent" are actually caused by that type of birth. For some women, it is medically necessary to have a hospital birth with a dr. on call, because they have a high risk pregnancy (my mom, for example, had preeclampsia and toximia and almost had a stroke when she was in labor with my brother because her blood pressure was so high).

There is a method (like "Lamaze") that you may or may not be familiar with called the Bradley method. Dr. Bradley observed animals when they go into labor and realised that when labor hits, they stop everything they are doing and just let it take over their body. They lay still and limp until the baby is born. They don't try to distract themselves, they don't tense up and fight against the labor. They don't travel (most animals instinctively know that labor is coming and will find a place to be before it hits), like women do who have hospital births. What he observed is that travelling often slows down labor - the adrenaline of getting to the hospital in time in traffic actually slows down labor because it tells your body you are moving and it is not a good time to have a baby. So when you get to the hospital, and there are four or five other women in line to have a baby, they often times give the mother something to speed up the labor. This makes it much more painful for the mom (and also helps increase the chances of episiotomy or tearing the perineum), so she often requests drugs for the pain, so she is drugged and not completely with it (and so is her baby) throughout the labor. Many midwives will help you have a birth in a hospital or birthing center if that is what you want or what you need, with a doctor standing by.

We are also choosing a midwife/homebirth because we feel like the hospital is not the environment we want our baby's first breath to be in -- hyper-sterile with super germs and viruses because of constant oversterilization, and hundreds of strangers and their germs in the building. We would rather be at home, in our space, with our germs and our things and our life and welcome our baby that way. I don't know of any doctor that will come to your house to deliver a baby, so, obviously we need a midwife.

There is a fantastic book that my husband and I are reading together called "Ina May's Guide to Child Birth" by Ina May Gaskin. She is the leading midwife in the US. Even if you are not considering a home birth, or even using a midwife, she talks about the ability of a woman's body to give birth and go through labor - it's is absolutely incredible. She mentions the phrase "giving birth is like trying to push an orange out your nostril" or similar analagies and says "but it's nothing like that at all. The nasal cavity was never designed or intended to pass an orange through it, or anything bigger than a little mucus. A woman's [birth canal], however, was designed just for the very purpose of having a baby". She also mentions that women who often have hospital births request medication to avoid the pain, but in the process usually have an episiotomy and have to have the baby pulled out with forcepts or a vacuum, instead of the body doing it's job (because it's not sluggish and numb)... All her efforts to avoid pain during labor result in more pain and grogginess after the baby is born, making it difficult to connect with or even hold her baby until the drugs or pain wear off.

Midwives, whether in your home or in a hospital or birthing center, are very good at honoring any wishes you have for your labor (breastfeeding or at least holding or seeing your baby immediately after it is born, specific positions you would like to labor in if laying on your back is painful or slowing down your labor) where as doctors and nursing staff usually try to do it their way, the text book way that they were taught and have observed.

One last note, most doctors and nurses, unless they have had a child of their own, have never seen a natural, normal birth from the start of labor to the end. They come in periodically when their schedule permits or when they try to get things moving so their schedule is permitting them to visit the how-ever-many-other women are in labor at the same time as you, or when there is a problem. Midwives are trained and make a career out of being present with the laboring mother, for hours if necessary, and walking through the process with her and helping her understand all the sensations she's feeling and are almost always aware of fears or questions (they do it for a living!) and are there to answer and calm. Most labors in hospitals don't go very smoothly and are quiet painful because of doctors and nurses (usually strangers) popping in and out and shouting down the hall and telling you to push and wait... Whereas a midwife builds a relationship with you throughout your pregnancy and is there with you through the whole process.

Just a lot of thoughts for you... You should seriously consider reading "Ina May's Guide to Childbirth"... It's totally eye opening about your ability to have a baby!

 
Old 11-01-2005, 07:19 PM   #9
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Re: Why do so many people choose to go to a midwife?

Thank you all for your replies. It seems like the main concensus for having a midwife is the reassurance that you get to speak to them during visits longer than you would an ob. I guess I must just be agressive because I ask my doc a lot of questions and she's in my room discussing my condition longer than 10 mins. The thing that I would be concerned with is what if you're in labor with the midwife and an emergency occurred, like a cord wrapped around the neck or loosing the heartbeat?? Wouldn't you be safer with an ob as opposed to a midwife??

Also, with the midwife delivery, do you forgo all drugs??? If so, you women are BRAVE! If I'm lucky enough to deliver vaginally, I am demanding an epidural:-)

 
Old 11-02-2005, 05:19 AM   #10
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Re: Why do so many people choose to go to a midwife?

I had an ob for my entire pregnancy until deleviry, as my dr. was not on call. A midwife was there for my deleviry and I have to say was amazing, there was a bit of a problem where my baby was coming out with her hand on her head, they brought in a dr to take a look and her said to push the baby back in and try again if not then c section. The mid wife thought that mabie I shoud try to let my body see if I could handle this on my own, but of course as long as there wasn't any dangers, well needless to say I had baby 25 mins later on my own the midwife helped ease out the babies shoulders and even after all of that not one stich. For my next baby I will use her again for all of my appointments.

 
Old 11-02-2005, 05:54 AM   #11
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Re: Why do so many people choose to go to a midwife?

Myloathe, using a midwife does not mean that you forgo all drugs. They are also trained to administer pain medication during labor. I have to disagree with someone's earlier post that basically all doctors won't listen if you don't want drugs, because with my first I saw the regular ob and had a drug-free vaginal delivery (no forceps or vacuum either), but they were very correct in saying that the midwives recognize that our bodies were meant to deliver babies and given the chance and opportunity, without immediate interference at the first sign of difficulty, will do so with a minimum of complications.

 
Old 11-02-2005, 09:38 AM   #12
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Re: Why do so many people choose to go to a midwife?

i don't know how midwives are traine din the us but yes the ones in the uk can deal with a cord round the neck, pain relief and more or less anything else they would just call the doc to check you if there were signs of distress or an assissted delivery was required

 
Old 11-02-2005, 10:09 AM   #13
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Re: Why do so many people choose to go to a midwife?

midwives are definitely trained to check for a cord and know what to do if there is one around the neck. You can find midwives who will administer pain meds if you want. The point Ina May makes in her book is that, in the process of avoiding pain through an epidural or other methods of pain medication, it is possible to not be able to feel how hard you're pushing and either tear or need an episiotomy because you will be pushing at the doctors command as opposed to when your body is telling you you're ready, and there is also potential to hurt your back. This isn't particularly common, but it does happen. I saw a news story on a woman who received an epidural and pushed so hard (because she couldn't feel it) that she damaged a nerve in her back and had to go through physical therapy for several months afterwards to help her walk again. I'm not trying to scare you, I'm just mentioning possibilities that can and do happen.

Also, in trying to avoid pain with pain meds (which also affect your baby, something you may or may not be comfortable with), a mother may delay pain during the actual labor, but many women who have had a medicated birth and then tried an unmedicated birth have said that with the unmedicated birth they experienced pain during labor but with the midwife and their partner beside them helping them relax through the process, it wasn't as bad as they thought and after the baby was born, there was very little pain to deal with, versus the medicated birth after which they were groggy and once they were more aware of their surroundings they were in so much pain it was difficult to even want to connect with their baby, to breast feed or to hold it. In trying to avoid the pains of labor, they felt they ended up with more pain afterward for a longer period of time.

As far as doctors not listening to the mother as to whether or not she wants to be medicated, what I was intending to say is that there are doctors who will honor your wishes, but in my experience most doctors have a tendency to pressure a mother by telling her she's crazy ("joking", but not really joking), warning her of "so much pain", etc. And there are many doctors who just won't do births that way. They are more likely to want to persuade you to make a decision that you hadn't originally planned to make, while you are in the throws of labor, or in some cases (does happen!) to decide for you because (they assume) you're not totally yourself or with it and must not be thinking straight.

Even if that's uncommon, the whole attitude of trying to persuade ("warn") you is very different from the attitude of midwives who are generally very open to whatever you desire in your birth.

One more thing, most midwives require (or are required) to have you connect with a back-up doctor and hospital (if you're having a home birth) incase anything goes wrong. You would also see that doctor perodically throughout your pregnancy so they have some idea of who you are and how your pregnancy is progressing. If you are not considering a homebirth, many hospitals will let you have a midwife at their hospital where your back-up doctor can be on call. But if you decide to go with a midwife, you'll want to check on that because some hospitals won't let you have a midwife. Old policies, I guess.

 
Old 11-02-2005, 10:21 AM   #14
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Re: Why do so many people choose to go to a midwife?

I must be extremly lucky because I have a doctor who is very caring and he spends as much time with me as I need. I never feel rushed and he always answers my "crazy" questions. He has been my doctor for 8 years and I feel very comfortable with him. But I do understand that not every doctor is as terrific as mine. I wish there were more doctors like him.

 
Old 11-02-2005, 01:05 PM   #15
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Re: Why do so many people choose to go to a midwife?

Quote:
Originally Posted by jriegel
As far as doctors not listening to the mother as to whether or not she wants to be medicated, what I was intending to say is that there are doctors who will honor your wishes, but in my experience most doctors have a tendency to pressure a mother by telling her she's crazy ("joking", but not really joking), warning her of "so much pain", etc. And there are many doctors who just won't do births that way. They are more likely to want to persuade you to make a decision that you hadn't originally planned to make, while you are in the throws of labor, or in some cases (does happen!) to decide for you because (they assume) you're not totally yourself or with it and must not be thinking straight.

Even if that's uncommon, the whole attitude of trying to persuade ("warn") you is very different from the attitude of midwives who are generally very open to whatever you desire in your birth.
I see what you're saying. My doc with my first definitely honored my wishes, but you're right about the persuasion factor. A few times during my labor (in all it was about 12 hours) asked me if I had changed my mind in a tone that indicated to me that I was crazy and surely I had by then. So, that was pretty annoying. I know for sure my midwife would not do that.

Jriegel, are you from the uk? It seems home births are much more common over there as opposed to the u.s.

 
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