Thinking About A Midwife

Eryn seconds oldNote: The following is a guest post by WoodTurtle and originally appeared on her blog, where she shares experiences in Islamic feminism and modern motherhood.

I’ve been thinking about getting pregnant.

Pregnant bellies have started looking really good to me and I’ve actually felt some jealousy when shopping for baby items and bumping into random bumps. I loved being pregnant and alhamdulilah I had a great birth experience. And of course it’s something that I’d like to experience again.

Naturally, there were definitely some things about my birth experience that I’d like done differently a second time around.

The hospital we chose was AMAZING. Apparently the labour help is top-notch, allowing labouring mothers to walk around and not to be tied down to an IV; no invasive baby monitoring; a low use of invasive delivery techniques such as forceps or episiotomies; and a dedicated nurse to coach you through labour (I wouldn’t really know first hand though, since we essentially walked in and delivered on the spot).

They don’t routinely suction newborns and will hold off administering any injections or clean-up if you request it. And the first place baby goes after being born is directly onto mama’s chest. There baby is left to calm down, breathe, and get some help latching on from lactation consultants if necessary. The aftercare is also brilliant — with daily group breastfeeding help sessions with one-on-one help available. I ended up using their breastfeeding clinic’s helpline almost weekly until Eryn was about 2 months old. They’ve also gone through extensive renovations and now have birthing units so that you deliver and recover in the same room. Each birthing unit is also equipped with a specially designed tub for water birth — which would be really neat in my mind.

Now, there were some things that I could have gone without. We were admitted at 7cm dilation. But within the time it took me to get changed and walk to the birthing unit (oh, about 10 minutes), I had hit the 10cm mark. When I walked into the delivery room I immediately said, “I have to push.” That’s when the nurse gave me a rigorous internal exam.

She swirled her hand around like she was washing rice and I quickly sat up and shouted, “woah! Not so fast!!” To this day I wonder if she was attempting to strip my membranes or trying to get my water to break. Once she determined I was 10cm, she lifted my legs, told me to grip behind my knees and push.

I was overwhelmed, confused and shocked. First I asked about the Hubby and if we should wait for him to come. He was SUPPOSED to be there. He was my voice and my support network. She said push. I then asked about my position — was it alright being flat on my back? In my head spun the unspoken options that we learned about in prenatal class: side lying, squatting, sitting. My crazy, hippy prenatal instructor was repeating over and over again, “avoid giving birth on your back.”

But instead the nurse said, push.

So I pushed. And a cheering purple push squad came into the room. After 10 minutes when her head crowned and the delivering OB came in he said, “stop pushing so hard. Ease into the push like you’re saying ‘house’. The slower the push, the less you’ll tear.” Great advice, but too late. Recovery had some interesting challenges outside of the broken blood vessels in my face.

So now that I’m wiser about how to deliver and I’ve been able to revisit my birth experience mentally and on film (God bless my techno-Hubby), I have a pretty good idea not only how I want to deliver, but how I’ll have the strength of mind to say, “I want to be side-lying or squatting. I’ll have none of the stirrups thank you very much.”

I also have been thinking about having a midwife instead of my OB. But I really have no idea about what the practical differences would be between a supportive OB (like mine was.. late, but better late than never), and a midwife. I could have my awesome OB throughout the pregnancy and end up with a dud on call for the actual delivery — which is what happened with Eryn. I had a dud throughout the pregnancy only to be delivered by Dr. Wonderful.

Delivering in a hospital setting is something I still would like to do, but to have more control over the actual delivery, which is what a midwife could potentially offer. There’s also the continuity of care provided by a midwife that the one 8-week OB appointment just can’t compare to. Instead of running to clinics, calling helplines, making specialist appointments during recovery, a midwife would coordinate all of that, or avoid the issues that would require extended aftercare. In fact, from what I understand, a midwife would also be able to mitigate purple push squad nurses and slow the delivery down to avoid a natural episiotomy (or as Dr. Wonderful told me to watch out for in future: prolapse)

What do you think? Anyone with practical experience willing to share?

We haven’t exactly started trying yet, or even really talked about it, but I’m starting to think the Hubby and I should start doing some research and have a couple of numbers on hand in case of a happy chance.

–WoodTurtle

This post originally appeared at wood turtle, where she shares experiences in Islamic feminism and modern motherhood.

 

3 comments

  1. Nakia says:

    I’d also recommend Henci Goer’s The Thinking Woman’s Guide to a Better Birth. Not only does it have excellent info on birth practices, but it’s got enough stats to keep a techno-hubby happy. And if you aren’t already considering it, think about home birth. Also, keep in mind that only Nurse Midwives are likely to play any role in a hospital birth, and sometimes get overruled by the OB on call. That’s what happened when I was having Zak- my nurse midwife who was caring for me since the beginning, got overruled by a doctor who’d never even seen me. Direct entry midwives generally only operate in freestanding birth centers and in homes.

  2. Asma says:

    Given that you sound pretty happy with your hospital, I’d suggest hiring a doula. An experienced doula will be able to ‘manage’ the nurses on your behalf, remind you of what you want, and generally act as your advocate at a time when you’re stressed out and in pain. I had a doula for 2 of my 3 deliveries, and I feel it gets you the best of both worlds in terms of care.

  3. BooRikti says:

    I had a homebirth with a midwife and doula (using hypnobabies) and loved it. The concerns I had about having a midwife-assisted birth in a hospital were that Certified Nurse Midwives in hospital settings can face some of the same performance pressures, time pressures and hospital policies that doctors face. I have heard many stories from friends and on mothering.com about “med-wives” in hospitals or birth centers pushing inductions or other unwanted interventions.

    That said, since you do want a hospital birth, finding an experienced doula (and experience is key) can decrease your risk of unwanted interventions and make the experience smoother for everyone.

    All the best to you. (Oh, and I second the recommendation of Henci Goer’s book!)

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