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Thursday, January 23, 2014

Switching to the midwives

My walk to work most days

 Well folks, I've done it. Last week I switched from my ob/gyn to a midwife practice.

I should start off by saying that these midwives deliver in a hospital, in birthing suites on a traditional labor and delivery ward. They are all registered nurses with extensive medical experience, they can perform minor surgery, and the ob/gyn is on call 24/7 in case of an emergency. The birthing suites are right by the operating rooms. I tell you all that so you don't do like my parents did and freak out. It's going to be very safe for me and baby.

It was honestly a little heartbreaking to leave the ob/gyn practice. The two doctors are these amazing, pro-life, Catholic men. They have 17 kids between them. They are warm and attentive, and I loved every visit with them. On top of that, just about everyone in their office knows my family, from the nurse with whom I went to grade school to the receptionist whose kids are friends with my sisters. Everyone was so friendly and welcoming whenever I came in.

Given that wonderful environment, you may wonder, why on earth did I switch to the midwives?

I started reading about natural birth before I got pregnant... possibly even before I got married. I really loved Ina May Gaskin's book and the movie The Business of Being Born. I continued reading and studying once I found out I was expecting—many thanks to Sarah for recommending another great book, Your Best Birth. I devoured articles like this and birth stories that spoke to the potential for an empowering childbirth. Based on everything I learned, I decided I wanted to try for a natural, intervention-free childbirth. Now, I know these things are always outside our control; every birth plan is subject to uncontrollable circumstances; I know that what matters most is a healthy mom and baby. But I wanted to at least give natural birth a shot.

Given all this background, I decided the best approach would be to visit the hospital where my ob/gyns deliver and see what it was like. Frank and I took a tour back in December. I was the least-pregnant lady there, and after the tour Frank and I stuck around for an extra 45 minutes grilling the nurses. We were those people. But what we learned was really helpful.

The hospital had a lot to recommend it. The nurses encourage the infants' rooming-in and skin-to-skin contact after birth, two things that really matter to me. They also assured me that all the nurses are trained in a bunch of different techniques for natural pain relief. But on the other hand, when I asked about their c-section rate, the nurse said, "Our c-section rate is consistent with the national average; it's around 30%." Urgh. Then I asked, "How many women would you estimate have a completely natural childbirth?" The nurse said, "Well, lots of women go natural, but of course we give them a little narcotic toward the end." "No, no," I said, "I mean completely natural. No drugs at all." The nurse looked confused and said, "Um... maybe 2%? That doesn't happen very often." They also thought it was "cute" and a little amusing that I had a birth plan. Those responses were red flags for me.

So my next step was to set up an appointment with the midwives. I found this midwife practice online, through a simple Google search. They offer free consultation visits, so one evening last week Frank and I went in to chat with them. The midwives offer the option of a water birth, something I'm interested in trying. I asked the midwife we met to explain the policies and philosophy of their practice, and after she was done, Frank and I agreed it was exactly what we were looking for. What really clinched the deal was when I asked her about their patients' c-section rate. "Fewer than 8% of our patients end up getting c-sections," she said. Those numbers say a lot. 8% vs. 30% odds of major surgery? I was sold. The next day I called my insurance company to make the switch.

When I spoke to my insurance company, I learned that they don't allow changes in prenatal health care providers after 27 weeks. Good thing I called just in time! I also found out from the midwife that their practice doesn't always accept patients who come in after 28 weeks; at that point they have a meeting to decide whether they can take on another patient in addition to their existing load. Luckily I made the cut-off for both those things, but they're good to know for the future.

I'm so excited about the switch. I feel incredibly happy, calm and peaceful knowing that I'll be having my baby in an environment that supports what I'm trying to do, and that also has safe back-up options in case things don't go according to plan. As sad as I was to leave my great ob/gyn, this decision wasn't hard at all. Now, as my friends keep reminding me, I will have to let you know how I feel about it all after I actually give birth.

13 comments:

  1. I'll pray you have a smooth time of it! I told my hubby that I wanted to try to go without an epidural and he said since it's available that I should take it :) If not for my sake, for his so I don't pull off his hand in delivery :) We'll see. I'll probably go as far as I can without and then ask for it if needed.

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  2. You're turning into a mommyblogger and I absolutely love it. :D

    ~ Country Girl's Daybook, recently posted: #whywemarch http://bit.ly/1aEsJk2

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    1. I know, I'm totally turning into that person! What has become of me? :)

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  3. This is the exact environment I was able to deliver in and I loved it. The CNMs are a fantastic option. Like you I like having the hospital as back up but in order to have a truly natural, intervention-free birth your birthing team needs to be on your side. Like you said -- so many nurses/medical professionals consider any vaginal delivery to be "natural." Hmm. Anyway I'm also like you and agree -- it just comes down to having a healthy momma and baby and whatever route you choose is your own. I still haven't had a chance to sit down to my computer. Out of town currently. But I really do want to write you that email. I have so much email ... Eek!

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  4. Hi Tess, First, I think it's awesome you're making the choice that feels right for you and your birth! I definitely agree that CNMs are a great choice for many low-risk women who desire little intervention. In terms of the C-section rates, I think you might be comparing apples to oranges, at least somewhat. Many higher-risk women aren't able to use CNMs as their prenatal care providers because of their and/or their baby's health concerns and might be more likely to require C-section for those reasons, not just that they're with an OB provider. Also, more women who have previously had C-sections (for whatever reason) are likely to deliver with OBs, increasing the % as well. Obviously CMNs and OBs CAN have fundamentally different approaches to delivery too. But luckily I think as long as you have a provider who you trust to be a partner in decision making during birth, you're doing the right thing. I hope that you have the smooth, intervention free delivery you plan - and that no matter what your baby's birth might throw at you, you're happy to have become a mama that day. Congratulations to you and Frank!

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    1. Thanks for your thoughts, Anonymous. I definitely agree that there is a difference in the care possible for high-risk vs. low-risk pregnancies, and that is reflected in the c-section rates for these two different hospitals. As a woman lucky enough to be in a low-risk pregnancy, those rates do hold some weight for me, but I absolutely agree that all anyone wants at the end of the day is a healthy mom and healthy baby—no matter how they end up getting there.

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  5. You're like my birthing kindred spirit. lol. I could have written this post myself. It troubles me that the default in this day and particularly in this country is to view birth as a medical crisis that requires interventions and medications rather than as the common and natural event that it is. Of course it's good to have the back-up if something does go wrong, but birth itself isn't the wrong thing.

    Also you're awesome for being brave enough to talk about it. I'm always hesitant to mention my desire to go med-free. Epidurals are so common these days that people seem to react a lot with: "Good luck. You won't be able to handle the pain." Women have done it for forever, and epidurals have been known to fail. Going into labor with a mind and body trained to cope in natural ways just seems like a winning situation to me, rather going in with the assumption that I can't do it.

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  6. Hi Tess! I had a natural birth with both Emma and Matthew. I was with an OB/GYN for Matthew's birth but made the decision to switch to a midwife when I was 20 weeks pregnant with Emma. I am so glad I did! Emma's delivery was complicated (baby girl was flipped the WRONG way), but the midwife was there every step of the way helping with my pain management and praying with Paul. She helped me through an extremely difficult delivery and I do not think I would have been able to do it otherwise. The delivery nurse told me after Emma was born that she had never seen that situation not end in a C-section...phew! I wish you all the best, Tess. You're going to do awesome.

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    1. Monica, that's such a cool story! Super inspiring, and great to hear after making this decision. Thank you so much for your support. :)

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  7. You won't regret it. The midwives that I used were so wonderful during my labor and delivery...as in... Rubbing my feet during hard labor in the middle of the night! I loved them and adore them!

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  8. I LOVE midwives! I've had one for all three of my children. My first birth ended in a c-section after 24 hours of labor and no epidural. I had comfort in knowing it was truly necessary. My other two have been VBAC's. Congratulations on your pregnancy! You won't be disappointed in a midwife. I get all mushy when I think about them. Love is the word. :)

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    1. Wow, that's so awesome to hear! Thank you for sharing! I'm really looking forward to having them there. :)

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  9. Hi Tess,

    Thank you for all your great posts. I am currently studying to be a midwife and so I think it fantastic that you have found them to be what you are looking for. :) Ina May's books is great. There are lots of other books if you are interested....

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