When I became pregnant for the first time, I was newly married and newly relocated to South Florida. I had found an OB I liked but learned after an extended hospital stay for pneumonia that I’d have to travel 45 minutes away to see her for prenatal care and probably to deliver. So I was a few months pregnant and on the hunt for a new doctor.
I got a recommendation for another local OB from one of hubby’s co-workers and everything was fine. I liked the doctor, we got along well and being my first pregnancy, I didn’t know what to expect so thought everything was fine.
In the beginning of my third trimester we did the standard hospital tours and I decided which hospital I wanted to deliver at. I carefully wrote out my birth plan after tons of reading and taking a Hypnobirthing class and at 35 weeks sat on the exam table of my OB’s office, birth plan in hands.
It was the only prenatal appointment hubby had missed throughout my entire pregnancy. The doctor walked in and we had the usual small talk. I eventually got up the courage to say “I have my birth plan ready and decided I want to deliver at XYZ hospital.” My doctor immediately went into a long explanation of the birth she had just come from where the mommy with a birth plan was refusing an episiotomy and, it turns out, she doesn’t actually deliver at that hospital anyways.
I left that appointment in tears. I called hubby hysterical. I didn’t know what to do. I didn’t want to go to the other hospital and I no longer felt comfortable with my doctor.
I immediately e-mailed my Hynobirthing teacher when I got home and she recommended a group of midwives nearby me, and I was lucky that they were willing to take on my care at 35 weeks. The care I received from those midwives was a stark difference from the care I received from the OB. It was the best decision I’ve ever made for myself and my children (I’m fairly certain I would have ended up with a c-section for my first baby had I stayed with that OB) and I ended up delivering all four of my babies with a midwife by my side.
There are many reasons why choosing a midwife is the right decision for many women:
Care is woman centered
I often describe the difference of midwives vs. doctors simply as: doctors are trained to look for something to go wrong, whereas midwives are trained for everything to go right. Of course there are exceptions to every rule, but, in my experience, midwives are generally more focused on the woman than the pregnancy. It’s not that midwives aren’t concerned for the health of the pregnancy, quite the opposite, in fact; it’s that they look at the pregnant woman as the whole being she is rather than merely a series of vitals and test results.
Appointments are more like meeting a friend
A typical OB appointment for me looked like this: get weighed by nurse and have blood pressure taken. Pee in a cup then go into exam room and wait for doctor. When doctor comes in, say awkward hellos and superficial “how you feelings.” Get fundal height measured, get the “everything looks good” or a short “I’m worried about…” followed by “I’ll see you next month.” All in, about 5 minutes of doctor time.
And while my midwife appointments were similar as far as the beginning went (weight, blood pressure, pee), the visit with the midwife was always much longer and more in-depth. How was I feeling? How was I really feeling? Any concerns? Any changes? At the end of my pregnancies, we would talk extensively about delivery and my hopes and expectations. My midwife appointments were long and thorough and I always left feeling better and at ease.
With the OB, I always felt like a passenger on the ride. My doctor knew what was going on and so long as she said everything was fine, I was to just go with it. I never felt comfortable asking a lot of questions or bringing up concerns. My midwives were the opposite, they wanted to know everything, even if it seemed somewhat insignificant.
Cost shouldn’t have to be a deciding factor when talking about the birth of a baby but the reality is that birth can be expensive and depending on your healthcare coverage, cost can be a major factor. A midwife, especially when choosing to deliver at a birth center or at home, is thousands upon thousands cheaper than delivering with an OB at the hospital, even for an uncomplicated vaginal delivery.
They are more supportive of natural delivery
Choosing a midwife if you’re hoping for a natural, drug-free birth means you’re more likely to get a person who is supportive of your journey, not just the end game of a healthy baby (though, that is obviously a top priority for midwives as well.) In general, doctors tend to be more interventive and are more likely to mess with the natural process. They’re more likely to suggest induction for being “overdue,” more likely to want to speed up a “slow” labor and more likely to decide to do a c-section (because they can, a midwife has to call an OB in if they feel a c-section is necessary so may be more likely to try other things first.)
They are usually more present during your labor and delivery
When you decide to deliver with an OB at the hospital, what you’re really choosing most of the time is to labor with a nurse you’ve never met with the hope that your doctor will show up to “catch the baby” when you’re ready to push. Your doctor might come in and check on you throughout your labor but that’s probably dependent on what else s/he has on his/her calendar that day.
You may experience the same thing when delivering at the hospital with a midwife, but in my experience, midwives are more willing to sit and wait with you when they are able. Both of my daughters were born late at night and with my second, the midwife sat in the room with me from the time she got done with her daily appointments until after my daughter was born at almost midnight. We chatted between contractions as she happily rocked in the rocking chair in my room (I was in the birthtub by this point.) She got scolded by her overseeing OB after Sugarplum’s birth for not speeding up my labor but she told me “you were doing great and baby was doing fine so why hurry things? I didn’t mind waiting.”
Successful VBACs are more likely
If you’ve previously had a c-section for whatever reason and are hoping for a VBAC, choosing a midwife is probably the way to go because midwives know that the risk of a VBAC are still less than that of a c-section (which is acknowledged by ACOG but not followed by doctors). Many doctors (especially in Florida where I live) will not even consider doing a VBAC and I’ve heard of doctor’s elsewhere doing a “bait and switch” where they’ll agree to trying a VBAC at the beginning of a pregnancy then deciding at the end, before labor has even begun, that it’s not a good idea. Being less interventive, midwives are more likely to allow a trial of labor with a VBAC and I know many, many women who have had successful VBAC deliveries with midwives, no matter what their initial reason for c-section was.
What other reasons led you to choosing a midwife for your birth?