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[quote=Anonymous]I gave birth with MCA in early June, after switching at 34 weeks from a high-intervention rate OB practice.  Overall, I was very happy with the choice I made.

The OB practice included 7 doctors, and while I liked 2 of them, with the rest I felt like part of an assembly line.  Even though I am of "advanced maternal age," my pregnancy was trouble free, and it seemed I was not very interesting to most of the OBs.  My questions were usually blown off, and my request to discuss a birth plan was dismissed at 34 weeks with "someone will get to that later."

Two colleagues at work had recently used midwives, one MCA and another a home-birth midwife.  Again, because of my "advanced maternal age," I opted to deliver at Shady Grove instead of at home, and so chose MCA.  I saw all but one of the midwives, and Angel, Dusti, and Caitlin (who was new to the practice and awaiting her hospital privileges) were the ones I "clicked' with the most.  I found the care they provided to be thorough and kind, and most importantly, they took their time and were very interested in my perspective.

When I went into labor, Nina (who has since left the practice) was on duty at the hospital.  My membranes ruptured spontaneously, and I was told that I would have to deliver within 12 hours or start on IV antibiotics, due to the risk of infection.  Despite my best efforts, I passed that 12 hour mark, though after discussion it was agreed that they would wait until 18 hours to start antibiotics.  Nina was very insistent that I start on pitocin, to which I was resistant.  I did eventually agree, and in hindsight that is probably the one decision I would make differently.  My son was "sunny side up," and so I was in back labor the entire time.  Pitocin made the contractions excruciating, and at 20 hours I asked for an epidural.  I was very disappointed, because I wanted to deliver naturally, but by that point I was exhausted.  Nina had rotated off and Angel had rotated on by that time.  Angel was incredibly supportive, and coached me through 3.5 hours of active pushing with incredible kindness and good humor, until my son was born after 26 hours of labor.  Amazingly, I had only a tiny tear which healed up easily.

I am certain that had I stayed with the OB practice, I would have had a cesarian section.  So I am thrilled that Nina and Angel were patient and supportive and that I had a vaginal birth.  Was it a perfect experience?  No.  Would I use MCA for a second child?  Absolutely!

One important caveat I would add is that the IV fluids I received with both the pitocin and antibiotics caused my breasts to become edematous/swollen.  I was completely unaware of this possibility!  The edema didn't become apparent until several hours after delivery.  My son was able to latch on and nurse immediately without problem, but 2 hours later my nipples had almost disappeared.  The comment of the in-house lactation consultant was "oh yes, IV fluids have ruined many a good nipple."  In short, my full milk supply was delayed in coming in by 2 weeks, during which time my son and I struggled (and he received supplemental formula), my nipples became very sore and cracked, and now  14 weeks later I still do not produce enough to meet his demands.  This is despite working with a fantastic lactation consultant.  It's most likely that the IV fluids set off this cascade of events, and if I have a second child I will be avoiding IVs unless absolutely medically necessary.

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