Reply to Trying to understand the midwife route

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[quote=Anonymous][quote=Anonymous][quote=Anonymous][quote=Anonymous] An important question: would you rather have a more qualified provider who may be more inclined to give you a C-section if they are concerned with your labor, or a less qualified provider who might not appropriately respond to a critical situation when necessary by doing needed interventions because they view the trajectory of your labor as “normal” or don’t want to transfer your care? [/quote]

I chose #3 for my two births: Qualified midwives who would respond to a critical situation when necessary by having a qualified OB do needed interventions. Of course it would be dangerous to have a midwife unwilling to transfer care when necessary, just as it would be dangerous to have a GP unwilling to transfer a patient to a specialist when necessary. 
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It’s nice to think that midwives always transfer care when they are supposed to but I’m living proof that they don’t and I know a number of other women on the same boat. Until CNMs divorce themselves from the CPMs and CMs and stop making natural physiologic childbirth the most important aspect of care, and remove some of the dogmatic views that they entrench in women during their training, the profession will continue to have bad apples who don’t know their scope. Unlike PAs, midwives are all about their own professional autonomy.

But sure, 60 hour poster, your kid didn’t get brain damage so I’m sure you feel like you made the best choice. But I bet you would have sued your midwife if anything was wrong with your baby. [/quote]

60 hour poster here. This is really fair. Obviously, I'm super supportive of midwives - have done it, will do it again. But I think this thread has actually really achieved its goal, which is to tease out what the real difference is. I imagine the whole thing is really helpful to the OP. There are degrees - certainly there are going to be really hands on OBs. Really risk-averse, highly trained midwives. Midwives who are too quick to transfer. OBs that go above and beyond to avoid a c-section. The world is a complex place. But there are some overarching, general differences in approach that I think this thread really teases out in a productive way, as to generally, what the two experiences are like.

One thing I will add, that goes with your brain damage point - I could not find studies/stats that specifically dug into the difference in safety between a Certified Nurse Midwife in a hospital vs. an OB in an hospital. All the studies I found were about midwives in birthing centers or at home, compared to OBs in hospitals. As midwifery comes back in a big way and grows in popularity, I would really like to see a comparison of outcomes (and particularly, adverse outcomes) between these two groups in a hospital setting.

One final point that you alluded to, but is worth spelling out for the OP, is the difference between Certified Nurse Midwives (CNM), Certified Professional Midwives (CPM), Certified Midwives (CM), and non certified midwives. In doing my research, there is a HUGE difference between these in training and preparation, and my love of midwives is limited exclusively to CNM, the highest level of midwifery training. I would never, ever, use one of the types. Something for anyone considering the midwifery route to consider. [/quote]

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