Reply to Why did you pick a midwife over a doctor?

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[quote=Anonymous]My first baby was born with midwives at a birth center. She is 10 now. I chose midwives and an out of hospital birth because I was 27 years old and low risk. I actually started the pregnancy with an OB practice (the same one I'd been getting gyn care for years) and transferred mid-pregnancy because I wanted a different kind of prenatal care - care that includes all the standard medical care but was more personalized. With the midwifery practice I chose, my appointments were 45 minutes, with my midwife every time from start to finish, and I had plenty of time to feel comfortable with her. My baby was post-date and my midwife was supportive of waiting from 40-42 weeks until labor started on its own (whereas my OB practice told me that if I hadn't gone into labor on my own by 40w1d, I'd be admitted for induction). I was comfortable with the backup physician care and the hospital (midwife had privileges at the hospital and would stay with me if transfer was necessary), which was 5 minutes from the birth center. When labor did start naturally, it was a long labor (51 hours from first contraction to baby's arrival), and my midwife was able to suggest things (tub, massage, position changes, etc.) that helped move things along. She was also there with me, in the room, the entire time I was in the birth center (probably only about 40 hours total since the first bit was at home, where she consulted over the phone about when to come in). I have a family history of postpartum hemorrhage, so midwife was on the lookout for any signs of that. The followup care included calls from midwife every day for a week after the baby was born and a home visit at 3 days postpartum with lactation support (I needed some help with latch). Office visits to examine physical recovery at 2 and 6 weeks postpartum.

My second baby was born with the OB practice I left the first time. She is now almost 4. I chose to stick with the OB practice and Sibley because the birth center was too far from where we lived at that time. My experience with that pregnancy and birth were completely different from my first for a lot of reasons, mostly because it was a higher risk pregnancy and more medical management was indicated. Also, as a second time mom with a previous unmedicated vaginal delivery, I felt a lot more confident about how I would experience labor generally - it was no longer a huge unknown for me. I felt more confident in my own ability to advocate for myself than when my first child was born. I was induced for medical reasons and  I was largely alone in the hospital room during the induction (my husband was at home with our older child until midday). Nurses would check in or come when I called them, but I think I saw the doctor once in the morning when the induction started, once midday to see how things were going, and then when I was ready to push. I was comfortable, at that time, with that limited contact from my actual doctor, but with my first baby, I wouldn't have been. Postpartum, I was in the hospital for a day and a half. After my OB stitched up the small tear that occurred during delivery, I saw him one more time before leaving the hospital. At that time, he did not visually examine my stitches and actually didn't ask me any medical questions at all. I think he made some jokes about the weather, told me the baby was cute, and then said he'd see me in 6 weeks for follow up/IUD. No one called me the day after I went home to see how I was settling in. It was like I ceased to exist once my baby was born.

I think that midwifery care should be the norm for low risk pregnancies and that everyone should start there and be referred up to a higher level of care (OB, MFM) if necessary. It would be helpful to normalize this birth choice so that women do not think it is an extreme thing to choose to work with a midwife during pregnancy. Postpartum care in the US is terrible. If women received even half the number of appointments that newborn babies have, I think many of the issues women have postpartum would be caught. I also think that pelvic floor therapy should be mandatory postpartum care for all women, but that's kind of another topic.[/quote]

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