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[quote=Anonymous][quote=Anonymous][quote=Anonymous][quote=Anonymous][quote=Anonymous][quote=Anonymous][quote=Anonymous]My reasons were the same as many folks above, including a terrible experience with an OB practice in DC. My midwifery practice listened to me, and took time to know me as an individual patient.

[b]Pregnancy and childbirth is unlike some other medical experiences, in that the comfort of the patient can have a profound impact on the outcome. [/b]

But it wasn't all touchy-feely. The midwives also took an evidence-based approach and took the time to explain the evidence for their decision-making.

For example, I had extremely well-controlled GD. Tested 4x a day, never blew my numbers after the GTT, controlled entirely with diet and exercise. The OB practice would have induced me at 38 weeks regardless of my numbers as a matter of protocol, but the midwifery practice let me carry to term based on the evidence around very well-controlled GD. They saw me as more than a checkbox, which let me carry my baby to term and have the birth I was hoping for. [/quote]

THIS. Thank you. I already posted on this thread with my reasons for choosing a midwife (in a hospital) rather than an OB. I have found some of the other responses frustrating, and couldn't come up with the words for why - this is exactly correct.

If I'm going in for surgery, yup, I want the best possible clinician, not the best bedside manner. But childbirth is very different!

I do wish there was more research/comparisons between outcomes from an OB vs. a CNM in a hospital.[b] When I was trying to look at studies about this in making my decision, there was a real dearth of information on this. Lots of studies on home birth with a midwife, but that's very, very different. And some that compared midwifery to OBs without accounting for location of birth at all, also very different.[/b] My instinct is that, yes, there are extreme cases of complex issues where midwives miss things, or can't handle something that pops up, and just the 10 mins it takes to get an OB in the room creates a negative outcome. But that there are also a fair number of people getting c-sections with OBs would wouldn't be getting c-sections if they had gone with a midwife, and a certain very small percentage of those will have negative outcomes because surgery always has risks. I'd love to see numbers on how this stacks up. Even the (agree, somewhat condescending) medical practitioner who commented on page two said "A midwife in a practice with physicians seems fine as there is backup easily available" and that's where I landed - but I'd love to see research on this, especially now that there are so many CNM working in hospitals. [/quote]

Where did you look, and what search criteria did you use?

I just checked and I found a good amount of information on outcomes of hospital-based CNMs and OBs, including a recent study on outcomes with a total N ~1500. [/quote]

I'm the PP you quoted. This was over two years ago now, so I honestly don't remember, but if you've found something please post a link! I'm eager to look. Thank you![/quote]

Sure. It's a study from 2017 IIRC, so it should have turned up.

Were you at the level of doing a lit review on PubMed, or do you usually just Google for this sort of thing?[/quote]

Dr. Google, for sure. I'm definitely a layman when it comes to stuff like this, so very possible I missed what I was looking for! I'm trying to find the study you're referring to and I'm still coming up dry - hoping you can help me out![/quote]

Sure, no problem! Google gets you pretty far, but you might well find more references (in the medical context) by using https://pubmed.ncbi.nlm.nih.gov/ . From the user perspective, it works a lot like Google. There are a lot of specific filters and stuff you can use, but that's more advanced. For your purposes, think of it as a free alternative to Google that might get you more specific results.

I was looking at these:

[i]Women's Health Issues[/i]. Jul-Aug 2017;27(4):434-440. doi: 10.1016/j.whi.2017.01.002. Epub 2017 Feb 16. 
[u]The Cost of Nurse-Midwifery Care: Use of Interventions, Resources, and Associated Costs in the Hospital Setting[/u] 
Molly R Altman  1 , Sean M Murphy  2 , Cynthia E Fitzgerald  3 , H Frank Andersen  4 , Kenn B Daratha  5 
PMID: 28215984 DOI: 10.1016/j.whi.2017.01.002 
--> (N is 1444)

[i]Nursing Health Care Perspectives[/i] . Jan-Feb 1998;19(1):26-33. 
[u]A model for the future. Certified nurse-midwives replace residents and house staff in hospitals [/u]
L A Ament  1 , L Hanson 
PMID: 10446546 
--> (from the abstract, this one is referencing studies from as far back as the nineties, so looking through the reference list might get you more gold to mine)

There are ways to legally get copies of articles for free, if you have to pay to access them otherwise (i.e., they are behind a paywall). Even if you are just looking at the free abstract, you can also use the "similar articles" link on PubMed to expand your search quickly to find other articles that might be relevant. There is also a section that lists other articles which have referenced the one in front of you, and that's usually another useful place to look.

If you want any more detailed info on how to access any of that, just post back.

Best wishes![/quote]

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