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[quote=Anonymous][quote=Anonymous]To me it's less about whether the doctors are "epidural pushing, back labor forcing monsters" and more about the extent to which the doctors are trained/equipped to assist mothers in natural childbirth. The Wisdom midwives had a great framing of their work vs. OBs, which is that they are skilled in handling low-risk, normal births (the majority of births) while OBs are trained to handle high risk births- even if the majority of the patients aren't high risk, sometimes when you are a hammer everything looks like a nail, at least in my experience with OBs. That's their job.

I gave birth with Wisdom and had a good birth and pregnancy with them, but the fact remains that there are very few places where there are trained midwives - people trained in normal birth and handling risks of normal woman - esp those that practice out of a hospital. There are few choices.[/quote]

My former doctor is about as good as it gets for a medical doctor. He was downright enthusiastic about natural childbirth and extremely supportive. the key difference, though, is a midwife is specially trained in achieving natural childbirth and brings skills to the table that will help you get that, and it is not just that she is dedicated to not interfering and supporting, but she can help you get it. And the environment at GW (and at FHBC for that matter) is set up with that in mind. The nurses are used to natural births and can support.

Midwifes can offer clutch assistance, that hinges on years of experience managing natural births, they are knowledge about best pushing positions to turn a baby that is not optimally positioned, they know natural methods to speed up or slow a labor just by changing positions (standing will sometimes speed up, lying on side will sometimes slow down, for example). I loved my doc, I really did, but ultimately there was a one-two punch to having an OB at my birth rather than a midwife. For one thing, doc checked me, realized I was 7cm dilated, and declared I would not be giving birth until 7 the next morning or so and went home for the night. So an hour later, when I got an absolutely incredible urge to push, and indeed, my body was pushing for me, the poor nurse had no idea what to do, only kept telling me "do not push, do not push, if you push with a cervical lip, you will have a c-section." So I wasted a ton of energy breathing through urges to push. Then doc arrived 20 mins later or so, I was pretty pooped from NOT pushing, but had lost the urge to, and then he checks, yep, 10cm, go ahead and push. Then after 20 minutes of pushing, he declares I'm not pushing effectively, so let's turn me over from my hands and knees position, which had felt really good, to sitting back against the bed, with spreadeagled legs. All I could think about was the charlie horse in my ass from the position, how my thighs hurt from DH and the nurse holding them back, and I said "i hate this position!" he said, by all means, turn back over, but I felt this overwhelming need to conserve my energy.

Then he said we may need to do an episiotomy and I guess that was the motivation I needed - I shot baby out like a buttered biscuit, to the tune of a third degree tear, for a 6 lb baby. I believe this is because I was in a very bad position for pushing, one that encourages tears. So then I was pushing in a position that hurt my hips, didn't feel right, and put a tremendous amount of pressure on my tailbone. I had a third degree tear with a 6 lb baby. I do believe a midwife would not have put me into such an unnatural position knowing that pushing in that position greatly increases chances of tearing AND does not open the pelvis as much as squatting allows. Additionally, with a midwife, I would not have been alone, with a frantic nurse trying to find someone, ANYONE to come in and look into my vagina and tell me it was okay to push, and that baby would have been out in a couple of squirts. As it was, I lost all of my oomph. (Ironically, doctor snapped at the nurse and said she should have let me push...but I don't think it was her fault).

anyway, I'm in NO WAY bitter about my birth. I would still highly recommend my provider as someone who is a great choice for a person who needs an MD but wants to go drug free. The ways he was awesome far outweighs the negative, despite the tear and fear that crept into the process. But, he's not a midwife.

I know there are some who would say I might have torn anyway (maybe) or that I should have just pushed (yeah, hindsight is great) when I felt the urge, or that a doula would have made a difference. But the truth is, a doula would NOT have done a thing; I would not have trusted her to make a medical decision. But a midwife? Yeah.

Anyway, that's my story, and sorry if too long, which I think illustrates the difference between even the most wonderful OB and an actual midwife. It's knowing what you need to help mom do to get baby out without medical interference, not just "not interfering" that makes all the difference. [/quote]

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