Midwife. a forgotten way

[deleted account] ( 24 moms have responded )

http://www.truththeory.org/the-business-...







Some women worry that a midwife cannot take care of them as well as a doctor. This is not true. Even the World Health Organization has recognized the importance of midwives, noting that women who give birth with a midwife often have shorter labor times and usually don't need as much medication.

A Short Midwife History

In many parts of Europe, using a midwife has been common practice for a long time, while in the rest of the world, a midwife is much more likely to be by your side during birth than a doctor, especially if you live in a rural area.



Midwives have been attending births throughout history and are even mentioned in the Bible. In the past, midwives had no formal training, gaining their experience from "on-the-job training" instead.



However, because of changing societal ideals, by the beginning of the 20th century, the number of pregnancies assisted by a midwife began to decline dramatically in the United States. Many women began to believe that having their baby in a hospital with a doctor was much safer than at home with a midwife. This change marked a shift away from viewing childbirth as a natural process and towards regarding it as a medical problem that could only be treated by highly trained professionals. This resulted in the profession of midwives being almost completely eliminated from the United States.



In the 1960s, there was a growing movement among women to regain control of their bodies. One important aspect of this was their right to choose how to give birth. Women did not want to be knocked unconscious or strapped to a delivery table during labor, which was far too common back then. Along with women's demands, there were nurse-midwives who had become common fixtures in many hospitals. Since nurse-midwives had been trained in an academic setting, educational standards began to be set, thereby giving the profession more legitimacy. These two factors coupled together meant that midwives were making a comeback in America.



Nowadays, midwives are increasingly becoming a fixture in prenatal care in North America. Education requirements for midwives have evolved to reflect the knowledge midwives need to become accredited. A midwife today must have a number of years of formal classroom training as well as practical training before she can be accredited and allowed to practice. Midwifery is no longer an illegal activity, which means that women all through Canada and the United States can benefit.



Midwife vs. Doctor

Many women choose to use a midwife rather than a doctor because of the difference in practicing philosophy. The Canadian Association of Midwives sums up the basic principles behind midwifery very simply:



We believe in a primary care model of midwifery that is community-based and collaborative. This model is founded upon principles of woman-centered care, informed choice, continuity of care and choice of birth place.



Midwives believe in allowing women to make informed decisions regarding their pregnancies. They feel that births do not have to take place in a hospital. They also believe that the whole family should be involved in a pregnancy rather than just the pregnant woman and her health care provider. Midwives look to support you through your pregnancy and provide you with information so that you can decide what you think is best for you and your pregnancy.



Midwives look to incorporate modern medical knowledge with traditional methods of dealing with pregnancies and birth. Having a pregnancy looked after by a midwife means that you are treated as a person experiencing a normal part of life, not as someone who has a medical condition. While all this sounds very nice, there are obviously some differences between a midwife and an obstetrician.



One of the main differences between a midwife and a doctor, aside from philosophy of care, is training. A midwife is trained to deal with women who are having a normal, uncomplicated, low-risk pregnancy. If there are any complications with your pregnancy, or if any develop while you are pregnant and under the care of a midwife, you will be referred to an obstetrician.



However, midwives have been trained to deal with all facets of prenatal, antenatal and postpartum care. Just like an obstetrician, your midwife will be with you right from the start of your pregnancy up until six weeks after you give birth. Even if you need to be transferred to an obstetrician during your pregnancy, many midwives will continue to see you in order to provide emotional support.



Another difference with midwives is that women receive much more personalized care. Most midwives work independently with a group of other midwives (usually known as a midwife collective). Some midwives work in birthing centers while others are based out of a hospital. If you go for an appointment at your midwife's collective or birthing center, you will probably notice that it has more of a warm, family-oriented atmosphere than a sterile medical feel. Midwives encourage their clients to come to their appointments with family members and friends and have appointment rooms large enough to accommodate everyone. In some parts of the world, midwives will even make the trip to your home for your prenatal check-ups. Your postpartum appointments will almost always take place in your home (if you want). Plus, midwives make sure they deal with any concerns you have about your pregnancy, whether it is medical or emotional. They are happy to have a long appointment with you in order to ensure that any issues you are dealing with have been resolved.



Midwifery in the United States



Certified Nurse Midwife

The level of care that you receive from your midwife is dependent upon how much training she has received. Always ask the midwife what certification she has. In the United States, there are two types of midwives: a certified nurse-midwife (CNM) and a direct-entry midwife. A CNM is a registered nurse who has also taken a graduate-level midwifery program. To be given the title of CNM, the nurse-midwife must also be registered with the American College of Nurse-Midwives. This is a regulatory board in the U.S. who accredits midwifery education programs and establishes the standards of clinical midwifery practice.



Direct Entry Midwife

A direct-entry midwife is a person who does not have any training as a nurse, only as a midwife. A CNM is more likely to work out of or with a hospital and is also allowed to prescribe medication. A direct-entry midwife is more likely to work in an independent collective of midwives and will assist in homebirths and births in birthing centers. However, she cannot prescribe medication. Direct-entry midwives should also be certified, preferably by the North American Registry of Midwives (NARM). If a direct-entry midwife has been certified by NARM, then she may prefer to use the title of "Certified Professional Midwife" or CPM.



Midwifery in Canada

In Canada, midwives fall under the singular classification of midwife. Unlike the United States, who have a national governing board, standards for midwifery in Canada are maintained provincially by the College of Midwives. Legislation regarding the practice of midwifery is also dealt with provincially. As a result, access to a midwife is not equal throughout the country. In New Brunswick and Prince Edward Island, for example, midwifery is not regulated which means that practicing midwives do not have any hospital privileges and women who want to use a midwife must pay for it themselves (in provinces like Ontario and British Columbia, the cost of a midwife is covered by the provincial health care system). Regardless, midwives in Canada do need to be registered, preferably with the College of Midwives in their province.



What to Ask Your Midwife

When you meet with a midwife for the first time, you might want to ask her some questions to make sure that she is someone you want to have looking after you. You should definitely ask if your midwife is accredited and by whom. This will help ensure that she has received the proper training and can provide you with a high level of care. Also, ask how long they have been practicing, as this will give you an idea of how much experience they have.



Additionally, it is important to inquire about the midwife's philosophy of care. While most subscribe to a more personalized method of care, there can still be variations in how each midwife practices.



If you already know what kind of birth you would like to have, or are thinking about an alternative birth, discuss this with your midwife. Not all midwives have hospital privileges, in which case a hospital birth would not be possible if that is what you wanted.



If you were thinking about having a water birth, it would be wise to bring this up since not all midwives have experience with this type of birth or feel comfortable with it. While most midwives encourage family participation in the pregnancy care, some midwives may discourage having family around for the labor. If it is important to you to have your family with you when you give birth, ask your midwife about this. Perhaps it is simply the location of your birth that will prohibit your family from attending, not the midwife, in which case you may have to reconsider where you give birth.



It is essential to remember that not all pregnant women can be looked after by a midwife. Ask what eligibility requirements your potential midwife has to help determine whether or not you can actually use her services. Also, consider the cost of the service. In the United States, costs can vary among midwife collectives and birthing centers, so it is worth doing some research into the price. Don't forget to check with your insurance company to see if part or all of the services are covered.



In Canada, most provinces cover the cost of having a midwife. In other countries, the cost of a midwife may or may not be covered. Be sure to ask regardless of where you live.



Giving Birth with a Midwife

Now, you may be wondering how your birthing experience will be different if you use a midwife instead of a doctor. One big difference is that midwives will attend to a homebirth while most doctors won't. Many women find the home birth experience to be a much more tranquil and enjoyable experience than a hospital birth. Women get to give birth in a familiar setting, surrounded by people they know and aided by someone who has their best interest in mind. Find a midwife who embodies these values for you.



A midwife will encourage you to do what feels best for you, whether you want to walk around, get into the shower or use some heat compresses to deal with the pain. Midwives also do not set you to a time limit when you are in labor. Many doctors will let you try to give birth vaginally for a set amount of time before they decide to perform a cesarean. Since midwives encourage vaginal births, no time limits are enforced which means fewer unnecessary cesareans are performed.



In fact, women who give birth with a midwife often have less medical interventions. Other benefits to giving birth with a midwife include fewer complications with both you and your baby.



However, you do not have to have a homebirth with a midwife. Midwives will also attend to births in hospitals and birthing centers (most birthing centers are staffed primarily by midwives but have obstetrical backing). Even if you give birth in a hospital or birthing center, a midwife will still encourage you to deal with any pain you experience in a natural way rather than injecting you with drugs. They will also do their best to make your experience as calm and tranquil as possible.



Midwives feel that their role in a birth is to assist the women in labor. As a result, many midwives will not use the term "deliver" since they feel that this refers to them doing all the work, not you. Instead, many midwives prefer the term "catch" meaning that they will catch your baby when it comes out of you or has been delivered by you. Also, some midwives will refrain from announcing the sex of your baby, a common practice in many hospital delivery rooms. Instead, they will let you announce whether you have had a girl or a boy. Because midwives take a more passive role in the birthing process, many women feel empowered by the control they are able to wield.

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24 Comments

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Jennifer - posted on 11/29/2010

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when i found out i was pregnant, i knew i wanted a midwife but i didn't (don't) drive, and we had no computer. i felt totally cut off from the world and i trusted my MIL when she said "i did research for you, and there are no birth centers, or independent midwives in the milwaukee area. you'll have to go through a hospital." i don't know if she intentionally sabotaged my pregnancy/labor experience, or if she just didn't really research because once i was able to research myself after my son was born, it was pretty easy for me to find a birth center 30 minutes away, and a homebirth midwife 45 minutes away. i was furious...not so much at my MIL, but at myself for not taking control of the situation. it was an unplanned pregnancy so i didn't even know where to begin, so i just let other people lead the way and it bit me in the ass...big time. it is definitely not something i will let happen again. whenever i'm done with school, and the hubby and i can have another babe, i AM prepared.

Kayleigh - posted on 11/29/2010

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Yeah America is one of the only places like that... everywhere else in the world the only time you see a doctor is when its life threatening... I wish it were like that around here... :P lol

Katherine - posted on 11/29/2010

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Midwifes are very rare here in the states, at least in Michigan they are. I know they give you a choice, but they don't give you any info. We aren't schooled well in midwifery at ALL.

[deleted account]

This all seems so strange to me, in NZ a midwife is the norm! We have a midwife who will usually only take on about four (at least, that's what I've been told) pregnant women per month, and you meet with that midwife once a month to get a check up (more frequently in your last trimester). I don't personally know of anyone that has used a doctor for their birth.

Kayleigh - posted on 11/29/2010

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Midwives that work in hospitals are held to the same rules and regulations that OB's are... that's why it was no different.

one of my midwives at the birth center was complaining about how a radiology center up north of here wouldn't take their patients anymore b/c none of them were being seen by actual doctors... she said "its really ridiculous that they wont see our patients simply b/c we are not being controlled by physician overlords"
lol. I really liked her... too bad she doesn't work there anymore ♥

Jennifer - posted on 11/29/2010

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i had a CNM for my son and even though she was a midwife, it was still a terrible experience. she was through the hospital i was going to deliver at. i saw absolutely no difference between her and an OB. i was induced at 40wks + 5 days because she was worried the baby would be too big. they started me with pitocin and broke my water a couple of hours later. once they broke my water my contractions were "too strong" and they were coming in every couple of minutes to turn the drip down. ended up having an epidural i didn't want but fortunately needed no other interventions. my midwife wasn't even the one to deliver my son because she wasn't "on call" at the time she had my induction scheduled for.



a couple months after having my son, we finally got a computer and i started doing research (i guess i should have done that before delivering). everything i went through could have been prevented had i just been informed. i really believe all the troubles my son and i had learning to breastfeed were in large part due to the epidural...we never were able to get my son to latch on and i have been exclusively pumping for him since he was about a month old (he's a little over a year old now). i've done a lot of research since having him and i've been so inspired by intervention free, and natural labors that i went back to school. i'm a nursing student right now working towards becoming a certified nurse midwife. i decided to go with CNM for the security of being a nurse but homebirth midwifery is where my passion is, and thats what i plan on pursuing.

[deleted account]

Oh most definitely! My stomach is still hurt. I could actually feel where the muscle was separated for a while. I'm extremely limited in my yoga now, a lot of the stretches put too much of a strain on my stomach because of the damaged tissue. Pretty sad when i cant do the only workout i thoroughly enjoy properly.....I couldn't imagine the damage after 4....

Aleks - posted on 11/27/2010

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Yeah. every woman that I know who got induced ALWAYS ended up needing intervention. Most ended up in surgery!
I dread inductions!!!! Majority of times it is sooooooo unneccessary. And women get scared into them by the doc's. A good friend ended up having 4 C-sections!!! Because they induced her as she was 10 days overdue and they made her believe that baby needs to come out. Then they scared her of Vbac for 2nd baby!!!
Now, the poor woman will have serious issues with her stomach muscles and the like for the rest of her life.
Seriously.

[deleted account]

its so ridiculous, i babys dont just stay in there forever! they eventually come out who needs all those stupid chemicals in their body while trying to give birth.....it makes it so you cant push as well or progress too fast or slow, the chances of a section increase by half when your induced...

[deleted account]

Yea i kept saying no to the induction so they would make another reason up, not to mention i had my bf and his mom saying you have to omg your going to kill the baby........bunch of nuts....the whole lot of em...doctors are mostly left brain prisoners

Katherine - posted on 11/27/2010

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Hmm, I had the same thing happen. I lost all of my amniotic fluid and they had to rplace it with saline. Then they made me induce.
Second time, I hated them.

Aleks - posted on 11/27/2010

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Yah, that is exactly what I was told. Placenta not working so well... and that any longer may start to break down, if that happpens..., then there would be some real trouble. I was 38wks!!!
Hmmm, but I guess I will never know exactly what was the reason.
Btw, in old scale my daughter was 6lbs8oz.

[deleted account]

Yea they tried telling me that the baby wasn't getting enough nutrients because my placenta was dying as well. I was 2 weeks over due. I had an 8lb3oz baby!! thats equivalent to 3.71kg if thats properly converted...she was a bit bigger than a lot of other babies i know.

Aleks - posted on 11/27/2010

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umm... funny that, most "birthing" hospitals here in aust (in major cities that is) have got midwives as standard!
Some are really nice, and some are terrible! I have been lucky and have managed to have nice ones at my 2 births :-) Some women I have spoken to were not so lucky :-(
But yeah, doctors can be reall nasty. I too was being scared into induction, and yeah, she used emotional blackmail to get me to it - basically at 38wks I only measured 32cm fundal height... I was supposed to be around 38cm. They sent me off to get ultrasound, fetal movement and heart monitoring. Results came back as not enough fluid around baby. Baby size is small est at 2.882kg, which in their terms meant too small! Doc said that baby isn't getting enough nutrition (ie, starting to be starving), so each day baby will have less and less strength and that could bode really really badly for the birht and since baby is kind of small, which means baby doesn't really do as well as bigger babies, greater chances of complications because of it. Smaller babies are not as strong during birth, nor afterwards. I think she said "smaller babies do more poorly" after birth.
And because I was 3cm dialated already she wanted to induce ASAP and trying to push me for monday (it was friday when I had that check up)! She did an internal (supposedly to check if plug is in and how far dialated I was... I think I would know if the plug got out!!!). Anyway, OBs have got this trick that if they want labour to get started they "stretch" the membranes a bit during the internal to get things under way. She did that to me - it hurts! I got "the show" when I got home. Went into labour Sunday night, baby born Monday morning. She was 2.928kg - exactly the same weight as her father when he was born!!! He was term! Had I known that I probably wouldn't have stressed so much.
She made me feel guilty by wanting to keep baby in as long as possible or to natural duration, by saying I am putting it in danger. I felt that if I didn't agree to the induction that my baby would die.
Thank heavens that I didn't need to be "hormonally" induced!
Oh, and baby did absolutelly fantastic during labout and after!

[deleted account]

Awe thats awesome congrats :D:D..You know what...you and me are a year apart...and our children will be too..:D

Kayleigh - posted on 11/24/2010

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will have ^_^ and thank you, I'm gonna pop any day now... hoping this week. lol.

[deleted account]

Yea the doctor didn't even think to check my chart or ask me what kind i wanted once i finally agreed to it. It was 7pm when i went in, i didnt have the painkiller until 11 am. They gave me morphine.. i m allergic to that. so they had to pump me full of antihistamines and gravol afterward. As soon as i said yes they just walked in and injected me with it. They were so invasive. My next child im giving birth to in my home. It is a good thing this happened though. Im going to be a midwife, im reading online about it now, im not sure about official school yet though.

Kayleigh - posted on 11/24/2010

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Oh wow, I'm so sorry that you went thru that Julianne! This is exactly why I wont even go to a doctor now... at like 15 weeks, after my doctor had pissed me off for the last time for not listening to me and treating me like I had no clue, I started doing research and found that movie... I immediately started doing more research on midwives, and natural birth, birth centers, and benefits of drug-free deliveries... even unassisted birth to see what those women were doing right that allowed them to not have any professional intervention of any kind.

Found out state medical covers midwives too! so now I go to the Puget Sound birth center and my midwives are amazing! I also have a Doula that is really awesome.

I'm already really weary of doctors and the last thing i could see my self handling is the way they treat women in labor... its disgusting and demeaning... not to mention TOTALLY COUNTERPRODUCTIVE TO THE BIRTH PROCESS! I could NEVER be able to handle giving birth in a bright room with a bunch of people I don't know, forced onto my back, unable to eat or move, having some asshole male doctor staring up my junk for 16 hours, and bossing me around. NO THANK YOU. not to mention painkillers make me sick...

I count my self fortunate that I found this information when I did. its made all of this incredibly less scary for me...

Also, one of the things we really wanted for the birth is for my husband to be as involved as possible. In a hospital he could do no more than hold my hand and talk to me, but in a birth center he can hold and comfort me, and he REALLY wants to catch the baby... try that in a hospital... lol

[deleted account]

I was induced, apparently i needed to be because of not enough space. If the baby was running out of space she would have popped out the exit! i was bullied into pain killers, i wanted to do it all natural but was told repetitively while in labor the pain was going to get 100x worse and i couldnt handle it. then when i went into hard labor i wanted to get up and move around..but wasnt aloud i could feel the baby was the wrong way. and needed to be wiggled and shifted into the right position...the doctor forced me on my back when i wanted to stand to push her out i kept saying no and noone would listen, because they knew what was right apparently. I pushed even tho i said it wasnt going to work like that....and i put stress on the baby, so her merconium released. Then i needed an emergency c-section. I told the doctors i cant get a spinal. I had spinabifida my family doctor told me that it could paralyze me if i did. They kept telling me my baby is in danger and i needed to. so while in surgery i crashed. They almost killed me and my daughter. i had no say whatsoever and they used emotional extortion to bully me into what i didnt want..i wish i would have looked into it as well. Then i wouldnt be scared for life! Oh and the spinal made it so my legs just go numb from time to time for no reason.

Katherine - posted on 11/24/2010

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I wish I would have looked into this, because I would have considered it. I wonder though, would they have had to induce me?

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