As a certified doula and childbirth educator, I have been exposed to an incredible amount of research and anecdotal information regarding pregnancy, childbirth and the postpartum period. I have also given birth twice myself in a hospital setting, attended multiple births in a hospital setting and studied the differences between midwives and OBs time and time again. I could write pages and pages about pregnancy and childbirth if given the opportunity (just ask my editors), and if you’d like to ask me a few questions about pain management in labor I suggest we set aside an entire afternoon to spend together — I have a lot to say on the matter.
Because of all that I’ve learned so far in my journey as a birth worker and mother of two, my outlook on decisions such as where birth should take place and who should be by my side as I labor and give birth to my children have adapted in many ways. One of the biggest adaptations to happen was my view on having an OB serve as my care provider. I have decided that if I am lucky enough to have more children, I will choose a midwife to be my care provider and I will (hopefully) give birth in a birth center.
Did I make my decision because I have slowly evolved into a hippie? No, but please don’t look at my long, middle-parted hair or read the ingredients in my DIY essential oil perfume that I made right before I did yoga nidra beside my crystal altar on the night of the new moon; you might not believe me.
Did I make my decision because I absolutely hate OBs? No. While I wasn’t pleased with my own personal experience with OBs, I am well aware that there are many great ones out there and they are invaluable to women experiencing high-risk pregnancies.
Did I make my decision because doulas and home births are #trending among celebrities? No. I don’t even know if that hashtag makes sense in that sentence.
I made my decision because after educating myself about childbirth, I have learned and seen that pregnancy and birth are both normal physical occurrences that my body was made to experience. So long as my pregnancy is low-risk, I don’t feel like I need a professional surgeon to oversee my every move. Midwives are a more than viable option when it comes time to choose a care provider during your childbearing year, and I’m not alone in my decision to choose a midwife instead of an OBGYN
Nurse practitioner Jessicca Moore, director and producer of the 2016 documentary Why Not Home?, chose to give birth with a midwife as well. She created her well-received documentary as a means of sharing the benefits of home birth from the perspectives of other medical professionals who, like Moore, opted for the social model of care embraced by midwives as opposed to the medical model of care within which they work. They, like many other women, have realized that midwives are a more than viable option when it comes to choosing a care provider to work with throughout your childbearing year. Here are a few reasons why.
Midwives are extremely qualified, trained and credentialed health care providers who care for women experiencing healthy, low-risk pregnancies. According to this study, the social model of maternal care practiced by midwives is founded on the belief that “the overwhelming majority of pregnant women have a normal and safe childbirth with little or no medical intervention.”
This means that midwives see birth as a normal life process as opposed to a state of being that is inherently risky. Furthermore, they believe that pregnancy and birth are incredibly transformative experiences emotionally, and thus require a more holistic and family-centered way of treating clients (midwives use the term “clients” instead of “patients” because they don’t consider pregnant women to be “sick”). Because of this, appointments are typically at least half an hour long and involve a lot more discussion about what the client is experiencing in all areas of her health.
Midwives believe in the power of a woman’s mind.
Midwives firmly believe that a woman’s state of mind influences the labor process, and therefore the care they provide is highly personalized to each client. They often ask personal questions regarding emotions and life at home, and they offer appointments dedicated solely to tackling any fears or concerns a client may have regarding their upcoming birth.
For many women, childbirth ends up being more painful because they are holding onto feelings of fear brought about by past experiences or the unknown. Midwives help their clients work through these issues or refer out to specialists if need be.
Midwives encourage and understand the importance of informed decision-making.
I love that midwives are all about childbirth education. This is because a woman’s direct participation in and ownership of her pregnancy and birth experiences results in healthier outcomes overall (even if emergencies arise). Some midwifery practices offer childbirth education classes while others hold group appointments. In these group appointments, multiple clients attend and share their individual pregnancy experiences while also being able to take advantage of the benefits one gets with an individual appointment. Not only is this a great way to prepare for childbirth, but it is also a cool way to meet other expecting parents. It’s never too soon start creating your village.
Midwives have low intervention and cesarean rates.
The social model of care practiced by the majority of midwives desires low intervention and cesarean rates and starts with the least invasive option if it comes time to handle any complications that arise in pregnancy and/or birth.
Proof of this can be found in this birth center study, which found that only 6% of the low-risk mamas who attempted to birth their babies at a birth center required transfer to a hospital for a c-section, whereas the overall rate of cesareans performed in U.S. hospitals on low-risk mothers is four times that at 27%. That’s an impressive difference, and one that is not to be taken lightly. C-sections are such blessings when they are truly needed, but when they happen for subjective reasons such as a “prolonged” labor that was actually perfectly within the normal labor time range, or a failed induction that wasn’t necessary in the first place, they can cause more problems in the long-run.
If a hospital transfer were to be required for a client, midwives are required to have backup physicians on speed-dial who are ready and willing to take care of mom and baby ASAP.
Midwives attend births at homes, birth centers and hospitals.
When seeing an OB, I was limited to giving birth in a hospital, which wasn’t the end of the world but it also wasn’t my birth place of choice. The vibe is much more medical, they don’t let you eat (some hospitals do, but most still don’t) and the whole nurse shift-change situation was slightly irritating. Having to meet new people over and over again while laboring half-naked was a quick way to distract me from any labor rhythm I had going on.
Birth centers on the other hand provide laboring women with a home-like setting within a medical environment. Giving birth in a birth center will give me a lot more space to handle labor pain in the ways I prefer, will allow me more time labor in peace and will also give me the opportunity to eat during labor, which is awesome because studies have shown no negative outcomes for mothers allowed to consume food and drink while laboring.
Can’t decide between a midwife and an OB?
If choosing a care provider is proving burdensome, ask yourself the following questions:
If you envision yourself giving birth at home or in an inflatable tub, a midwife may be the best choice for you. If you feel more comfortable in a hospital setting, then a certified nurse midwife (CNM) or OBGYN may be your best bet. Check out this document to find out what makes a birthplace mother-friendly, and see how your ideal locale compares.
If finances are a factor, then starting with what your insurance pays for may be the most helpful place to start. Keep in mind, though, that many midwives and birth centers that insurance plans don’t cover offer financial assistance in the form of payment plans. Many expecting families have also found success in receiving financial contributions through crowd-funding sites and baby shower gift registries like BabyList to fund their birth center and home births.
To help you figure out the way you see birth, it may be helpful to read about the Mother-Friendly Childbirth Initiative. Compare this to the birth intentions you’ve set for yourself. See what resonates with you, what you agree with and disagree with, and have an open conversation about everything with your partner and any care providers you choose to interview (see next point below). A potential care provider’s willingness to have that conversation in the first place will speak just as loudly as the opinions they may share.
Things to Remember
It is important to remember that you are the decision-maker when it comes to your and your baby’s health. You always have options and you are always allowed to change your mind, even when it comes to your care provider. If you choose a care provider that ends up not being a good match, you can always find a new one, no matter how far along you are in your pregnancy. To prevent this from happening, or to find a new care provider if this does happen, interview potential care providers and ask them questions that will help you make the best decision for you and your family.
While a midwife is my care provider of choice, an OB may be yours, and that’s great! Everyone has different needs, concerns and ideas of what is best for themselves and their families, and I would never push my opinion onto anyone else. What I advocate for more than anything is that women educate themselves on their rights and options. So long as you’ve considered the possible outcomes of your choices and paid attention to your intuition, your decision will always be a good one.