Some might remember the recent IMHO and Pit threads about someone’s plan to have a home birth, and the lengthy debate and insult-fest that ensued. Although I think a lot of good things got brought up and discussed in those threads, there seemed to be lingering questions and skepticism with regard to midwifery.
This blog is written by Barbara Herrera, who is a Licensed and Certified Professional Midwife. She’s done homebirths for years, but recently switched to doing monitrice and doula work with women who birth in the hospital. I look to her for informed, and levelheaded opinions on pregnancy and birth issues of all kinds. I mention all of this to preface this link to a recent blog about education and licensing for midwifes (which happens to be written by a guest blogger, Colleen Scarlett, LM, CPM ).
The way the issue gets discussed, it seems like people either think midwifery and homebirths are incredibly dangerous and stupid, OR they have simplistic hippy dippy ideas about birth being a natural event and no professional help being necessary. In reality, there are great midwifes like Barb, who are well-educated and conservative in practice, bad ones who make dangerous decisions and practices, and everything in-between. I wanted to share this blog post because I very much agree with the points about the importance of education and licensure in midwifery.
When it comes to fighting ignorance on this topic, there’s still a long way to go, but I think discussions like this are a good start. The more birth professionals who are out there with good educations, licenses, and high standards of care, the fewer reasons people will have to label them all as wishy washy hippies.
This is so true - I had my baby with midwives in birth center that is one floor of a hospital, and I saw midwives for all my prenatal care. They were awesome and brilliant and highly educated and let me be in any crazy position I wanted during labor. At one point the midwife was on the floor between the bed and the wall because I was in a weird kneeling position at the edge of the bed. My dad (yeah he was there too but he didn’t look at the juicy parts) said he had a hard time imagining a doc who would do that. My husband, the baby, and I all slept together in a four-poster bed for the days we stayed there. It was the best of all worlds and was perfect for us. I can’t imagine having it any other way.
I don’t really care about home births one way or the other. If a woman is getting good prenatal care and there doesn’t appear to be any problems, go ahead. I was very surprised that midwifery does not adhere to any standardized educational program or practices. In states without midwifery licenses, how do they get away with providing medical advice without a license? How does a couple know they’re getting someone with the proper education and skills rather than someone from the hippy dippy set?
I worked with both a midwife and and OB during my pregnancy, with the plan to have the midwife attend if there were no complications and call in the OB (who would already be at the hospital) if needed. I liked having that choice and developing a relationship with both professionals. They had different outlooks and different specialties, and I was good to know that in any event I had a great team on hand to help me out.
I ended up developing hypertension in pregnancy however, so the OB attended the birth (induced). The midwife was still there and got to check in on me, though, and I liked having the emotional support she gave even though she wasn’t attending my case.
I’m now looking into becoming a doula and I strongly advocate women try to develop a relationship with a good midwife/OB team. The important part, I think, is not to be anti-hospital or anti-doctor, but make sure WELL before your due date that the professionals you’re working with have the same birth philosophy as you.
Good question. I would feel a lot better about midwivery if the mother to be actually was under standard medical care who would work with the midwife to decide that home vs hospital birth question. I am in favor of having a hospice and midwife floor in a hospital, best of both worlds, midwivery for those who want it and almost immediate operating theater if something goes all wahooni shaped suddenly.
I agree wholeheartedly - I think it’s too bad that the discussion seems to be “fully medicalized hospital birth” vs. “fully unmedicalized home birth.” I had my son in the hospital, but with a Certified Nurse Midwife - nary a doctor in sight. I got to do it my way and had a fantastic experience. But for me, part of that experience was knowing that if something went wrong we were already at the hospital so whatever we might need would be right there.
I’m friends with my midwife on Facebook, and she recently linked to this article. It made me so sad, that the happy medium of hospital birth with a midwife seems to be an option for so few - or at least that it’s not discussed very often!
I know it isn’t the perfect choice for everyone, but I wish it were a choice for more women.
I had midwives with both my sons’ births. In Ontario, all midwives are certified RNs with a specialty in midwifery care. THey did everything short of the c-sections. When things went medical they stayed on as consult/support personnel. With my oldest’s birth, our midwife stayed with us for over twenty-four hours, and explained things, asked our opinions, and took care of me. With the second they did house calls twice a week after I developed high blood pressure and was put on bedrest. They did the lactation support, post-birth care for me and the babies, and checkups for six weeks.
I love midwives. I’ve got the same midwife for my current pregnancy and I’m worried I’ll be fully transferred to and OB because we’re just found out it’s twins, and high-risk. I’m hoping she can stay on at least for some of my care.
Home births for normal pregnancies offer several advantages. 1. A more comfortable environment for the parents. 2. Much lower likelihood of getting one of those dangerous hospital generated infections. 3. Less incentive for C-sections, forceps delivery, speeding of labor with pitocin or other medical interventions.
Hospitals offer quicker response to complications of labor and births and presumably have the life saving knowledge and equipment at hand that a normal home would not. Clearly, a hospital is the place for any pregnancy with high risk(s), though defining just what “high risks” are is an issue.
In an ideal world,
Nurse-midwives and homebirths for uncomplicated pregnancies would be encouraged except in cases where the time to the nearest hospital (or equivalent) is so great as to remove the effectiveness of any backup offered. The nurse-midwives would be well trained and certified.
Pre-natal care would be expert and incentivized. Whether given by a midwife or doctor chances of missing a complication would be small. The patent, through lower fees, or whatever, would be encouraged to take advantage of the care offered. Poor folk would not be turned away.
A fully equipped and well staffed facility would be available as a backup to homebirths on very short notice.
Obstetricians and nurse-midwives would cooperate easily and well throughout the entire process. There would be no competition between the two groups.
Obviously that ideal is far from being met, and outlawing midwives would be a step back.
NO WAY! IF YOU ARE HAVING A HOME PREGNANCY YOU ARE IRRESPONSIBLE AND FRANKLY SHOULDN’T BE ALLOWED NEAR KIDS!
Just kidding, of course. I remember the previous conversation on the topic, and while some people were reasonable, there was a lot of the above sentiment.