Four years ago, I had a typical pregnancy (aside from severe morning sickness) overseen by a typical obstetrician. I gave birth at a typical hospital and received a ton of typical birth interventions, none of which were based on actual need. When my first child was born she was immediately taken away to be poked and prodded instead of being held by her mother. Typical.
What was lacking in the care I received was even a small amount of choice about my body, my rights and my baby or the acknowledgment that this was, in fact, a natural event that was about to occur. I believed it was. Modern day medicine however, did not. So when I got pregnant again, I decided to seek out a different mode of care. I wanted someone I felt I could trust but that also trusted me. Time and time again I was told “you’re looking for a midwife.”
I found two highly recommended CPMs (Certified Professional Midwives) in my area that specialized in home birth and made an appointment. I had one appointment with an obstetrician at the very start of my pregnancy for blood tests, internal ultrasounds, two hours spent in the waiting room with a three year old, discouraging words about home birth and shitty bedside manor. Needless to say, I haven’t been back. As if I hadn’t been convinced before, finding another sought after OB who left the same bad taste in my mouth pushed me even further over the edge.
For the past seven months, I have met with my midwives every four weeks for about an hour, sometimes more, each appointment. I have never had to wait for more than five minutes. I have never been questioned about my personal choices or beliefs. I have not even had to undergo vaginal exams, which actually provide little information about a pregnancy. I wasn’t scheduled for “routine” sonograms, though I opted for one at twenty weeks. We have also discussed at length the kind of birthing experience I want to have in terms of who will be present, what will be done to my baby once he arrives and the care that I will receive afterwards. But all of it, barring a true emergency, is completely up to me. My body. My baby. My choice.
Though it wouldn’t be that hard to trump the treatment I was given during my first pregnancy, my midwives have exceeded my expectations ten-fold. The care has been so much more in-depth, personal and far-reaching than I ever received from an OB. While some might believe a midwife isn’t as cautious as an obstetrician, I feel that the exact opposite has been true. I have been asked about everything from my diet to my sleep habits, things that were also never discussed or considered during trips to the OB. I have had my blood pressure taken, my iron level checked when I was suffering major fatigue, heard the baby’s heartbeat at every appointment, though since about twenty weeks it has been done with a fetoscope rather than a doppler to limit the baby’s exposure to ultrasound, given that long-term effects of repeated ultrasound on a fetus are not fully known.
I feel cared for and respected, like my pregnancy is in fact mine. I’m not bending to anyone’s will around every turn with unnecessary treatments or testing. I also feel like my experience, the experience of growing a life, is given value. My feelings are not brushed over, my intentions to have a natural birth are respected, not drawn into question. I also feel truly safe because so much more is delved into about my pregnancy than any tests could show.
The mentality of an obgyn and a midwife, the way I see it, is completely different. A obgyn tests, plans, predicts everything that could possibly, maybe, somehow go wrong and even banks on it. Even if testing is invasive or possibly harmful, it is often viewed as the best bet to a safe delivery and a healthy baby. Even if an epidural or a c-section has many known risks, it is many times considered a better option than letting nature take it’s course even when actual need is not present. Some of the most common reasons we hear for c-sections, that are happening at unprecedented rates in the US , are that a baby is simply “too big” to come out vaginally or because of “failure to progress.” In most cases, this rationale is not evidence-based. It is a way of manipulating women into an often unnecessary procedure. And many other times, a true need for such procedures happens as a reaction to other hospital interventions such as laying flat in a bed, the use of pitocin and other drugs.
I’ve come to believe that midwives simply have more trust in a woman’s body. They aren’t afraid of big babies or long labors because their training and experience has taught them that babies for the most part, know how to be born when we actually let them. Though interventions can happen in any birth, a midwife isn’t as fearful of the what if’s. She is however, far better equipped to deal with them than those who fear homebirth may realize. She knows the route to the hospital if need be, she can stop a hemorrhage, she knows well in-advance if something is wrong because of how closely she is monitoring the laboring woman (which is generally very different from a hospital where women may be left alone in a room for the bulk of their labors). But she doesn’t bank on that scenario and knowing that your caregiver has faith in your body can’t help but foster one’s own faith. Likewise, feeling that your caregiver is banking on interventions that often comprise a woman’s rights and devalue her experience causes her to doubt her body’s own abilities.