Momming

Going with the Right Midwife for You

Children are a gift from the Lord; they are a reward from Him. ~ Psalms 127:3 NLT

After a lot of research and thought, you have decided to go with midwifery for your pregnancy.

Great! ….. So now what?

Choosing the Place

First, it’s time to decide on where you want to actually have your baby. When I used to think of midwives, images of women at home with their families pushing out babies in a bathtub or squatting on the bedroom floor came to mind. Midwifery, however, is all about customizing the birthing experience. Midwives can attend hospital births, deliveries at birthing centers, or home births. I recommend deciding where you want to have your baby first, as some midwives only attend hospital births and some only attend birthing centers or home births.

A hospital birth with a midwife offers more of the modern approach to birth rather than the holistic delivery most choose midwives for. The highest certification of a midwife in the United States is a Certified Nurse Midwife, which in a hospital setting still requires a doctor’s presence. Essentially, your midwife would be more of an advocate for your birth and a personal nurse, while also getting the nutritional and emotional counseling midwives uniquely provide their clients. She (or he – while uncommon, male midwives do exist) would step in on your behalf to ensure you are getting the birthing experience you desire. That is, as long as there are no complications that require a deviation from your birthing plan.

Some hospitals will employ midwives in their labor and delivery triage. However, just because the hospital does not employ midwives does not mean they will not allow a midwife to attend your birth. If this is the way you want to go, check with your local hospitals to see how they feel about midwives attending deliveries. They may already have a list of midwives they work with.

My darling Peach was born in a Naval hospital, but we had a midwife who monitored the beginning of our birth. She worked at the hospital, and was the only person on staff who listened to my husband when he was trying to find someone to help me. Due to hospital negligence my daughter and I would have died if it hadn’t been for this woman. If I could go back in time, I would have had a midwife from the very beginning instead of an OB doctor.

A home birth is what I have chosen for my upcoming daughter’s arrival. Although I touched on some of the specific benefits of home birthing in my post, “5 Reasons to Choose a Midwife,” here are some of the main reasons women may prefer a home birth:

  • Familiar Setting – Being in your safe space to have your child can take some of the stress off of delivery. This helps with relaxing and keeps blood pressure as well as heart rate from spiking due to anxiety. This translates into an easier labor with less risk for tearing, hemorrhaging, etc.
  • Sounds and Smells – Tying in with being in a familiar setting, many mothers are put off by unfamiliar hospital surroundings. Abrasive noises such as whirring machinery, staff movement, and other patients, coupled with the typical sterile smell hospitals have is not something most ladies look forward to when imaging their birthing experience. At home you can light candles, have the smells from the kitchen wafting in, or simply enjoy the fresh air. Favorite music or TV show can be playing in the background during contractions, or you can opt for complete silence.
  • Family, Friends, and Attendants – Hospitals typically have a limit on how many guests can be in the delivery/recovery rooms with you along with what hours they can be there. On the other hand, delivering at a hospital can mean sharing a room with a stranger while having dozens of hospital staff walking in and out. Delivering at home, you only have the people you want there. You can have as many or as few people in attendance as you want. Typically a midwife will have an assistant with her (or him) in case both mother and baby need care at the same time, so the instances of indecent exposure to non-family members can be limited to two people in a home birth.
  • More Control – Home births enable ladies to have more authority over what happens in their delivery experience. Since a midwife is much more likely to adhere to the mother’s wants than a doctor, based on midwifery ideology, women have more say in what happens to them at home than in a hospital room. Furthermore, women have recalled times in their hospital births where doctors and nurses performed unnecessary and unwanted procedures on their babies the mothers did they consent to.
  • Lower Risks – In 2014, a group of medical professionals used data from Midwives Alliance of North American Statistics Project 2.0 to determine how safe home births are. The International Journal of Women’s Health published a study comparing the safety of home births with midwives from all over the world. Other studies have also been published in the Journal of Midwifery and Women’s Health. The results? Home births with midwives are actually safer and end with significantly less intervention than births planned at the hospital with an OB. Midwives are trained professionals, able to identify life threatening complications that need the medical care of a doctor, but will do everything to avoid intervention otherwise.

If you don’t want to give birth in a hospital, but are afraid or unable to deliver at home, a licensed birthing center may be the ideal place for you. It is the perfect blend, in my opinion, of the home and hospital setting. While the sights, smells, and noises are more friendly and comforting, birthing centers also have access to more medical equipment to monitor the mother and baby. The delivery remains more natural/holistic than a hospital birth while having a professional setting. Family and friends are typically welcome, rooms are more personal, and staff are less invasive. Even some licensed physicians work at birthing centers. Birthing centers also cost about the same as a home birth, which are both considerably less expensive than delivering at the hospital (always a plus).

Even if you choose to give birth somewhere other than a licensed birthing center, you may want to contact your local center for birthing classes. Many birthing centers also have support groups available where you can connect with other mothers who share holistic values.

It is important to note that, no matter where you choose to have your baby, life-threatening complications could still call for a trip to the hospital. Some hospitals will not allow midwives to attend you with the rest of the staff, so they will be treated as visitors or even asked to leave. Always have a backup plan prepared with your midwife should something go wrong at the home birth or birthing center.

Choosing the Person

Once you have chosen where to have your baby, it is time to think about who is going to attend your birth. To understand what type of training your potential midwife has, here is a breakdown of the classifications:

  • A Certified Nurse Midwife, or CNM, is someone who started as a registered nurse and then continued their studies further into child birth and midwifery. This is the highest level of certification a midwife can have and is usually accompanied by a doctorate or masters degree. Certified Nurse Midwives can attend births in any state as long as they have the proper licensing.
  • A Certified Midwife, or CM, is someone who started with a degree in something relating to midwifery but not necessarily medical. This degree could be in some form of Psychology or Sociology with a focus on Women’s Studies. Certified Midwives then do the graduate-level training CNMs do.
  • A Certified Professional Midwife, or CPM, is someone who doesn’t have a degree prior to studying midwifery. I think it is interesting that CPMs are the only midwives who must have extensive experience in home births prior to obtaining their certification. Certified Professional Midwives are classified as independent practitioners.
  • Other certifications for midwives include Direct-Entry Midwives, or DEMs, and Licensed Midwives, or LMs. These certifications are usually obtained through informal study or hands-on experience. CMs and CPMs are sometimes categorized under DEMs depending on who you talk to, although they do receive formal study. All midwives in the United States, with the exception of Certified Nurse Midwives, must obtain a separate license for each state they wish to practice midwifery in. Not every state accepts all classifications of midwives, and each state has unique requirements for obtaining a license to practice.

When I chose my midwife, I planned free consultations with all the midwives in my area just in case I didn’t feel like I clicked with the first midwife I contacted. I highly recommend this route, as the midwife I chose was actually number three in my line-up.

My midwife and I share a similar belief system and love of family. While I didn’t think beliefs would be that important when choosing a midwife in the beginning, being able to freely talk about faith during such an emotional time is relaxing for me. My midwife is also older so I view her more like a mentor. Some women prefer to have a midwife closer in age to them to feel more connected, but I personally like the wisdom and motherly feel my midwife provides.

When choosing your midwife, make sure you not only feel comfortable with them but that they know what you are wanting for your birth from the very beginning. It is always a good idea to have a list of questions and topics prepared to ask your midwife. For example, I do not vaccinate, which is a hot and touchy topic for many. I wanted to make sure the midwife I chose would not pressure me to vaccinate myself or my baby. I also wanted to make sure I could have a water birth along with being allowed to use the placenta immediately.

Your comfort and health are the most important aspects of childbirth, as a healthy baby often requires a healthy mommy. I hope your journey into pregnancy and parenthood is wonderful, and good luck!

 

Sources:

American Association of Birth Centers

American College of Nurse-Midwives

Midwives Alliance of North America

Bernhard, C, et al. “Home Birth after Hospital Birth: Women’s Choices and Reflections.” Journal of Midwifery & Women’s Health., U.S. National Library of Medicine, 2014.

Cheyney PhD, CPM, Melissa, et al. “Development and Validation of a National Data Registry for Midwife‐Led Births: The Midwives Alliance of North America Statistics Project 2.0 Dataset.” Wiley Online Library, Journal of Midwifery & Women’s Health, 30 Jan. 2014.

Cheyney PhD, CPM, Melissa, et al. “Outcomes of Care for 16,924 Planned Home Births in the United States: The Midwives Alliance of North America Statistics Project, 2004 to 2009.” Wiley Online Library, Journal of Midwifery & Women’s Health, 30 Jan. 2014.

Zielinski, Ruth, et al. “Planned Home Birth: Benefits, Risks, and Opportunities.” International Journal of Women’s Health, Dove Medical Press, 8 Apr. 2015.

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