Nervous about my midwife...

nycteach · April 2011

I've had one child, born at 41w6d. I was induced with a midwife and had an easy, med-free childbirth with only a 5 hour labor. Beautiful, wonderful experience.

I moved to the DC area at 28 weeks pregnant and wanted to find another midwife because I had such a good experience the first time. I'm delivering at George Washington Hospital with a midwife and am starting to think that I didn't ask enough questions when I joined this practice.

At my appt last week, I asked at what point inductions are done and explained that I didn't feel comfortable being more than 42 weeks pregnant. The midwife told me that as long as there were no medical complications, there was no end date - that we would try natural induction methods but that I should be prepared to wait it out.

I was sort of gobsmacked by this and really, really wished I would've asked this question sooner. I tried every natural induction method known to man when I was pregnant with my first child and NOTHING put me into labor but being induced. I'm all for natural birth but I also think that a certain point enough is enough.

I will ask at the next appt, but do I have the right to be induced (by an OB) if I get to 42 weeks? I really don't see why that is unreasonable and for me, one of the main reasons for delivering at a hospital is that other interventions/support are available if the need arises.

The whole conversation made me feel a little bit like I had to be committed to a natural birth no matter what (no epidural, no induction). I think the main reason I had a successful natural birth last time was because my midwife was so encouraging, did not have her own agenda at all and I felt empowered to make my own choices all along. Drugs were available but no one pushed them on me, etc. I also feel that just because I was able to tolerate a natural birth last time, it doesn't necessarily mean that I'll have the same experience this time so how can I commit to having a natural birth?

So now with less than 2 weeks to my due date, I'm scared about the whole thing and I'm really not sure what to do about it at this point. Do I cross my fingers and hope for the best? Switch to an OB (if that is even possible at this point)?

rnin02 · April 2011

I can't imagine any midwife associated with a hospital letting you go past 42 weeks, that is just too much of a liability. Maybe she didn't quite understand your question or something. Definitely ask again at your next appointment, and tell her you want an induction at 41 weeks 6 days. At this point in your pregnancy it would be extremely difficult to transfer care, I think most OBs would not accept. I think most midwives have OBs that are their "back ups" for c-sections, high risk deliveries, etc, maybe you can switch to the backup OB if your midwife refuses to do an induction. Good luck!

LindseyJW · April 2011

i'm really sorry that you are experiencing unease with your midwife. that can't be a good position to be in! i hated my midwife with my first baby and really wished i'd made that known so that she wouldn't be sent when i was in labor (i didn't, she was, i ended up in the OR).

possibly the reason she said she wouldn't induce without medical need is that without medical need for induction, the baby shouldn't be born yet - it's the midwifery model of care. 40 weeks is an average gestation and it's completely a guess for any woman individually. in France, the due date is estimated at 42 weeks. are French women and babies so different from American women and babies? there are things that midwives can do to determine the health of the placenta in those latter weeks. and, maybe your babies just need a little longer to cook! quite common. unfortunately, so many moms are induced these days, it's eventually going to throw off the averages, making it that much more difficult for those who prefer to allow their baby to fully mature.

that said, i don't know what your rights are with regards to induction without medical need. sometimes, insurance won't cover an elective induction (which, without medical need, yours would be - again, the midwifery model of care doesn't support time-based induction without evidenced need), which is why many OBs lie on medical records. does your practice have OBs on staff? can you switch to an OB?

if it really makes you uncomfortable, you should definitely raise this as an issue with your medical team. you should not be uncomfortable with the decisions that are made regarding your pregnancy and labor, no matter what they are. and if you ultimately decide to stay with this practice, i'd hate for you to feel like you are not on the same page, philosophically, about your birth experience.

there is one other practice that i am aware of with midwives who deliver in a hospital - physicians and midwives in alexandria (they deliver at INOVA Alexandria). though i'm hesitant to recommend them as i've had two good friends with super awful experiences there.

G/L! and don't be afraid to speak up for what you want!

ETA: do you know about the Natural Birth Board on the bump? (look left on the menu list)

Mrs.Handy · April 2011

I agree about speaking up for what you want.

Just chiming in my experience. I had a great experience with Physicians and Midwives. I'm sorry your friends had a negative experience. My MW was amazing and no OB would have let me push for the 3 hours that it took to birth my son. She was patient and encouraging.

victoria1212 · April 2011

I think with any medical advice- if you don't feel comfortable, it is always best to get a second opinion. Sorry you are having issues this late in your pregnancy.

nycteach · April 2011

Thanks everyone. I'm really hoping I go into labor on my own before 42 weeks so this becomes a non-issue. I'm bringing DH to my appt tomorrow for extra support. I basically need to know that there will be a hard end date (at 42w) or we need to find some way to change providers. I don't see the advantage of continuing a pregnancy beyond that point and it's too difficult/stressful to be on stand-by so to speak for an indefinite period of time.

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