Question about CNM

Eastie156 · April 2012

First off, I'm new here ! I have a question about CNM's. I made the assumption that if I chose a CNM she'd be very pro-natural childbirth. I'm find outing that although I love my CNM, she's very much the mindset of if you need drugs, you need drugs. This is my first LO and guess maybe I made the wrong assumption about CNM's? Do others have experience with a CNM like this? The reason I ask if because I'd very much like to have a drug-free birth, but am afraid that my CNM will be much to ready to provide some sort of relief for me.

WildcatPrincess · April 2012

I guess it depends on the context of "if you need drugs you need drugs". I know my MWs feel that way as in if YOU feel you need and want them they will not question or try to dissuade you. But if you don't want them and state that they won't at any point suggest you get them. With my daughter they knew I didn't want drugs, so when I asked for something at the start of transition (not knowing that's what it was) they asked to check me first and when I found out I was at 7 I said never mind and she quickly waved off the nurses. As much as I didn't want a provider who would push drugs I wouldn't want one who would withhold them if I changed my mind.

Bonidiebabe · April 2012

I have heard of few MW's not being as NB friendly as one would think. Yes, sometimes drugs are necessary. I think you need to look at the whole package. Where you choose to deliver can very much put you on a distinct path for a certain L&D experience.

The BC i plan to deliver at does not offer an epi. They do offer some of the things that make you feel like you've had a cocktail or two, which I will put in my birth plan not to give me even if I beg. They do skin to skin, delayed cord clamping. ect all standard. So, I was pretty surprised to hear that pretty much every mom recieves a very small amount of PIT after the delivery. I understand why they do it though. It significantly redues the risk of PP hemmorage which keeps the heat off of them. They have to be conservative.

My advice would be to ask a TON of questions and be very open about your desires. You won't know if you're on the same page unless you know what each other is thinking. If you should find that you're not seeing eye to eye there is nothing wrong with seeking care elsewhere.

ETA: I truly believe some woman do need the epi in order to be able to calm themselves and relax enough to be able to dialate. Maybe this is what your CNM is speaking of. Some woman just go in and "wing it". I on the other hand felt it was necessary to try and prepare. Therefore, I am doing the hypnobabies homecourse study. There is hypnobirth as well. Check out some of the you tube videos of these types of NB.

xnbride · April 2012

Well the way I see it is that CNM usually practice at hospitals and the majority of women who birth at hospitals do get an epidural, so although she may have very strong opinions or views on natural birth, she is likely also aware of the realities and limitations of what she can offer her patients given how the system is structured.

I get the sense that this is true for my hospital midwife. She obviously believes in the midwifery model and she herself has had 5 natural births but not all of her patients are in allignment with her views so she has gotten to be very good at being diplomatic and just going with the flow; she is very good at giving the birthing mother what she wants. I live in a small community and there are many people who are her patients and so far, everyone says how they are getting the epidural yada yada yada. I can only imagine how frustrating that must be for my CNM. I think alot of people go to the practice because it is lower cost and because of her quality care/reputation (especially in comparison to the roulette practice across town), not neccesarily because they are wanting a natural childbirth.

pixieprincss · April 2012

My BFF did a CNM for her first birth and it seemed very much like OB care but with some additional emotional warmth thrown in. CNMs can really vary from what people refer to as "medwives" who are very much part of mainstream OB care to more of what you might have imagined in terms of emphasising a woman's ability birth per natural impulse (barring a contraindication). CNMs (in my state, at least) can only work under the supervision of an OB, so they are limited by the mainstream system, the rules of hospitals (if practicing in a hospital), and have been educated through mainstream nursing schools. That said, a CNM can use all of that in different ways. My CPM is also a CNM (as well as a trained holistic healer). The CNM model wasn't a fit for her, so she went the CPM route, but her background does make her great for those clients that end up in the hospital. But, to be fair, not all CPMs are the same either, nor are all OBs.

Optimally, your provider--no matter their certifications-- will work with you to envision a birth that meets your hopes versus their own vision. And should something get in the way of that vision, he or she will talk you through the options with respect. I think that asking questions along these lines will help you know if your provider is a fit or not for you rather than was other patients do or do not elect. GL!

alixhayes · April 2012

i agree w/wildcat.

i SAID i wanted NO EPI a million times, then when transition hit it was like "pls pls pls give me effing something asap!!"... but they KNEW me, so they suggested a narcotic -- nicely...i was like, nahh... then i changed my mind, and bam -- it was too late anyway. after i gave birth to my 2nd naturally, the MW was like "i knew you could do it w/o drugs, just like you wanted." i would THINK most MW's won't PUSH drugs unless you've spoken to them about your intentions.

BigAppleBiggerBelly · April 2012

Like Bonidie said, sometimes the epi may be the best option, especially if the mom is too anxious or exhausted to make progress. I have two close friends who both planned on natural births (one at home and one at a birth center), and both ended up in the hospital with epis after their midwives suggested it. One had labored in the birth center for several days, and her water had been broken for longer than 24 hours with no progress, so her MW suggested an epi to relax her and let her rest for a bit. She quickly went from 6 to 10 and delivered her healthy baby, and she credits the epi for letting her relax enough to dilate, which saved her from the c-section she was facing due to her water being broken for so long.

The homebirth friend had a very intense labor for almost two days before she also was transferred to the hospital, with a similar result.

Eastie156 · April 2012

intheflowers:

Do you expect her to turn down a woman who wants drugs? Make them feel bad? I think what she said sounds very reasonable-- they're there if you want them, and there's nothing wrong with that.

I had a CNM for my home birth and she was respectful, professional, and knowledgeable. All providers are individuals and will have their own philosophy of care. I don't like to make blanket statements about CNMs, OBs, CPMs, etc.

Of course I don't expect her to turn down a woman who wants drugs/nor make them feel bad! I don't think I ever said she was being unreasonable either. I just emphasized that I was suprised at how forward she was about the use of drugs over natural childbirth. I made the assumption all CNM's had similar views. This is my first child so I don't have experience with any of this, as you obviously do. I'm simply asking as a FTM who's never had a natural or any kind of birth before~

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