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Natural Birth
midwife vs. doula vs. giving up?
hi, this is my first post to this forum...i just found it a day or two ago. the faq is very helpful! i've been really anxious lately about what to do and i'm hoping someone can point me in the right direction. I would like to do natural birth. However, my husband isn't very supportive (so doing it at home is out) and where is live isn't supportive at all. There are no birthing centers within a 1 hour drive. There's only hospitals. So the only choice i seem to have here is trying to get a midwife that's allowed to practice in one of the local hospitals...i think. Since i didn't really have an ob/gyn, (i've been seeing an RE for over a year) i chose a very big one in this area. They were supposed to have a midwife, but when i arrived for my first appointment i was told that she quit the practice. I was also told there would be 2 coming on board before my due date. At my second appointment, i was told they would be coming on board, but they are only part time so it would just be chance that i could use one. (That's pretty much how they seem to work there - if i just went with a normal doctor, it would just be luck of the draw as to which of the dozen or so i would get when i'm in labor) They also refuse to let you have a birth plan. So now i have a consult with a midwife at a different, smaller practice - just the midwife and two doctors. I've been told (by the receptionist) that there would still be a chance i wouldn't get the midwife; since there's only one if someone else was using her when i needed her i would be out of luck. But the receptionist also told me they are ok with a birthplan.
So i don't know what to do. I'm really running out of options; not many practices in this area even have midwives on staff (I can't believe the lack of resources in this area of NJ). I am wondering if i should just go with the small practice and then hire a doula. Also,i don't know what my insurance covers (most likely nothing but doctors) so most everything would be out of pocket. But i kind of think it's worth it if I feel more comfortable about the whole thing...i want to be able to depend on someone and i don't think my husband will be doing anything but encouraging me to take meds...
He just wants me to stay with the big practice and not worry about anything....Does anyone have suggestions? Or am i overanxious about all of this for no reason?
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Re: midwife vs. doula vs. giving up?
It is possible to have an unmedicated birth in a hospital and without a written birth plan. That's exactly how things went down with the birth of my DD. I researched relaxation/laboring techniques beforehand, labored at home as long as possible, and when the nurses at the hospital asked if I wanted an epidural, I said, "No thanks" and that was it.
Edit: After DD was born, we were able to bond and BF right away. It was the hospital's policy to allow that but if it wasn't the case, I would have just asked. The nurses aren't going to memorize a written birth plan, even if a birth plan was allowed, so you and your DH (esp. DH!) need to be vocal about your wishes.
Well, not all OBs are anti-natural birth. Mine is very encouraging of it. Just because she isn't a midwife doesn't mean she's going to push meds. I've also heard that OBs that are DOs, not MDs, are more NB friendly since they tend to take a more holistic approach to healthcare. Again, this is a huge generality and not a reason to choose or not choose someone - but it might help weed through a long list of options without making a hundred phone calls.
I also think it's entirely possible to have a natural birth, even with an OB that doesn't necessarily agree with your desires. If you don't need pain meds to cope, all you have to say is, "no thanks." They can't force you into it. Having a provider that's on the same page as you - especially in terms of timing (how long you can labor in the hospital, how long with ruptured membranes, when would the OB want to induce) but ultimately you have to consent to any treatment. I think your DH is more likely to be the issue than your OB. For this reason, I would consider hiring a doula.
If you are finding midwives in practices with OBs, it is highly likely that everything would be covered by insurance in the same manner as if it was an OB. Definitely call the offices and your insurance and check on this, but I think you'll be surprised. I've heard of homebirth midwives not being covered by insurance, but I have not heard of midwives who have rights to deliver at hospitals not being covered.
Maybe consider starting at the hospital level. Tour a few and ask lots of NB questions - have tubs? Let you shower? Intermittent monitoring? Hep lock, no IV? Birthing balls? c-section rate (keeping in mind a hospital with NICU will have more in general as they take the high-risk births)? Nurses trained in natural pain management techniques? Baby-friendly hospital? Encourages breastfeeding? etc.
I think it's really important to find a hospital that's a good fit so you will have a supportive environment from the get-go, even before your OB shows up. Then find a midwife or OB that delivers at that hospital.
I think it's important to find a provider who is supportive of your desires for a natural birth. That may be an OB/GYN or that may be a midwife, but I do think it's important. Also, I wouldn't so fixated on the midwife within a practice thing because very often midwives who work within an OB/GYN practice have the same medicalized philosophy as the doctors do. Just because they're a midwife doesn't mean they practice traditional midwifery, KWIM?
Natural birth is certainly achievable in a hospital, but if I were you I'd find a supportive care provider, educate yourself about birth and maybe even take a natural birthing class, and definitely get your husband on board! I think it's going to be an uphill battle for you without his support, for sure. Talk to him about why you want a natural birth and what the benefits are. I know when I was pregnant last time I did TONS of reading and relayed the info to MH, but I eventually had him watch The Business of Being Born with me so he could see in the info I had been talking about firsthand and it really helped him understand.
Now, can you achieve an natural birth with an unsupportive care provider, unsupportive husband, and no birthing classes? Sure, but it's going to be quite an uphill battle. I wouldn't give up though because there's a lot you can still do to help yourself.
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I just switched obgyns because mine and the hospital she delivers exclusively at have very high c-section rates.
I chose an obgyn that is natural friendly--you find this out by asking the right questions and being diligent before settling with one (I didn't do this in the beginning of my pregnancy and chose wrong). And I chose a hospital that is also more geared toward options--my new hospital has birthing tubs, balls, etc. They still offer pit/epi/c-sections, but they support a woman's option.
Lastly, I encourage you to read Natural Hospital Birth: The Best of Both Worlds by Cynthia Gabriel and have your support person (husband, mother, etc) read it as well if you won't have a doula.
Good luck! If you're strong minded enough to entertain natural birth, you should be able to acheive a low-intervention birth, if you're prepared.
As PP have said, it's absolutely possible to have a natural birth without a midwife - or doula either! Don't give up! I think your biggest challenge may be DH though, so it would really be helpful to have another support person. If a doula isn't an option financially, what about a family member or friend (or friend of a friend even) who has had a natural birth? She could be a great resource for you and help advocate for your wishes. That being said, it will also help to do some reading to help you find your own coping strategies. My favorite is Birthing From Within, and I also love Ina May Gaskin's books. HTH, best wishes!
Haha, my username should read "3Girlsand1BoyMama"...with #5 on the way! (and then we're done.)
Me, 33, DH, 32 DDs 9, 7, 4 and DS 2. EDD #5 4-29-15
I think it's good you are actively checking out your options, and you certainly don't need to settle for the first big practice you came across before you started looking into things more.
I have heard a lot of good things about family practice doctors who deliver babies, vs. OBs, as far as being natural birth friendly, open to mom's preferences, and allowing you to get more continuity of care (that is, high likelihood of the same provider who sees you for your prenatals being the one who attends the birth of your child). I have no idea what the options are like in your area, but if you're not finding midwives very easily, perhaps family practice docs are more plentiful. OBs are trained as surgeons, so if you don't need surgery for your birth then an experienced family practice doc can be a good, capable fit.
I think you are right to be concerned about not having your husband in your corner. If it were me, I would take a (non-hospital based) natural childbirth class TOGETHER so he is getting the info from a 3rd party. If he's the type to read books you give him, then there are lots of good ones directed to birth partners. If you can watch the Business of Being Born, that helps some people open the eyes of their partners. If it were me, I would also strongly consider hiring a doula.
You are not over-thinking this. This is YOUR birth and you get to feel however you feel, and you deserve to be in a supportive environment when you birth your baby.
Where in NJ.? My MW will travel approx an hour. They're located in Pennington.
You could also contact MWs and ask if they know anyone.
Amazing post! Very informative. Thank you!
thanks for all of your encouraging responses. I met with the midwife in the other, small practice today and I was very happy with her...I went with a full list of questions (most of which I came up with from reading this forum) and she seemed right inline with what i'm looking for. She has had 2 NBs herself. The hospital they use seems a bit NB friendly; at least you can turn down the different non-NB things they offer and you can walk around and do whatever you want (pretty much) while in labor.
Now i have two things i have to figure out...The first is how to deal with the IV. The mw said i can just do the heplock, but i understand that it's something that needs to be in my skin...which is actually what bothers me about the IV. I kind of freak out with IVs. (well, not kind of, i do)
The second is a doula/dealing with my DH. The mw recommended a doula in the area (after i asked about using one); but my DH got really offended with me and tells me I don't trust him to be able to support me. Which I kind of don't...the entire visit he kind of scoffed at the interaction between the MW and myself. He told the MW he doesn't understand why i won't do everything the "conventional" way (i.e., epidural). I guess i'm just going to have to ease him into the idea, somehow.
I am also from NJ and the hospital that I am birthing at has an unnaturally high c-section rate. However, I feel comfortable with the doctors and midwives in my practice and hired a doula for additional support. It may not be the norm where I am from to birth med and intervention free but I feel that I have done my research and spoken to all of the necessary supports and should be able to achieve this as long as everything with baby and me is fine.
My husband also was not thrilled with the idea of having a doula when I initially brought it up. I had to dialogue with him several times before he was accepting of the idea and willing to interview one. I also did my research and found a doula that is not only fantastic and well respected but also can speak my husband's science and research lingo. After the initial meeting with the doula, my husband had no more hesitation or doubt.
Any time we come across a stumbling block whether it's vaccinations, interventions, etc. we have to find the scientific evidence in order for my husband to make an informed decision. Talk to your husband and find out what information he needs in order to help him make an informed decision.