Midwifery births

lovesclimbing · October 2016

Hey ladies,

I thought I'd start this as the place to talk and ask questions for those of us considering/having/planning a midwife-assisted birth.

Here are some questions to get us started.

-Why do you want to have your baby with a midwife?
-Birth center or home birth?
-How far along are you in planning for the birth?
-Will the rest of your care (prenatal, baby checkups) be with the midwife as well?
-GTKY: white, dark or milk chocolate?

lovesclimbing · October 2016

-Why do you want to have your baby with a midwife?

I want the more natural, homey atmosphere. I want a natural birth and don't want the pressure for meds or speeding things along that can sometimes accompany a hospital birth

-Birth center or home birth?

Planning for at a birth center. I might consider a home birth for the next baby.

-How far along are you in planning for the birth?

A couple days ago, I called the birth center I hope to use and set up a consultation, which is where you walk through the facility and meet the midwives. Hopefully, if all goes as planned (I'm familiar with the center already. My mom used them so I don't have too many concerns), we'll set up for prenatal visits there and the birth.

-Will the rest of your care (prenatal, baby checkups) be with the midwife as well?

Planning for it.

-GTKY: white, dark or milk chocolate?

Milk is where it's at!

pghctwife · October 2016

My 3 boys were all caught by the same midwife at a hospital. I started out at a larger practice that was a mix of OBs and CNMs. My midwife and another one left the group in between 2& 3 and once they were approved for delivery I followed them. So now it is a small 2 lady operation and I love it, much more personal and a bit more crunchy. For us it is a great balance of the hospital and the low intervention models. There were a few obs that I really really hated and once my 2 favs left it was a no brainer.

1) I just like the care better. I love my mws and want to be irl friends with them haha. It is so nice to feel known and comfortable with your care provider. I also prefer a low intervention and med free birth, and that seems most achievable this way.
2) neither, hospital. There isn't a birth center nearby so I use the more birth center-ish hospital. We live a little too far from the hospital for our comfort level to birth at home. And my first was a shoulder dystocia so that may risk me out anyhow. I wuld love a home birth just so I wouldn't have to stay overnight at the hospital, hate that.
3) not sure I understand the question. This is number 4, haven't really planned anything other than I will hopefully have another low intervention med free birth at the hospital.
4) my prenatal, my gyn care too. We have a pediatrician for the baby.
5) dark!

lovesclimbing · October 2016

Haha, I guess that question was a big confusing. I guess I meant are you still just researching it, have you made appointments yet, have you picked one yet, etc.

jackiemarie1989-2 · October 2016

-I had my first with a midwife, in the hospital, but the OB had to come in last minute to do vacuum-assisted birth. I still enjoyed having my prenatal appointments with the midwives though because they really had time to sit with me and answer my questions.
-Neither. Hospital
-I don't plan to have a birth plan because I learned the last time that it can go out the window in a second. I'd rather be able to go with the flow, then feel like it must be a certain way and then feel disappointed when it doesn't.
-yes!
-dark or milk, I love them both.

Good fact to know: there are 2 main types of midwives in the USA. Certified Nurse Midwives (CNM), and Certified Professional Midwives (CPM). CNMs practice in hospitals and birthing centers under an OB, who is there for when things go wrong. Might not be physically there, but on call. CNMs are board certified medical professionals with liability. They are required to have a master's from an accredited program. CPMs, who do the majority of home births, are not board certified and in the USA there is not a universally recognized required education for them. This makes it harder for them to be held accountable. There are CPMs that are good and knowledgable, but some that are not and it's very difficult to verify their credentials.
Thats just the US. In other countries, especially in western Europe, midwives are more universally certified. Just an FYI, when you do you search for a midwife. I personally chose CNMs that practiced in an office under an OB.

pghctwife · October 2016

Gotcha! My midwives are stuck with me

its decided

jackiemarie1989-2 · October 2016

Wow, I realize my post came off super know-it-all. I didn't mean it to. I just have noticed in the past, there are some women who weren't aware of the difference.

pghctwife · October 2016

To add to @JackieMarie1989 it is also all dictated by your state. In many states he births are illegal. And the strict limiting regulations can tend to cause some unsafe home births, and less skilled caregivers, IMO. I'm lucky to live in a state that allows home birth, and CNMs and CPMs attend them.

My midwives are are both CNMs. They do not work with an OB; though they have a separate OB group on backup for medical emergencies, and they only do hospital births anyhow.

lovesclimbing · October 2016

Hmm, the office I'm looking at has all CNM and they do not have an OB. It is a stand alone facility that is not connected to a hospital. I don't know yet if they have hospital privileges or anything like that.

jackiemarie1989-2 · October 2016

lovesclimbing said:

Hmm, the office I'm looking at has all CNM and they do not have an OB. It is a stand alone facility that is not connected to a hospital. I don't know yet if they have hospital privileges or anything like that.

Even if there isn't an OB at the office, they may have hospital privileges and therefore would be able to contact whichever OB is on call there. That would be a good question to ask them though

pghctwife · October 2016

@lovesclimbing I think much of this will depend on your state. I'm sure when you meet with them you'll discuss what happens in the event of an emergency or if you risk out of their care, and what that consists of.

MrsW524 · October 2016

@JackieMarie1989 I don't think you came off as a know it all. I think there is a lot of confusion as to the certifications for midwives. I have a feeling that my parents are going to freak out a little when they hear I'm using a midwife because they, and so many others, just don't realize how much training CNM's have.

Why do you want to have your baby with a midwife?
I'm attracted to the lower rate of interventions with comparable outcomes in low risk births/pregnancies. I generally prefer conservative care when possible.
Birth center or home birth?
Neither. I'll be at a hospital, which was something I wanted anyway because I'm nervous about what happens if (heaven forbid) there are crazy complications that require emergency interventions. My CNM has an awesome background and practices with some of the best OBs in the state who are ready to take over if need be.
How far along are you in planning for the birth?
I have my first appointment set up for 10/28. I was able to select my CNM (there are 3 at the practice) ahead of actually coming in. I was very attracted to her medical background and what people had to say about her.
Will the rest of your care (prenatal, baby checkups) be with the midwife as well?
That's the plan. I'll be looking into the pediatric practice they are directly associated with too.
GTKY: white, dark or milk chocolate?
Dark, especially if I can mix some spice into it.

lovesclimbing · October 2016

pghctwife said:

@lovesclimbing I think much of this will depend on your state. I'm sure when you meet with them you'll discuss what happens in the event of an emergency or if you risk out of their care, and what that consists of.

Yea, that's on my list of questions to ask. I live in Alaska, and I will say Alaska has pretty loose standard on a lot of things.

it cut off the rest of my post! No restrictions on homeschooling, anyone can conduct one wedding ceremony, etc.

thankfully · October 2016

Why do you want to have your baby with a midwife?

I prefer the evidence-based low-intervention standard of care. I prefer the philosophy of care that is foundational to nursing as a profession. I prefer the 1 on 1 care.

-Birth center or home birth?

If all goes well, this will be my 4th homebirth with the same practice (and they are all CNMs).

-How far along are you in planning for the birth?

Haven't even been to my first appt

-Will the rest of your care (prenatal, baby checkups) be with the midwife as well?

They do it all, from prenatal through 6 weeks of mom and baby care plus well woman care. They send out to an imaging center for ultrasounds though.

-GTKY: white, dark or milk chocolate? Dark!!!

loopstation104 · October 2016

Midwife is the only choice here unless you are high risk and I love that. I loved my care last time. Definitely going to have a hospital birth (here its either hospital or home) as we have no room for a tub in the apartment and I want to labor in water again and maybe have a water birth. Also, they have laughing gas in the hospital and I have NO SHAME in using that. It was brilliant.
First appointment is 10/28 :-) Same prenatal care midwife as last time.

Dark, for sure.

lovesclimbing · October 2016

loopstation104 said:

Midwife is the only choice here unless you are high risk and I love that. I loved my care last time. Definitely going to have a hospital birth (here its either hospital or home) as we have no room for a tub in the apartment and I want to labor in water again and maybe have a water birth. Also, they have laughing gas in the hospital and I have NO SHAME in using that. It was brilliant.
First appointment is 10/28 :-) Same prenatal care midwife as last time.

Dark, for sure.

----------

stuck in in the box.

Wow, I think that's great!!

loopstation104 · October 2016

@lovesclimbing I think we're super lucky here

jackiemarie1989-2 · October 2016

@MrsW524, last time people made a lot of assumptions when I said I was seeing a midwife. CNMs are very qualified and accountable. Even my fellow nurses don't seem to be very aware of the different types of midwives. I am passionate about this subject because I hope to become a CNM eventually.
For personal reasons I don't think I would choose homeborth, or if I became a CNM, ever attend home births. But to each their own. And everyone has the right to have a qualified professional attending them.

mombod · October 2016

1) A million reasons the first time ranging from very important (lots of research on outcomes) to silly (not wanting to wear a hospital gown). This time my reasoning is it was the best experience last time and I hope for the same this time
2) birth center
3) Have an appt on the 31st
4) all of my care is with them including aftercare and lactation consultant, we have a pedi for the baby
5) white

Cythe · October 2016

Just want you guys to know I'm stalking the shit out of this thread because as a FTM I'm pretty overwhelmed with my options and feeling like I'm supposed to know what I'll want during labor. Also, doesnt help that my only local midwifery center I *think* ONLY does med free births. What if I want meds?!

Mrs.DeRuysscher · October 2016

Why do you want to have your baby with a midwife?
I had my first dd with an ob and while he was great I always just felt rushed like just another patient, I want to feel like the person helping me give birth is more involved, when I was in labor for my daughter it was literally just my husband me and my nurse till her shift changed and the new nurse came in my doctor came in for a moment to discuss him breaking my water after his c-section he needed to do, I didn't see him again until I accidentally made the monitor lose the heartbeat (got sick moved wrong way) that's when the ob and a bunch of nurses came in through a mask on me and they broke my water and put a clip (to monitor the heartbeat) in. After he left the room till I was ready even while I was pushing for the most part it was just me my husband and a nurse.
I also want someone who is more supportive and helpful with breastfeeding as it didn't work out with my daughter and I really want it to work.

-Birth center or home birth?
Neither we will be using midwife in a hospital, both hospitals are 40 mins either direction of us.

-How far along are you in planning for the birth?
I had contacted the midwives when I found out I was pregnant in August that ended in a miscarriage they didn't get back to me till Oct 6 when I found out I was pregnant again, we have to set up a dating ultrasound find the apt date out Monday, then contact the midwives to figure out our first apt.date. I plan to do the same as I did with dd I went in just trusting my body and listening to it, I had medication relief with dd and if I needed it again I'm not against it. Like I said I just trust my body to tell me what I can handle.

-Will the rest of your care (prenatal, baby checkups) be with the midwife as well? Yes all care will be with midwife which I like because aftercare seems to be so much better as with a ob they just see you at 6 weeks.

-GTKY: white, dark or milk chocolate?
I'm a dark chocolate fan

lovesclimbing · October 2016

Cythe said:

Just want you guys to know I'm stalking the shit out of this thread because as a FTM I'm pretty overwhelmed with my options and feeling like I'm supposed to know what I'll want during labor. Also, doesnt help that my only local midwifery center I *think* ONLY does med free births. What if I want meds?!

I'd call them and double check. But if you want meds and they don't offer them, you'll have to go to a hospital. I think it's pretty common for outside of hospital births to be med-free.

MrsW524 · October 2016

@Cythe I'm a FTM too, so I'm not an expert, but near me it seems like the outside the hospital midwives are all med free, but the ones that deliver in a hospital (like mine) encourage med free but leave it as an option. I'm not sure what kind of research you've done, but I didn't find my CNM at a midwife center. I found her while looking through the local OBGYN practices and found that a few of them had CNMs on staff.

Cythe · October 2016

@lovesclimbing and @MrsW524 thanks for your answers. I'm just really uneducated in it all. Recently I've been down the rabbit hole of doulas but I think what I really need to do is find out where I can labor with the most med free encouragement without being pigeon holed into it. I like the idea of med free, but what if I get there and just cannot take it?

The good news is the midwifery center near me shares a floor with the birth center that has drugs, so I think I could get wheeled down if I needed to.

thankfully · October 2016

@Cythe Free-standing birth centers don't typically have an anesthesiologist on staff. Luckily if you're interested in midwifery care there's a whole range of options (except maybe in super rural areas). Here we have OB/CNM practices and independent CNM practices that practice in traditional hospital setting, hospital-based low-intervention "birth centers", freestanding birth centers, and home. Something for everyone.

QueenNub · October 2016

Why do you want to have your baby with a midwife?
Wanted an environment that is not so busy and ready to intervene medically before it is needed. I want my birth to be treated like a condition and not a medical condition. My first birthing experience was not what I wanted. I was induced and hated the epidural that was given to me way too soon. No feelings for 17 hours was horrible.

I am also excited about the hour long prenatal appointments and the yoga classes that are part of care.
Birth center or home birth?
Birth center
How far along are you in planning for the birth?
Already signed up with the only freestanding birth center in the state. I am in Louisiana and we are always behind the times.
Will the rest of your care (prenatal, baby checkups) be with the midwife as well?
Yes, but baby will have to go to pediatrician within 48 hours of delivery.

GTKY: white, dark or milk chocolate?
Dark chocolate. I prefer the bitterness of it.

The birth center here has 1 CPM (over 20 years experience) and 3 CNM. A very renowned OB is the owner and overseeing doctor.

bornmommy · October 2016

Cythe said:

@lovesclimbing and @MrsW524 thanks for your answers. I'm just really uneducated in it all. Recently I've been down the rabbit hole of doulas but I think what I really need to do is find out where I can labor with the most med free encouragement without being pigeon holed into it. I like the idea of med free, but what if I get there and just cannot take it?

The good news is the midwifery center near me shares a floor with the birth center that has drugs, so I think I could get wheeled down if I needed to.

FWIW - The research shows that where you choose to birth is the main factor in your birth. What I mean is that the hospital culture has more impact on your birth then anything else. I'm a doula (and Evidence Based Birth® Instructor) and I work mainly in hospitals with OBs. I attend MW births but this area is mainly OB run so that's my client population. When you're in a hospital setting with a CNM, you have access to everything you would like you were under the care of an OB, like an epidural, as long as your qualify. (There are some medical necessities that go into your ability to get an epidural that many women don't know - like your palette count.)

Hope that helped shed some light!

Cythe · October 2016

Turbotastic said:

Cythe said:

@lovesclimbing and @MrsW524 thanks for your answers. I'm just really uneducated in it all. Recently I've been down the rabbit hole of doulas but I think what I really need to do is find out where I can labor with the most med free encouragement without being pigeon holed into it. I like the idea of med free, but what if I get there and just cannot take it?

The good news is the midwifery center near me shares a floor with the birth center that has drugs, so I think I could get wheeled down if I needed to.

FWIW - The research shows that where you choose to birth is the main factor in your birth. What I mean is that the hospital culture has more impact on your birth then anything else. I'm a doula (and Evidence Based Birth® Instructor) and I work mainly in hospitals with OBs. I attend MW births but this area is mainly OB run so that's my client population. When you're in a hospital setting with a CNM, you have access to everything you would like you were under the care of an OB, like an epidural, as long as your qualify. (There are some medical necessities that go into your ability to get an epidural that many women don't know - like your palette count.)

Hope that helped shed some light!

Thank you for this, and shout out to doulas

I just looked into ones in my area and found one that I think I could really like. I have a plan to call my midwife center and ask some questions.

You guys are the best, thank you!

bornmommy · October 2016

Why do you want to have your baby with a midwife?
Because I believe in birth and find that many midwives, at least the ones I choose, have similar philosophies to mine. I had the same CNM for both my sons' births and I'm going to miss her this time around since I moved.

Birth center or home birth?
There is a very unique hospital that my CNM practice (only CNMs) assist in deliveries at. The L&D floor only has 5 five rooms and they allow water birth. You also never leave your room in the time you stay there. There cesarean rate is 17.5% and the epidural rate is 5% for non-ceseran births. Its pretty amazing and not the standard in the area so I think I'm lucky!

How far along are you in planning for the birth?
I've been planning this birth since I moved to the area! Since we knew we wanted more kids, I found the group that met my needs for my regular care so we could move over into prenatal when the time came!

Will the rest of your care (prenatal, baby checkups) be with the midwife as well?
For me, yes. For my baby, no because they will see a pediatrician.

GTKY: white, dark or milk chocolate?
most of the time milk chocolate does the trick but those little "bark chocolate" things are really becoming my go to and I believe they are dark.

pghctwife · October 2016

Someone was talking about their OB birth and how he wasn't there. My first two were with a larger group and I had obs on call firsthand then shift change to my mw. The Drs were not there at.all. Luckily I had excellent nurses.

My third with the midwifery group? She was with me the.whole.time. Like, every second. My friend looked at my birth photos and commented that it looked like she was a doula or nurse and how awesome to see the care provider acting as such a labor support. At the hospital a very different experience.

silliegirlie143 · October 2016

-Why do you want to have your baby with a midwife?
I did not like the assembly line feel of my hospital experience with DD. I did not do well in the hospital postpartum. I was the "problem patient"- none of that with a MW. Also, I am a firm believer that you want to be seen during birth by the expert in your situation. OBs are surgeons so when I need surgery, I will see one. Not for a vaginal birth.

-Birth center or home birth?
MW in our area only do home births

-How far along are you in planning for the birth?
We went to our initial consultation with the MW last week. Now, we are in the process of seeing what's covered by insurance.

-Will the rest of your care (prenatal, baby checkups) be with the midwife as well?
I will get all my prenatal care from my MW and the clinic she works works with for U/Ss. Baby will go to our beloved pediatrician.

-GTKY: white, dark or milk chocolate?
Dark is preferable but I will eat ALL the chocolate

PolarBear517 · October 2016

-Why do you want to have your baby with a midwife?

I just decided to go this route after doing more research about providers in my area! At first I thought "I guess I'll just go to the office that does my paps, because that's what ya do, right?". I'm glad I came across the office, though! I really, really want a low-intervention birth.

-Birth center or home birth?

I will be at a hospital, but the hospital is opening low intervention rooms, which are meant to give an experience similar to a birth center.

-How far along are you in planning for the birth?

Not far! I gave the office my insurance information on Friday and I don't get to schedule an appointment until preauthorization is all set (hopefully Monday, maybe Tuesday). I was told my first appointment will be between 8 and 10 weeks and will involve blood work and an ultrasound for dating the pregnancy.

-Will the rest of your care (prenatal, baby checkups) be with the midwife as well?

Yes, all appointments with Certified Nurse Midwives! Unless my pregnancy is designated as too high risk further down the line, then I will be transitioned to the care of one of the physicians at the office.

-GTKY: white, dark or milk chocolate?

Dark, hands down!

JAGinMI · October 2016

-Why do you want to have your baby with a midwife? I like that he midwives usually have a much lower c/s rate. The one I was seeing before I had my mc told me their c/s rate was around 13%. I want to work with people who are proponents of low-intervention childbirth.
-Birth center or home birth? A hospital birth center. While I want zero to low intervention, I want to be in hospital in case things go awry. I believe there are times when interventions are necessary and I want to have it quickly accessible if I need it.
-How far along are you in planning for the birth? I don't know how much I will do this time other than some re-reading to prepare to go med-free again.
-Will the rest of your care (prenatal, baby checkups) be with the midwife as well? All midwives!
-GTKY: white, dark or milk chocolate? Milk allll day!

JAGinMI · October 2016

@JackieMarie1989 you didn't sound like a know-it-all, I appreciate that because I didn't know the difference! It makes sense now that I have only seen CNMs because I have never looked for one who didn't work out of a hospital.

halfthetree · October 2016

Love this thread, and the info! I'm in Canada, in a region whew midwives are provided under our health care, BUT this also means that there is an incredibly high demand, so a lot of women are stuck with GP or OB care who want midwives. The insurance for private practice midwives is astronomical, so they literally can't even afford to practice. It's crazy.

Why do you want to have your baby with a midwife?
- my second child was a midwife baby, born at home. I caught her, and we were in the living room having tea two hours later. I LOVED that feeling.
Im also a birth doula, and value the trust they have in birth, and also the experience that they provide to deal with unexpected situations. I wouldn't unassisted birth, but wouldn't birth in a hospital unless necessary, so having a CNM there is awesome.

Birth Centre or Home?
-home, we don't have a birth centre here. We literally only have one hospital to birth at. It's crowded, gross, a teaching hospital with a VERY high c section rate (talking over 35%).

How far along are you planning for the birth?
-I've already called my midwife and my doulas. I will set up my birth altar (yes I'm one of those!) closer to 15-18 weeks. I'm a Sacred Pregnany Instructor and will take a class from a fellow instructor closer to 30 weeks.

Will the rest of your care be with the midwife as well?
- I haven't seen a doctor yet, and won't. My midwife will handle everything from now until 6 weeks postpartum for me and baby.

Milk chocolate obviously!

mombod · October 2016

@halfthetree I dont know anything about Sacred pregnancy and I am very intrigued. Can you tell us a little more?

brij2006 · October 2016

-Why do you want to have your baby with a midwife?
Lesser of a chance of C-section and more control over labor and delivery.
-Birth center or home birth?
Labor at home for as long as possible then hospital delivery. Unless I can find a MW that will do a home birth.
-How far along are you in planning for the birth?
We used a MW with DD's birth so I'll go the same route as last time.
-Will the rest of your care (prenatal, baby checkups) be with the midwife as well?
Yes.
-GTKY: white, dark or milk chocolate?
Dark!

Adding: We use a midwife for DD's labor and delivery. I labored at home for as long as possible, and showed up to the hospital 45 minutes before she was born. Now, the hospital is an hour from our house. This time I will go in sooner so I'm not in transition stage on the car ride. That was absolute Hell.

silliegirlie143 · October 2016

@halfthetree The high C-section rates are concerning. My local hospital is very nice, not a teaching hospital, and we still are above 40%. My metro area hospitals combined sit at 37%.

halfthetree · October 2016

@mombod Sacred Pregnancy is all about slowing down, embracing the spiritual/feminine aspects of pregnancy and birth. It is about preparing the WHOLE woman for birth and motherhood. It is not a typical prenatal class, there is childbirth education, but also relationship work, fear releasing, a beautiful honouring day, and SO much more.

There is a Sacred Pregnancy Book, from Anni Daulter that is a week by week journal. I absolutely love it!

Sorry if thst hat is vague, it's hard to explain it fully without typing out and entire page

halfthetree · October 2016

@silliegirlie143 That's just crazy. I've worked with OBs who boast about a 50% section rate. I just don't get it.

JAGinMI · October 2016

halfthetree said:

@silliegirlie143 That's just crazy. I've worked with OBs who boast about a 50% section rate. I just don't get it.

I mean, that is just sickening. It's necessary at times, absolutely, but to be boastful about a rate like that is almost barbaric.

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