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Certified Nurse Midwife?
I'm seriously considering using a CNM for my delivery in mid August. My mom did have issues with her deliveries, I was her first and she was in labor with me for 24 hours and I became distressed, wrapping the umbilical cord around my neck twice. She was rushed into an emergency c-section, and so for my younger brother and sister she also had a c-section. I know this is probably a big check on the "don't use a CNM list" but the more I read about CNM's the more I'm interested. I like the low technology intervention along with medicine. Pitocin makes me shudder and I don't want to be rushed into a c-section just because a hospital wants me out of their bed. I've heard that a lot of midwives will deliver at hospitals but keep their philosphies of low intervention there. Does anybody have any opinions or experiences with CNM's, whether you met with one and decided against it or went with it?
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Re: Certified Nurse Midwife?
I will be using a CNM for prenatal care, as well as L&D. I already see a CNM for my annual gyno exams and I love her.
I chose the CNM route for well-woman care (and eventual pregnancy care) because I agree with what you said about the lower intervention-- I want a med-free water birth, and you (usually) don't find an MD willing to be supportive of a birth plan like that. There are a lot of added bonuses to using a midwife. Two books to check out are The Thinking Woman's Guide to a Better Birth, and Birthing from Within. You also might want to find The Business of Being Born on YouTube (it's a birth documentary by Ricki Lake) for more information.
All that being said, don't let your mother's birth experience dictate what choices you make regarding your own. How you give birth isn't necessarily genetic and L&D practices have changed a lot since you were born. Just make the best decision for you, your DH and your baby and tell everyone else to MTOB. Good luck with whatever you decide.
I just want to add that CNM tend to stay with you more. OBs tend to do most of their work at the end, where as a midwife gives you more continued care. I'd recommend reading "Born in the USA" by Marsden Wagner. He was formerly the director of Women's and Children's Health for the World Health Organization and he's a big advocate for the use of midwives for normal deliveries. His book discusses a lot of research about the use of midwives in other countries as well as here in the US. It's a great read. And it's by a respected OB.
Remember that midwives can do basically everything an OB can do expect a C section. They just tend to intervene less and treat every woman as a unique person with a unique birth experience. I'm using a midwife in a birth center. I wouldn't go to an OB unless my pregnancy became high risk.
I'm planning on using a CNM for this next pregnancy all the way through. I, too, like the low intervention philosophy. There are CNMs that work with a hospital near us, too. Despite you're mom's troubles, I'd look into it. A CNM will tell you if she doesn't think it'd be safe.
With DD, I was in labor 25 hours, and doing fine w/o an epidural until the doctor told me I had one hour to dilate further, or they were going to push for a c-section (which I REALLY didn't want). This was with absolutly NO fetal distress. That's when I asked for an epidural (if I was going to have a c-section, I at least wanted to be awake). Thankfully, I delievered DD vaginally. So, I totally understand the being pushed into a c-section fear. That's why I'm going with a CNM this time around. Hope this helps.
Oh, I was delievered by a midwife, and my mom said it was the best experience of her life (and I was born after an ectopic pregnancy that ruptured, so mom wasn't a perfect candidate either).
My CNM, in a major teaching hospital, was the only person on hand during my difficult shoulder dystorcia delivery that knew to use the Gaskin Maneuver, a tecnique used to get stuck babies out. The OB resident that came rushing into the room actually said, despite my baby's head already being out "push the head back in, we'll do a section!" Um no.
MW's often have more training than the residents used in larger hosptials. Her quick thinking and hands on attitude prevented further injury to the baby.
Yup. IMHO, CNM is the way to go. Oh, and your mom's delivery has no bearing on yours...
I am using a CNM for this (my first) pg. I am absolutely loving the experience. There are 3 CNMs who work together at this center and I get to know all of them. They are all wonderful and I will feel completely comfortable whoever is on call when I go into labor. I also love that the appointments are an hour long instead of the quick in and out that you get with the OB. They actually spend about 40 minutes talking with you about what you are going through, how you are feeling (emotionally and physically) and see if you have questions. It is all so personal, and it's such a relaxed atmosphere you can't help but kind of melt into it.
My suggestion to you would be to schedule a consultation or two and maybe tour a birth center. You can tell them your concerns about labor based on what your mom went through and see what they think.
I'm using a CNM for this pregnancy (my first) and i love her! I started with my regular OB but after researching her hospital c-sec rate, i decided i needed to find alternative care. All i can say is the care that you get from a CNM vs an OB is like night and day. you really can't compare the two. CNM will give you first class care the entire time, while an OB is restricted to the amount of attention they can give you due to insurance restrictions.
For example, reg appt with OB would last about 15 minutes and i felt like i was on my own to do all the research when it came to nutrition and daily care. With my CNM, my appts are 1-2 hours and we discuss everything from my diet to my sex life. She is attentive and on the day of the delivery she will be by my side from start to finish, not just during the pushing like an OB.
If you are having a normal healthy pregnancy and want a natural birth. A CNM is the way to go!
And i agree with the PP. Your mothers experience birthing does not define how your birth will go. My pregnancy has been completely different from my mothers 6, yes 6 births and my 2 sisters (3 births each) experiences. No 2 births are exactly the same, not even in a family.
Good Luck with your research and decision!
I think you have to judge each healthcare provider on an individual basis. Having a CNM doesn't guarantee low intervention prenatal care and L&D and hour long appointments.?
I went to a large practice with 5+ CNM's who deliver at a hospital. Each of them was wonderful throughout my pregnancy. I had quickie appointments (fine by me, I didn't need more time and was always free to ask questions, etc). I had all the usual screenings and tests that OB's order.
For the birth I was admitted to the hospital after flunking the NST/BPP. My midwife stuck around for the whole L&D and fixed me up afterwards which was great. I was supposed to be induced so Pitocin and an epidural was not out of the question even though I didn't want either. The MW's are somewhat under the pressure of hospital rules just like OB's.
My labor was fast so we didn't use any of that. In the end I trusted my MW's judgement and felt good and safe under her care. Unless I had a high risk pregnancy I would go with a CNM. Chances are you'd be referred to an OB for high risk anyway.
I just switched to the midwives at my OB/GYN office. Love them so far. They are more caring and willing to sit and talk about anything. Plus I'm wanting to do an unmedicated birth this time around, midwives usually lean toward it.
Here are some other books you might want to look into:
The Official Lamaze Guide, Husband Coached Childbirth (Natural Childbirth the Bradley Method), Hypnobirthing, Active Labor, Painless Labor, Ina May Gaskin's Guide to Childbirth.
ha I'm a walking library.
This just does not happen. Can you imagine the lawsuits? And what incentive is there? A hospital is much more likely to increased funding if it has to deliver babies in the triage room than if it shuffles women into the OR to get others into LDRs... it makes no sense from a medical, nursing, liability or funding perspective.
I would never use a CNM. If you need to foresee a medical emergency AND AVOID it like I did, a Dr will do it better any day. That's what they are trained for and they have more training and education in their little finger than a CNM.
I would have ended up with a c section almost for certain if my OB had not forseen it and prevented it in ways a CNM would have been dead against.
Then again I spent the first 2 years of my life in a hospital and despite encountering a few biotchnurses when I had DS I still find hospitals nice comfortable safe places. If your fear is that irrational of a hospital then maybe you should stay out of them and leave them for those who appreciate them??
What incentive is there? A c/s makes the hospital more money. A c/s takes MUCH less of the OB's time than a labor and delivery. I GUARANTEE a CNM would forsee the same medical issues an OB would.
I have seen both. How you can predict what a CNM would forsee if you never used one.
You are still a pyscho douche. On every board you post on...
i was scared to death of pitocin and ended up needing it. i was dead set on an all natural birth experience...well, i ended up on 14 hours of pitocin but still had a pain med free birth. it was amazing and so far from impossible.
I'm sorry, but you are an idiot if you really think all this. I am happy you had a good experience with your OB, but don't assume CNM's have no training or no experience.
You do know that many countries use midwifes as their main care for pregnant women? And that OB's only see patients if they have a problem? The UK is one of these countries and I am *fairly* certain that millions of women who have babies their with midwifery care are good examples that midwifes actually know what they are doing.
They also don't push natural births if you don't want them. I was offered drugs and an epidural and the second they thought there was a problem with my son they would have had a Dr in there. I had excellent pre-natal care and when I was spotting and worried I saw an OB as well as a midwife.
Don't bash what you don't know.
And in terms of liability, a c/s has a much lower risk associated with delivery than a vaginal birth.
Strangely enough an OB is paid the same, exactly the same, whether he delivers 10 babies or 100, and whether they're all C/S or all Bradley. Seriously. He doesn't care. And he certainly doesn't have the hospital's bottom line in mind. He has no alignment with their interests on that score.
As for CNMs not forseeing problems - take for instance someone who would get complications from having to push for more than about an hour. The midwife in my OBs practice said oh no worries, I just don't believe that. You just keep going until the baby is out. I have no respect for a NURSE who thinks she is a NEUROSURGEON. When a neurosurgeon says do not push more than an hour I think you had better believe them.
The OB on the other hand said get an epidural and we'll leave you at 10cm not pushing for a while, up to 2 hours if need be. Then your chances of being able to push the baby out in under an hour are much much better.
A CNM is not a doctor. She simply doesn't have either the training or the respect for medicine that another Dr would have.
BTW I know several people who have had babies in the UK... a very very painful experience as they have little choice but to suffer in agony with a midwife yelling at them for hours. I'd choose my peaceful pain free birth in a hospital any day.?
You, again, are an idiot if you think that having a baby in the UK equals suffering in agony with a midwife yelling at you. I had medicine, an epidural, and a midwife who was nothing but supportive. I would venture to say that if every experience in the UK is as you claim then their birth rate would decline or they would stop using the midwifery system.
I also have friends who had problems, and immediately were seen to by a doctor, at the referral of a midwife.
It is fine is you wouldn't use one, but don't put down the whole system because YOU don't agree with it.