Why I’m using a midwife instead of a doctor

by Lesley on May 13, 2013 · 11 comments

in babies,motherhood

When I got pregnant with Anna I was a neurotic typical first time mom when it came to finding the right prenatal care provider.

Even though a few of my friends had great experiences with midwives, I didn’t understand the allure. In fact, I never considered anything other than a standard hospital delivery with a physician. I did lots of research on local doctors and asked friends for their personal recommendations, which is how I eventually found Dr. H.  She saw me every single appointment, patiently answered questions, and never treated me like a clinical case. Even though Dr. H wasn’t on call during my labor, she still showed up at 4:00am for the delivery. When I thanked her profusely for being present at the birth she said she liked delivering her own patients so much that she bought a home only minutes from the hospital to make it easier. Whoa.

As context, I’ve been told it’s somewhat of an anomaly these days to find a physician like Dr. H.  But, since Anna’s prenatal care was fantastic I still didn’t understand the argument for using a midwife, delivering at a birthing center, or even trying a home birth.

Then our insurance changed and I couldn’t see Dr. H anymore. Within the first few weeks of my second pregnancy I began to understand why some women would rather see a midwife over a doctor. 

Without going into all the specifics, I had difficulty getting appointments with the doctor I wanted to see; I was assigned to a different person for my first four appointments; and I dealt with multiple cancelled appointments. None of the doctors or nurses wanted to discuss my last pregnancy or delivery, saying such information wasn’t important for them to know. One person did ask how long I breastfed Anna, and then lectured it wasn’t long enough. (Almost 11 months? Um, I beg to differ.) At one point I began researching birthing centers. Jonathan knew better than to argue.

I realize the issues I’m describing are first-world problems. I am blessed to have medical insurance, and I’m grateful to live in a country where my baby will be delivered by skilled, trained hands in a clean and safe setting. ButI also think it’s tragic when pregnant women are treated like a number or a textbook medical case. We are unique creatures, growing unique babies. And once I started comparing Anna’s prenatal care to this baby’s prenatal care, I realized why so many women choose midwives over doctors.

Something needed to change, so at Sharon’s encouragement I began seeing her midwife when I was 16 weeks pregnant. (We have the same insurance provider, and our insurance has midwives in their practice.) I knew Jennifer was fantastic almost immediately. Unlike the other people I’d seen in the prior weeks, she actually asked about my first pregnancy and delivery. At each appointment since she has greeted Jonathan and I by name, looks us in the eye and asks how I’m feeling. Jennifer encourages (and leaves time for) questions. We never feel rushed.

When I compare the care I’m receiving now to Anna’s prenatal care, I see very little differences. Both Dr. H and Jennifer want to know their patients, show up consistently for appointments, and take time to answer questions. A lot of women are growing convinced that midwives can provide more individualized care than doctors. And while I can’t entirely agree, I can’t disagree either. I’m simply thankful I have options to see someone who cares about me and my baby.

When it comes to prenatal care, here’s what I’ve realized about myself:

  • I don’t need to feel like a princess, but I would like to be greeted by name when I show up for appointments.
  • I don’t need to be coddled, but I would like to be assured my opinions and questions matter.
  • I don’t need to see the same person every single appointment, but I don’t want to see a different person every single time.

When it comes to prenatal care, here’s my opinion on the doctor versus midwife debate:

  • To each her own.
  • Don’t settle for a provider that treats you like a number.
  • Know it’s possible to receive incredible care from both doctors and midwives–but you have to do your research, and speak up.

Have you had any experiences similar to mine when it comes to your prenatal care?

Also, from Babycenter.com:  Doctor of midwife: Which is right for you?

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8 comments
LesleyM
LesleyM moderator

Thanks for all your thoughts, Paige! I'm always impressed by people who are brave enough to birth at home because I do think it takes courage to go outside what's now considered "the norm." It seems like almost everyone I've talked to who has done at home birth has nothing but good things to say about it. And, I'm sure you're right--when delivering in a hospital you're going to receive a certain type of care regardless of your provider...and it's probably harder to find the model/mindset you were looking for in a hospital setting simply because of attorneys/litigation/etc. Hospitals have to protect their own butts which makes things complicated. 

I hope you deliver in a hospital if you have a third because I'd love to hear about your experience comparing the two! 

paigebartel
paigebartel

So this is why I have chosen a home birth/birth center midwife for both of my births: http://www.youtube.com/watch?v=yu0pXqIiRdo

I agree that the standard of care isn't dependent on the type of degree your provider has, but I have found that it is highly dependent on where they practice. In my experience, if you are working with a provider that practices with in the hospital environment, then there are certain ways they *have* to practice to satiate the ACOG & and hospital policy requirements. 

I had a tentative, "if timing and schedules work out" plan to birth at my moms house in Ventura (two hours away from where we lived at the time) for my first with a midwife I had know most of my life. But I had an OB in the town I actually lived in do all of my prenatal care... even though there were midwives in his office. The reason was two-fold: (1) If I saw the midwives, I got rotated between the 3 of them for my appointments, and I didn't like the lack of continuity in care; and (2) In a hospital setting, a CNM doesn't get to make the final call... if there is a challenge to standard of practice, they have to defer to the OB on call. I knew that if I ended up birthing in the hospital (which would have happened if I went into labor early or late) I would want to put off every intervention possible... basically I knew that I was going to challenge the standard of practice. I wanted to know and be known by the doctor who was getting to make that call. 

I have also worked with a home birth OB (yes, a MD, as in medical school). Though I never delivered with him, I have friends who did, and I had a few other well woman type appointments with him. He was amazing. 

I believe it has everything to do with the mindset and model of practice of the provider, and very very little to do with the letters after their name. However, the model/mindset that I prefer is much more common in the home birth community. 

ALL THAT SAID... If I ever get pregnant again, I am pretty sure I want to deliver in a hospital. I have had two beautiful, empowering, and completely natural/unmedicated births at home. But as I am training to be a doula and Childbirth Educator, I feel as if there is an experience I have missed by staying home that makes it hard for some women to relate to me. Now that I am a "confident birther" I feel that I could easily and confidently have a natural birth in a hospital, and I would get to take part in the "American Birth Experience"... if we make it to the hospital in time that is!

christiearley
christiearley

First, congratulations for being able to bresstfeed Ana for 11 mo! What a gift you gave her and yourself and in the midst of such a hard year! Second, I had a midwife for my first and a doctor for my second. It seems crazy but one of the reasons I chose the doctor the second time was the hospital and I wanted to see the difference. It was fine. I'm fairly confident I will go back to a midwife for the third(if we get pregnant again). My midwife had moved so I had to pick a new provider anyway. She moved back days after Eve was born so she is my first pick:) I pray you have a great second birth experience! What is crazy about number two is it is the same but also can be completely different, but this time you have done it once so you know it will end. I wasn't so sure the first time;)

tim_fall
tim_fall

Our doctor for both the kids births was a lot like the way you describe Dr. H, plus he was a believer so we got to talk theology in between contractions. Bonus!

san_in_ca
san_in_ca

I think you have VERY good points.

I'd like to go so far as to say everyone, who goes to see a doctor ( being pregnant or for any other aches or pains), should feel heard and valued by their physician. It drives me up the wall if I go to see a doctor and they're not interested in any history/background information/personal experience and/or concerns. It's just wrong.

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