Many women are blind to how certain decisions with choosing their care provider can traumatize their whole birthing experience, but fortunately there are many ways to have a baby today. From birthing in a traditional hospital setting, a child birthing center, or even at home. I would just like to begin by saying that your birth experience would better benefit from utilizing a midwife during pregnancy rather than a gynecologist.
I was one of those women. I was a young, and was under the care of a gynecologist. I came up on my due date, and no baby. My gynecologist didn't even give it a second thought; he scheduled my induction for a mere 4 days after my due date all because that would be the weekend that he was on call and we "needed" to get the baby out. Unfortunately, between the pitocin, pain, and having to lay flat on my back for nearly 30 hours, I wasn't progressing enough and I was taken in for cesarean. There was no medical need for me to have a cesarean. My body just wasn't ready; my baby wasn't ready. Had I hired a midwife during pregnancy, this all could have been avoided.
A midwife is a health professional who provides holistic health care to the childbearing woman and newborn (MAWS), or as Dee Cummings so wonderfully puts it, "a labor support person; the keeper of normal birth." The big difference between a midwife and a gynecologist is that a midwife views the birthing process as a normal life event that a woman's body was made to do where as a gynecologist views birth as a "medical procedure". A midwife knows that a woman's body is capable of delivering a baby without medical intervention. A midwife also forms strong personal relationships with the women during pregnancy, and becomes a support person during the birthing process. A midwife doesn't tell you how to labor or birth your child; they encourage you to follow your instincts with your birth, and are there to aid you through your journey. A midwife can be your greatest tool to achieving a natural, safe, comfortable birth experience.
Many women will not even think twice about their birthing options, because it is so normal to birth in a hospital under the care of a gynecologist. But even The World Health Organization has stated that birth is actually safer when utilizing a midwife during pregnancy and childbirth (MAWS). When under the care of a gynecologist, you have little choice in location of your labor and birth experience. Many gynecologists will allow you to labor at home, but will have you come to the hospital to birth your baby. Once in a hospital setting, you may be subjected to a number of unnecessary interventions.
If your labor is not progressing at a rate that is suitable for the hospital or gynecologist, they may suggest starting pitocin to "speed things up". Pitocin can greatly increase the need for a cesarean because when using pitocin, it causing the uterus to contract so hard that it causes a great deal of pain. If a mother is in a great deal of pain, she may then need to have an epidural, and an epidural can cause your labor to slow, or even stop completely. However if your labor continues, when you are ready to push you may not be able to push effectively. It may be necessary to use forceps or a vacuum extract, which can be very dangerous for both mother and baby. Some doctors may not even go to that extent. Some doctors will just suggest a cesarean section, which is also dangerous for mother and baby. There is a risk of excessive bleeding, infection, lacerations to the baby, or future uterine rupture. All of these things can be avoided if under the care of a midwife.
If you are more than a week overdue, a midwife may suggest a series of labor inducing procedures such as walking, herbal drinks, castor oil, nipple stimulation, sexual intercourse, or as a last resort, stripping the membranes (Cummings). "The only interventions that I ever utilized during my time as a midwife was a little pitocin post partum, oxygen, and 10% episiotomy. All of which, occurred with different women. In a hospital setting you can expect to see all of these interventions performed on just one mother, and that’s on a good day," says Dee Cummings. You can see the significant differences in the safety between a midwife and a gynecologist’s intervention methods. Also, a midwife doesn’t believe that there is an "ideal" time to deliver, however if your labor is lasting abnormally long and the mother appears to be under a lot of stress, a midwife may suggest transferring to the hospital. The World Health Organization feels that the ideal cesarean rate should be between 5%-10% and that rates above 15% do more harm than good (Childbirth Connection). Currently, Central Washington Hospital’s cesarean rate is at 25.9%, while Washington State’s average is at 30.4% (Unnesecarean) According to the national average, one in three women will undergo a cesarean section (Childbirth Connection)
In most cases it is best to utilize a midwife during pregnancy and labor, but sometimes even women under the care of a midwife may need a cesarean. Cesareans aren't always bad. Sometimes they can even be lifesaving. For instance if a mother has a uterine rupture, baby’s heart rate plummets, or even if the mother begins having seizures, etc. cesarean section can save both the mother and the baby’s life. Things do happen, and sometimes there is the need for medical intervention, however, not as often as it is occurring in our nation. And through using a midwife, your chance of needing a cesarean section is reduced by 50% (MAWS).Throughout the years that Dee Cummings was a midwife; she stated that she only had 7 women out of 150 that needed to have a cesarean. However, none of those were emergencies. "If we notice anything out of the norm that can pose a serious risk, we would transfer the mother to the hospital and they would decide there that she needed a cesarean," states Cummings.
There are so many more options that you may get when working with a midwife that you won’t get when working with a gynecologist. With a midwife, you have the option to birth at home, at a birthing center, in the hospital, virtually anywhere. With a gynecologist you may labor at home, but will more than likely be asked to come in to the hospital to birth your baby. During labor, you are also allowed to eat and drink as you please while under the care of a midwife, where as this is something that is highly discouraged by your gynecologist. Your gynecologist and hospital may even keep you from eating or drinking during labor, because since it is "a medical procedure with risks" you may need to go in for an emergency cesarean at any time, and it isn't good to have food in your system while being administered anesthesia. There are also more options with your placenta. Some women like to save their placenta, and either have it encapsulated, ground into food, buried, dried out and saved, or even make placental prints. This all is not possible if birthing in a hospital.
The relationship that a midwife has with a mother is like none other. When you have a gynecologist you developed a relationship of trust, but it is unlike that of a midwife. A midwife's relationship with the childbearing woman can be comparable to a relationship with a sister, an aunt, a mother, a grandmother. They become a part of your family. This is because midwives have a strong belief in partnership with the mother, and understand that the birthing process is as normal as breathing. They strive to empower mothers with education and support to make their birth be what they feel it should be (MAWS). Midwives don't "delivery" the baby; the mother births the baby, and the midwife "catches" the baby (Cummings). Midwifes are a guide, they aid in the natural process of childbirth, not force it. I feel that I was robbed of the birthing experience that I have always longed for due to the ignorance of my gynecologist and the hospital setting. In a way, I feel as if I was taken advantage of due to my lack of knowledge. If we can educate and empower women to utilize a midwife and follow their maternal instincts, we can end this unnecessary cycle of birth trauma.
