Using a Midwife: A Personal Choice

Using a Midwife: A Personal Choice

As many of our family and friends know we have chosen to have a midwife guide us through this pregnancy and to be there for the delivery of our baby. It still surprises me just how many people are taken aback by this, who can’t quite understand why anyone would  choose not to see a doctor.  I guess I always assumed that in this day and age people would be more open to the idea … still some work to be done on that front I guess. So why did we choose a midwife?

Financially: We pay a lot of taxes here in Canada and these taxes are applied to medical services provided by both doctors and midwives but we feel we certainly are getting our money’s worth from the service we have received from our midwife. Of course I don’t have an experience of seeing an OB for pregnancy but I do have many stories from friends and family that I think justify my take on doctor visits. Our monthly visits to the midwifery centre are never less than an hour and we can ask as many questions as we want. Also, we have never waited for more than 15  minutes in the waiting room to see our care giver and before each visit we call ahead and if she is busy with another patient in labour her pager will say so, so we don’t go to the office needlessly. We simply reschedule for a couple of days later.

Outside of our monthly visits, any time I feel something is not right I can page my midwife and within five minutes she will call me back and assess the situation. If I were seeing a doctor and had a concern over the weekend I would have to go to the emergency wing of the hospital and see an unfamiliar doctor after waiting for some time presumably.

Furthermore the midwifery practice that we visit has a library in the waiting room that you can borrow from, everything from books on pre-natal health and home birth, to yoga DVD’s and documentaries

Greener: Births that are attended by midwives rather than physicians are less likely to require medical intervention. The most severe kind of medical intervention being delivery by cesarean section. Since 1996, the C-section rate has  risen 46% in the US. In 2005, one in three babies were delivered via cesarean section. Cesareans are real surgery and carry with them the risk of infection and much longer recovery times for women. Of course they also involve the use of pharmaceuticals for the mum. While there are less severe forms of intervention like epidurals and pitocin, the wides spread use of these medicines is not good for the environment. Their residues, excreted by humans, are found in waterways and have been known to cause defects in fish and other small critters.

Comfort: Sustainable PF and I are fairly private people and don’t want a ton of unfamiliar people in the room when we have our baby. So I like the idea that when I do go into labour, it will be a familiar face there with me, helping me along and delivering the baby. A key point to emphasize is helping me along the whole way. A midwife will stay by your side once you are in active labour until you deliver whereas many doctors in hospitals will wander off and see other patients and come back every so often to check on you. Now it is possible that our primary midwife (who we will see for about 80% of our pre-natal visits) cannot attend he birth of our child because another patient has gone into labour before me. In that case we have two backup  midwives who we will have met and had a couple of visits with before the end of the pregnancy. In other words, they will not be strangers to us and they will have a good understanding of our needs and desires for the labour and delivery.

Safety: I have heard many people say that they are less comfortable with the idea of seeing a midwife for their pregnancy and delivery especially if it is a home birth because they think  if a doctor is not around things could go horribly wrong. The fact is every study has shown that a home birth is just as safe as a hospital birth with a professionally trained midwife attending. Moreover, with a home birth you are exposing your new child to only the germs in your house which he has for the most part already been exposed to in utero. A hospital environment is a while other story with all sorts of nasties floating around.

I think all in all what I have believed for some time and what has been reinforced by being pregnant and really thinking long and hard about how Sustainable PF and I want to bring lil’ SPF into this world is that there are options and that we as parents (yes even before the child is born) have the right to make those choices. We can choose to bring a baby into this world in a way that is more cost effective, greener and safe.

We would highly recommend to anyone interested in learning more about midwives and home birth to check out their local library, their local directory of midwife associations  and also view this documentary: The Business of Being Born.

Would you consider using a midwife?

40 comments to Using a Midwife: A Personal Choice

  • I don’t have children of my own, but many years ago I worked for a lactation consultant who had two of her three children at home using a midwife. She had a very bad experience delivering her first in a hospital environment and opted to have her other two at home. She said it was much more comfortable and perfectly safe (she wasn’t a high risk pregnancy and she was young.) I’d be open to the idea if I ever have kids (though I’m now pushing the limit of safety with age ;) )but I’m pretty sure my husband would be freaked out by the idea. It’s great that both of you are on board with this. Congrats again!

    • I’ll let Mrs. SPF answer most of the comments here but since you brought up your husband … I was not overly comfortable either, at first. Mrs. SPF had me watch ‘The Business of Giving Birth’ (Rikki Lake documentary) and while it made me a bit squeamish I gained a lot of insight into a) why Mrs. SPF was interested in home birth and using a midwife but also highlighted the issues w/ the institutionalized hospital baby conveyor belt / health / drug / surgery issues of using the new “norm” for child birth.

    • Thanks for the comment Little House. I know many women who had their first child in a hospital and did not have good experiences and so turned to a midwife for the next kid. It’s just too bad that anyone needs to have a bad experience to begin with. I am glad to hear that you are open to the idea. I would recommend that if you become pregnant to ask whether a midwife would assist you-you never know! and its possible that the midwife would assist you but might have you see an OB from time to time in addition plus perhaps have the delivery in a hospital but with the midwife…there are all kinds of options-dont rule them out! and as Sustainable PF says, have you husband watch the documentary, it’s quite eye opening.

  • MarliO

    I trained to be a midwife in Ontario although I’m not practising as one.

    The fears about midwifery care and home birth were very common. At least on the home birth issue, it seemed to help to point out that midwives bring to the home all of the basic equipment and medication that you would expect to have available when birthing in a level 1 (i.e., usually rural) hospital — equipment to monitor fetal heartrate, mother’s BP, etc., oxygen tanks, various medications, etc. It’s not the “scissors and hot water” scenario that many people imagine.

    Basically if someone would be OK with planning a birth at a level 1 hospital (with the option to transport to level 2 or 3 as needed), then I would encourage them to consider the home birth option as well. If they felt very strongly that they wanted the highest tech environment possible, then I’d help them plan for that … but with the caveat that high tech environments have their own dangers.

    Both of my boys were born at home. One of them had some unexpected complications including difficulty breathing initially, and he got exactly the same care that he would have received in hospital. If there had been a really dire emergency, we’re confident that it would have been handled equally well.

    Funny story — my mom is the only one of 6 kids who was born at home. At the time the hospitals were full of war vets and the doctors were telling women to stay home. Hard to imagine today!

    @ LittleHouse, age isn’t usually a big risk factor. There are some relatively minor issues related to age, but I can’t think of any really significant ones except genetically (for conditions such as Down Syndrome). Some day I hope the message, “you’re too old” will be tossed out with the other old chestnuts such as “your hips are too small.” :-) Cheers.

    • Great feedback MarliO, thanks! You are right to point out that midwives come prepared and can deal with most issues. We are only 5 minutes away from the hospital so that also gives us some comfort in case of a really dire situation. Good story about your mum-wouldn’t it be great if doctors could say that now?! A hospital is for sick people and pregnancy and birth are normal parts of a healthy woman’s life…

  • The problem with comparing home births to hospital birth, is those with medical issues most often must give birth in a hospital which affects the results. I have medical issues and most likely will have to have cesarean, and I therefore I will be having a hospital birth.

    • Ginger, I completely agree that there are many instances when women must deliver in a hospital because of medical issues. The results I was speaking about were for women with low risk pregancies, so they were comparing apples to apples.

  • Good choice! I used a midwife with my son and loved the personalized attention. I also used a doula and took a hypnobirthing class. Essentially, I was in a very relaxed state during labor and was fully dialated and did not have to have any medication. I highly recommend looking into both a doula and hypnobirthing. Unfortunately, my son was 2.5 weeks late, facing the wrong way and had the cord around his neck in addition to weighing almost 10 pounds, so I ultimately had to have a c-section. Still, I was glad for the choices I made; I just had to accept that the birth didn’t turn out as I had hoped. Ultimately what matters is that he was healthy.

    • Completely agree Melissa in the end he was healty which is what counts. You bring up a good point which is that you have to be open to the idea that things may not go as planned…which is hard for me to do in everyday life but I am really trying to keep that front and center when it comes to thinking about the birth of Lil SPF.

    • Oh and I just read about hypnobirthing…is this something you paid for outside of the services provided by your doula?

      • I took a hypnobirthing class, and as it turned out, the instructor was also a doula, so I hired her. I don’t think I could have done the hypnobirthing on my own. She was wonderful; in the end when things got intense, I just listened to her voice as I was in a semi-hypnotized state. I could feel some discomfort, but it wasn’t painful, which is the only reason why I could make it without medication. I think the hypnobirthing class cost around $200, but it was worth it. :)

  • Our children were born (natural childbirth)in a hospital with an OB (colleague of my wife). My wife is a former labor and delivery nurse (RN) and recognizes things can go wrong quickly. She wanted the safety of a hospital. Our daughter was 7 weeks premature and required hospitalization for 30 days. Our son was on time and was fine. These birth occurred 37 and 34 years ago when things were certainly different, but she would still want the safety of a hospital.

    • That is fair krantcents. The data does show that homebirth is just as safe as a hospital birth for uncomplicated pregancies but I also understand that it is a very personal choice. I guess I just feel that everyone should be better informed of the choices out that are out there and the pros and cons of each which a non-biased midwife or OB can provide in more detail.

  • optionsdude

    There are plenty of births that have occurred over the years without the benefit of a hospital. If not, we wouldn’t be here since the human species might have died out long ago. So each one should do what is comfortable for them. The only tragedy I know of regarding a midwife is a baby that was born at home, didn’t get a vitamin K shot, and had a massive hemorrhage in the brain leading to brain death.

    • Midwives in Ontario are certified and go through a TON of university schooling. We’re not concerned about what they know. And all of our meetings w/ our midwife, her 20 or so years experience have me comfortable.

  • I have been planning on using a midwife for years and I think I have convinced my husband to support this. However, with both of us being medical professionals, and his concerns, we are probably going to go with the hybrid approach of having a midwife deliver in a hospital. That way we can get help if needed. We might decide after the first birth to try at home for the second but we shall see.

    There is a new birthing centre opening in our city that I may look more into as we get closer to starting a family.

    • We are SO close to the hospital I can hear the helicopters flying overhead. I think 5 minutes was even a bit much – it’s more like 3 … 2 if we catch the one light. That’s the driving distance at least. If something was going wrong it would take a bit of time to get Mrs. SPF into the car.

      Do have your husband check out the documentary The Business of Giving Birth. It was a real eye opener for me.

    • Happy to hear you also support midwifery MissT. Birthing centers are a very nice option between home and the hospital. We don’t have one here but I have read about them and seen them in shows and documentaries and they seem like a great idea. I would suggest that you have a tour of the bithing wing and maternity suite at your local hospital before you make the decision about where to give birth in the future. We just did such a tour and it at least gae us a good idea of what we would be in for if we need to go to the hospital.

  • I have a friend planning an midwifed home birth. The idea makes me nervous, but it shouldn’t. Like she said, woman are designed to pop out babies. They’ve been doing it for as long as humanity has been around.

    Heck, with my last kid, we just needed someone with a catcher’s mitt. It’s not every day the baby is carried into the delivery room at our hospital. Usually, the brats wait until the mother has been checked in.

    With my first kid, I did more during the delivery than the doctors or the nurses. At this point, barring complications, I’d be reasonably comfortable delivering a baby.

    • One of my pals had to deliver his 2nd child with assistance only from the 911 operator. In Europe I think 75% of births are done by midwives and outside of the “west” likely closer to 90% of births aren’t done how we’ve been trained/brain washed by the medical establishment tell us births should be done.

  • MissT, you are right midwives do have an ambulance on stand by more or less. Also as soon as you are in labour, they notify the hospital and the hospital makes sure it plans accordingly so if you do need to come in there will be doctors and nurses available to assist you.

  • Kay

    I was not very happy with the hospital birth of my daughter. Next time around, it will be midwifery for us!

    DH’s family is full of ob/gyns and do elective caesarians for their own deliveries and they sure as hell will be personally offended if I go through midwifery. But hey, my body, my child, my choice! :)

    • Right on Kay, your body, your child so you and DH should be making the decision. Hopefully if all goes well with the midwife the family might learn a little something about midwifery and be more accepting of it.

  • Amanda

    I had two hospital births with midwives, which worked well for me. I flirted with home birth for the second but was tempted by the jacuzzi tubs and lack of 3-year-olds in the awesome St. Mike’s birthing rooms. Two additional factors that I really liked about having a midwife were (1) the midwifery model that the patient (me) is in charge of her care and should be kept fully informed at all times, and (2) the midwife does the first 6 weeks of neo-natal care, including home visits for the first week or so. This meant I could go home rather than stay in hospital for the first 24 hours (I was home 3 hours after my second was born) and kept my newborn out of our family doctor’s waiting room in the height of the flu/Christmas season.

    • Thanks for the feedback Amanda! We’re in Peterborough, which has a nice hospital, but St.Mikes sounds luxurious!
      We agree with your points 100%. The midwifery model is so much more nurturing to mother and child than the hospital/doctor model. The before and after care is phenomenal.

  • Alex

    I am very concerned about vaccinations (for myself, I don’t get them) But also for my child, oddly I’ve been looking at information on the subject starting from when I was about 8. My dad mentioned something that really must have stuck. Now that I am married and having kids Its a concern for me. all that being said I found this on the Vitiman K shot ( for those of you who are scared your child may die with out it)

    “The breastfed infant can be supplemented with several low oral doses of liquid vitamin K9 (possibly 200 micrograms per week for 5 weeks, totaling 1 milligram, even more gradual introduction may be better). Alternatively, the nursing mother can take vitamin K supplements daily or twice weekly for 10 weeks. (Supplementation of the pregnant mother does not alter fetal levels but supplementation of the nursing mother does increase breastmilk and infant levels.)

    Either of these provides a much safer rate of vitamin K supplementation. Maternal supplementation of 2.5 mg per day, recommended by one author, provides a higher level of vitamin K through breastmilk than does formula,10 and may be much more than necessary.

    Formula provides 10 times the U.S. recommended daily allowance,” and this RDA is about 2 times the level in unsupplemented human milk. One milligram per day for 10 weeks for mother provides a cumulative extra 1 milligram to her infant over the important period and seems reasonable. Neither mother nor infant require supplementation if the infant is injected at birth.”

    The information came from Vitamin K: Inject or Not to Inject
    thebabybond.com

    you should check it out. It turns out most of the time (as far as reasurch goes, and we all know how that is..) It does not do much harm but if there really is a better way.. why not do it?

    I would also like to note for myself that site is one I just found so I’d have a reall qoute for this post. I was aginst the Vitiman K shot before this.

  • Alex

    Also I was givin the vitiman K shot and was still jaundice.
    you may also want to note A,D,E,and K are the Vitimans that taken in extream doses can be harmful. Im sure they would have to be taken in huge amounts ( i say huge, but I mean way way more than what a doctor would tell you in to much as they tent to not recoment vitimans they would rather you take medication.. i wonder why?) Babies are injected in the heal with about 1mg of vitiman K which is way more than is needed exspecially for those not breast fed. On another note, you do not see babies dying left and right for a vK OD, so there is also that to take into concideration.

  • Excellent post! I love the way you broke it down. I know I’m late to the game, but it’s great to see a post like this on a personal finance blog.

    When I was pregnant, I did so much research on everything and was very interested in a home birth as it seemed to be the philosophy that fit best with me. It just made sense. But in the end, I settled on hypnobirthing classes (which were fantastic) and delivering in a hospital (my local hospital does not have a birthing room that allows midwives). Oh, and the US also has something like a 22% c-section rate!

    My birth went beautifully and unmedicated. I was in the zone and all was great until the doctors determined it was taking too long for the baby to come out (tick tock). So, I got the dreaded pitocin (I wish I’d had a doula there to advocate for me!) and somehow I ended up with an unnecessary c-section and a horrible recovery. It sucked. It’s been 6 years and I’m over it now, but I was upset about this for a while.

    We are not having a second child, but if we did, I would definitely have a home birth.

    How did your birth go by the way?

    • So glad you enjoyed the post Mrs.Money Mustache. I am really sorry to hear that you did not get the birthing experience that you had hoped for. I can also understand that it took time to grieve this. I know many doctors will say: “well we had to do a C-section and the mum did not want it but she should not complain because her and the baby are alive and well”. Well that may be so but I know what it is like to have a very strong idea in your head of how you want the birth of your child to happen. I cannot even imagine having all of that pulled out from under me and wheeled into an operating room. We were very fortunate to have had Lil SPF at home with our wonderful midwives. The whole experience was beautiful and I would do it again in a heartbeat. And sometime in the near future I will have a post up about that whole experience and of course the whole financial aspect to it as well.

      By the way, did you get to use the hypnobirthing a lot till the doctor intervened? Did you still feel present and in control with the hypno? I am curious because I thought about it but decided it was not for me in the end.

      • Thanks for your response, Mrs. SPF! I’m also glad you can understand the “grieving” process. People say that to me all the time — “well, at least your son is healthy and you are fine…” Well, yes, that is very true, but the more I read about it, the more I realize I had been wronged and it’s the principle of it that bothers me. The fact that this is somehow acceptable in our hospitals.

        I did use hypnobirthing the whole time. I honestly didn’t know how it would go, but I was really able to focus on the task at hand and think about what my body had to do and relax. It was actually really pleasant. I had no fear and a lot of confidence in my body. I was completely relaxed. I also felt like my husband could be involved as well. I mostly sat on a ball and he massaged my back the same way we had done in class. He said I was like this amazingly calm woman that knew exactly what she was doing. The time went by very quickly.

        I became fully dilated in no time and my doctor was very surprised (and impressed with hypnobirthing!), so I was glad that she could see that it can work (I’m sure she had her doubts). Then, when I was fully dilated, I simply did not feel like pushing. Everything I read about had told me I would be ready to “push” at this point, but that wasn’t the case. Later, when reading more in a book by Ina May Gaskin, I learned that some women’s bodies need time (like a breather between dilation and having the baby), but I didn’t know that, so I was confused.

        The doctors insisted I push even though I didn’t feel like it. They finally let me have one hour to walk around. I still was unmedicated at this point. Finally, they said I had to begin pushing, despite my body clearly not being ready. Anyway, I did and obviously it didn’t feel right and my baby wasn’t ready. So, even though the baby was fine and I was fine, they said they needed to give me pitocin to speed things up (I remember they kept looking at the time, as if my time was running out). Since I wasn’t informed on the matter, I ended up agreeing (big mistake) and then I pushed on pitocin for 5 hours unmedicated. By the end, I was having ridiculous spasms and it was truly awful. My baby was sunny side up and they tried the vacuum and it totally backfired, so off to surgery I went.

        Anyway, sorry for the novel, but it sounded like you might be interested. :) The short answer is YES! Hypnobirthing was fantastic. It got me through all that, including pitocin and 5 hours of pushing!

        • I am really glad that the hypnobirthing worked so well for you Mrs Money Mustache…well before the docs stopped trusting your body. That makes me so angry that this sort of thing is still happening! Interesting about the pushing, or lack of feeling to push. I had the opposite experience. I wanted to push before I was fully dialated and SPF and the midwives coached me through breathing excercises to stop me from pushing….honestely it was the worst part of labour for me. And you pushed for 5 hours…omg, you are a warrior mommy!! Just out of curiosity did you ever get fill out an evaluation of the doctors and hospital? We did with the midwives and I was just curious how it worked in the hospital…

          • Thanks Mrs. SPF! :) I don’t believe I ever got to fill out an evaluation (my memory of that whole hospital stay is pretty hazy). They ended up being really nice to me because the pitocin they gave me never went into a vein, so my whole arm puffed up to a ridiculous size! I called it “puffy pitocin arm”. I think they were afraid I was going to sue them or something. Midwives are just way better at everything. I almost want another baby just to have a homebirth, but we decided to stop at one. ;)

          • Wow pitocin arm! I am going to ask around to if any mums I know got to evaluate the care they received in the hospital.

  • Looks like a bit of an older article, but SPF just promoted it on Twitter so I got a chance to see it again. I’m just composing my thoughts on midwifery, and will probably post something in a few days, but after having a not-so-smooth pregnancy with a midwife I would say:

    1) absolutely a midwife is a great way to go for care, and if we haven’t high-risked ourselves out of the option, we’ll go with our midwife again.

    2) I was highly uncomfortable with the home birth idea before-hand (our plan was a midwife-assisted hospital delivery), but after seeing how quickly things can get hairy I would advocate against it. I had “NICU on-site” as one of my criteria for picking a hospital, and in hindsight was really glad it was.

    Anyway, things turned out well in the end and we’ve got her home now, but IMHO a midwife-assisted hospital birth is a great way to go, giving you the best of both worlds: good patient-centred care for a calm, natural delivery your way in the majority of cases where that’s possible, while still being able to summon 3 doctors and 4 nurses in an instant for the minority of cases where it’s needed.

    • Thanks for your comment HolyPotato. I am glad you support midwifery. It is great that midwives will attend births in a hospital or at home, depending on the clients preference. I personally believe homebirths are safe and people often underestimate how much midwives can do when complications arise. I will be posting on our homebirth experience soon

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