June 28, 2008

I had a thought

So, I keep meaning to write down some tips about how to have a "natural childbirth." I may still do that, but I haven't yet, because I feel like I will have to have so many caveats ("not that I believe in the category of the natural!" "not that I think 'natural' childbirths are necessarily better!") that I might never actually get started on the advice. I dunno.

But I was just thinking that one piece of advice I would give any expecting mother, regardless of her attitude towards "natural childbirth," is that you should STRONGLY CONSIDER having a midwife-assisted pregnancy and labor.

Get a CNM--that's a certified nurse midwife, who has all the relevant obstetric medical training, and who (in most states) will be associated by a doctor who is available to provide all surgical medical proceedures, as needed. Most midwives work in hospitals, where you will never be far from any needed medical care.

I suspect getting a midwife seems like some major lifestyle choice--certainly the idea was radical to me when I considered it myself, especially as someone who is very mainstream in my medical ideas and choices. But it's really not. CNMS are medical professionals. They just have additional training, less corporate pressure, and a different idea of what counts as sufficient prenatal care.

I'm sure that if you are pregnant you have one big goal--to have a healthy baby. Both midwives and OB-Gyns will do their best to meet that goal. Most OB-Gyns are completely committed to both healthy babies and healthy mothers, and while disasters happen, most OB-gyns will get you that healthy baby.

But I suspect that most pregnant women have a second, if somewhat less important, goal, and that goal is to have a pregnancy and childbirth that feels special. I did. I wanted, when I was pregnant, to have my world think that my pregnancy was an interesting and exciting event, a milestone worth attention. I wanted my pregnant days to feel accomplished, like Mary's, and I wanted to feel like what I was doing was an accomplishment. Because it was; I was making a person.

In this department, midwives as a group stand far above OB's as a group (I'm sure there are execptions). Midwives go into midwifery because they think that birth is not only a physical event but also a major life transition, for both the baby and the mother, and thus deserves to be treated that way.

Midwives, in general, give you longer pre-natal appointments, are more sympathetic to a wider range of questions, and will treat you like an adult and a peer. They will be on a first-name basis with you, because they are less interested in having authority over you and more interested in supporting you.

As the health-care industry becomes more concerned about money, more scheduled, and more compressed--in general, more industrial--the pressure on OBs to make obstetric care more and more time-efficient and less personally attentive will only increase.

So: midwives. Regardless of what you hope your birth will be like, I would encourage you to consider a midwife's ability to make that hope a reality. I think it will make your pregnancy and birth more fun.


Brandon said...

Maybe the difference between midwives and standard OBs is a bit like the difference between getting married by someone who stands in your life as a spiritual (or other) counsellor, vs. getting married at the courthouse by a justice of the peace.

Either way, you get married, and things usually work out fine. But given the choice, I think most people opt for the former. (In the birth arena, I think most people simply aren't aware that there is a choice.)

Anonymous said...

Thanks for the thoughts, Sarah. I started out with a midwife for my first pregnancy (that didn't work out), and got an OB for my second (that turned into Darwin!). It's kind of funny -- I had exactly the opposite experience I thought I would -- the CNM was less attentive and gushy, and the OB was all talking about how he was so excited to help people who "love each other enough to make a baby." But, despite that, I still have an inkling of going back to the CMN next time, I think just because of the idea I have in my head of what a midwife is. Hearing about your experience definitely helps. Where did you go? I can't remember, but I know you really liked it.