Miller Family and Jeanne Prentice, Certified Nurse Midwife (Center Back)
This week of October 2009 is National Midwifery Week. It’s unfortunate that many expectant parents know nothing about the option of hiring a midwife before giving birth for the first time. During my first two pregnancies, my husband and I were in this position. We made long drives to each appointment, sat in stuffy waiting rooms (sometimes for hours), and eventually moved to an examining room where I sat, naked and cold, waiting for my exam. At some point, a nurse or doctor came in to check all my vitals, poke and prod my body, scribble a few notes in my file, and ask me if I had any questions before they moved on to the next room. On the way out the door I scheduled another appointment where we would return to the office and start the waiting process all over again. It was sterile, impersonal, somewhat dehumanizing, but efficient. What more could a girl ask for?
To be honest, I liked my doctor. I felt “safe” surrounded by all of his medical equipment, not to mention his air of studied wisdom. His walls and practice were decorated with evidence of his experience: he was clearly very busy as both a gynecologist and an obstetrician, and the framed documents lining the halls said he was highly certified. His intelligence was impressive to my 20-something mind, what with his use of highly technical terms like chorionic villus sampling and human chorionic gonadotropin. During our 5-10 minutes together each month, carefully worded comments suggested that things would run most smoothly if we left most of my birthing decisions to his expert medical opinion. There was actually little we had to do to prepare during those months. However, much later, when our dreamy birth turned into a living nightmare of typical hospital interventions, neither I nor my husband were equipped to advocate for myself and my baby. We felt completely helpless as things continued to spiral out of control. For some, the common domino effect of standard birthing procedures ends up just fine. They’re the lucky ones. Others, like me, face months of physical and emotional healing with countless questions left unanswered.
When we discovered I was pregnant for the third time, we knew we wanted things to be different. I joined several online communities of moms and read hundreds of stories each week written by traumatized mothers who had similar stories of their encounters with the American birth machine. In those hours of reading we heard about doulas and birth centers and even more about malpractice laws that often dictate hospital policies thereby affecting standard obstetrical care. Then we encountered information on the ins and outs of home birth including safety practices, home birth supporting obstetricians, and positive statistical outcomes. Still tentative about delivering in a home setting, we called a local Certified Nurse Midwife just to set up an introductory appointment. I was taken by surprise when she asked about my family and our home town. She also asked about my previous birth experiences, my work, and much, much more! At the end of our hour long talk, she suggested we have a face-to-face meeting to go over a few details and discuss whether we wanted to employ her to assist our birth at home or in the hospital. I seriously felt a little like Alice in Wonderland, but I was intrigued and delighted.
Over a series of hour-long meetings, we discovered that the focus of a midwife isn’t solely on my uterus and vagina. A midwife seeks to assist, educate, and collaborate WITH the mother to achieve the healthiest birth possible. My mind was just as valuable to her as my pregnant body. On my couch we’d sit discussing the birth literature my husband and I were reading each week. She readily listened to my concerns and offered options for consideration. We discussed safety measures and what would happen if the need arose for a hospital transfer. In due course, I learned to listen to my body and to recognize when something wasn’t right. The power of posture and attitude was revealed to me as I worked through optimal fetal positioning methods. Our skeptical minds opened significantly during those hours of preparation and I loved it…every minute of it.
"And something else was very different -- I was no longer afraid of birth."
By the end of my pregnancy, not only could I quote medical studies and statistics that were particularly important to me, but my husband and I made each decision carefully and deliberately and took ownership of the whole process. We were confident that we didn’t want the very real risks associated with an induction, an epidural, or the downward spiral of other multiple interventions. I consciously requested intermittent fetal heart rate checks for reassurance, a warm birthing tub to relax and labor in, and some privacy. Once our plans were finalized, we waited for our baby and my body to indicate that it was ready for birth. It should be no surprise that labor finally happened all on its own with no need for interference.
In short, our midwife-assisted labor and birth was absolutely perfect and I was healthier in the hours just after giving birth than I was WEEKS after my previous births. As important, the whole experience was healthier for our whole family: my husband was a more natural participant in the whole process, rather than feeling excluded from it, and our baby has been the healthiest and happiest of our three children. I only wish we had benefited from the enlightenment of a midwife long before our first baby was born.
The two most common types of midwives in North America are the Certified Nurse Midwife (CNM) and the Certified Professional Midwife (CPM). Although very different in education and certification methods, both carry a similar philosophy of intently listening to and preparing women for birth in a way that is often lacking in a standard obstetrical practice.
Studies published around the world continue to provide evidence indicating that for a low to medium-risk pregnancy, hiring a qualified midwife leads to fewer unnecessary interventions and yet equal and often better outcomes to birthing within a traditional model of care, in terms of both mother’s and baby’s emotional and physical health. Recent studies extend this conclusion to midwife-attended home births, as well. Therefore, it’s important for women to know that choosing a midwife is a viable option.
If you choose to consider hiring a midwife, first take the time to review current birthing literature and specific legal requirements in your state. Additionally, discover whether you’re a good candidate for a midwife-assisted delivery, ask her for personal references, and conduct interviews regarding standard practices and statistics. Whether you select an obstetrician or a midwife to assist your pregnancy and delivery, remember that no two providers are identical, so it serves you best to do your own investigating beforehand.
Shaye Miller and Jeanne Prentice, CNM
This National Midwifery Week, we celebrate the thousands of midwives around the country working to offer women a model of care that our culture seems to have lost over the last century. I send my personal gratitude to my own Certified Nurse Midwife, Jeanne Prentice, for serving me in the most considerate and honorable manner. Jeanne, words cannot express our appreciation for your continued belief, challenge, and support throughout my last pregnancy, birth, and beyond. You are an inspiration to me and countless others you’ve served through the years.
Jeanne Prentice, CNM is the owner and midwife of WomanKind Midwifery in Spearfish, SD
In short, our midwife-assisted labor and birth was absolutely perfect and I was healthier in the hours just after giving birth than I was WEEKS after my previous births. As important, the whole experience was healthier for our whole family: my husband was a more natural participant in the whole process, rather than feeling excluded from it, and our baby has been the healthiest and happiest of our three children. I only wish we had benefited from the enlightenment of a midwife long before our first baby was born.
