Are you having an ultrasound?
the midwife asked, at my first appointment.
I thought there had been a miscommunication: nobody had told me whether I would have one.
Well, its up to you, she said.
She could explain the pros and cons, but the decision was mine.
Welcome to the midwifery model of care.
Midwives are an alternative to obstetricians for women with uncomplicated pregnancies.
They have training in pregnancy and birthoften a graduate nursing degreebut they arent doctors.
Midwife care isnt (just) an alternative woo-woo birth option for the granola-crunching crowd.
Theyre committed to giving care that is backed by scientific knowledge, and putting you in the drivers seat.
They work with you to carefully consider all options instead of just weve always done it this way.
*There are other perks to midwife care, but this was the clincher for me.
Midwives Put You in the Drivers Seat
The American College of Nurse-Midwives lays out their philosophy here.
In some cases, I departed from the guidelines for reasons particular to me and my medical history.
There are certainly doctors who work this way, and I applaud them.
Obstetricians education focuses on what can go wrong in labor, and how to fix it.
There aredifferent types of midwives, and licensing varies by state.
They dont have to work with a doctor, and they can prescribe medications.
CNMs arelicensed in all 50 states.
An epidural is a hospital thing, and you need an anesthesiologist to administer it.
I had chosen a birth center, in part, because I didnt want any of that.
And Ididend up with an epidural with my first baby, so Ive had both experiences.
Since it wasnt an emergency, no ambulance was called.
I, my partner, and the midwife drove the ten minutes to the hospital in our cars.
(Thats where I got the epidural.
It felt great.)
If theplacenta separates from the uterus before the baby is born, thats another disastrous situation.
Both of these are 1-in-10,000 risks.
AnotherCochrane reviewfound no difference between midwife care and standard care in serious outcomes like newborn deaths or hospitalizations.
Women under midwife care had fewer interventions (likeepisiotomyoramniotomy) and were overall more satisfied with their care.
We chowed down, knowing that we both had a long night ahead of us.
At most hospitals, women in labor are told not to eat or drink anything.
The standard fare is ice chips (to suck on).
Its hard to generalize across all midwives versus all doctors, so these arent universal statements.
You cansearch for a birth center near you here.
Besides birth centers, some midwives practice at hospitals, and others do home births.
You cansearch for a Certified Nurse-Midwife or Certified Midwife here.
If your state has Certified Professional Midwives, you cansearch for one on this site.
Then, ask providers about those things specifically.
Dont be afraid to ask what percentage of their patients get C-sections, for example.
Here is alist of ten good questions to ask a midwife or obstetrician.
If you want to be thorough,this list of 47 questionsgets into more detail.
Youll want to check your coverage for the midwifeandthe facility they practice in.
Im really glad I did.
Illustration by Tara Jacoby.
