I was pregnant again and looking to change things up from the first pregnancy. Reflecting on my first pregnancy, I wished I might have been more aware or knowledgeable on certain decisions that were not previously discussed at appointments such as episiotomy versus natural tearing. I also mentioned during appointments and at the hospital a desire for no pain medication and to leave the hospital as quickly as I could (under the assumption that both the baby and I would be healthy). But I was constantly asked if I wanted to take pain medication, cut when I felt the need to push for, what to me felt like deliver as quickly as possible as it was past normal business hours already, and ended up staying in the hospital for just over 3 days because I (and not the baby) had not been given release paperwork yet.
In 2020, freshly into the pandemic, in an attempt to find another solution that might align with my personal preferences more, I met with a local midwife in a birth center. She touted personalized appointments, lasting about 45 minutes, following the lead of the mother during birth in regards to what felt comfortable and several visits postpartum. This was also during the first year of covid, with strict hospital regulations sending several people to search for alternative birthing options in efforts to allow for more support people during birth. Having feared being away from my first child for days long, I liked the idea of only being under care of a midwife for 6 hours following the birth, and the options to choose what I wanted at my birth.
I will admit, she listened to the concerns of my husband and asked if I was eating enough at every appointment, but did not delve into exactly what other than after the first appointment. She did the same things that would be done at a typical prenatal visit with an OB – looked at a urine sample, took note of weight, blood pressure, measured fundal height, position of the baby and asked how I was feeling – all in the same length of time I was with my OB for my first pregnancy. I was a bit underwhelmed at the personalized service I was paying for in regards to follow up of bloodwork or lab tests in subsequent visits as it often took more than 3 days (and follow up text messages) in which I felt I would have seen the results online through Lafayette General much quicker. Social media portrayed these lessons on a white board, props used during appointments to demonstrate how to flip a baby, comfortable laboring techniques or what to expect during contractions, but my appointments consisted of none of this.
When my water finally broke, I messaged the midwife to notify her late that evening. Under her instructions, I tried to relax and rest as much as I could and notify her if things were to pick up. I can say I tried to sleep, but I was too excited and anxious to truly relax. It was 9 am the next day before the midwife checked in on me. At this point, I was wondering if it even was my water breaking or maybe just incontinence because I had not experienced a single contraction. After meeting her, she was able to confirm it was time for labor to kick in and perhaps my body needed more help starting labor by connecting to a breast pump to jump start contractions. Overall, I was disappointed in the involvement on her part, often sending in the midwife in training in her place to check the fetal heart rate, trying to get contractions to remain consistent as a health care provider, as well as ultimately maxing out her time constraints when my water had broken a near 24 hours earlier versus just being frank with me and forwarding me to the hospital earlier. Finally, as the contract stated, I was supposed to receive several home visits from my midwife following the birth, regardless or being born in a hospital or not. She made one visit on day 3 later in the evening. Otherwise, I never received another visit and never really heard from her again.
Finding myself anticipating the birth of a third child, I am torn on what delivery options I’d like to pursue.
I’ve switched back to an OB for prenatal care during the pregnancy for several reasons. My husband is scarred from the birth of our second child as it resulted in late transfer to a hospital anyway and the anxiety he felt in the hours leading up to my decision to transfer. Also finances – I paid for the midwife out of pocket and then incurred the costs at the hospital in the form of deductibles again, essentially paying for the birth of our second child twice.
But I don’t think all midwives, or midwife experiences, are bad.
There are other midwives in the Lafayette area, and even a second birth center open now! Oschner Baptist and Oschner Medical Center – Baton Rouge both offer midwife options within a hospital setting. This means all the benefits of a midwife birth such as freedom to birth in a bed or tub, alternate birthing positions and use of fridge for food and drinks. The benefits of the Baton Rouge facilities having midwives within the “home like” hospital setting is it’s billed through the hospital (only pay for the birth once!) and if you should require more intervention such as Pitocin to help labor progress or even a C-section, you just get wheeled to a different floor/room within the same hospital. The only con if you will is that they do have to adhere to hospital regulations which require a minimum 24 hour stay after the birth for monitoring. While I haven’t fully committed to any birthing option yet, I am highly considering traveling to Baton Rouge for the birth.
I suggest getting a doula. My doula team helped me to ensure my birth was as close to what I wanted as safely possible. And when I needed to find a new doctor, they were there supporting me. Doulas are not medical professionals and will not deliver your baby. But they are support for you, someone who can clearly argue for the things you do and don’t want, with you, and even for you during labor.
I used a certified nurse/midwife back in 1989 and 1990 in Cleveland. I wanted much more control over my birthing experience and felt this was a good option. She was connected to the hospital and also had an OB connected to her practice. I loved the experience, though my first child was breach and I ended up having to have a C-section. My second birth also resulted in complications and the OB had to be called in. But I still felt listened to and respected. This was in Cleveland. When I moved home to New Orleans in 93 I was pregnant with my third and wanted to find a similar situation. There was nothing to be found and it was difficult to find an OB who would let me deliver vaginally and basically leave me alone unless needed. But I managed to find a wonderful one and delivered my next two children at Baptist. The nurses were very confused by me but by then I had found my voice and understood my body much better and was able to advocate for my needs (along with a very supportive husband). I think a Doula is definitely the way to go in the area that we live in. They can help women express what they want and be that extra voice that is often needed. We have the right to birth in the way that we want barring medical emergencies. But even then we should have a voice.