- A woman labors with her fourth child for a little over 3 hours for a successful delivery of a healthy baby at 41 weeks gestation.
- A woman labors with her first child for over 20 hours at 41 weeks and 5 days gestation. Baby is born healthy, but there were complications that required an episiotomy and resulted in a tear. Mother and baby were healthy overall.
- A woman labors with her first child for approximately 13 hours. Baby was delivered successfully after less than 20 minutes of pushing.
- A woman in labor with her third child and the father assists in catching the baby as the provider has not arrived yet. Mother and baby healthy and no interventions necessary.
Before you analyze and try to figure out the common denominator among those four deliveries, I want you to consider these two stories as well.
- A woman is transferred at the end stages of labor due to complications. She delivers a healthy baby with assistance from health care providers on call.
- A woman delivers a healthy baby at 40 weeks 6 days of gestation despite recommendations from members of her care provider team that she will need interventions to assist in the birth.
The same thing applies to a birth day. The events leading up to that birth happen to the mother, father or partner, and the baby. Those events help color the picture that mother, father, baby, and entire family take with them for the rest of their lives. The picture is beautiful and precious, but there are flaws and varying colors on the canvas that make it that way.
Involved in painting the pictures in the births above were midwives. A Midwife is a medical professional who specializes in the specific care women need for reproductive health. They assist in providing birth control, annual exams, childbirth and delivery support, postpartum care, breastfeeding assistance and menopausal care. Certified Midwives have completed a baccalaureate level study course in midwifery where they study childbirth, postpartum care, breastfeeding, and other practices related to women’s health. Certified Nurse-Midwives have completed nursing training in addition to their midwifery certification requirements, and often have Masters Degrees or even Doctorates in nursing care. Certified Professional Midwives have completed an educational program and also met standards set by the North American Registry of Midwives that allow them to assist and offer out-of-hospital births. There are several schools and programs aspiring midwives can attend to earn their degrees, and numerous certifications they can achieve that can often put their medical knowledge on the same level with professional nurses or some physicians.
I know you didn't read that sentence because you stopped and paused at out-of-hospital births. Yes, they still happen, and they’re actually remarkably safe.
Midwives, huh?
So those births above were all attended by midwives. No, not all of them. The last one was attended by a group of Obstetricians. What’s the difference then? All of them had good outcomes, so why bring attention to it?
Obstetricians are doctors and have thus gone through years of study regarding the human body. Their focus as doctors is to provide overall care for all types of patients, including high-risk pregnancies, complex situations and emergencies, infertility treatments, and surgical procedures as needed. Midwives are trained to rely on the natural developmental and physiologic processes that women’s bodies go through during their lives – including the natural processes involved in birth. They only use interventions when necessary.
I personally feel many obstetricians are trained to regard pregnancy as a “condition” and birth as a “cure.” But it’s not just OB’s however that feel this way; I believe our whole society thinks this way. We're a society of convenience, and interventions that speed up the painful process of labor and delivery are convenient ways to get the unpleasant part over with so we can get to the good stuff. Like skipping the prologue of a story to get to the good parts.
But skipping and disregarding the prologue can leave you feeling unsatisfied with the whole story.
Right now there is a bill in the legislature regarding midwifery practice. The bill would give licensure to midwives to continue practicing and supervising out-of-hospital births. Midwives traditionally refer high-risk patients to obstetric practices (as they should), but for normal low-risk births there are restrictions to how they can practice and if they can assist their patients should they need to transfer care during labor.
Why am I bringing this to your attention if you're not pregnant and don’t plan on getting that way? Why should you care what midwives do if you’re done having children? Why should it matter to those who wish to remain childless what goes on in the birthing world? Because who delivers our children, and how they are delivered, are choices we should be allowed to make.
If you haven't figured it out, those four births I mentioned above in the beginning of this post were all home births. The last two were hospital births.
Home birth number one was done because no care provider would agree to supervise a VBAC delivery (Vaginal Birth after Cesarean) with less than 18 months between pregnancies. Her options were to consent to unnecessary surgery, or seek out a CPM for a home birth to avoid that. I’m sure she was told the results would be disastrous because laboring after a C-section only results in tragedy according to some nurses and physicians… but they were wrong.
Home birth numbers two, three, and four were all elected for personal reasons. Obviously, there can be complications in any birth, but they were handled appropriately. I should also mention that number four scenario was a VBAC as well.
Just as you wouldn't want your general practitioner to force antibiotics on you for a headache, many women don’t want unnecessary interventions thrust upon them to speed up a natural process, or interrupt a natural event when there is no indication of a problem.
We need choices in who our providers are, and to ensure the safety of patients all around CPM’s need licensure to assist their patients wherever they need to deliver. It matters to everyone that women have choices in who they see for care because birth affects everything. How a birth happens affects the bond that mother and baby have, and that bond affects how the child develops and how the mother develops too. We don’t stop growing and developing as adults; our experiences color and change us – for better and for worse.
Women who have choices are more satisfied with their overall birth experience, and while this may seem moot since the child is already born and the picture already painted, the process is still important and can affect that woman for years to come. If it affects the mother, it affects the child, and therefore affects all of society as a whole.
We advocate for choices in who we love and can marry. We advocate for choices in politicians and school officials. We advocate for choices of who fights in war and who can serve in the military. These issues may never affect you directly, but many of you still advocate for them. Why shouldn't you advocate for the event that brought you into this world to begin with?
For more information on how you can support Midwives and bill # Hf 2086, visit Push for Midwives, Improving Birth, or contact your legislative representative and tell them that we should all have a choice in how the future is brought into the world.
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