Call The Midwife

I’d like to preface this whole post by saying that the answer to these questions are just my own opinion and what was best for me and my family. Your birth choices are YOURS and you should feel confident in them. Making informed and confident decisions for YOUR birth is what matters.

Here’s some frequently asked questions about why we chose a midwife after 2 previous hospital births and our experience using a birth center.

1. Why did you choose a midwife/birth center?

The factors that drew us to the birth center were; water birth option, private space, one person overseeing my entire pregnancy care from start to finish as well as the birth and postpartum, no lengthy stay, encouragement of natural birth, choice of pushing positions, proximity to our home, visitors allowed, more direct contact with my provider, more intentional prenatal appointments, less pressure to make certain medical decisions.

We originally looked into a birth center in the height of Covid when the idea of being in a hospital was not ideal for us as a family.  I wanted my parents to be there and I didn’t want to push/labor in a mask if I didn’t have to. Although those are pretty petty reasons, it’s what launched us into researching hospitals vs. birth centers.

I had always wanted to have a water birth and a midwife but those weren’t really an option in Midland. With more resources here in Houston, we knew we’d be able to have the birth we’d wanted. As we were deciding which route to go, we watched the documentary called The Business of Being Born. It was very eye opening for us and, with me being very low risk in all categories; we decided that a birth center was for us.

2. What were the differences between the birth center and a hospital?

Because my labor was so fast and furious, I’m not sure of how different the laboring process would have been from start to finish. However, I loved that I got to be in constant communication with my midwife. I labored at home for as long as possible, updating her on contractions and she told me when it was time to come in. Laboring at home as long as possible was more comfortable and felt safe to me. The birth center is really for just that; the birth. When I got to the birth center, I just got to keep laboring. There wasn’t a line to register, wait for a room, wait to get checked, etc. My labor wasn’t stalled.

Another difference was the freedom. With both of my previous births, I’d asked for intermittent monitoring on the baby and, while I technically got it, that came with wires still hanging around my neck and the heart monitoring band around my belly the whole time. With my midwife, she checked the baby’s heart rate with a Doppler after each contraction and had me move if needed, especially when I was pushing. I was also free to birth where I wanted to; in the bed, pool, tub, birthing stool, floor, etc. in any position I wanted to; side lying, back, squatting, lunging, etc. I know most hospitals allow some of those options but in my experience, I got lots of pushback and “discussions” when I chose something perfectly safe that was against the usual hospital protocol. I didn’t want pushback. I wanted someone who would let me trust my body and my instincts to birth how I needed to. Another freedom that was important to me was the freedom to eat during labor. I know that hospitals don’t let you eat “in case” you need an emergency C-section but that’s not really true. Its in case they need to put you completely under and your aspirate, that RARELY happens. My labor with Winifred was 27 hours and by the end I could barely push and needed forceps to get her out, I’ve always wondered how it would have changed if I’d been allowed to nourish my body during labor. I wanted to be able to eat, and I was able to do that with the birth center.

The BIGGEST difference for me with the birth center was the postpartum experience. After Elijah was born we got almost an hour and a half of skin-to-skin and nursing in before anything else happened. It was peaceful and productive for Elijah and I to bond so immediately without being poked and prodded. My midwife did his APGAR screening and then let us be for a while. I can’t say for sure, obviously, but part of me thinks this might have really helped with breastfeeding being successful this time around. We also got to go home that night. 3 hours after Elijah was born we were in the Whataburger drive though headed home. We got to sleep our first night in the quiet of our own home; it was incredible. The next day, my midwife came to our home to do Elijah’s newborn screening and that was truly a gift. I didn’t have to load everything up to take him in after just giving birth. She also did his 2 week checkup and checked on my healing as well. It was amazing to have us both checked on at the same time.

3. How was the cost different than using an OB/Hospital?

Great question, but this is different for everyone depending on your insurance. Most insurances will actually cover partial costs of using a midwife, doula, or birth center! We have a high deductible plan with an HSA account, so we chose not to go through our insurance because we would have paid out of pocket anyway. Our total cost for prenatal, birth, and postpartum care was $4,200 and we paid most of it with our HSA. It was very nice to just pay it all upfront.

4. Did you tear? Could she stitch you up?

Yes, most midwives are trained to stich your perineum if you were to tear in labor. Fortunately, I did not tear badly this time. With Winnie I had a 3rd degree tear, with Daphne I had a 2nd degree tear, but this time I had a minor tear that did not need stitching. I credit that to the water birth and pushing in a lunge position.

5. What if something went wrong?

Most midwives are VERY trained. My provider had a list of over 20 complications she had successfully dealt with in the birth center. She has delivered over 1000 babies and has an extensive list of credentials and trainings. When I asked her this question, she said “You know, I’m not a hero. I know when I’m out of my league and I know when it’s time to go”.  To be honest, I trusted our guts. I knew my body and she knows birth. The birth center was very close to the hospital, so I wasn’t worried about being too far away if we were to need to get there. She looked for any sign of complication during my pregnancy and monitored me closely during the birth. I was confident in her and trusted her fully. The most common reasons for a hospital transfer are failure to progress, pain relief, and exhaustion. We had a plan to combat those reasons. I didn’t go in a “no hospital under any circumstances” mentality. We would have gone there had we needed to.

6. How did you combat anxiety/fear of something going wrong?

This sounds cliché, but I had faith. This was what my body was created to do and I trusted that this was the best environment/situation for all of us. My pregnancy had 0 complications and there was no reason to believe I couldn’t do this. I prayed over this baby every single day and I trusted that I’d done everything possible to ensure this babe’s safe entrance into the world. God was in charge and we knew that.

That doesn’t mean I wasn’t scared at times, I mean I was about to push a hummer out of a compact parking spot, but making decisions out of fear isn’t a way to make decisions. Anxiety/fear are a part of life, they shouldn’t rule your life.

I made a list of concerns and went over them with the midwife and she told me what would happen in each scenario. Knowing there was a “plan” let me take things as they came.

7. How do I know if a midwife is right for me?

Shop around! Interview midwifes, birth centers, doulas and figure out the best provider for you. You have time to switch if you need to. Some midwives and doulas can come with you to the hospital if a birth center isn’t what you want.

Here’s some questions you can ask a provider to see if they’re right for you.

             Do you take insurance? What’s the self pay price? How many babies have you delivered? What’s the percentages of births you’ve had to transfer to hospital? What kind of emergencies have you handled? Have you resuscitated babies? What are your certifications? If I transfer to the hospital, will you accompany me? Are there any type of birth you don’t support? What is your stance on vaccines/circumcision? What is your policy on visitors? Can I have a birth photographer? Do you provide other options for the glucose test? What if my birth overlaps with another client? Do you provide prenatal nutrition advice? What’s your experience with homeopathy? If I tear, can you stitch me up? Can I keep my placenta? Do you offer postpartum care? Are you lactation certified? What happens if I go into preterm labor? What are you procedures for immediately after birth? How can I stay in contact with you? Why did you become a midwife? What is your birth support style? What are my options for pushing? Do you offer comfort measures? Can I eat in labor?

Don’t be afraid to ask any questions, especially if it’s important to you. Your provider works FOR you and with you, it’s important to be on the same team!

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