Saturday, September 09, 2006

Today it's all about the chips and salsa...

I promise that this is not turning into My Pregnant Blog. There are other interesting things about me, I swear. For instance, I like enchiladas; also, Toffifay. However, the purpose of today's entry reverts to an easy topic: That Which Resides Inside.

Even after a reasonably good birth experience with El Guille, I decided that I would change the things I didn't like about it by changing my doctor. In fact, I gave up my doctor. I decided that a midwife might be more my style.

Now, if you'd of asked me ten years ago if I would consider going to a midwife I would have laughed in your face. This super spacy girl, "Sally," I grew up with wanted to be a midwife. She was one of those earthy freakazoid girls with the pasty skin of a die-hard vegan and the intellect of a concrete block. Sally was going to apprentice and then attend births with her accumulated experience (so the idea of her attending my birth was enough to put me off for a good long while.)

The other part of me knows the history of midwives, romanticizing the idea of women who served their communities. I understood how those women had been pushed out of the delivery rooms in favor of doctors with medical training--essentially medicalizing the birth process. Putting women under general anesthesia and then feeding their babies evaporated milk and corn syrup all in the name of modern progress. Modern OBs have come a long way, but they are still incredibly busy and incredibly unwilling to wait for the process--favoring control and routine over specialized needs. I am very aware that women used to die, like, a whole lot more than they do now. I also know that c-section rates approaching 30% is absolutely ridiculous. When my OB threatened me with a c-section after two hours of pushing, I knew our relationship was over. I could have gone much longer, but he was eager to make his appointments.

Our confidence in the ability of our bodies to do as they were designed has been undermined.
I decided the least I could do was to meet with one to see more of what they were all about. I went to the website of a clinic I'd heard about and actually found a picture of a friend of mine who is now a practicing midwife. It's a sign! I said while J laughed at me. I made an appointment and met with my (possible) midwife this week.

Here is what I learned:

1. My midwife is an R.N., a nurse practitioner, an additional medical masters in midwifery, is licensed by the State and board certified. A far cry from dippy Sally.
2. Midwives deliver in the hospital and also have OBs attached to their practices just in case.
3. While Utah average c-section rates are nearly 25%, my midwives are at 8%. EIGHT FREAKING percent. Even their OBs are only at 12%. Are you kidding me? It makes me want to punch Doctors and their tee-times.
4. Whatever I want goes. Epidural, sure. No medication? Sure. Change your mind in the middle and need something, anything? No problemo. Move around, take a walk, hop in the tub, why not?
5. No routine anything: significantly lower rates of episiotomies with none being done just because, less 'tearing' (you know what that means,) less internal monitoring by route (you know, where they literally screw a cord into your baby's head while he's still inside you).
6. How about a health care practitioner who LISTENS to you. I spent half an hour talking to my midwife in addition to my physical exam. My OB had, at most, ten minutes to spend for everything. I have a family history of gestational diabetes. Although my OB knew this, he didn't test us early to catch a problem. My midwife already has three tests scheduled to monitor me along the way.
7. The midwife told me that I can be the first to hold the baby and I can hold it for as long as I want. "You did all the work, you should be able to hold it as soon as possible." Sounds like a simple idea right? Well, when El Guille was born they took him away, cleaned him, suctioned him, wrapped him up, showed him to me, and then removed him from the room. Everyone else followed. I was left alone. Totally and completely alone. "I guess I'll take a nap," I thought, and promptly did. I didn't get to even hold the kid for probably 45 minutes. I didn't realize how much that bugged me until she mentioned their Mom First philosophy.
8. There are other things but this list is long enough for now.

Needless to say, I'm on board. Why did I even go to an OB in the first place?


brittney said...


Brittney Carman again, thanks for inviting me back. Just wanted to say that I delivered my daughter, Stella, at the hospital in American Fork with midwives from the Timpanogos clinic, and even despite totally breaking down and mainlining all kinds of things for the pain (i do believe they actually gave me morphine before the epidural because the anesthesiologist had gone home for the night and it was gonna be a while before he got back to dope me), it was the most amazing experience. Those ladies are so so rad. They took precautions I doubt an OB would have to see that I didn't tear. Once when the nurse wanted to screw in a fetal scalp monitor, my midwife totally told her to stick it (as in, disallowed the unnecessary and somewhat dangerous procedure) and things turned out just fine. They know their stuff and never for a second did I doubt their skills. The experience was personal and unhurried, and I felt like they were truly advocating for me. Three years later my husband says if we have another one we'll make the drive back down there to do it, though it's a solid 13 hours away. Plainly, they have our confidence.

metamorphose said...

Wow! After reading your post, I'm persuaded! When you mentioned midwife in a post a while back, I was like, "hmmmm..." but honestly, that sounds FANTASTIC! I don't plan on having a baby anytime in the near future whatsoever, but I will definitely keep this in mind!!!

Bek said...

I didn't have a midwife, but my practice had just one OB (who is herself an earth mother type) and a nurse practitioner who sound very much like your midwives. My OB delivered in shorts and a tshirt after sharing dinner with us (well, my husband). She was so calm and low key. In fact, they handed me the baby right after birth and then finally I was like...can someone take this baby an clean it off for me....? That is when Derek got her.

I didn't realize how lucky I was to get a situation like that. I didn't konw that Dr's acted any other way until I atteneded the birth of my son and his brother (who were medicaid babies). It was terrifying (although...they didn't push C sections because that would COST MONEY!!!!!!!). I am still bitter at the nurses at Pioneer Valley for their behaviour during the delivery. They should be fired. (THey were telling M that "come on, stop complaining because it can't hurt that have done this before...stop moaning...") I had to hunt them down and BEG them to do anything. In fact, whem M said she was ready to push, the nurse came in..DIDN"T check her..and told her to relax. I found another dr. walking the hallway, told him and Jacob was born 3 minutes later. THREE MINUTES!!!!!!! Delores at Pioneer Valley...I MEAN YOU!!!!!!!! I guess she thinks that poor black women don't feel pain and that they don't know when they are delivering their 4th child what it feels like to be be ready to push. would have had a heyday with that one.

I think people have the wrong idea about what a midwife is. All the girls I know here have used midwives and in fact, almost every OB office has a midwife or three on staff for those that want to go that route..but still stay under the umbrella of the OB (sometimes insurance can get tricky).

Good for you for finding what was right for you. I think you should be a doula.

It is ok to turn this into a pregnancy are pregnant right? Beside, I love to hear the stories and remember what it was like.......

Bek said...

I meant to say that every OB office HERE has a midwife on the staff...

maybe it is a california thing?

Queen Scarlett said...

Thanks for the link to Toffifay... and the recommendation for Izze - YUM.

And... maybe I'm lucky and/or maybe it's a Calif thing - but I've been really lucky with my doctors and nurses... all very pro-Mom and baby...

...and I think of you as an incredibly strong woman ... I'm miss. indecisive so I admire your ability to take control.

wendysue said...

I LOVE Toffifay. . .

I can say AMEN to this blog for sure! I had a regular Dr. OB for my first, but the midwife was on call that night, so she delivered and it was great. Well, as great as pushing the watermelon out can be. And get this, the midwives go on call for the Drs, but the Drs don't go on call for the midwives (because they know their patients would have a fit!!)

So, 2nd time around I switched to her. The practice has about 5 Drs and 2 midwives, one of which was the first board certified, licensed in Nebraska--they rock.

What I noticed in particular

--Time. They take as much time as you need. With my Dr. I spent most all the time with the nurse and he came in, measured and asked if I had any questions. . .my midwife did a lot more actual teaching and educating about my body and what the baby was doing. . .She was also wonderful to my children when they had to come with me.

--My midwife was at the hospital during my entire labor for all 3 kids. Yes, a nurse was with me for most of the checking up stuff but she was nearby when I needed her. There was no "hold on, don't push, the Dr isn't here yet". Yeah right, like that's happening. I also had no episiotomies or internal monitoring and very little tearing.

--As soon as that baby was out she was mine, right up on my chest. With Whitney she was wheezing a little, but they kept her in the room and cleaned her off and got her all checked out right there, by ME!

--One of my favorite memories, see if your midwife will do this, is the babies first bath. Usually babies are sent off to the nursery to get cleaned up, bathed and sent back later. But my midwife let Matt give them their first bath (with her extra hands to hold on), but they just had a little bath right on the bed, so I was right there too. It was a great time for Daddy and baby to bond.

LuckyRedHen said...

Dr. with the 1st and midwife with the 2nd - either way works for me because I'm cool like that.

This is me said...

I had an OB with both babies but they were totally different experiences. My first was bad, bad, bad. I was his last patient after over 24 hours on call and he could not wait to get it over with. Too bad for him, I pushed for 2.5 hours. Then the next dr from the practice came on and I never saw the delivering dr again. I mean, who should be checking up on you but the dr that was actually there when you delivered?! My baby was also taken away and I was left all alone for about 3 hrs. Not cool.
The 2nd was in a different area and was fantastic. I asked my dr to induce me early b/c my first was quite big and I was miserable and he just shrugged his shoulders and said Okay. Then he said, "We are actually going to let you take this baby home and raise it so we figure you should be making the delivery decisions, too." So refreshing to hear from a dr. I also asked for no episiotiomy and they honored that request. Much faster healing, thank you. Like WendySue, they bathed the baby in the delivery room so I could watch and then nurse him right away. AND, the pediatrician did his first exam in there as well. That baby never left my side unless I asked for them to take him (so I could shower, etc).
My point in this long comment is that fabulous OBs are out there, they are just harder to find. If I can't find one like that next time, I would definitely seek out a midwife. Thanks for the info.

reva said...

I'm so jealous right now it hurts. I found a female doc who speaks English, but she told me with a first baby, an episiotomy is not an option. Like, I HAVE to have one. They think tearing is barbaric here. Um, it heals better! There's only one doc in all of Campinas that doesn't do routine episiotomies, and he isn't on our insurance. I need to not know what they do in America, it just depresses me. You have it soooo good.

AzĂșcar said...

Tell her you will SUE her if they do it. I cannot stand that they would force a medical procedure on you, that's just unbelievable. Maybe your husband will help you out by making it clear during the actual delivery that a routine epis will not be tolerated--they might listen to him.

You are the mom, it is your choice. (Maybe you could just kick her in the face when she's about to try *haha*)

I know there are good OBs out there, and there were a lot of good things about mine, but I think there tends to be a mentality about what obstetrics is and is not (no matter the mom and dad's opinion on the subject.)

Nope, it's not usual for a midwife to be attached to a regular OB's staff here.

Bek- isn't it amazing the difference in patient care in this country? When you witness those actions it's all too evident that something is broken.

Q - I read that you've got your c-section scheduled already for numero dos. I'm curious how you felt about your first c (maybe that's too personal?) I love to hear other women's stories.

LRH - 'cause you roll (and rock.)

Wendys- now THAT's what I'm bloggin about!

Queen Scarlett said...

I don't mind sharing... let's preface by saying... I'm allergic to pain, needles, blood... I'm a big chicken. ;-) ...and yet I wanted to have a baby - go figure.

I took all the classes, prepared and was planning to squeeze my baby out of an itty bitty hole in my nether region...

I remember laboring for a week before Kalea finally decided it was time. My water never did break. I labored for 23 hours and I'd gotten to 8cm...but things weren't progressing and Kalea had pooped meconium inside of me and her heart beat was becoming eratic. When the DR came in he said that we may have to go the c-sec route. I bawled - it was everything I didn't want to happen. I was utterly devastated. I had this picture of having Kalea naturally and ready to have angels in the room and all that.

The DR said he'd let me try for another hour or so... so he left. I had my Mom, Dad and Ry with me. The pain was agony - and it was agony for my Mom watching me go through this... you can't help but feel like a bit of a failure when things don't work out the way "it's supposed" to happen.

So we prayed. That last hour humbled me. The pain was even worse...and I could only rely on my mental conversation with God. It was then that I realized being such a control freak I needed to let go. Once I realized that I felt such peace. That's not to say I wasn't nervous...but I was finally at peace with the c-section and what had to be done.

When I was first checked in all the staff were writing up what they thought my baby would weigh... ranging from 6-7 lbs. I'm short - 5'3" and petite frame ... so that made sense...and it would be my first baby.

After the c-sec and they pulled Kalea out - we were all shocked. A loud, unanimous "oh my gosh" echoed in the surgery room. She was 9lb6oz and 21 inches. I still don't know how she fit inside of my belly.

I've had other moments in my life where at first I want things a certain way and after I give it over to my faith... it all clicks into place. Does that make sense? I believe the Lord knew what I needed more than I did.

While I first felt like a failure when the Dr told me what might happen... after making peace with it... I realized that we're all different situations and there isn't just one cookie cutter way of doing it.

I'll tell you one thing - I'm so grateful to live now... I would've died out on the plains as a pioneer and so would've my baby.

BowlerGirl said...

I am really pro-whatever-the-mother-needs. I generally go on and on about natural childbirth. What it really comes down to is what YOU need. Hubby is terrified for when we have kids because I'm personally so pro-midwife. He worries about complications, the need for medical intervention etc. I constantly have to remind him that in general giving birth is NOT a medical emergency. There are always the cases where medical intervention is needed, and I'm grateful that it's the year 2006. But let’s also remember that women have given birth for a millenium and have done just fine.

La Yen said...

The only thing I am against is home birth. Because there is no way in hell I am cleaning that up.

Julie said...

My first was a C-section. My BP was up and the baby was diagonal, so the doc opted for a section. I'm still not sure, looking back on it, that he made the right decision, but it's all over now. And it went fine. With no scar on my nether regions, recovery was a breeze. I would do a C-section any day, if that was the safest option for my baby.

My second baby was with a different doc (female), whom I really liked a lot. With her help, and the help of an amazing nurse who suggested a relatively new procedure at the time, we were able to avoid another C-section and have a successful VBAC. The only thing I hated was the tearing. I requested that she not cut me, so I got what I asked for, but I totally regretted it later. I had second degree tearing, she spent 45 minutes trying to stitch me up, and it was weeks before I could sit down without gritting my teeth.

Birth experience number three was awesome. Another doctor, again, since we moved and the female doctor was too far away. Dr. number three took time to answer questions, resolve concerns, and allowed me to meet with his partners for some of my visits so, if he wasn't available, I wouldn't have some stranger delivering my baby. (His partners are all great.)

Our goal, again, was another successful VBAC. I asked him to hold off on the episiotomy unless it looked like I was going to tear. My request was granted. He did end up doing the ol' snip snip thing, but the recovery on that was WAY easier than with my tear. I felt great within a week. And I didn't have to carry a donut thing with me everywhere I went. Based on my experience, the episiotomy is the way to go. But, then, my babies have huge heads.

I love hearing about everyone's experiences. And I love that birth is such a unique process for each person. I also love that the comments here have been so accepting, even when opinions have differed. Pregnancy is an amazing experience. The delivery should be just as amazing. You have to decide what you feel most comfortable with and hold your ground.

kristenlibrarian said...

I love enchiladas AND toffifay TOO!

Do you think that because you've already had one child and you kinda know what to expect that you feel more at ease about a mid-wife? That's how I'd feel, anyway.

This mid-wife does sound wonderful, though. I love the "mom first" part!

Stepper the Mighty said...

thank you!