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Why I chose a midwife and why I will suggest my daughters do, too.

January 13, 2021

Twenty-six years ago, when I gave birth to my eldest daughter, I had a midwife in attendance who was part of a local obstetrics practice. I gave birth at Rose Medical Center in Denver, and an obstetrician was on call should anything go array. At the time, I didn’t think the choice of midwife unusual. However, now I know that my choice (in 1992) was rare.  


Why a midwife?


Maybe it was because my sister had a midwife when all three of her children were born. And every birth was uneventful. She had no complications, and the kids were born with all their fingers and toes and were healthy. Or maybe because my mother had a midwife for the birth of her four children in the 1950s and 1960s. Or because I grew up in England, where midwifery is a much more common practice. More than 50% of births are midwife-assisted in the U.K. Who knows why I chose it, but I am glad I did.


What makes some women more amenable to the prospect of a midwife versus an OB/GYN?  


For me, it was a normal, natural path to choose a midwife. My mother’s best friend, Sunny, was a midwife and my mom chose her to be there for all of her births in the 1950s and 1960s.  A midwife was an anomaly back then when the norm was a drug-fueled birth where mothers received a cocktail inducing something called “twilight sleep." In addition to knocking the patients out, doctors commonly used forceps and episiotomy during deliveries to prevent rare complications. This approach of aggressive interventions to minimize the potential for the worst-case scenario was common. For my family, who resided in Wyoming at the time, midwifery seemed a little more palatable.


Today,
midwives attend 9% of U.S. births. In Europe, they are highly regarded and in some countries are the main provider during labor and delivery. Even Kate Middleton (Prince Williams’ wife) used a midwife with the birth of her daughter Charlotte. So, if it’s good enough for the British Royal family, why isn’t it good enough for Americans?


A lot of it boils down to how we see and interact with our health care system. We’re taught to believe that medical doctors are the best at providing care regardless of one’s condition – emergent, urgent, or a naturally occurring condition like pregnancy – and that the best possible  outcome and the safest options are with a physician. That may be the case in lots of medical situations.  Believe me, I’d rather have a neurosurgeon work on my brain if I have a brain tumor, or an emergency room doctor treat me for a heart attack, or an oncologist if I have cancer. After all, these are specialists in their fields. So, too, are nurse-midwives who are highly trained and skilled in pregnancy, labor, delivery, and post-partum care. They are not witch doctors. They actually receive extensive education. And the University of Colorado College of Nursing has one of the best nurse-midwifery programs in the country.


I’d much rather include an obstetrician when needed in situations if labor is not progressing at all, the mother is hemorrhaging, or if the baby is having challenges transitioning to life outside the womb. Just because the baby is not coming as quickly as the M.D. thinks, should not be the reason for intervening. In the U.S., cesarean-section rates are currently at 32%. That is nearly triple the rate of other industrialized countries. I can’t help but think that it’s not all about the health of the mother and child. It smacks a bit of “doctor knows best.”


Who chooses midwives?


Today, all types of people choose midwives. From those who want a certain type of experience such as un-medicated birth or a water birth to consumers looking for a particular outcome to those who have a distrust of the medical establishment. Midwifery appeals to a variety of people who are looking to align their birth experience with a personal philosophy. It may not be as widespread as the traditional OB/GYN path, but it has its following. And I highly suggest that if you are considering midwifery that you thoroughly vet the practices. Just like you would do for a good OB.  Ask friends and family who they used and why. If a practice has regularly scheduled meet & greet sessions, sign up! You want to feel comfortable with the practice, the providers, and where you will give birth. Most practices like the Center for Midwifery – Longmont are affiliated with hospitals and require the mothers give birth at the local hospital. This ensures a safer birth.


For my daughters, I will highly suggest a midwife. For multiple generations of my family, it has proven to be a safe option in childbirth. I think the key is being educated about what you want your pregnancy and birth experience to be like. And, feeling like you are part of the process. Remember, if you choose a midwife, it
doesn’t mean that you won’t have access to all the medical care imaginable, including an obstetrician, anesthesiolgists, and pain medication. Millions of women throughout the world choose midwives and for them it’s proven to be a safe choice.  
The point is – it’s your choice.

headshot of woman smiling
pregnant woman sitting in birthing tub
May 30, 2024
Water birth is when you labor and give birth in the water. This choice may interest women who prefer the calm and relaxing feeling of water. It can be soothing for both mom and baby. If you think you may want to use water during labor or birth, please tell your your midwife at a prenatal visit at UCHealth Longs Peak Hospital. It is important that your midwife knows of your desire for this choice early in your pregnancy. This lets you talk about your wishes and make plans together. You may want to think about water birth and have it as a choice for labor if: Your pregnancy and labor are low risk. You understand your duties during a water birth. What happens during a water birth? If no problems arise, you may labor at first in a bathtub before the pool is set up. The pool gives you more space and deeper water to float in and change positions. Your midwife or nurse will check the baby’s heart rate on a regular basis with a hand-held listening device, a doppler, under the water. If the heart rate stays within the set limits, your provider thinks it is safe and you do not have any problems, you can labor in and outside of the water as you desire. If it is your first birth, we may ask you to push in many positions inside or outside the pool. Using many positions can help move your baby further down in the birth canal. If this is not your first vaginal birth, it often works well to stay in the pool and start pushing when ready. Your midwifeCNM stays at the side of the pool to help with the birth process. Your support person can be at the side of the pool or can get into the pool with you. After your baby is born into the water, your midwife brings your baby up to the surface where your baby takes the first breath. Your baby will then be placed in your arms. The midwife clamps the cord and you or someone of your choosing may cut the cord. This can happen in the water, or after you leave the pool. After helping you out of the pool we will wrap you and your baby in warm blankets. You will walk to the bedbed for delivery of the placenta. Your midwife will also decide if you need stitches. Your baby will snuggle on your chest under the blankets and may breastfeed as soon as they are ready. What factors need to be present for water birth to be an option for my labor and birth (eligibility criteria)? You are generally healthy without concerns like high blood pressure or diabetes, to name a few. Your midwife will determine if you are eligible. Your prenatal blood work (laboratory testing) and routine testing are normal. You do not have any infections. The baby is full term. (You have completed at least 37 weeks of pregnancy.) The baby’s position for birth is head first. The baby’s heart rate pattern is normal (not concerning) on admission and stays normal during your labor. The amniotic fluid is clear when the bag of water breaks. Meconium (baby’s first stool) cannot be present. It is OK, however, to be in the water after your bag of waters breaks. Other situations may arise where your midwife decides that water birth is not a safe option for you and/or your baby. At any time, if there is any emergency or other concerns, we will help you to stand up right away and get out of the pool. We might do this even if it is difficult for you or during the moments of the birth itself. We need to do what is best for the safety of you and your baby. If you desire a water birth it is very important that you agree to leave the water when, and if, instructed by your midwife.
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