As a birthing mother I wanted to make sure that the provider I chose was someone who knew what they were doing and who I knew would keep me and my baby safe. I also wanted someone who I liked personality wise.
Now as a legally practicing home birth midwife I encourage potential clients to ask questions of the providers they are interviewing, be that Dr’s or midwives, about their statistics. How many births have they attended? What was their training like? How many complications have they managed, what type? How would they manage this specific complication? How many moms were successful in VBAC? How many moms ended up with a c-section? And many many more questions. It is important that you are comfortable with your midwife, not only from the standpoint of personality compatibility but also from an education and experience perspective.
What makes me really sad is when people simply call themselves a midwife but have not done any work as an apprentice under the supervision of a senior midwife. In the home birth world it is imperative to have worked under supervision of someone more experienced so that you can have a guiding hand should you need one in, at least, your first 50 births you manage. Book knowledge alone is never going to cut it when it comes to complications that can and do arise in birth! It honestly infuriates me when a so called ‘midwife’ gets a bad outcome but she never had any formal training or apprenticeship and was someone who simply asserted herself into the birthing world only a few years ago. Some say that if midwifery was legal in all states this would never happen. I disagree because we often have properly credentialed and legal midwives who also end up with bad outcomes. There really is no perfect scenario. Licensure cannot possibly address the entire issue because there will always be those ‘under the table’ midwives and there is no way that just because you hold a credential means you are going to always make the best judgement calls.
We also have the problem of hospital staff looking down on midwifery and legal midwives. This creates a tension for the families that should not be there. The reality is that in countries where midwifery is respected and more common they have much better outcomes for women and babies. This is a fact that cannot be denied.
Then we have the other issue of is hospital birth really safe? This is a direct quote from an article I recently read written by a hospital based OB/GYN (1): “Unfortunately, giving birth at a hospital isn’t universally safe. NPR reported that the United States is the only developed nation with an increasing rate of maternal death, which has more than doubled from 1987 to 2015. According to the Institute for Health Metrics and Evaluation, it is now nearly twice as dangerous to give birth here as it is in Britain, France or Germany, despite the fact that the United States spends more on health care per capita than these countries. ACOG notes that the statistics are even more dire among minorities, with black women being three to four times more likely to die than white women.”
As a Certified Professional Midwife I hold the only national credential that specializes in the home birth setting. This credential also requires book knowledge and many months, and often several years, of apprenticeship under a senior midwife. This is the only credential that focuses on out of hospital care. My specialty is providing respectful patient participation prenatal care along with peaceful, gentle and safe birth for mom and baby. My clients participate in shared decision making and are never shamed for their decisions. Their babies are born gently and safely at home. I carry all the needed items to respond to any emergency. When the need arises to go to the hospital we go!
I have one more baby to arrive to finish out 2019 but I did go ahead and compile my statistics so far for 2019. To be totally honest this was a very difficult year for me in my practice. I had to learn many lessons and solidify theories, some of which are:
- Transferring to the hospital does not insure a good outcome. In fact, going to the hospital can cause greater harm than staying home.
- Babies can be born early and perfectly healthy with no need for medical intervention after birth.
- Breech babies can be born at home as a planned event with no bad outcomes. I already knew this as I had a couple of surprise breech babies in previous years with grandmultips but this year 2019 started off with a planned breech at home which was a first for me. When I really researched what was best for my client and for her baby in respect of their wishes it was clear that she was not guaranteed a better outcome by us choosing to go to the hospital. We practiced shared decision making with clear guidelines of what we were all comfortable with and had a great outcome at home. Disclaimer…I take these cases very individually and reserve the right to decline this service for anyone at any time. This is not something I will offer every family with a breech.
- Chiropractic care can help a struggling baby, better than NICU teams, when the baby endured a difficult delivery.
- There are many unknown causes for infections in babies and no matter how many spinal taps and NICU stays Dr’s require they are often clueless as to the cause or the best treatment moving forward.
In regards to that here are my statistics for 2019:
I support natural birth out of the hospital with great respect for the fact that we do not have perfect bodies and therefore things do not always go as planned. I am not afraid to transport a mom or baby if it is needed. Most of the time birth is perfect and beautiful and needs nothing more than encouraging respect, love and support. However, I am comfortable with and do have the skills to respond to any emergency that may come up.
I am so very thankful for the years I spent working under the supervision of more experienced midwives. I was able to encounter a wide variety of complications that now help me to have a more well rounded view of birth and emergency response, critical thinking skills and respect for each family’s wishes and desires.
Midwifing is not a right it is a very great responsibility and I am very grateful for each and every family who trusts me to be on their team!