Midwives VS OB

Hello,

I am 24 weeks pregnant with my first baby. I am young, only 18, and so far I have been taking very good care of myself but I have not been receiving checkups from the doctor. I have done research and I very much want a natural birth and to breastfeed for at least two years after the birth.

My first appointment is with a doctor, to get a scan and make sure the baby is alright. I am very nervous, but I feel in my heart that everything is OK. I was wondering what some of the differences are between receiving care from a midwife and receiving care from a doctor? Do you think a midwife would be willing to see a patient my age, this far along without previous care?

-Addy

Hello Addy,

You have wonderful goals for yourself and your baby. A natural birth and breastfeeding for at least two years - just wonderful!

I have had 5 homebirths, attended by 2 different midwives and a lay midwife. I have also attended a hospital birth and during my first pregnancy (when I was under the care of my midwife) I was exposed to slap cheek and had to have some care from a doctor (extra doctor visits and scans).

I'm going to include a video here for you to watch because I think it will inspire you. I will then come back and share some very specific differences in care between a midwife and a doctor.

I also want to encourage you and let you know that a midwife would probably welcome you as a client, especially if your scan shows that everything is progressing normally (and there's no reason why it shouldn't show this). Transferring your care from a doctor to a midwife is very easy if you decide to do this.

This is the birth story of a single mum named Amy who is planning a home birth. Enjoy!

http://www.youtube.com/watch?v=wBhsNsRv2D8

Hey Addy,

Just wanted to let you know that I think a midwife would be a great fit for you, and most would be very happy to see you. I have have seen and worked with both OBs/GPs and MWs and though there are some great doctors out there, the level of care and time spent with clients just doesn't compare to midwives in my experience. Also, as long as everything looks good on your scan, and you are a healthy, young patient I am fairly sure most midwives would be willing to overlook the lack of early prenatal care.

Best of luck to you, whatever your decision!

Angela

Hi Addy,

There's an excellent article on this site that will help you better understand your choices and the costs (or lack thereof) associated with each. The article is entitled Pregnancy Choices - Who Do You See?

The article includes a statement from a mum who used a Birthing Centre with midwives (looks like that may be free, if a space opens up). She says...

Quote:

“You walk into this cosy place where all the midwives wear normal clothes and you make cups of tea and toast and there is really nothing around to remind you of a big scary hospital. They had big baths where I spent most of my labour. I can truly say I loved having Sam.”

I'd highly recommend you look into what it will take to be able to give birth in a birthing centre because it may take some time being that you are already 24 weeks along. I'm sure you can always give up your space if you decide to give birth at home, or in a hospital, but it's probably a good idea to move forward with learning more about how to get into a birthing centre if it's going to take some time to get in.

You asked what the difference is between receiving care from a doctor, and receiving care from a midwife, so I'd like to share my personal experiences with both.

The doctor who I saw in the middle of my first pregnancy (due to being exposed to slap cheek) had about 10 minutes, at most to see me. My appointment went like this: I arrived and waited quite some time before each of my appointments (for some reason, this doctor always seemed to be running behind). I know that's not standard with every doctor, but I do have to say that many doctors I've seen have kept me waiting. I was then taking in by a nurse I did not know (different nurses each time) and they would have me urinate in a container. Then I was taken to a stark room with the typical "examination table", and asked to put a gown on (ugh - personally, I don't like putting gowns on when it's simply not needed). They took my weight and my pulse and my blood pressure - the normal things. And then I was left by myself to wait (again) for the doctor.

The doctor would eventually come in, check the baby, order blood work, and quickly answer any questions I had. He was done in 5-10 minutes, and off I would go to the lab to see yet another unfamiliar face.

Now - compare this to my prenatal appointments with my midwife. The first midwife saw me in an area adjacent to her home. The 2nd saw me either in her bedroom or in someone else's home (closer to where I lived). In each case, I either laid on the bed, or on a beautiful exam table with a pretty, floral, cotton sheet (no white, crinkly paper, no stirrups).

I don't remember waiting more than 5-10 minutes for an appointment, and often there was no waiting at all. When I did have to wait, it was in the living room of a warm home, and there were no other patients around. I could even bring my other children with me to my appointments which was very convenient.

When the midwife was available, she would come and greet me with a hug and a smile. Always a hug and a smile. She would have me go into the bathroom and test my urine myself (I just filled a little cup and put the dip stick in it, then I would read the stick myself). I felt like this gave me a sense of being in control of my own body. If the sugar in my urine was a little high, I was the first to know.

I would then go into the bedroom and we would sit and chat for awhile. Again, I had 30 minutes to get to know my midwife and for her to get to know me. I didn't have to put a gown on - I just pulled my shirt up to bare my belly and she would do her exam with her hands (much like you saw in the video above).

Blood work was done right there in the room, by my midwife. Blood pressure was taken in the room - oh, and when I was in the bathroom doing my urine check, I would also step on the scale and weigh myself. The midwife wrote all of this down in my chart.

She would then give me suggestions on things I could do to improve my health or my baby's position so that I would have the best chance of having the easiest and shortest labour possible.

Midwives are very skilled with their hands. Their C-Section rates are around 3%, as compared to many doctors who have a 25%-30% C-Section rate. They are patient and often will wait for the woman's body to do what it needs to do to go into labour and/or birth the baby, rather than intervening and moving things along faster. Yet they also are very skilled at knowing when an intervention is needed. It's just that once you start with one intervention, it often leads to the next, which leads to the next. This is one reason why hospital births end up in C-Sections so often - simply because they tend to intervene too early.

Probably the biggest benefit of having a midwife is that she is your caregiver throughout your entire pregnancy, and she is there at your birth. She becomes your friend and your advocate. She knows your history well and she doesn't come in just for the "catch" like doctors do (in a hospital, it's usually the nurses that monitor you through labour, and then the doctor comes in for the catch).

Please let me know if you have any specific questions about the difference in care between an OB and a Midwife. If I can't answer, I'll be sure to let our resident midwife, Jane know that you have a question waiting for her.

Warm regards and big hugs, as you start your pregnancy care.

Kate