how Choosing Midwives helped me succeed in natural birth
I remember the first time I saw a home water birth delivery. It was about 4 years ago when a woman I worked with posted her birth video on Facebook- yes Facebook, and though I thought it was a pretty private video to share on such a public platform, I was impacted. I had never seen such a calm, peaceful experience of labor before or a woman so relaxed and in control of what was happening to her body and her baby. I was mesmerized. All I had to compare it to were horror stories or scenes from movies with complete chaos and trauma during labor. Before I saw her home birth I never could have thought birth could be anything else but pure pain and panic. From then on that image stuck with me. I always knew I wanted to be a mother and after seeing a water birth I could actually visualize a beautiful delivery and even catching my own baby someday.
For years I have been practicing a more holistic lifestyle. From cleaning products to the foods I eat to even my deodorants and toothpaste is carefully picked. Anytime I feel I’m getting sick I choose herbs, teas and holistic remedies over medications and visits to the doctor, so a natural non-medicated birth just seemed to be more aligned with my life. So I began my search for the right provider. I tried to look up Obstetricians who leaned towards holistic approaches but I found that Midwifery care seemed to offer exactly what I was looking for. It isn’t black and white when it comes to providers or the outcome of birth- but at the end of the day an Obstetrician is a trained surgeon, and a Midwife is trained solely for natural births, so I decided going under the care of Midwives was the best option to hopefully carry out my birth plan. Although I wanted a home birth, my partner and I decided on a hospital that provided a birthing center ran by midwives- this gave us all the things a home birth could provide with the safety net of a hospital in case of any complications.
Even though I was set on a natural birth without an epidural I still weighed my options. For many women, there is a lot of fear surrounding the pains of childbirth. I heard from some very vocal women about the unbearable pain and that anyone who decides against an epidural is out of their mind, but after learning more about the benefits of a non-medicated vaginal birth and more about the power of the female body, the pros outweighed the fear and I began to reassess what defined pain. Now this didn’t mean I completely dismissed the possibility of having an epidural or necessary c-section. I mean this was my first baby after all, this wasn’t just choosing the right dish soap. This was Birth. I had no idea what the outcome would be nor did I believe I had any control over it. All I could do was use the evidence-based research and find the support to motivate me and my desire to birth naturally, and here’s what I learned that helped me to decide.
8 Major differences between a Midwife birth & an OBGyn birth
who is accepted
To be considered by a birthing center or have a home birth delivery with a midwife the expectant mother must be without any serious health issues and have a low risk pregnancy. Glucose testing, blood work, and fetal positioning are all monitored to make sure the mother has normal levels and is cleared for a non-medicated vaginal birth. On the other hand, OBGYN’s are able to accept all types of pregnancies from breech babies to mamas with gestational diabetes.
Induction techniques
While a midwife will most likely allow a mother and baby up to 42 weeks for spontaneous labor and opt for holistic approaches (herbal supplements, diet) for cervical dilation and kickstarting contractions, an OBGYN might want to schedule an induction by administering medication or breaking fluids closer to due date at 40 weeks gestation.
freedom of movement
Natural birth advocates such as Midwives and Doulas encourage the mother to move her body however she feels during labor. Depending on the progress or positioning of the baby a midwife will use her training to recommend different laboring positions to ease discomfort or to help labor progress. Because the mother is not hooked up to IV’s or under medication, she has free range during the entirety of her labor. Traditionally a hospital birth allows little to no movement for the mother because of constant monitoring or in the case of an epidural the mother must be in bed and on her back during labor.
Fetal/mother Monitoring
During pregnancy and labor, if under the care of a midwife with no known health issues you will only need 2 or 3 ultrasounds- one to show a viable pregnancy and another for the anatomy scan. The mother’s tummy is measured at each visit to estimate size of baby and a doppler is used to hear baby’s heart rate. As a mother you might not even be checked for dilation at prenatal visits unless requested. There is also minimal monitoring for mother and baby once in active labor. Midwives rather depend on baby’s positioning, cervical dilation and effacement to measure progress.
Women who are under the care of OB’s are more likely to be measured for dilation and effacement a few weeks before due date to gauge the progress of labor. While more hospitals are now able to provide wireless systems so mama has more freedom during labor, it is still pretty standard to have the mother hooked up to IV’s and monitoring systems which may limit her mobility.
Interventions
Although a spontaneous labor is ideal for natural mamas whether under midwifery care or an OB, it can be difficult for some to achieve. If a mother makes it to term without any signs of labor or if labor isn’t progressing, interventions will be put on the table and the methods will vary based on the provider. It is the belief of many midwives that the more interventions the more setbacks for a natural birth to take place so interventions aren’t typically discussed until the due date onwards of 42 weeks. In a hospital setting, a mother might be scheduled for an intervention before her due date or just days after. From there, it is common to be suggested the use of Pitocin- this medication will intensify contractions, creating more discomfort for the mother which then pushes her towards getting an epidural to manage the pain caused by the Pitocin. Often times, if these interventions occurred before spontaneous labor took place (ie before cervical dilation, release of fluids) the result is more likely to go towards a cesarean.
pain management
A commonly asked question to expectant mothers is “Will you have an epidural?” Many women plan on having an epidural right from the get go and others make the choice the day of. If your care is with a midwife you aren’t given the choice of an epidural which can only be administered by an anesthesiologist under an OB’s care. Instead women under midwifery care are prepped for pain management in a different way. Methods such as HypnoBirthing and the Bradley Method use coping techniques such as body positioning, partner support, massage and relaxation techniques to aid with discomfort. Birthing balls, peanut pillows nitrous oxide aka “laughing gas”, and lastly water therapy via birthing tub are also used by midwives for pain management. This of course isn’t for everybody and for some women an epidural is the only way to get through the intensities of labor. More hospitals are now introducing coping techniques such as offering birthing balls and showers to promote a more natural birth.
birthing tub
Oh yes, the birthing tub. A natural birth wouldn’t be complete without one. The tub is filled with warm water and provides a soothing environment for the mother to labor and even deliver her baby. In a home/ birthing center delivery the woman has the option to be joined by her partner and birth her baby inside of the water as well. From outside the tub the midwife is able to check baby and mama’s heart rate and do any necessary monitoring. During a water delivery, the mother may even bring up her own baby from the water. Some hospitals are now offering birthing centers within their labor and delivery wards, however due to hospital regulations not all hospitals permit birthing inside of the water. Showers are a great alternative if a birthing tub is not available.
post-labor baby care
Skin to skin- This is a must for natural mothers and is now being offered even to cesarean mothers in what’s called a “gentle c-section”. Although it is becoming more and more common in hospitals it is not the standard and may have to be requested in your birth plan. Skin to skin contact between mother and baby- and even father and baby is considered important because of the immediate bond and connection established by the exchange of hormones and pheromones. You can expect a whole hour dedicated for this before baby is weighed or measured as long as there are no complications.
Delayed Cord Clamping- Natural birth advocates encourage to wait to cut the umbilical cord up to 10 minutes after delivery or until the cord is seen to stop pulsating. This is because the placenta- the baby’s source of oxygen and nutrients is still transferring its supply to baby through the cord after birth.
Bathing- It is standard for midwives to omit bathing or wiping baby down after delivery. The coating seen on the baby’s skin called vernix, contains antioxidants, antimicrobials and is a natural lubricant to protect the babies skin. Today, it is still the standard in most hospitals for nurses to clean baby off right after delivery before handing over to the parents.
Injections- Although both providers are able to offer the same injections for the baby after delivery you might not know you have the option to decline if you are in a hospital. The Vitamin K injection and the eye ointment are offered for your baby right after delivery but a lot of parents don’t know they have a choice. A vitamin K shot can be chosen without preservatives and the eye ointment (protects baby from an infected mother with gonorrhea) is optional.
It is a woman’s right to choose how and where she births her baby and whatever the choice, it is the right choice. This blog is based on my birthing experience and what I’ve learned during my pregnancy. My goal is to bring the awareness to women and their partners so that they know they do have choices and to encourage them to do their own research so that they may have the birthing experience they hope for and ultimately have a beautiful birth!
Sheri Presley is a Certified Pilates Instructor and Holistic Health Advocate in San Diego. Through actively pursuing and sharing her passion for health and wellness, Sheri aims to inspire others to live a vibrant, passionate and functional life.