Midwife Crisis

I am re-watching the documentary The Business of Being Born this week with my husband and it has made me feel even better about my decision to have this next baby at home with a midwife.  I thought I'd write a few thoughts while they are fresh on my mind. 

I don't want anyone to misunderstand my purpose in writing this post. I am not trying to win anyone over to my way of thinking. I'm not even trying to persuade people to agree with me. It's just that when I tell people that we are planning a homebirth with a midwife an awkward silence usually follows. So, in order to answer some questions that I know people have, but are too afraid to ask, and to put your mind at ease about my sanity, I thought I would write a little post about this decision. Again, I'm not trying to get you to agree with me. I'm just trying to help you understand why a relatively sane person would want to have their baby at home in this day and age.

Let's rewind a couple of years, back when I was pregnant with Tommy. We had an awesome OB whose office was literally a five minute drive from our apartment in Mesa. The hospital was just as close. I was going to graduate school at ASU at the time, so I had really amazing student health insurance. As part of my job, the school paid my insurance premiums and it included really good maternity coverage. So we were set and everything worked out beautifully. I loved our OB and I had a decent experience delivering Tommy at the hospital. It wasn't perfect, but my complaints are quite minimal. Overall, we were treated well and we felt like we were in good hands. If we were in that same situation again I'm sure we would probably be visiting the same OB and delivering at the same hospital with this little one.

But, life has changed quite a bit since then. We moved about an hour away from Mesa and I quit going to school so I could stay home and raise Tommy. We had to get new insurance and I had to find a new doctor. I started calling around to different insurance companies about 18 months ago to find out about getting maternity coverage. What I found was actually really disappointing. I won't go into all the details, but basically it wasn't worth it to get maternity coverage. In all cases, paying the premiums, copays, and deductibles turned out to be thousands of dollars more than if I had the baby in the hospital without insurance and paid cash. The option to have the baby in the hospital without insurance was on the table, but my doctor said it would be about $7,000 for that. So I kept looking for another option.

It was about this same time that I found out that two of my good friends from Utah were planning home births. They are both people I have always loved and admired, people who are educated and successful. I stalked their blogs and talked to one of them after she successfully delivered her son at home. I was completely enamored by the idea of having a baby at home, though I have to admit that at first I thought they were pretty crazy. I started reading books and I watched The Business of Being Born, which I recommend to everyone who is having a baby in America. The more I learned the more I realized how little control I actually had during my birth with Tommy. I am fortunate that I had a capable doctor who wasn't afraid to deliver a nearly 11 pound baby. I realized that I had probably come very close to having an unnecessary c-section and that a lot of the problems I had during and after the birth were because of the medical interventions that were done (epidural, episiotomy, delivery of Tommy with a fancy plunger). I'll give you a few examples:

• During labor Tommy's heartbeat slowed down after my contractions, which can be really dangerous. The nurses had me turn on my side and gave my oxygen and his heartbeat returned to normal within a few minutes. I just found out that mothers with epidurals often run into this situation because the epidural makes your blood pressure go down, which then affects the baby's heartbeat. Pretty scary.
• I just didn't like the way the epidural made me feel.  Because it lowered my already-low blood pressure, I got dizzy and light headed, so I had to lie all the way back in the bed the whole time I was in labor.  As the epidural wore off my whole body became really itchy and they told me the epidural often does that. 
• While I was pushing Tommy got "stuck". I know a lot of people think that's just because he was so huge, but his head wasn't actually that big. He got stuck because his head was turned a little to the side and so he couldn't slip out like he should. I pushed for 2 1/2 hours, a lot of that in vain while the nurses called and waited for the doctor to come do the episiotomy and vacuum extraction. If I had not had an epidural and if I had a midwife I could have changed positions or done some movements to get him to change positions. It could have saved me a lot of time and pain that I spent pushing (I say pain because I could feel the contractions by then, plus the longer one pushes, the longer the recovery often is).
• I had a really long recovery, probably due to all the interventions. My body got really beat up during the delivery with all the pushing, episiotomy, and the big plunger.
• I really struggled with postpartum depression. Not anything really serious or debilitating, but it was like I lived in a dark cloud for several months following Tommy's birth. I have read several times that the rate of postpartum depression rises for every medical intervention a women has during labor and delivery. Since I know I am prone to that, I want to decrease my chances of going through it again by having little to no medical intervention this time around.

Anyway, all of this came together some how and I started researching homebirth and midwives in Phoenix. I got some referrals from a friend and started getting really excited. But, the real confirmation that a midwife is what I want and need this time around came in March this year when I had a miscarriage. It was devastating. Naturally, we called my OB and scheduled an appointment for the following week. It was just what one would expect when calling a doctor's office. The staff asked for my name and why I needed to come in and scheduled an appointment with the doctor. It was very formal and cold, the way it is in a doctor's office. I was on the verge of tears as I made the appointment (I was basically on the verge of tears all the time for a couple of weeks). I felt myself yearning to be taken care of, not just checked out by a doctor who doesn't know my name. So I called a midwife a few days later and talked to her about what I needed to do. It was like night and day.

The midwife I talked to was so empathetic and patient as I sobbed on the phone and told her about what happened. She comforted me and told me what to do next. She told me what symptoms to watch for that would necessitate a trip to the hospital. She inspired me to have confidence in my own body and to trust what I was feeling, both physically and emotionally. It felt amazing to be able to talk to a compassionate professional without having to wade through an office staff first.  Needless to say, I canceled the appointment with my OB and got pregnant again immediately.

After that experience I was absolutely convinced that I wanted a midwife to deliver my next baby. When I got pregnant we interviewed a couple of midwives and found one that we love. I feel so spoiled. My midwife does all of my prenatal visits at our home and she never sends an assistant or a substitute. She usually stays for about an hour, or as long as it takes to answer all of my questions.  I feel like she really knows and cares about me and my family.  Sometimes we just chat and laugh.  I always feel like I am her most important client and I never feel like she is just trying to go through the motions with me so she can get on her way to see somebody else.  I'll deliver the baby at home. If there is a problem there is a hospital about five minutes away that we can get to quickly.

Here is a list of great resources I would highly recommend to anyone thinking about having a baby without an epidural:

• Ina May's Guide to Childbirth
• Birthing from Within: An Extra-Ordinary Guide to Childbirth Preparation
• The Thinking Woman's Guide to a Better Birth
• The Business of Being Born