Can someone explain to me the reason for a Mid wife?

Just curious as my OB/Gyn office has one and not sure what she does except for taking my blood pressure and weighing me when I have my bi-yearly gyno appt. She only does this when they don't have another nurse on staff that day.

Most midwifes do not take the place of a nurse. Midwives are experts in the care of women's ob/gyn health. I am seeing a midwife to deliver my baby, instead of an ob/gyn. You MUST be in a low-risk pregnancy to do this though. I get very personalized attention from my midwife. Most appointments last over 1/2 hour and she was on the phone with me for 45 minutes the first time I called. They are more hololistic in their approaches to pregnancy and labor. I still have the option of medications during labor though and will have my baby in a hospital.
When you go to an ob/gyn practice you have no way of knowing which doctor will deliver your baby. It all depends who is on call that day/night. I needed the security of knowing who would be with me. Also, most doctors do not stay with you while you are in labor, until it is time to push. I wanted to have the same person with me from start to finish. My midwife doesn't leave me because of a shift change. That is very important to me.

I prefer to have a MW as my provider b/c I believe that pregnancy is not a condition that requires a medical doctor unless there are specific medical reasons. I don't see pregnancy as an illness, and if I'm not sick, I don't need a Dr. I just need someone who is familiar with obstetrics to assist me with what my body will do naturally.

I have the same MW as Michele, and I chose her b/c some of the reasons that Michele stated. Just want to say thought, that our MW is VERY unique in that she has her own practice (she does not work under a Medical Doctor) and she is on-call 24/7, 365 days a year. She does not take vacation and the furthest she goes away is to the Hamptons or into Manhattan. Her back up is another MW, only if something happened to her. It is not common to find a MW that is this dedicated to her practice. I've met with 2 other midwives, one at Beth Israel Medical ctr and one that was affiliated with St. Vincent's. Both of those were practicing under physician's, and you basically got whichever MW was on-call when you are in labor.

My MW takes any patient, regardless of due dates being too close. She said it has only happened 1x to her where more than one patient was in labor and dialated and ready to give birth so close to each other.

I get a little defensive about the whole Ob/Gyn thing because I am probably going to do an Ob residency when I finish med school. The reason why I want to be an Ob is that I don't think pregnancy is an illness either, and I love the fact that most of my patients will be healthy young women.

All of the MWs I have ever met are amazing women who really care about taking care of other women. It is a great choice for someone who is healthy and desires a more intense relationship with their provider. Unfortunately, time is something that MDs cannot always give alot of, but many can give patient, holistic, tender care to women. It really comes down to the MDs and MWs you have the fortune/misfortune of meeting.

Jessica, I could not agree with you more!

There are certainly benefits to having a midwife during a pregnancy or delivery, but midwives are by no means more expert in women's health than an OB/GYN would be. Any woman can have countless reasons or just one reason for choosing a midwife over an OB or vice versa.

The most common reason a women would choose a midwife is b/c she prefers an alternative method of delivering her baby - like a home birth, water birth, hypno-birth or a non-medicated birth (meaning no narcotics or epidurals are used), although some do make drugs available as a last resort for managing pain during delivery.

Most OB's do not practice alternative methods of delivery (probably b/c of malpractice insurance, among other reasons), and usually OB's will only deliver your baby in a hospital. HOWEVER, many OB's do encourage alternative methods for relieving pain during labor and delivery - like walking, showering, massage, meditation, using the birthing ball, Lamaze or Bradley methods, etc.

I personally do not agree that most OB's don't have time for their patients - I was never rushed during my visits, and my OB was with me for the entire 4 hours that I was pushing and eventually delivering my baby.

There were 3 OBs in the practice that I went to, and I made it my business to get to know each one of them during my 10 months of pregnancy, so that I was comfortable with whomever was on call when I was ready to deliver. I had no problem with this set up.

I think there are OB/GYN practices out there that DO offer personalized attention to their patients - you just have to find them.

Also, another option for a woman to consider is to use a doula as a birthing coach. Doulas support women in achieving the birth that they desire. Doula's work in homes, hospitals and birth centers. A doula gives emotional, physical, and informational support, but you still see your regular OB or a midwife to take care of your prenatal care and birth or the baby. My birthing class was given by a doula, and she said that the majority of what she does is take the fear out the birthing process for women (especially first time Moms), so that they can focus on their birth experience and not worry about what is happening to their bodies.

Hey lets not downplay the value of a Dr now!
Im sure you wont be saying that if (knock wood) you need an emergency c-section, then what will you midwife do, hug you and make it go away? Sorry, I just thought all this Dr-bashing is not nice. (even though we all do it sometimes, me too ) But seriously, lets not talk about having a baby, and NOT NEEDING a Dr., or at least until you have 'been there'. You wont get a badge of honor for 'not needing' an epidural or for not 'needing' a Dr.

I once overheard someone say that a doula/midwife is a 'hired friend'. but thats not nice either. I think a MW is a nice idea, but in this day and age, when we have so much available to us, why not take advantage? Why is it so bad to say you 'need' a Dr.? If I do look into a MW, it would be in addition to a Dr.
OB, MW, Dr. or Doula, 'you never know' when someone will or will not be available when you give birth. Thats just life. My sisters OB delivered her first 2 children, and for the third he had a family emergency and had to fly out of NY the night that she went into labor. It happens. It doesnt make him less valuable because he's a Dr. and is not a MW. As a matter of fact, I think Dr's are Gods handiwork sent to help us all

I'll end my babbling now. Its really late, im tired and this thread just got me going...
Lets have our babies and not get so involved in how 'natural' it was or wasnt. If you have a healthy baby in the end, does it matter if you needed a Dr. or if you meditated to get the baby out?

Gnite girls.
God Bless your precious babies.

just out of curiousity?

**how do MWs get their training? do they have to be certified? is there a program that they go through?

**what about NPs and PAs? I go to a NP and I had a roommate that went to school to be a PA...and the studying was intense...2/3 the time of med school...are they more DR-like or MW-like?

I am NOT doctor bashing nor did I say that a MW is MORE of an expert than an OB. That is not the truth anyway. A midwife is an expert in wome's health and no other type of medicine is what I was saying. So you don't go to a midwife for a broken arm. There are MANY women who 100% need a medical doctor's attention during their pregnancy and labors. MW are not doctor-subs. But I looked high and low for a female OB that would deliver my baby and guess what? Not one of the more than 10 offices I called said that I would have the female OB deliver me. All of them said 'You have who is on call'. I didn't want that. Also, I have known MANY women who never spent 45 minutes with a doctor just talking about what is important to them about their pregnancy/birth etc... So if your OB gives you that kind of time that is wonderful but not the norm.

Many OBs are just not open to anything other than what is considered 'normal practice'. i want to try to avoid an epositomy and most doctors I spoke to feel that it is very normal and routine to do so. Now, of course, many women need them but I don't like the idea of it being part of a routine when it might not always be necessary.

Michele, Nina made more of the discussion towards no Drs and not needing them unlesss medically necessary. I was responding to the thread as a whole not to you specifically

I also dont think a Dr. would just cut someone 'since its normal practice' If its needed, its needed. Or you tear, thats another option .

hey there girls...
said to say but I researched this quite a bit ( as did hubby) and most drs will perform epis as it is a 'normal' procedure. This is NOT SO. if you need it, then you need it alotho what I have read is that the tear is actually less painful and easier to heal then the CUT.

If you are high risk, this issue may be a mootpoint, but the MW can ALSO help you then. THey can do the checkups, etc and report the findings/results to the DR.

in the practice I went to, it was known/titles as DR so&so AND THE MIDWIVES. There were about 4 diff midwives ( 2 diff offices). I spoke with the dr and asked how many births HE performed vs the midwives. was about 60/40. 60% midwives! if i REQUESTED him, he could not deny my request. If medically I needed him, then there was no discussion...etc.

MW are board certified and have degrees.

my MW walked in the hospital with me and stayed with me the whole time (except for maybe 30 min total when she was warming up towels for my pain relief)...and she stiched me ( ONLY one stich- natural tear) and stayed with me until I went up to the room. we were a team.

Doulas also AID in pain management and offer a buffer between hospital staff ( who normally push drugs on you- they want u quiet).

this is my 2 cents ladies....

My first post is totally based on my personal experience and opinion and what I've learned from reading books on pregnancy and childbirth. I wasn't knocking the role and importance of a OB either, nor bashing Drs. I'm going to be giving birth in a hospital, and I trust my MW to alert the OB on call if and it is needed, and I'll be very grateful to the OB that saves mine or my babies life if an emergency c-section is needed (something that my MW is not trained to do)!!

The training of someone who goes to medical school for obstetrics is different from a nurse-midwife training. I think most people would agree that in general, physicians aren't necessarily trained in 'bedside manner' compared to nurses. But, that doesn't mean that there are OBs out there who aren't nurturing, and spend lots of time with their patients at every appt, or that there are MWs who don't have a caring/nurturing personality.

I do believe that MWs are the only professionals who are trained for the 'natural' event of pregnancy and childbirth. I'm not using the term natural as in non-medicated here, just saying once again that their training is different from an OB in that it is seen as a 'normal' event in a woman's life, not only as clinical procedures. JMO, but that doesn't mean that they are 'better' or 'worse' than a Dr.

Back to the original question, I think the most important thing is choose a caregiver that views birth as you do and chose someone whom you're comfortable with. Who you chose will make a difference because there are differences in practices of routine episiotomy, inducing labor and unecessary c-sections (all often due to convenience to the practice). Your caregivers attitute about how you are doing during your pregnancy and during labor, and even afterwards will make a big difference, IMO.

I chose my caregiver based on the fact that I am hiring her to assist me in my childbirth, and to intervene when necessary. She supports me in my decisions and goals, instead of making decisions for me. I trust that she will take charge if needed, but my feeling is that OBs take charge and are more authoritarian than I would like.

Bottom line, no one can say that a MW or OB is better than the other, it's your decision on what your comfortable with.

Niha, I totally understand your perspective about using a MW, but I don't agree with your analysis about OBs.

Personally, I believe that the proliferation of using epidurals and having 'routine' episiotomies are the doing of many of the female patients - NOT the Dr's forcing certain clinical procedures on their patients.

In my OB's practice, they had an extremely low percentage of c-sections and episiotomes b/c they believed in using perineal massage during delivery (this helped me not to need an episiotomy) and using alternative methods for relieving pain. They did use epidurals alot, but that was elective by the patient AND a large percentage of c-sections were ELECTIVE by the patient - NOT performed just to the convenience of the OB's practice.

Personally, I believe that more and more women today are selecting the dates that their children are born to convenience themselves and that is contributing to this misconception of how OB's are treating their patients. JMO.

My OB Office is also very strict on not doing c-sections unless medically necessary. Its unbeleivable how many woman WANT and try to REQUEST c-sections, to avoid and 'skip over' the whole fear of labor. As far as me making my own decisions, I feel that Dr's are 'professionals' in their field, and their decision, based on their expertise and profound knowledge of what is going on will by FAR outweigh 'what I want'. Going from my own experience, seeing how pregnant women cant get LOUD, NASTY, and out of control (I wasnt that bad, LOL) but when you are in such extreme pain, you might make demands and requests that are not necessarily in yours or your babies best interest. I dont see it as authoritarian, but more as the advice of a Dr. They are not counselors, they are Dr's who have a job to do, and that job is to make sure that mom and baby are happy and healthy. Daddy's job is to make sure mommy's being given TLC I dont think I can hire someone and just become buddies with them. Thank God I had my sister by my side for that.


There are no rights or wrongs, its a matter of what you prefer and what makes you feel most comfortable.

Anna

I don't think anyone on the thread was Dr bashing by any stretch! I just don't think the initial responses gave a well-rounded answer to the initial question about why someone would choose to see a midwife.

I also don't think that we should just take a Dr's advice just b/c they have a medical degree. That's why people go for second opinions all the time before having surgery or making a serious decision about medical procedures and diagnostics.

Personally, I firmly believe that women should have a choice in there own prenatal care, and if you don't agree with a Dr's practicing philosophies, than you find someone that more closely meets your needs/views. All doctors are different! A medical degree doesn't assume that all doctors will practice medicine the same way. That is why I am interviewing new pediatricians for my son - I want to take him to a Dr that believes the same things I do about what is the best care for him at this stage in his life.

Hiring a midwife is not about becoming buddies w/them. You search and interview them to see if your personality 'clicks' and your beliefs match, just like w/a medical doctor. They (a MW) travel the amazing journey of pregnancy w/you, and help you to achieve the individual birth experience that you envision. They are not a doctor's replacement in my eyes, but rather an augmentation of a doctor's care for pregnancy and childbirth only.

I do not think this discussion should be Doctor VS. Midwife, but rather how they can both partner with each other (in some cases) and their common patients, in order to achieve balanced and natural birth experiences for women who desire them.