midwives and good fits - choosing someone for prenatal care and delivery

Preconception & Pregnancy Midwives
1

Hi Moms,

I'm hoping to see if my experiences so far are unusual or an indicator that I should try to connect with people I click with more. Some people say you should be very particular about choosing the person, or group, who delivers you. But one only has so much time . . . and it's hard to know how much of a connection is really needed. (Additionally, the midwife group I'm with is large and even if I click well with an individual midwife, the chances are slim that she'll be on call the day I deliver.)

So, the back story: I'm due in June and decided to go with midwives for my prenatal care and delivery. I did this because I think they are more inclined to support natural childbirth and a woman finding the power and peacefulness in her own body to become a mother -- from prenatal care through delivery and beyond. Also, I wanted a forum where during delivery I would be allowed to walk around, squat, listen to punk rock, or bluegrass, or wear hightop sneakers, or do whatever I physically or emotionally needed to do while delivering. I know that a lot of OBs would be fine with all this, but I thought that the spirit of midwifery would be more likely to be a good fit.

So, interestingly, I've found that the approach of the midwives I've been interacting with so far are not quite what I expected. They all seem very competant and confident, however, perhaps because they are rushed and over-worked, a bit bossy and a bit dismissive of questions.

At the beginning of the pregnancy I heard a lot of "call if you have the slightest question" and "It's always better to check" . . . But I have found that when I actually am pro-active about asking questions, there's a little bit of "don't worry so much" and "we're the experts, you don't need to concern yourself with that." For example, when I ask about nutrician, I've heard things like, "Well you're not eating McDonald's and soda every day so you're doing pretty well. Any other concerns?"

This has been at my regular check-ups, and mostly just irritating. I did have one experience though where I felt pretty clear that the system wasn't working as it should. A month or so ago, I'd felt something the size and shape of a golfball in my lower right abdomen. My partner confirmed this. For several days I told myself it was probably just a muscle knot and nothing to worry about. I massaged it once in a while thinking that might help.

A few days later I was at the hospital to visit a family member who had just had surgery. It is the same hospital where I'm due to deliver; my midwife group runs out of there. I now know you cannot do this -- but at the time it struck me as a good idea to stop by the midwife station and see if someone could put their hand on my belly and confirm there was nothing to worry about. Getting confirmation seemed like a better idea than assuming all was well.

So, to make a long story short, despite my insistance that it probably wasn't a big deal, I was bracelet-ed and swept up into the OB/GYN triage unit. I asked several times if I instead could just chat quickly with the midwife on duty. They said no, but that it was no problem to route me this way, and that in fact it was an underutilized service, so I should go for it. I told them several times I didn't think this was necessary and that I was concerned about using resources needed by other people. I was reassured that it was a free service, underused, and that I should not worry about a thing.

But then when the midwife came in it was a completely different story. It was as if two lambs-- the woman at the front desk and the nurse-- had escorted me to the gate of a lion! She was confrontational, provocative, and almost accusing. She said it was clearly nothing but a fibroid, that I shouldn't come in for such a small matter, and that I definitely should stop touching it because it could cause contractions. She also told me I was using up the resources needed by other people. (I almost laughed at this point because it was the very question I'd asked on the way in.) When she asked me questions, she interrupted my attempts to answer.

Anyway, I can understand that her job is extremely hard and she was stressed, and that the real problem is probably miscommunication between the gatekeepers and the midwives about who to let in. However, I was still pretty surprised. It wasn't only that she was harsh and dismissive, but she also gave me incomplete and inaccurate information. (I later found out that touching the fibroid would in fact not give me contractions.)

So, perhaps this, and my general experiences so far are simply the ups and downs one has with any health care providers while riding the additional ups and downs of pregnancy hormones. But I thought I'd run these impressions by the group to see if anyone had thoughts to share. I've been hoping that the midwife who is on call for my actual delivery is more gentle and sensitive, but it's a gamble, I guess. Or perhaps I should count on my partner and support persons to be sensitive and emotionally supportive . . . and the midwife to be competent and experienced. This does seem a bit different than hopes I'd had at the start, but that may be the reality.

Thanks for reading this long post! Any thoughts or shared experiences much appreciated!

Eliza

2

With my first child, I, too, felt more comfortable with a midwife. But I soon found out, it was the "idea" of the midwife that I was into- and ideas often do not match reality. Though my prenatal care was excellent, when it came to labor and delivery, they were distant, unattentive and careless. I was on more drugs than a sunset strip street walker and my recovery was brutal. I know where you are coming from, but don't fool yourself into thinking that having a midwife will deliver you from evil! If you really feel inclined to go "au natural," hire a doula- someone who is there for you and you alone. Though I did not have a doula with my second baby, I did deliver my daughter at a major hospital. She was 7 weeks early and the warm fuzzies of a non-medicated birth were out the window. However, it was a wonderful expereince- MUCH better than with the midwives. And my recovery was nothing. I still curse those midwives to this day and will never go to one again. Bottom line, don't set yourself up- Labor and delivery are unpredictable! Good luck!

3

You should send most of the "letter" you wrote directly to the board that runs that clinic of midwives. I am sure they would like to know what is really going on.
Next, you should find a doula to hire and to run interference for you and be your support through all of this. They are excellent to have for YOU!

If you really feel uncomfortable, find a midwife that is at a smaller, more caring facility.

4

Eliza, I would seriously consider lodging a complaint with the ombudsman at the office where that particular midwife practices. I had a similar, disempowering experience with an OB at my first child's birth, which led me to a midwife and a home birth with my second. We did register a complaint against the OB, and while she was not disciplined, she was asked to attend a bedside-manner class.

I am so sorry to hear that a midwife treated you this way. My midwife was exactly what you describe you are looking for with your care. She was informative, caring, reassuring, and really did talk to me any time, any where; once while skiing with her kids! She taught me that she had professional training and informed answers, but that I was the real expert about my body and my baby. It was a very powerful experience.

It sounds like you need a new midwife. I know you are in JP, but I'd recommend the practice I used in Milford, NH. It's called the Birth Cottage and they do home births as well as births in their independant birth center.

I'm sure other Moms can recommend other great practices closer to you, too.

Hope you find a care-giver who really respects you as a woman. You deserve the chance to experience birth as the wonderful, difficult, joyful, powerful experience it ought to be.

5

I too agree that you should send this exact letter to someone to complain! Are you kidding me?????????? I had midwives, and high risk OB's and loved them both. The midwives would never have spoke to me that way. No one should talk that way to anyone reguardless of any situation! Change...it's your body and it's your baby, don't stick around.

6

I had a midwife with my son and absolutely loved her. I found one in the practice that I really liked and had all of my appointments with her and requested that she do my delivery.
I did find, however that before she came, the hospital was not very helpful to me at all. I think that the hospital has a huge impact on your labor, and there are so many rules that the midwives have to follow. I want to look into a birthing center next time, as hospitals make it tough to have a peaceful labor. However, as soon as my midwife got to us we did have a peaceful labor.

7

Hi
I only have my experience and opinion to go on, but having read your request, I felt the need to respond. I'm not sure where you live or what group of midwives you're referring to, but no one should make you feel your questions aren't worth answering or tell you that they know best and brush them off. You should feel as though your questions and concerns are important.

My daughter was born 11/06 and I went through Coastal Women's Heathcare, where there is a large group of ob's and two midwives. I chose the ob partly because I work in a hospital and felt that was better for me as a person. My point is that the whole group is great. There is a 24 hour hotline where if you have any questions or concerns (and I had plenty) someone will address them and answer them properly and without making you feel brushed off. A lump in your abdomen should have been attended to and telling you you could contractions by touching it is just crazy! I think the little voice inside you is giving you the right information, and that is that you should find someone else to take care of you. I hope you find someone that will take your concerns seriously and therefore allow you to enjoy your pregnancy and birth experience!
Good luck!

8

Eliza,

I changed providers at 7 months pregnant due to treatment that I considered subpar. I was seeing an OB group that was well-known and convenient to my job. They barely allowed me to ask questions and I felt pushed out of every visit. I would absolutely recommend that you contact someone in the office regarding your treatment AND find yourself a new group. Childbirth is too important to leave it to people who don't take you seriously, let alone to those who are mean to you. You deserve to feel confident and at ease with your midwives. Best of luck!

9

Eliza,
What a story!
I don't know where you live, but if at all possible, call the Birth Cottage in Milford, NH at 603-673-6010 and if possible schedule a "Meet & Greet" even if just to restore your faith. If Milford is within your drive distance, like withing an hour, it would be well worth your time. I used to work there before I had my son there and I got asked all the time how it felt to work with the people who would help me birth my baby. Well, here's my answer..... I've waitressed in a few of places where I'd not take the food home to eat because of a few things I saw, not dangerous things just not what I'd prefer about my food..... understand? I trusted those midwives COMPLETELY!! The Midwives are wonderful there and you can generally call the one you are most comfortable with and feel comforted that unless she is out of town she will be @ your birth. We used to have people transfer in all the time and the latest transfer I saw was 37 wks, so don't feel stuck where you are. Their website is BirthCottage.com if you want to start there.

10

Eliza,
It's so hard to find a good provider. We are also using midwives for our birth in August...if it goes well, we are probably going to use a home midwife and do home birth for the future. Then we would have one midwife the whole time. I have found my large midwife practice, although generally very friendly, to be very inconsistent (ie one tells me that senna laxative are safe, another says nothing is safe except metamucil). That's frustrating for a first time mom! I don't have a lot of advice but wanted you to know you're not alone. However, I feel the care would be less than satisfactory anywhere else as well...I haven't met many people who were 100% happy with their OB/GYN.
Melinda

11

Someone mentioned you live in JP. I delivered both my children at Mass. General Hospital and was very pleased with the care. I did not use a mid-wife, and middle-of-the-night labors meant deliveries with OBs unknown to me, but I was thoroughly impressed with the care I received from the nurses, pediatricians, OBs, etc....

12

Eliza-

I'm so sorry to hear the way you were treated. I have two children and had a Midwife both times. The first preganancy I had a lot of scares, and was treated by both O.B. and Midwife at various times. One instance, I had called my primary early on because I had some bright red spots at the back of my throat, I was about 15 wks, of course I was in a panic (I work closely with people and thought I caught something)to boot nobody returned my call right away so I called back after an hour. The people on the phone were not sympathetic and in fact were pretty annoyed I was so upset. Looking back I realize that although I don't agree, some in the medical community become numb to the fact that there is a person behind the illness or pregnancy. Don't allow this one situation to discourage you from going with a more natural approach. I would approach the woman who treated you badly to discuss how you felt that day or discuss it with another Midwife. It's so important to feel safe and supported during delivery. I say this because my first delivery was let's say not exactly smooth sailing. When I got pregnant with the second, I was seriously anxious and increasingly so throughout the pregnancy, I didn't want to have the same experience. At 33 wks I finally confessed to the Midwife how scared I was and with care and warmth we worked through my fears. Just communicate with those taking care of you throughout this journey, if you keep having similar experiences that you stated above, then consider changing the group you are working with or hospitals.

Best of luck to you!

Julie

13

Eliza,
I delivered my first happy, healthy baby November 27th with the help of OBs and nurses. I originally planned to go with the care of midwives, and coincidentally the hospital where I delivered decided last year that they would no longer allow midwife-assisted births (temporarily...they are now starting their own hospital-based midwife training program). My husband and I were faced with either using midwives for prenatal visits but having a strange doctor deliver the baby, switching practices, or using OBs. We decided for a number of reasons (convenience being one) to use OBs...and I LOVED the care I received. I really think the letters after the name matter less than the name itself...it is all about personality and whether you feel comfortable.

14

I say run (or hobble!) while you can! I believe the birth of your first child is the most overwhelming experience and you need the support of people you can count on to answer your questions (and your partner's) before, during and after. Truthfully, I would tell you to find an office with a couple OBs that will be there for your delivery. (My office had two and one was always on call.) It is important that they know a little bit more about you than what's written in the file. You can tell them exactly how you imagine your birth scenario and see what their reaction will be. I know that most hospitals will allow you to do whatever you need to do to feel comfortable during labor unless there are complications--and then you'll be happy to be there anyway. My suggestion would be for you to do some hospital tours and get a feel of the labor wings--let's be honest, the doctors will only be there near the end. It's the NURSES that will take care of you 98% of the way. So look at their faces as you walk by with your big belly and say hello. If you're lucky enough and you see a new daddy or mommy in the hallway, ask them what they thought. The nursing staff can make or break your labor. Some hospitals even have bathtubs and showers for women or waking areas. In my hospital bag, I took my iPod with little speakers and played music the whole time, too. I walked outside and inside for 8 hours, used a yoga ball, and only was hooked up to the equipment every couple hours to check the baby's heartbeat, which was nice to know that the baby was well. I applaud you for your courage to make this experience about you and the baby. It was the scariest, craziest day of my life and the more you can do to prepare, the better. It made my day beautiful. Good luck! Dana

15

Eliza, I'm so glad you wrote, because (except for the couple responders who said their midwives were bad and that you can't hope to get what you want) you're getting EXCELLENT advice. First, definitely report your feelings to the head of the practice you're currently attending! The supposed care you're receiving is appalling and it makes me sad for you, because this is the exact kind of story that scares women away when we NEED more women to feel like you do--that pregnancy and birth are natural, empowering, and that we ourselves are the experts on our own bodies! (You were right to be concerned about the lump, but what terrible advice and treatment you receieved! Absurd!) Second, start researching for a new midwife today! There are LOTS in the greater Boston area who are WONDERFUL. Although I started my first pregnancy with the midwife at Mass General, I quickly switched to those at Women's Health Associates in Wellesley. I knew I absolutely did not want an intervention-filled hospital birth, and I was low risk despite being 35 at the time. At that time, the Birthplace at Wellesley was open (the only independent birth center in eastern MA). We toured that one and Cambridge Birth Center, but I felt CBC was too small and too tied into the hospital's routines and protocols to afford me the independence I wanted. My first son was born The Birthplace 3 years ago (75 minutes after I arrived) and helping me deliver were 2 of the 5 midwives I'd met with on a rotating basis. I loved getting to know them all and was reassured by the fact they all shared very similar philosophies, I never received contradictory information, I could ask ANY question without feeling embarrassed, and best of all, most of my 30 minute appointments lasted 45 minutes or longer, because they spent so much time talking with me. Not just about the pregnancy, but about my mental health, how my job was going (stressful), and about my relationship with my husband and any concerns I thought he might have about being a new dad. It was SUCH a great experience, I can't recommend them highly enough. Their website is: http://www.womenshealthassoc.com/ and their phone is (781) 237-0080. There are also OB-GYNs on staff there. The practice is closely affiliated with Newton-Wellesley Hospital, which is a great hospital. They have an excellent reputation for working very cooperatively with this team of midwives and the intervention rate there for women using these midwives is lower than elsewhere from what I understand. They have a terrific Meet the Midwives Information Night on the 1st Tuesday of each month (free) and you get a LOT of information about the practice at that time, including costs.

The MA state law currently prohibits CNMs from doing home births, so upon the closure of the birth center due to factors beyond the midwives' control, I opted to have my second son at home. However, I stayed with the WHA midwives until I was 35 weeks along because of a potential complication. Once that resolved itself, I immeidately switched over to a Cert. Prof. Midwive, Nancy Wainer. (She is actually rather famous, she's the woman who coined the term VBAC so many years ago and has written several books.) I should add that I did look into the Family Birth Center at Salem Hospital, but I felt it would be too far to drive for my 2nd delivery. (My first labor from start to finish was 6h10m and I fully expected my second to take less than 3hrs--I was close, it was 3h26m.) So I had a home birth with Nancy Wainer's practice. And although she missed the birth due to attending a wedding in Canada, I was attended by Heather Laier, her backup (a licensed CPM who studied under her originally), plus Heather's backup (another CPM), AND both Nancy's apprentices were there. I'd met Heather once and loved her, and met with Nancy and both apprentices at every single visit.

My visits with Nancy were always an hour long, and she (like the WHA midwives) asked questions about all aspects of my pregnancy, health, and life in general, especially focusing on nutrition and how to take of myself during recovery while also caring for an 18 month toddler. I will be using Nancy for my next home birth in a couple years, even though I'll be 41 by time I deliver. I have every confidence in her, and she really listened to my concerns about having a low-lying placenta at 36 weeks (it moved up 10cm at 37 weeks--supposedly unheard of if you ask an OB but common if you ask a midwife!). She authorized ultrasounds because it made me comfortable even though she felt they were never necessary in my case.

In conclusion, I would say your experiences are normal for people who deal with hospitals, because the medical staff are always so pressured and harried. Sad but true. And it's why we need more midwives, why we need the legislature to approve a bill that's being discussed this week about approving a Board of Midwives that would allow CNMs to attend home births, among many other benefits to the midwifery community. You absolutely need to find a midwife to help you deliver whom you feel very comfortable with. Do not feel like you don't have the time--I started looking to switch at 30 weeks and made the final changeover around 35 weeks with no regrets. I'd have stayed with WHA if it wasn't for being forced to have a hospital birth--but I really have no regrets whatsoever and truly look forward to another home birth. DON'T GET DISCOURAGED! If you would like to contact me personally, I have a list of midwives in your area who I would recommend. You need to do what's right for you and your baby, and I think you would be very disappointed in your birth experience if you stay where you are. You made the step to ask for advice. The next step is up to you. Be strong! Follow your gut and go for the best prenatal and birth experience you can get, becuase it's what you are entitled to! Good luck! Niki C. in Bedford

16

Wow, you know it is never to late to swich providers! I used a midwife with my first child, and delivered in the hospital. I loved the experience and the birth but it wasnt what I wanted this time. So I hired a homebirth midwife. I have had only the first appointment and so far she is AMAZING! And the appoints last over an hour, she is so open to everything! If this might be something you are concidering I can give you her number.

17

hi eliza,

i just gave birth to my daughter last week. i had decided to go with midwives as well thinking they would be more supportive and available! not the case! during my checkups they have mostly been as you described, irritable, impatient and providing incomplete information. the most surprising thing is that considering the midwives are supposed to have weekly meetings to discuss every case, they never agree on the advice they give you! this messed up my post-delivery care as well. next time i am definitely going for a doctor. i think you should do the same while there is time. midwives don't provide anything that your husband and family anyway don't. mostly they just come in and look on you once in a while. all the best and take care.

18

Hi Eliza,
First off, let me say how sorry I am you experienced this. I would have chosen the midwife/homebirth route had I been able to, but I had a very high risk pregnancy and was uber monitored by a perinatoligist the whole time. I think that what we hope for and dream of for our pregnancies and births is so often not what we experience, and that is a crying shame. It should not be that way, and the only advice I can render is COMPLAIN. You should absolutely go straight to the director or whomever is in charge and confront the practice on this.
I didnt find my voice until labour and delivery. I had similar experiences with being given contradictory answers to the same question, felt talked over or brushed off, and even a nuisance when I called despite the mantra no question/concern is too trivial. I am so very grateful for my excellent medical care and truly love my OB, but the rest of the experience was stressful and made more so by a majority of less than friendly or even pleasant nurses or staff.

Due to being high risk I was induced at 39.5 weeks. Induction was the last straw for me, it was so against every instinct in my body that it was honestly the hardest thing I have ever done. It felt so wrong, and that feeling was compounded by an unpleasant, to say the least, DR who treated me. She was so rough and inappropriate administering my first internal that even the nurse next to me winced. I felt I had been violated, it was a terrible feeling and one that should never be felt especially during what is one of the most wonderful, or should be, experiences a woman can have. I felt helpless, and so sad that this was the experience I would have delivering my so very wanted baby. I tried to convince myself that a healthy baby was all that mattered, and ultimately thats true. But really I had become so numb by the unexpected negative experiences during my prenatal care that feeling marginalized was becoming second nature. I was seen by other drs throughout the day/night and the next morning when delivery was imminent I heard the first DR's voice in the hall and burst into tears. My husband was so worried and I finally said to him, she cannot be the one to deliver our baby, find someone else. And he did, it was that easy. I wish I had taken a stand sooner in my pregnancy and stood up for myself more. I think its so overwhelming being pregnant on a normal day, that we often dont process whats happening to us until later. I now look at the proactive mother I am and think how could I not stand up and push back? I think when pregnant we are curling into ourselves protecting our growing baby. And there is still a cultural undercurrent that discourages women from asserting ourselves, especially in the medical arena.
At my 6 week post birth checkup I told my OB about all of it and she was wonderful, deeply sorry and ultimately happy I had told her so she could address the situation and the specific dr involved. What made me talk to her was the thought that some other newly expectant mother or woman on the verge of delivering would have a similar experience. I felt duty bound to speak up.
I encourage you to confront this as much as you feel comfortable with, and to even look for another practice if you feel you need to. Dont give up your hopes for how you want this to be, I so very much wish I hadnt. If I am lucky enough to become pregnant again, I will take so much more control of the experience.
Again, so sorry you went through this, its not at all trivial but sadly I think very common. I have since heard so many similar stories from friends who thought this is how it must be, you get swept along by the tide of professionals and just deal with it, midwifes or traditional medical practices alike. Someone told me I should watch the documentary the Business of Being Born because its meant to deal with this topic, but I have yet to. Maybe you should check that out.
Good luck to you!

19

Hi Eliza-
I'm sorry you are having such a frustrating experience. I have delivered 3 boys naturally. 2 with M.D.'s the 3rd with a midwife. The treatment you are getting from these women remind me of the male ob's I had for my first two deliveries. I strongly feel that this is not typical of most midwives. Many of my friends and family members have had wonderful, informative, nurturing, experiences with midwives--and that is not what you are getting. Any concern you have regarding you or your babies health is 100% valid and you should be treated with genuine care and concern, not disdain! If there is a senior member of the group (or supervisor) I suggest you speak to them, or hand deliver a letter (its can be hard to successfully deliver all of your thoughts with pregnancy horomones coursing through you!) Then find another midwife. I just recently moved back to MA, but I heard there are two women with a small practice in Wareham who are wonderful. I was lucky enough to have my sister-in-law with me at all of my births, she is a mom of 4, all home deliveries ! She really knows her stuff! I'm sure your partner is supportive and will be a good advocate for you, (which you need in the hospital), but my experiences were that you really need someone else you can trust in your corner--and these women don't sound like they are going to cut it! Good Luck-tara

20

Hi Eliza,
I have 3 children. Two were born at a Birth Center, the first with an OB and the second with a midwife. My 3rd child was born at home with a wonderful pair of CPM's. My daughter was my biggest baby and she got stuck but the midwives at my homebirth were fantastic and knew exactly what to do without the use of any "tools" of the trade. And there was no tearing! So what I'm trying to say is I recommend looking into having a homebirth. If I could go back and do it all over I'd have my first 2 kids at home too. The prenatal care and affection I received from my midwives was the best.

Either way, I would highly recommend that you and your partner take Bradley Method Birthing classes. This class goes beyond what the hospital classes (Lamaze) teaches. It empowers you, and even more so your partner, to be very in tune with what you will be going through during the birth. Your partner will learn all the signs to watch for coming from you so that he can help you along the way. It will also give you the knowledge and confidence to know what you want for this birth and to stand up to the hospital staff to get what you want. It will be a much more rewarding experience for both of you and your baby. You can go to their website to find an instructor near you .(http://www.bradleybirth.com/). Good luck and best wishes.