I am five months pregnant and have not seen a doctor.
The Lion and I enjoy a primal lifestyle. Of course, we also enjoy a lot of what modern technology has to offer (including running water, electricity, and the internet!), but we also appreciate the more primitive aspects of being human, like being outside and getting sun, avoiding processed foods, sweating, sleeping with the sun cycle, and generally being introspective and in-tune with our mental and emotional needs. Along those lines, a birth that is heavily medicated, in an unfamiliar setting, with hospital lighting bearing down and the smell of chemicals and sterility surrounded by strangers watching me pee/poop/fart does not sound like an experience that I would enjoy (I mean, if I’m going to pee/poop/fart with an audience then it might as well be with people I feel relatively more comfortable with, right? :\ )!
My first exposure to midwifery care was through a book called Baby Catcher, recommended to me by a friend who had a homebirth with their son a few years ago in LA. The book is a collection of stories and experiences by the author, Peggy Vincent, a California midwife. Baby Catcher made me laugh out loud and cry, and it really opened my eyes to the possibility of giving birth naturally, at home, with someone you trust, and with as little intervention as needed. Thus, when I became pregnant, I decided to research more about midwifery care and what it entails to determine if it really was the right path for me.
When I saw what the midwifery model of care entailed, I was hooked:
The midwifery model of care is based on the fact that pregnancy and birth are normal life events. The midwifery model of care includes: monitoring the physical, psychological, and social well-being of the mother throughout the childbearing cycle; providing the mother with individualized education, counseling, and prenatal care, continuous hands-on assistance during labor and delivery, and postpartum support; minimizing technological interventions; and identifying and referring women who require obstetrical attention. The application of this woman-centered model has been proven to reduce the incidence of birth injury, trauma, and cesarean section. —The Midwifery Task Force
The first sentence in the midwifery model of care struck me as unusual because I had never heard or thought of birth and pregnancy as “normal life events,” but indeed, birth is a natural “instinctive act.” Our bodies have evolved through million of years to provide the best possible outcomes for mothers and babies, provided that we understand and care for our bodies the way that nature intended during this normal physiological process. As many of you probably know, women’s hormones are changing drastically during pregnancy, and that’s no different for during childbirth and afterwards too. The brain is producing hormones related to excitement (epinephrine/norepinehprine), love (oxytocin), mothering (prolactin), and pleasure (endorphins) during pregnancy, labor, and childbirth to elicit instinctive mothering behavior in humans. Oxytocin also causes the uterus to contract, adrenaline increases heart rate and makes us feel courageous, giving laboring women the “power” necessary for the final pushes, and endorphins rise and help block the reception of pain.Physically, the laboring mama is driven to move more, and sometimes, even to sing, grunt, groan, moan, or to shower/relax in a bath. Those options are not always available to women who choose to give birth in hospitals (as Vincent recalls in Baby Catcher). Women who are feeling afraid or self-conscious [in front of strangers] tend to secrete hormones that delay birth. In quiet, semidark, private conditions, the laboring mama can let down her guard and let her instincts take over. I knew that working with a midwife was a first step to accomplishing this, where I would be allowed to have the lights lowered, to stay in a comfortable place (my home), to move about freely as needed, and to be with loved and trusted ones as I begin one of the most challenging times of my life.
I also knew that I wanted the individualized care of a midwife (or in the case of the birth center I’m working with, three midwives!), hands-on care, and postpartum support. I am a unique person who has had a unique health history and will have a unique pregnancy and birthing story, so why shouldn’t my care be tailored to me? My most recent experiences with doctors in the dental industry were not pleasant; my dentist told me that nutrition is unrelated to teeth health, that I shouldn’t believe everything on the internet (I read books, not webpages), and did not ask a single question about my dental history. The endodontists I visited seemed impatient with my questions and complimented me on being a “biochemical major” when I asked questions. One of the endodontists I visited had even started pulling out her tools, ready to perform the “routine root canal procedure” the day of my consultation! So, this was certainly not the type of experience and attitude I wanted throughout my pregnancy or at the birth of our first child. When I go to my prenatal appointments, I wait no more than 10 minutes in the waiting room. The staff at the birth center know me by name and face. They know The Lion by name and face. The midwives ask me how I’m feeling, they listen and commiserate, they host picnics and events for everyone to interact (the midwives, the parents, the doulas, the birth assistants, the staff), and they ask for my health and nutrition history. I get the feeling that they are mother- and baby-centric; I trust that when I go into labor, I can call them for help or advice, even if it isn’t during office hours. I trust that I have a choice and won’t be pressured to make a biased one. This is the kind of help and promise that I want and appreciate as a newbie mom. When I interviewed the head midwife of my birth center, I asked her what she expects of her clients. She responded, “I expect them to stay healthy, educated, and relaxed.” This is exactly the kind of pregnancy and childbirth that I want to have!!
As for minimizing technological intervention but also encouraging women who need obstetrical attention to seek it, this is a big point that I think many people have missed of midwifery. When I first told my family that I plan to birth with a midwife, they immediately became concerned of the risks of birthing out of hospital. Luckily, the midwives aren’t above asking for help when they (or the laboring mama) need it! The Lion and I live very close to a hospital, and we have discussed what will happen should I need to be transferred to the hospital. Furthermore, the midwives at my birth center are certified nurse midwives. In other words, they know and can perform the same duties as a doctor, except surgery. I hope to have an “undisturbed birth.” As described above with the hormonal processes, birth is a very complex physiological process, and it is extremely sensitive to outside influences. Many techniques that are used in hospitals to monitor a laboring woman is painful or uncomfortable and usually involve strangers overstepping personal/bodily boundaries. In addition to the distrust of a woman’s birthing ability and their body’s natural processes, these are ingredients for a difficult birth. This is not to say I will have a solitary or isolated birth. I believe that once I am in labor, I will need all the help and support (physical, mental, emotional) I can get to cope with the pain! But a midwife’s method to coping with pain is not to medicate, but rather to understand where the sensation originates from and whether a change of position, attitude, atmosphere in the birth room, or another factor can help mitigate this discomfort.
My main concern with this pregnancy and birth experience is NOT to avoid pain at all costs, but rather to have a healthy baby in the most natural, healthy, accepting way possible. I am so excited to have these midwives be my advocates and guardians during childbirth!!
(I don’t cover the risks of cesarean surgery, epidurals, opiate painkillers, synthetic oxytocin and other synthetic hormones, ultrasounds, early clamping, and inductions here because they require their own blog post and more astute meta-analysis. Buckley’s book (link below) provides a much more in-depth analysis of these and other common interventions of birth. I hope to write a review/summary of her book at a later date.)