Natural care from Midwives vs. Medical Care from Doctors 101

Natural care from Midwives vs. Medical Care from Doctors 101

There are so many things I learned about womanhood and motherhood from my midwives.  I’ll never be able to capture the full essence of their wisdom with words, so instead I’ll just give you a taste of some food for thought.  Whereas hospitals view a labouring woman as a patient in need of medical intervention, midwives empower women to embrace the process and allow it to happen naturally.  Below is a summary of contrasts between Midwifery (M) and Western Medicine (WM) perspectives on childbirth.  Again, this is simply my understanding of the general consensus within each group – I realize there are exceptions to the rule.

Checking dilation

WM – In the weeks leading up to the due date, a woman should be checked for dilation to help estimate whether baby will arrive early, on time, or late.  In hospital births, women are often checked at regular intervals to track progress.

M – The onset of labour cannot be predicted.  Many women begin to dilate days or even a couple of weeks before baby’s arrival therefore it is irrelevant and unnecessary to check dilation prior.  Even during labour, dilation is only one of many indicators of progress.  Dilation is often hindered by stress and anxiety, therefore frequent checking can actually be counterproductive.  Some might even argue that farm animals are treated with more dignity than women since a labouring cow would be left alone since a farmer would likely be kicked in the head if he poked & prodded her every hour!

Length of Labour

WM – A woman’s labour is often hurried along by medical staff, with the underlying assumption that risks increase as time passes.  For example, if a woman’s water breaks, she is often told that she needs to deliver within 24 hours to avoid infection.

M – Each woman is different and will labour accordingly.  There is no real stopclock once labour begins – it can take hours or even days.  Even if a woman’s water breaks, her chance of infection is extremely low so it is unnecessary to react by speeding the process up.

Setting

WM – The hospital is the safest place for a woman and her baby.  It is important to have several medical staff present.

M – Unless indicators of risk arise, the best place to give birth is where the mother is most comfortable – which often means at home.  You can imagine how difficult it might be to give birth in a hospital bed if you compare being constipated and asked to have a bowel movement in front of strangers! 

Induction

WM – Once a woman reaches her due date, she may have to schedule a date for medical induction such as the use of pitocin or having her water broken with a needle.

M – A normal pregnancy lasts anywhere from 37-42 weeks, with first time moms usually at the longer end of the spectrum.  Induction is not usually discussed until about 41 weeks and 4 days – and natural methods (such as a castor oil concoction) are tried first.   Chemical induction is avoided since it can often begin a spiral effect of making further medical intervention ‘necessary’.

C-sections

WM – C-sections have become increasingly common in the last few decades and are used in more than 30% of North American births.  Apparently your chances jump even higher if you happen to be due right before Christmas or at other times that would be inconvenient for your doctor!
M – C-sections along with other medical intervention (e.g. forceps, vacuum, etc.) are needed in less than 5% of births.

Umbilical cord wrapped around baby’s neck

WM – This poses a serious threat to baby’s safety and warrants medical intervention to get baby out as soon as possible.

M – This is very common and not necessarily concerning unless there are other indicators of risk.  Many midwives have seen the cord wrapped around baby’s neck up to four times without harming baby in any way.

Risk of Hemorrhage

WM – It is unsafe for a woman to deliver outside of hospital since she could bleed excessively, putting herself at risk

M – The risk of hemorrhage during a natural childbirth is extremely low, but is often magnified in horrific media portrayals of childbirth.  Generally, excessive bleeding would only happen if the uterus fails to contract the placenta out after the baby is born.  Midwives offer an optional injection of pitocin as baby is emerging to help prevent this possibility and monitor bleeding carefully afterward to ensure mom’s safety.

Pain management

WM – The pain of childbirth is excruciating and unnecessary in today’s society.  Women would benefit from pain medication, such as an epidural, as soon as the pain becomes significant.

M – Contraction pains or ‘waves’ are necessary to help a mother’s body massage her baby out.  Epidurals are counterproductive since the numbing effect often makes it more difficult to push.  Natural pain management, such as water or acupressure points, are encouraged.

As you can see, I’ve become just slightly biased toward the natural view of childbirth.  The knowledge I gained from midwifery throughout my pregnancy allowed me to have such an amazing childbirth experience that I often catch myself daydreaming about the next time!  One last analogy I’ll leave you with when comparing a medical birth to a natural birth is considering the body’s reaction to consensual vs. non-consensual sex.  When a woman is comfortable and relaxed, the birth canal can expand for a positive and pleasurable experience.  Conversely, when a woman is scared, her body becomes tense and the same physical act can become painful and traumatic.  I don’t use this analogy to be dramatic or to suggest that medical professionals intentionally would ever intentionally harm a woman or her child.  However, I do feel that society’s shift toward medical hospital births is an injustice to women who are being convinced that they ‘need’ medical help to have babies.  I think we should listen to Dorothy and Oprah: we’ve had the power within us all along and we just need to embrace it!

My personal and spiritual evolution under midwife care during pregnancy, delivery & post-partum

Like many new moms, I found my pregnancy and delivery to be a transformative experience.  Some of that was obviously due to the process of motherhood itself.  However, I also attribute a significant amount of this spiritual awakening to the gentle care I received from midwives.  When I began receiving prenatal care at Birth Partnership Midwifery Services, I felt like I was walking into appointments with my eyes tightly shut.  I was torn between my dependency on Western medicine thus far, with my interest in natural childbirth.  However, at that point, my interest remained focused on just that – natural childbirth with no intention to further explore the world of natural healing.  At one of my first appointments, during a discussion with my midwife about the possibility of post-partum depression, she told me about how women in some cultures eat their placentas to balance their hormones and how even in our urban hometown, there’s a service that will encapsulate your placenta for consumption (http://www.purebirth.ca/placentaencapsulation.htm).  I was so turned off by the thought that I didn’t even have time to put on a poker face – I just looked disgusted and thought to myself ‘I would never do that’.  Well, as it turns out – ‘never say never!’.

During the course of my pregnancy, I gradually shifted from a being skeptic to a believer and proud user of natural remedies.  I used judge people who ‘wasted their money’ in the health food store…to being someone who is now willing to pay a bit extra for natural products.   Below are just a few of the natural remedies that I tried and found to be incredibly effective alternatives to Western medicine:

For Pregnancy-related issues:

Papaya enzyme tablets – to treat heartburn

Shredded potato  - to treat hemorrhoids (okay, I never tried this one cause I was scared of potatoes falling out of my pants…but apparently it works!)

To prepare for birth at full-term:

Homeopathic ‘EZ birth’ pellets – to help body prepare for dilation, anxiety, and pain

Evening primrose oil capsules – to help ripen cervix

Red raspberry tea – to help prepare uterus to contract

Acupuncture treatment and acupressure point training for labour

Post Partum:

Evening primrose oil capsules – to balance mood

Valerian tincture – to reduce anxiety

Homeopathic Coffea – to calm and reassure

Rescue Remedy Bach Flower – to calm and reassure

Placenta Capsules – to restore iron and nutrients lost during delivery in order to balance hormones, increase energy, and stabilize mood
Homeopathic Arnica Montana – to promote healing

Homeopathic Calendula – to promote healing

Infant Care:
Breastmilk - apply to baby's dry/irritated skin or lips
Sunlight - to treat mild jaundice

As you can see from my long and growing list – natural remedies have truly changed the way I view my body and health.  So if you happen to be the skeptic I used to be – I dare you to try just one natural remedy the next time you have an ache, pain, or other health difficulty, to see if you might be converted too.  

A mother's love

When I was a baby, you were my world.

I thoroughly enjoyed being your baby girl.

I played with your ears, when you held me in your arms.

You captured me with your smile and your motherly charm.

When I was girl, we used to love to talk.

When we cuddled at night, or on our countless walks.

You taught me about life, and what it meant to be

A girl who knew herself, a genuine me.

When I was a teen, I put your love to the test!

I challenged your authority, I gave it my best.

I brought you gray hairs by staying out late,

But you never gave up, through your worrisome wait.

When I went away to school, I started to see

How very much I missed you, and all that you mean to me.

You saw me through hard times, when I was overcome by tears,

You loved me when I didn’t, you helped rid me of my fears.

When you walked me down the aisle, I again began to cry,

As I saw flashes of all the years, that had quickly passed us by.

But you hugged me and released me into a new phase of life,

To grow into a woman, as somebody’s wife.

I still call you on those days, when the sky appears to fall,

You comfort me with your ever-wise words, you support me through it all.

The good times have been a plenty, the bad ones have been so few

That I dread that day in the future, of a life without you.

Now that I have a daughter of my very own,

I finally understand just how much I’ve grown.

I owe it all to you, I’m so glad you’re a part of me,

Without your gentle love, I don’t know who I’d be.

I look forward to the years to come, now that I’m a mother

The love that I have for my child, reminds me of another.

I’ll share this gift you gave to me, the kind that knows no end,

I hope to be a mom like you, an unconditional best friend.

Why I Chose a Midwife and Homebirth

I can’t quite remember when I first became interested in midwifery and homebirths, but I think it was a progressive curiosity that emerged several years ago.  Soon after getting married and moving to Calgary I continued my research on midwifery and homebirths and was crushed when I learned that they had been covered in our previous home-province of Ontario but not in Alberta.  Lucky for me, in April 2009 - not long after we started trying – Alberta finally caught up and approved the coverage of midwife care too!  However, this recent change meant that I would be competing against a swarm of other open-minded preggo’s, all desperate for a birthing experience that differs from today’s norm.  Since most people who know me, know that I pride myself in being Queen efficiency and highly competitive, let’s just say I was up to the challenge.  I again did some internet research and learned that there were only three midwife agencies in Calgary (that I know of), each staffing a handful of midwives.  After reading all of the bios, I was particularly drawn to the ‘Sage Passages’ team at Birth Partnership Midwives (http://birthpartnershipmidwives.com/sage/).  So after applying to all the agencies the moment I had a positive test (literally), I was one of the lucky few to get through the waitlist…and even luckier to get my #1 choice!  

I walked into my first midwife appointment with only the tidbits of knowledge I had gained from obsessively watching home and/or waterbirths on TLC’s ‘A Baby Story’, for the last several years.  I was definitely interested in a homebirth (in fact, the day Ivan & I chose our house, I told him ‘now that’s a tub I can homebirth in!’), but wasn’t yet fully committed.  At that point, I hadn’t yet done enough research myself to battle off “what if’s” from concerned family and friends in an educated way.  But at some point during my 2^nd trimester, our research taught us that not only are homebirths as safe as hospital births, but probably even ‘safer’ in the sense that hospitals often over-use sometimes unnecessary interventions such as forceps, vacuum, C-sections, episiotomy, inducing medication, and – the all powerful epidural (http://www.cmaj.ca/cgi/content/full/181/6-7/359; http://www.bmj.com/content/330/7505/1416.full?ehom)

Now, let me just say that I realize some backs might be arched, and some feelings might be hurt, by moms who have experienced births involving some of the interventions I just mentioned.  So let me clarify a few things:

1.             I am not ‘against’ medical care for high risk pregnancies. Midwives will be the first to tell you that they respectfully turn this over to OBGYN’s who specialize in this field.  However, since less than 5% of pregnancies are considered high risk, why would the remaining 95% of healthy low risk pregnancies be treated in the same way? 

2.             I am not ‘against’ delivery interventions altogether, and I definitely understand that there is a time and place for them.  Even when working with low risk pregnancies, a midwife will gladly accompany you to the hospital in ambulance if she sees signs of distress in mom or babe during labour.  However, a midwife’s view of fetal distress is far less conservative (and many, including me, would argue far more accurate) than the hospital’s view

3.             Neither am I ‘against’ a woman’s right to choose whether or not she wishes to receive pain medication, such as an epidural, during labour.  Some people have the misconception that natural childbirth advocates, like myself, are masochistic hippies who decline medication as a matter of principle and competition.  Okay – I may be competitive, may be principled, and may even be turning into a hippy…but I definitely don’t seek pain for pleasure.  The fact of the matter is that hospitals today rely on a downward spiral of inducing medications (such as pitocin) and pain medications (such as epidurals) that continue to counterbalance each other, make each other ‘necessary’, and most importantly – numb and confuse a woman’s intuitive connection with her body.  In a nutshell: induction intensifies contractions to be more painful than in natural childbirth, often causing a woman to feel the need for an epidural – which numbs her, makes it hard to push, and therefore slows labour (thus leading to the cycle of needing yet more pitocin and more epidurals).  There’s a great documentary by Ricki Lake (yup, I said Ricki Lake, the 90s talkshow host) that captures this topic far better than I can:

            http://www.thebusinessofbeingborn.com/

So whereas I don’t think less of women who chose pain medication – I do worry that many were not given enough information to make an educated choice…and that many are not given much of a  choice at all, considering how paternalistic the hospital way of managing births can sometimes be.

Finally, I want to end by explaining that I realize I am generalizing when I talk about medically delivered births vs. midwife delivered births.  The only way I know how to discuss the topic is to review the general trends I am aware of.  I appreciate that there are some wonderful nurses and doctors who support women through positive hospital births just like there can be not-so-great midwives who may not be able to create serene homebirths.  However, this blog is a summary of my personal overall opinion – take it or leave it : )