Birthing with a midwife: – your options for a natural pregnancy and childbirth.
Giving birth, for most of us, is a profound experience: pain almost beyond endurance, bringing forth a new and perfect life into the world, and entering the life-changing journey into motherhood. For most of us, though, birthing is also a very practical one: How will I eat and exercise during pregnancy? How and where will I give birth? Who will be my doctor or health-carer? How will I take care of the baby when he or she arrives? Women have more options today than ever before, and birthing with a midwife is becoming increasingly popular. Midwives offer the kind of philosophy, support and care that many women look for without compromising on professional and medical expertise. For those considering having their baby with a midwife, I thoroughly recommend it. Having had my two babies with a midwife, I can share with you my experiences, and also relate my midwife’s perspective on helping women with their birthing experience.
A mother’s story
I gave birth to both my sons with a midwife at a birth centre. Jack was born in 1997 when I was 32, and Mark in 2004 when I was 39. I chose to birth with a midwife because I wanted the kind of personal care a midwife offers throughout my entire pregnancy. I also wanted my pregnancy and labour to be as natural as possible. And I wanted to know who was going to be with me when I gave birth. The midwives’ philosophy of assisting and empowering women during pregnancy and labour really appealed to me too. I had always believed that women instinctively and intuitively know what they are doing during pregnancy and childbirth if they are positively encouraged in this regard, and I knew that a midwife would support me in this, as well as provide sound medical treatment.
What did I like about having a midwife during my pregnancy?
The most important thing for me was the relationship I developed with my midwife – it was personal, and I never felt like ‘just another pregnant lady’. The appointments were never rushed. My husband was always included and made to feel welcome. My midwife would always check on his well-being too, and discuss any issues that were important to him. And when my second son Mark was born, his older brother Jack was also welcomed at appointments. My midwife was also interested in all aspects of my health and well-being, not just my pregnancy. I could contact her at any time, even if it was just to talk about how I was feeling. She also gave me very good medical advice, including recommendations for natural/alternative therapies. It was so easy because all the information, treatment and support I needed was wrapped up into one person.
What were the benefits for me of having a midwife during labour?
I was fortunate – my first labour lasted five hours and my second lasted eight hours (felt like 80, though!). I had wanted to at least try to make it through labour without drugs, and with the help of my midwife I was able to do this. I depended on natural pain relief—I spent most of my labour in a warm bath, while my husband and midwife applied massage and warm running water to pain areas. Both were tireless in their efforts to relieve as much pain for me as they possibly could, my midwife only stopping to regularly monitor and record medical information. It was in labour that I also discovered the power of gentle, positive encouragement. My midwife and husband constantly reassured me of how wonderfully I was doing (except when I demanded absolute silence from both of them), and this gentle encouragement miraculously got me through some extremely difficult pain spots. I could change my position whenever I needed, and when I was ready, I was helped out of the bath and I gave birth on all fours – again, my choice. My midwife was a medical professional, which was very comforting, but more than this I was in the care of two loving people who supported me in every way as I brought new life into the world.
What post-natal care did my midwife provide?
This was a very important aspect of midwife care for me, especially after the birth of my first child. Before I left the hospital, my midwife showed me how to breastfeed properly. Although breastfeeding may come naturally, positioning a baby correctly to the breast often doesn’t, and can be very painful! I mastered this quite easily with my first baby, but after a seven-year gap, had forgotten how to do this with my second once I got home, and was in excruciating pain. I went to see my midwife, and she had me sorted out in five minutes! I knew that if I needed any information or instruction on any aspect of childcare – emotional or practical – she could provide it. My babies were thoroughly checked – weight, height, hearing, development, etc. – before I left the hospital, and follow-up appointments scheduled. The medical care was second to none, but unobtrusive. My midwife also made sure I was physically and emotionally ready to go home. And once again, my midwife was available if I just needed to talk at any time after I went home, and sometimes this is what new mums need most of all. Throughout it all, I always felt safe and never felt alone. I couldn’t ask for any more.
A midwife’s story
Karen is an experienced midwife at a birth centre.
Why did you become a midwife?
I became a nurse in 1980 when I was 17, and at 23 became a midwife. I trained in England, which offered the best midwifery training at the time. Although I loved nursing, I had always wanted to be a midwife. Having a baby is a happy and life-changing event, and I wanted to be a part of that. I love children, and I also care passionately about women’s issues.
What do you think are the main benefits for women of having a midwife?
‘Midwife’ means ‘with women’ – I love that midwifery empowers women during pregnancy and childbirth, and involves families in the process: Women can choose what positions they want to use in labour, what kind of pain relief they want, and who is to be present at the birth.
When women choose to birth with a midwife, children and families are usually very involved in the pregnancy and birthing experience. If the woman doesn’t have a partner, or her partner is not supportive, midwives provide an invaluable function by offering care and support. Some women have had traumatic birth experiences in the past – either as a result of the way their doctor has handled things, or because their partner was not supportive. They have been disempowered, usually told what to do and given few or no options, and felt very alone. It’s very gratifying when women who have had this history experience healing when they give birth under the midwifery model of care. Sometimes a woman will bring her mother to her appointments, and sometimes it is the mother who experiences this kind of healing when she shares in her daughter’s pregnancy.
What are the options for birthing with a midwife?
There are a few options for birthing with a midwife. Women can birth at home with a midwife, or with midwives in a hospital midwifery program. I work at a birth centre, which is a separate birthing unit attached to a major hospital. It’s relatively independent, but the hospital is there for medical support if there is a complication during the pregnancy or labour. The midwife is still the primary carer if the woman is transferred into the main hospital. A birth centre is set up to create a home-like environment. The rooms contain a double bed so dad can sleep with mum and baby, comfortable chairs and sofas for guests, a bathroom, telephone, fridge, television, with midwives and medical care just outside the door. Mums are encouraged to take care of baby the entire time (with our help if necessary) so that they feel confident when they get home. If women choose a home birth, they are already at home, of course, and the midwife will help them settle in there.
Can you describe a typical labour with a midwife?
Most women who come to the birth centre or birth with a midwife aim to go through labour without any drugs. In a birth centre, the woman can have access to gas (nitrous oxide and oxygen), and some birth centres offer pethidine, but the woman will need to be transferred into the main hospital if she wants an epidural. Most women successfully give birth without any drugs using just the support of midwife, partner, massage, showers and baths, acupuncture, aromatherapy, and by using a variety of birthing positions; so the birth is completely natural. Many women have told me that the constant reassurance from a caring midwife during labour eases the pain and helps with endurance.
What are your other duties?
In addition to supporting the woman during labour – providing pain relief, checking medical vitals, and offering encouragement – my other regular duties include ante-natal checkups, post-natal checkups and providing education classes. Ante-natal appointments can be scheduled during the day or evening, and during these I chat to the mum (and dad or birth partner) about how she’s doing, check her blood pressure, check the foetal heartbeat and baby’s position, and discuss any pregnancy-related issues that are relevant at the time. Post-natal checkups usually involve monitoring baby’s development and checking on mum. Education classes give mums (and birth partner) information about pregnancy, labour, breastfeeding, bathing, clothing, feeding and generally caring for babies, and for themselves.
Because babies can arrive at any time, midwives are on call 24 hours, 7 days a week, which can interfere with a social life. But when you love what you do so much, it’s something you’re willing to do. If I do need time off – a weekend, or holidays – I just need to organise it in advance so another midwife, who also knows the mother, can be available if she goes into labour. Needless to say, midwives usually have very supportive partners!
What is your most memorable experience?
This is a difficult question to answer. It may sound sentimental, but every birth is a treasured experience. I do have one amazing story, though – I delivered all four children in one family, and I’m still very close to all of them. I still feel excited, privileged, and very emotional at every birth. Sometimes I still cry. It’s like being at a miracle every time.
In the past, midwives were trained in hospitals following their nursing training. Some hospital-based training still exists. Contact hospitals in your state to find out if this option is available. More commonly these days, though, midwifery is studied at university, with courses being offered at undergraduate and postgraduate levels.
Belinda Burman is a Reiki practitioner, teacher and freelance writer living in Brisbane.
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