Thursday, February 18, 2010

Midwifery Decisions

I am pregnant. I am four months along and have chosen to manage my pregnancy, labor and delivery with midwives at The Midwife Center for Birth and Women's Health in Pittsburgh, PA. Since it seems I must explain and often defend my decision to go this route, I wanted to explain my rational in detail here.

I can imagine most everyone’s surprise at my decision to go to midwives. My sister, who has done almost everything before me – cut Barbie’s hair, shave her legs, use a curling iron, get married and have babies – delivered her two beautiful children at The Midwife Center. I have to be honest and say, I thought she was NUTS! Before and after her first child’s birth, I was pretty against any delivery that was not in a hospital. I couldn’t imagine birth without drugs and didn’t want to even consider any other options. Keep in mind though, I hadn’t read anything about pregnancy, labor or delivery either. Nor was I in a place in my life where these things required any research.

Fast forward two years. I was engaged to my husband and my sister was pregnant with her second baby. I had recently gotten into a little tiff with my gynecologist of three years because she would not spend time with me to discuss some cervical concerns I had from a previous procedure. She was always rude to me and I just never really liked her that much. Since I cannot stand male gynecologists, I knew I needed to find a new practice soon since neither my soon to be husband nor I wanted to wait very long to get pregnant. Ha!

It was around that time that my sister and I were shopping for some items for my wedding and decided to combine our trip to the flower-girls ballerina store with one of her visits to the midwives, that my eyes were opened. She was in for one of her 7month check-ups. I was really impressed with the relationship the midwife had with her and the time she took just hanging out with my sister and gaining her trust. It seemed so different than my gynecological experiences, and since I moved around so much, I had had many gynecologists over the years. The midwife actually cared and didn’t seem bothered by the time the appointment took.

I was really overwhelmed with a sense of “home” after that visit so I decided I would switch my care to the midwives, since I greatly disliked my OBGYN anyway. When I first found out I was pregnant with the baby we lost, I decided I wanted to stay with the midwives but deliver in a hospital. It seemed the best of both worlds. I could have drugs but also nice midwives to care for me. But then we miscarried. My cervix dilated, the uterus contracted, and we lost the baby. The pain was horrible but something interesting happened in those intense hours of expelling. My body took over and found tolerable positions. I breathed through each contraction, even the medicine induced contractions, and I got through it. Hopelessness and all. There was no pot of gold at the end of that pain, no baby to make it worth it, only disappointment and grief. But I still made it through.

After talking with one of the midwives, she explained that everything I went through, all the meds I had to take to make me contract, felt a lot like childbirth. (minus the pushing and crowning…which I know is really hard!) I’m not comparing it as if they are the same but in a lot of ways, I feel like I got a taste of childbirth those hard days and I woke up to the power and beauty and pain that women are capable of managing, naturally.

It was then that I started to think about the kind of atmosphere I really wanted when we got pregnant again. Did I want any of the local hospitals with their technology and policies and 40-some% ci-section rates or did I want a more family-friendly environment that had a proven track record of safety and low interventions? And the real question, did I want medication or did I want to do it naturally? After much discussion and thinking, I came to a personal conclusion that while I am NOT a hippy/I will never use pain meds sort of person, I AM the sort of person who has a strong will when I choose to do something. I realized that the reason I always wanted to deliver in a hospital was because I was afraid that I couldn’t handle the pain. It was about fear, not about a love for my baby or even for my own body. As someone who does not want to be controlled by fear, but instead love, I decided to read more about natural childbirth. “Perfect love casts out all fear.”

Since I had already gotten a taste of childbirth, minus the baby and including deep sorrow, I decided then and there that I wanted to try to deliver naturally. I had a new respect for my body as a woman and a faith in my ability to withstand pain for the love of a baby. Hope and resolution of will are profound tools! And the fact remains, it IS healthier for the baby to remain drug-free. It IS a better recovery for the mother to deliver drug-free. It’s unarguably better to deliver naturally, unless something goes wrong. Naturally, if something does go wrong or the baby doesn’t turn I will deliver in the hospital, probably with drugs and still be happy if the baby is healthy. I’m NOT saying I can brave it ALL but I am saying, I’d really like to try.

I know there are many differing viewpoints on this subject. I know you many people have pre-conceived ideas about midwives but I think those are people who haven’t experienced the loving care of a midwife, haven’t done honest research and are afraid. I read Your Best Birth and watched The Business of Being Born by Ricky Lake and Abby Epstein recently and it truly confirmed my stand on this issue. It is my intention to go this route, despite the seeming negativity that surrounds the decision.

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