Why We Chose a Midwife
Growing up, I never would have imagined that I would choose a midwife for the birth of my children. Going to a hospital and working with an obstetrician was just what one did when having a baby. I believe most American women who have grown up in the past fifty or sixty years have had a similar experience. Giving birth with the assistance of a surgical doctor in a hospital setting became the overwhelming norm through the course of the twentieth century. There are many good reasons for this. Mothers will always want the best care for their children and the least possible amount of risk for them. With birth, as with every major medical event in one’s life, there is always the chance that something can go wrong. The difference, though, between the birth of a child and nearly all other medical events, is that giving birth is a natural process that a woman’s body is built for. Unlike a disease, a broken bone, cancer, or a heart attack, becoming pregnant and giving birth is something every healthy woman’s body aims to achieve on a monthly basis. Entire organs and systems within her body exist to build and nurture new life. Pregnancy and childbirth aren’t maladies. Rather, these incredible experiences are the healthiest possible expression of a woman’s liveliness.
My husband and I look back on our decision to work with a midwife with immense gratitude. It is one of the best decisions we’ve made in our lives. I can only share the experiences we’ve had because that’s what we have to inform us. The following is some of our story and our philosophy behind making such an alternative choice for the birth of our children.
The story of deciding to use a midwife begins before Andrew (my husband) and I had even begun to date. After graduating from college there were a number of friends and acquaintances who immediately got married, and several of those couples soon began to have children. I’m exceptionally thankful for the friends who were a step or two ahead of me in these life events because I was able to learn so much from them as they experienced the changes and challenges of engagement, the early years of marriage, and then, of course, childbearing! It was one of these friends who first mentioned to me that she and her husband were seriously looking into the use of a midwife rather than going the normal OB route. I was stunned at first, and undoubtedly made some dumb comment about how medieval the use of a midwife sounded. But then this friend began to explain some of her reasons to me. How in western countries we have begun to subconsciously view pregnancy and childbirth as a sickness, as something to be treated, rather than guided. She told me about how we have made the process of labor more difficult by forcing women to remain in unnatural positions for the sake of the doctor’s ease rather than her own. And that even with the healthiest of births, many doctors and nurses are quick to apply interventions of all kinds to allow for less pain, or a quicker delivery.
Following a number of conversations like this, I began to take the idea of midwifery seriously for the first time. These ideas resonated with me on a physical and even spiritual level. The overwhelming, beautiful message that a woman’s body was made for the act of bearing a child stuck with me, and also sounded foreign compared to the subliminal messages I had received about my own body since adolescence. Discussion of female body parts always seemed to imply that this is just how the woman’s body happens to be structured. These discussions seemed to gloss over the fact that my body was intentionally created with the corresponding organs, muscles, tissues and hormones to (when all was healthy and the conditions right) conceive and bear a child. And that it was these attributes that, at least biologically, were the very definition of what made me a woman.
A cascade of questions remained with me after conversations with friends about their experiences with midwifery. Why hadn’t the unique and definitive purpose of my body been emphasized more in the lectures intended to teach me about the reproductive process? Why would I alter the extraordinary experience of bearing a child in any way if I didn’t have to? So many doctors, and, subsequently, mothers, have fallen prey to the desire to make birth convenient by scheduling unnecessary inductions, or resorting to Caesarean section far too early in the labor process. When this is done before the need presents itself, is it not a dismissal, however small, of the natural way and timing God intended a child to come into this world? And what about our readiness to mute the pain of childbirth? Doesn’t this pain, as with all pain in this life, more closely unite me to my God, the one who suffered the greatest of pains by dying for me on the Cross? Wasn’t this pain the just sentence that accompanied Eve’s sin in the Garden? Before ever even having begun to date my future husband, I knew that when the time came I felt called to pursue the most natural means possible for bearing a child.
Now, it’s important that I insert a caveat or two here before going on. First, discovering more about the most natural possible way to give birth was very appealing to me at the outset because I have always been someone who avoids going to the doctor for any but the most serious of reasons. I have never been anything but a visitor in a hospital (with the exception, I suppose, of the day my mother gave birth to me), and would like to do everything I can to keep it that way. Second, I understand that just because I have been blessed with good health, and, to a certain extent, good luck, that does not mean I expect every other woman to have had the same experience. There are many multitudes of good reasons for a woman to rightly choose the care of an obstetrician for the delivery of her child, and in turn there are occasions in which a doctor with the full power of western medicine at his disposal will be able to save a mother or child’s life -- which is of course the most important part of any medical conversation. By writing about our experience with a midwife, I do not mean to dismiss either of these realities. That being said, I have come to feel passionately about allowing every possible opportunity for natural birth to take place. I believe it’s better for a married couple, better for the mother, and better for the child if everything is able to proceed in as uninterrupted a fashion as possible. It is a miracle that God created women’s bodies to do what they do, and the less we intervene with that design, the better it will function.
It took time for me to come to this point of view, which is certainly an outlier in the modern approach to pregnancy and childbirth, but thankfully, God gave me this time and the right women and families to learn from along the way. As things would turn out, that first friend to confide in me that she and her husband were considering a midwife was only the first of many. As other friends married and had children before me, I continued to learn from their experiences, listen to their beautiful birth stories, and grow in my appreciation for natural births. Before long, I was in their same position: newly married and staring dumbfoundedly at that double pink line on the pregnancy test. It was time for my husband and I to make our own decision!
Some quick google searches indicated that options for midwifery in our area were exceptionally limited. There were just two practicing midwives within a sixty-mile radius. One only worked with a nearby hospital, and one only attended home births. By matter of chance, I was never able to get in touch with the nurse-midwife who worked within a hospital setting. On the other hand, I was able to speak with the home-birth-only midwife, Melanie, on the very first call. We set up a consultation appointment for the following week so that we could both have the opportunity to assess our comfort with working together. During this meeting I became completely convinced that this was the woman I wished to work with. Melanie was gentle and direct at the same time and exuded calm joy. I felt more comfortable with her than I had ever felt with a doctor, despite barely knowing her, and loved her philosophy of pregnancy, birth, and the empowerment of mothers.
Of course, every midwife is different. Each has a unique personality, philosophy, and scope of practice that is particular to her. For us, though, Melanie seemed to be the perfect fit in almost every way. This was proven time and again over the course of the seven plus months that we worked together as I carried and delivered our first child, and has proven true through the course of my current pregnancy as well. Melanie and her team came alongside me, educating me, caring for me, loving me. Unlike the purely clinical approach that is often present with most prenatal appointments that occur between a doctor and mother-to-be, Melaine was concerned with treating my whole person, not just my body. My appointments with her, which nearly always happened in the comfort of my own home, were an opportunity to confide in her my anxieties, my hopes, and my joys, as well as discuss the changes taking place in my body. She educated me on how my body naturally works, what to expect in coming weeks or months, and especially what to anticipate when it came time for labor and delivery. Perhaps most importantly, there was a relationship of deep, abiding trust that was able to be established over the course of our time together. Melanie taught me first how to trust my own body, listen to it, and understand it. Through that educational process I naturally began to trust her.
Melanie’s temperament, her constant, calm, and reassuring nature, helped me to look forward to the birth of my daughter, rather than fear it. Don’t get me wrong, there was still plenty of nervousness, but it was a nervousness of excited anticipation rather than dread. I have only memories of peace and determination as labor began for me early on that December morning. My memories of the birth of my daughter were nothing like how birth is often spoken of or depicted. There was no screaming or cursing, no hatred toward the world, no mean jokes toward my husband about how this was all his fault. That doesn’t mean it was an easy experience, by any means. Giving birth to my daughter is the hardest thing I have ever physically done, and probably the most painful as well. But just because there was pain didn’t mean there was hysteria. This, I think, is one of the greatest gifts Melanie bestowed - she gave me the tools to have a peaceful labor and delivery. Funnily enough, I don’t have just a ton of memories of Melanie at my side during this process. I know she was there, but my tunnel of awareness was much smaller than that. I know she, her attendant, my doula, and my husband were talking to me, encouraging me, and comforting me through those hours, but I didn’t do much responding. I was focused.
Those last moments before Elise was born were incredibly difficult. I didn’t know how my body was going to achieve this incredible feat or whether I would survive to tell the tale. But I knew what I needed to do, and I knew that a little life depended on all the effort I could muster. I listened to the encouragement of my husband and pushed. After a moment or after an eternity (I’m still not sure which) my daughter was with us, her beautiful eyes taking in everything around her (as they still do). How everything came together in the next minutes and hours I would not be able to repeat accurately. It’s all become a little fuzzy. There was busy-ness checking baby, delivering the placenta, stitching me up, checking baby again, checking me - all of the routine immediate postpartum activities. But I mostly remember being exceptionally grateful that we were in our own home, our own bed, that my own mother was there to prepare delicious food, and most importantly, that my precious baby Elise didn’t spend more than a few seconds away from me. I remember being cared for, pampered, in fact. The first hours and days of my daughter’s life, while of course demanding, were also happy, peaceful, and simple.
Ok, why am I telling you all this? Am I just trying to brag about how great of a labor and delivery experience I had? No, that’s certainly not my intent.
The birth of a child is always difficult. It doesn’t matter whether a woman is using a midwife or a doctor. But I have come to firmly believe that we have made the process of pregnancy and birth more difficult by trying to address it as a sickness to be cured, rather than a natural process to be embraced. As women, we have each complicated our relationship with our own body by distancing ourselves from a full understanding of how it works, and eliminating trust that it can work in the way it is meant to. It is this natural relationship with our body and the children produced by it that I believe the use of a midwife can help restore. There are few things more empowering than a mother feeling and knowing the full extent of her body’s abilities.
Birth doesn’t have to be something that is gross, unmentionable, or complicated. It can be simple, beautiful, and natural. You are capable of understanding what is happening. Pregnancy and birth are not a Calculus equation that only a select few are able to comprehend and manipulate. These natural phenomena are things that all mothers can come to know and love. I encourage every woman to pursue such an experience rather than feel as though she has no choice but to do what everyone else does, or worse, think that she has no ability to understand what’s going on with her own body. If she feels this way, she will make her choices based on fear rather than knowledge.
I understand, however, that many women make the choice to use an OB because any alternative just seems too risky. Are there risks to having a midwife-attended birth? Yes, of course! But for most healthy, uncomplicated pregnancies these risks are similar in scope to the same risks you would encounter if your birth was attended by an OB, if not less. Let’s let the facts speak for themselves. In a study completed by the National Institute of Health, the primary conclusions for the safety of a midwife attended birth are summarized as follows: “After controlling for social and medical risk factors, the risk of experiencing an infant death was 19% lower for certified nurse midwife attended than for physician attended births, the risk of neonatal mortality was 33% lower, and the risk of delivering a low birthweight infant 31% lower. Mean birthweight was 37 grams heavier for the certified nurse midwife attended than for physician attended births.” You can find that study here.
I want to emphasize again that there are absolutely differences between midwives. Quantitatively speaking, there are different kinds of certifications that midwives can get that speak to their level of education. But there are also differences in temperament and ability. Just like you should thoroughly vet any health care provider, you should interview and thoroughly investigate the woman you hire as a midwife.
There are a number of women with whom I have shared the fact that we have and continue to use a midwife for the birth of our children. Many respond with interest in the idea of a labor and delivery experience that is at least more “natural” than what they experienced at their local hospital. These women will tell me things like “You’re so brave” or, “I just don’t think I could feel safe enough without an OB present at birth.” Really, though, I don’t think I’m much braver or more willing to take risks than most expectant mothers. Rather, I’ve read a lot about the various options available to me, encountered the positive experiences of many many friends, and ultimately feel convicted that it is right and good for me to give birth to my children at home.
My objective in this piece is simply to encourage women to seriously consider a midwife as an option for their own birth experiences. I hope that by sharing the experience my family had, others will feel more comfortable with the idea of considering a midwife. Of course this is a process of investigation and evaluation for every woman and her husband. I’m not trying to tell anyone to do something they’re uncomfortable with, but the reality is that many pregnant women never even take the idea of working with a midwife into consideration. I urge you to consider midwifery, if only because it means you will be more educated about the options you have as a mother-to-be. But if your experience is anything like mine, working with a midwife will empower you. It will allow you to lay claim to your experience of childbearing in a personal, beautiful way. By my estimation, working with a midwife and having as natural of a birth as possible is the best way to remind oneself of what birth actually is: an incredible act of self-giving followed by the presence of new life.