OB vs. Midwife - Video

This completely describes my own experiences with OB care vs. my home birth midwife.

Pregnancy and Health Gadgets

Blood Pressure Monitor

 I love gadgets, and when I can get gadgets that help with my family's health, it's even more fun!

My midwife recommended I get an automatic blood pressure monitor. I have a cuff and stethoscope and I'm comfortable taking my blood pressure with that, but she felt the automatic monitor might be easier and more accurate. It was like Christmas to get one and bring it home.

Traditional
Blood Pressure Cuff

She also suggested that I get my own doppler to listen to fetal heart tones. I already have a fetoscope that I haven't been able to use yet, because I'm not far enough along yet. A fetoscope can be used starting around 18-20 weeks, and I'm really looking forward to trying mine out. I love that the fetoscope doesn't use electricity or sound waves like the doppler, but I think a doppler would still be fun to have, especially since I plan on becoming a midwife and would like to have one for my future practice. I'm not sure how much I'd use a doppler versus a fetoscope, but I'd like to get some practice with both, especially the fetoscope since it takes some skill, or at least a trained ear, to use.

Doppler

Fetoscope

I don't have a history of blood pressure problems or other pregnancy complications, but I'm getting these things as part of my plan to take charge of my prenatal health. As I talked with my midwife about these things yesterday she also suggested that I bring home the file she started for me, and use that to track my prenatal health. She asked me to bring the file to each of the five prenatal visits and she said:

"You're responsible, which is really true for everyone, but they don't always take that responsibility."

And that statement pretty much sums it up for me.

Planning and Meditating on Birth - Part 1

I was talking with my sister recently about birth choices, and I started wondering how much the decision of where to labor and give birth has an impact on the experience and the outcome. I told my sister that if I'd been in the hospital with my breech baby I probably still would have had the outcome of a healthy baby, but the experience would've been altogether different. The labor itself would have been different and I wouldn't have been so relaxed and comfortable. And then there's the issue of the surprise breech, which would have led to an emergency cesarean. Instead of recovering from a vaginal birth at home, I would have been recovering from abdominal surgery with 4 small children and a newborn. My fear of c-sections in general would have left me scarred emotionally, and I would've had a lot more to heal from than just the physical trauma from the surgery. I also would have ended up with a uterine scar that could impact future births.

I shared my home breech birth story with a group of my midwife's clients at her home. At the very same meeting another mother shared her hospital birth story, and it was a striking contrast to mine. She had a natural labor without interventions in the hospital and everything went smoothly. However, after the birth she noticed her baby was twitching. The doctors and nurses hadn't noticed it. It took the mother's eye and intuition to see that something was wrong. They determined that the baby had suffered a stroke sometime after the birth. Because they were in the hospital, the infant was able to immediately receive the medical care he needed. What was even more interesting to me was when she told us that she had considered planning a home birth, but whenever she thought about it she felt uneasy. She didn't know why she felt uneasy, but she followed her feelings and planned to have the baby in the hospital. She was exactly where she needed to be, and it was because she followed her feelings. I, on the other hand, had felt nothing but peace when I planned my home birth, and I was exactly where I needed to be.

I believe there are times when no matter which choice we make, we'll still have a positive outcome. Almost all babies would survive whether they were born at home or in the hospital, whether born vaginally or by c-section. Almost all mothers will survive birth regardless of where it takes place or under what circumstances. But the outcome is not the whole picture.

Rixa from Stand and Deliver has a great commentary post on her blog about the way people say that all that matters is a healthy mom and baby. "Health" in this sense usually means "alive".  

We all know that health is all-encompassing, and it doesn't simply imply survival alone. Health is physical, mental and emotional. When a woman has a traumatic birth experience under any circumstances, she is emotionally unhealthy. Trauma can lead to Post Traumatic Stress Disorder, and while it's not commonly associated with postpartum women, if the mother suffered trauma during the birth she is more prone to this state of disease. Trauma is not associated with specific birth events, but rather the woman's interpretation of them and her feelings of either being in control and respected or being out of control and disrespected. By definition the CDC considers cesarean section a "morbidity", which would imply that any woman who's recently had a c-section is physically unhealthy. We can see that there are many different situations under which a mother and baby can survive birth but still be unhealthy afterward.  Heather Armstrong wrote a beautiful, yet heart-wrenching post on The Unnecesarean about her own experiences with emotional and physical trauma regarding birth.

The outcome matters. The experience matters. The emotional, mental and physical well-being of mother and baby matter. How can expectant parents plan for birth with all of these variables in mind? How can they make decisions about their baby's upcoming birth hoping for the best experience and the best outcomes?  


Click here for part 2...

"Hope is better than nothing"

Women in Charge blog wrote this. It really touched my heart, and I want to pass it on to my readers:

Hope is better than nothing

by Maria Iorillo

I keep thinking about Sara from Uganda. She runs a 15-bed clinic along with 2 other midwives. She receives $5 per delivery. Some women come for prenatal care and not too many people come postpartum. Once a healthy baby is born, most of her clients feel they don't need to return.

Sara came all the way to Washington, DC to represent the Ugandan Midwifery Association at the Symposium to Strengthen Midwifery. She received a scholarship to attend Women Deliver. The UMA has over 2000 midwives and was started in 1948 when the government tried to make midwives retire at 55. You can imagine what the midwives said to that! So they formed an organization to better represent themselves to the powers that be. Sara says the UMA is the best midwifery organization in the world.

When the Symposium was almost over, Sara was discouraged and asked me what would happen on the ground. On my last day with Sara, we were walking from store after I had bought chocolate for her to take home to her children. She was hopeful, particularly because I had just made a blog for her that morning. She wants to use the blog to tell the stories of maternal death in Uganda. She wants to post about the midwifery meetings they will have. She has a new vehicle for communication. She is going home with SOMETHING already in her pocket. She says that hope is better than nothing. She says that she has a new friend, she has a blog, and that she knows that she is not forgotten. That the women of Uganda are not forgotten. Sara decided to call her blog, Women for Survival.

Women for Survival

I keep thinking about Sara and our fast friendship. I am thinking about our partnership and how one-on-one we can help each other strengthen midwifery. I know so well how the Bay Area's midwifery community has grown simply because of the one-on-one support we give each other. Why can't we do that across the global? I guess I'm saying there's no reason why not.