I wouldn't have necessarily predicted that I would have a midwife deliver my children. Even after I had my first (with an OB-GYN), I wasn't hellbent on seeking out "alternative care." But when I found myself pregnant, in another state, and searching for a new provider, the one I liked most was midwife. I'm so, so glad I made the switch, not because I didn't like my experience in obstetrics, but because I just loved the midwifery model so much more. There are things all moms who used a midwife know to be true that, when asked about my experience, I am more than happy to share.
There are lots of reasons an expectant mother might choose to go with a midwife instead of an OB. For some it's a desire to have a less medicalized birth. For others, it's previous birth trauma. For more still, it's simply a mere preference for the midwifery model of care. In my case, the midwife who delivered my second child was one of the few practitioners I found who was willing to back me up in a vaginal delivery after a previous C-section. It wasn't that I wasn't a good candidate for a VBAC, but many OB-GYNs just don't do them as a matter of course (despite, I will point out, the recommendations of their governing body). Moreover, she had the statistics in her practice to prove that she wasn't just placating me to get me on as a client, only to change her mind once I went into labor.
So I was going into the care of a midwife with a specific goal in mind, but I would recommend that anyone consider if it's right for them because of an overall excellent experience. And that experience comes with the following knowledge:
People Don't Know What To Make Of You
At best, people are confused or concerned. At worst, people accuse you of wanton recklessness. I don't necessarily blame them (though I do roll my eyes a bit when they start to get super judgmental, not gonna lie). Here in the United States, midwives account for less than 10 percent of lead birth attendants. While that number is growing, most people have no direct or even secondary experience with midwives. Many think midwifery is a relic of a bygone age when women regularly died in childbirth and so their opinions are, understandably, negative. These attitudes, incidentally, are not accidental, they are the product of 20th century campaigns intended to discredit midwives.
Those of us who have used a midwife to help us through a pregnancy and birth are fully aware of other people's confused or negative opinions. Sometimes we're able (and willing) to explain our choices to them in a way that makes them come around. Other times we just nonchalantly deal with the fact that people think we've lost our minds.
Among The People Who Are Supportive, There's Always One Who Completely Misunderstands Your Motivations
On the other side of the confusion coin is that one friend/acquaintance/well-meaning stranger in the grocery store who runs up, rubs your belly, and starts getting overly-personal really fast. When they learn you're using a midwife, they are all about it, which is nice, but then they start to project and project hard. Like, whatever reason they have for being down with midwives is now your reason for being down with midwives. For example:
Them: OMG, you're going to use a midwife?
Me: Yeah, I found someone I really like.
Them: Good for you! I would never use an OB.
Me: Oh, that's not...
Them: Never in a million years. They're only interested in money... also they're alien lizard people who want to steal the baby's stem cells to make a clone army to conquer Earth.
Them: That's why delayed cord clamping is so important. Don't let them get the cord...
But the truth is that those of us who use midwives all come to that decision for different reasons, and they're all personal. One should never presume to know our motivations.
Midwives Are Qualified Care Providers
A lot of people think midwives are wackadoo witches who eschew medical knowledge in lieu of incense and, like, good vibes, man. And, I will admit that there are some practitioners who will take on the title "midwife" with little-to-no formal training and they are allowed to do that. However, there are robust and demanding bodies governing the training and certification of midwives in America. Many often go through years of training. My midwife, for example, was a certified nurse midwife (CNM) and spent more than eight years achieving that goal. (And no, that did not include a three year meditation journey or anything.) That time comprises an undergraduate degree in nursing from Johns Hopkins, a masters in midwifery from NYU, and then additional hours training for various certifications. In short, she knew her sh*t.
Midwives Are Not Doulas
Lots of people assumed that when I said I was going to be working with a midwife what I meant was "doula" and that an OB would be doing the actual delivery. No. There are big differences between a doula and a midwife. Mistaking the two is kind of like mistaking a museum docent for Picasso: the former can understand what the latter is doing and help you to understand it, too, but they cannot do what the latter does.
A doula is there to provide moral support to a pregnant/birthing mother. A midwife is there to provide prenatal care and deliver your baby. That's not to say that a midwife can't provide amazing emotional support, but their primary focus is getting everyone through pregnancy and delivery safely.
Using A Midwife Doesn't Mean Having A Homebirth
While a lot of women who choose the midwife route will want to deliver at home, the idea that midwives are synonymous with home birth is not accurate at all. Personally, considering the fact that I had a previous (emergency) C-section, I wasn't comfortable with the idea of delivering at home. I wanted to be as close to emergency medical care as possible. Fortunately, my midwife had privileges with a nearby hospital and I chose to deliver there. As time goes on, more and more hospitals are opening their doors to certified nurse midwives, providing women with more and more choices. (Woo hoo for choice!)
Things *Are* A Little Bit Crunchier
Like, it's not all meditative yoga and herbal remedies... but I'm not going to lie to you and say that there is not a higher than average use of that sort of stuff when you work with a midwife than an OB.
Appointments Are *Long*
When I was pregnant with my son I saw a (wonderful!) OB. I could usually get an appointment handled during a lunch hour. It was very convenient, and I was happy with my level of care. After moving away from that practice and selecting a midwife, I figured appointments would basically run the same. Yeah, I was wrong. I found that I basically needed to take off the entire afternoon on appointment days (thanks again to my last job for being so awesome about that, by the way). There were a lot more lengthy, in-depth discussions with my midwife than I ever could have guessed.
You Will Talk With Your Midwife As Much About Your Feelings As Your Vag
Part of why those appointments were so much longer than my OB appointments is that my midwife would really delve into everything with me. So in addition to monitoring my progress, she would give me lots of time and space to go deep into discussions about birth anxieties, worries I had about about going from one child to two, baby books I'd read, and my birth plan. While I don't doubt that lots of people have similar relationships with their OB-GYNs, in my anecdotal experience it seems that midwives more typically take a more "mind/body/soul" approach to prenatal care than doctors.
You're On A First Name Basis
It feels so weird but also so cool. Like, "OMG we are so BFFs." Culturally, we're used to distancing ourselves from care providers by using honorifics. I'm not opposed to that, by the way — if I earned a medical degree I would probably insist on being called "doctor", too —but it's a nice change of pace to be like, "Oh, that's Kristin, my midwife. She's cool."
More People Should Consider #TeamMidwifery
Which isn't to say it's the right choice for everyone, but those of us who have had positive midwife experiences (and I'd venture to say that most people who go with midwives have a positive experience) know that most people don't even realize it's often an option for them. More choices make for more empowered births, no matter what you decide, and that's always good thing.
Check out Romper's new video series, Bearing The Motherload, where disagreeing parents from different sides of an issue sit down with a mediator and talk about how to support (and not judge) each other’s parenting perspectives. New episodes air Mondays on Facebook.