Belly Up

* bellies * birth * babies * breastfeeding *

Thursday, May 3, 2012

Cinco De Mayo

So what does a holiday generally equated with liberal amounts of salsa and beer have to do with childbirth?  Nothing I suspect, though perhaps 9 months after Cinco de Mayo there is a slight uptick in births?  That thought aside, May 5th just so happens to be the International Day of the Midwife. So as a tribute to midwives everywhere, I thought I would attempt to dispel a few of the myths that surround midwives and their care. 

Make love (ie make
babies) not war!
MYTH 1- Midwives smell like patchouli, ie they are all hippie chicks. 
I can't claim that no MW has ever smelt of patchouli, but I can say none of the ones I have ever worked with have. There are certainly some proud hippie midwives in the mix but there are some proud hippie expectant moms so that works out just fine.  However, midwives come in all shapes and sizes and in all flavors of religious and political views.  They've got diversity covered (if you don't count gender anyway). Here in DFW there are probably more conservative Christians midwives than anything else but, as they say, this is the Bible Belt so that makes sense.

MYTH 2- Midwives are not trained to handle emergencies.
Midwives are trained to handle emergencies, they just are not trained to handle emergencies with surgery. Even better, midwives primary training is to prevent emergencies in the first place.  I think most of us would agree preventing the emergency is usually better than having to deal with it at all and so midwives spend a lot of time educating and preparing couples to have the healthiest pregnancy and labor possible. So for example, typical obstetrical care doesn't address gestational diabetes until it is tested around the 28th week of pregnancy, whereas a midwife will start helping mom with nutrition in the 1st trimester so that she can avoid insulin issues.  When it comes to labor, midwives bring equipment to monitor baby's heartbeat and mom's vitals, they always have oxygen (and even baby oxygen masks) and they are certified in neonatal resuscitation.  They can run IVs, deal with a post partum hemorrhage, deep suction a baby, cut an episiotomy, repair a perineum, monitor baby's blood sugars and do blood work.  Depending on the midwife, they can often even deliver a last minute turned breech baby.  Not bad!  Even better is that a midwife has been trained to help reduce the risk of all those things happening.  If an issue arises that is beyond their training, they know when and where is appropriate to get mom different care.

MYTH 3- Midwives only deliver out of the hospital,

MYTH 4 - Birthing with a midwife means mom better just bite the proverbial bullet pain wise.

Hi mom, hi dad!  Hi midwife!
MYTH 5 - A couple cannot have a sonogram if they birth with a midwife.
I will answer all these together.  There are various types of midwives, and their licensing varies from state to state.  I am a TX girl and so most of what I say is about TX and not necessarily all 50 states.  Certified Nurse Midwives (CNMs) often deliver in hospitals and operate similarly to an OB in terms of type of office.  These CNMs offer moms the option of birthing in a hospital, access to an epidural, narcotics, pitocin and of course natural birth along with the more personalized care of a MW. In most states they can also write prescriptions.  Other CNMs will choose to solely attend deliveries out the hospital.  Obviously out of the hospital, the epidural is off the table, but moms can choose to receive narcotic pain meds.  Certified Professional Midwives (CPMs) only attend out of hospital births and they cannot write prescriptions, however they do blood and lab work and many do their own sonograms as well.  Either way, you can catch a glance of Junior in the womb.

MYTH 6 - In an emergency I can get help more quickly if I am at the hospital and have an OB.
While it is true that one will be at a hospital more quickly if one is already at a hospital, it is also true that the OB most likely will not be there.  OBs typically do not head to the hospital until baby's arrival is imminent so if a true emergency occurs before that moment, help from an OB is as close, or far, away as where the OB lives or offices...or takes his family out to dinner or plays golf etc. In an out of hospital situation, it is likely that a mom transporting in will arrive about the same time as an OB. The midwife will have called ahead and everything will be prepared for whatever the next step needs to be.  One bonus to midwifery care is that a midwife will be with mom during her active labor and if anything looks off the midwife should pick up on it quickly and can take action to fix the issue or make the move to seek assistance. 

I do know that there are some OBs that practice more in a midwifery style and some midwives that have less of the personal and preventative approach.  However, since this is a day of celebration, I will just leave it at that.  Happy Day of the Midwife...and pass the chips and salsa!