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Midwives & OBs

Posted by on Nov. 20, 2009 at 12:13 AM
  • 4 Replies

For the sake of better health, safety, and enjoyable experiences, I encourage women with healthy pregnancies to consider midwives.   The statistics show that this is usually a safer option, but there are other factors to consider, too.  There are some great OBs out there and some not-so-great midwives.    Learning about what the options are and what each mom prefers is relevant.   But when looking for safer and healthier outcomes, midwives do excellent work! 

It's been interesting to learn that many women don't know much about midwives.   I would like to offer a little something for fun here.  Check it out, what you think?

Are you using a midwife?   Is she a nurse-midwife out out-of-hospital midwife?
How is your maternity care?
What are the differences you've noticed between OB and midwifery services?  (If applicable.)

MIDWIFERY: Astonishing Facts

In the United States, with the highest per capita expenditure on health care of any nation in the world, now ranks 25th among Western industrial nations in infant mortality. Almost every other industrialized nation in the world has better infant survival rates than we do.
(The State of the World's Children, 1996, UNICEF)

In every single one of the nations where infant mortality rates are lower than ours, midwives are the principal birth attendants.

The largest study ever done of freestanding birthing centers (where midwives are the primary providers) in the United States was published in the New England Journal of Medicine in 1989. The results found that the infant death rate for all births at birth centers was much lower than that for births occurring in hospitals. If that wasn't astounding enough, it was also found that the cesarean rate was 4.4 percent - less than one-fifth the typical hospital average. Satisfaction with the birth centers was so high among the women in the study that 99 percent said they would recommend the birth center to friends. To top it off - costs averaged 30 percent less than hospital maternity care.
(New England Journal of Medicine: "Outcomes of Care in Birth Centers- The National Birth Center Study" 12/28/89

It is estimated that if all American women had birth attendants with a midwife approach, mother and baby mortality rates would be halved, and the rates of brain-damaged children and other birth injuries and complications in newborns would be cut by three-quarters. Others add that we'd save $8.5 billion a year.
("Mothering Perinatal Healthcare Statistics and Sources," Mothering 1993)

Every president of the United States except Jimmy Carter and Bill Clinton was born at home.

The sober truth is that the data does not speak well for contemporary obstetrics. A three-year experiment was undertaken at Madera County Hospital in California, during which time midwives managed the vast majority of births. The neonatal death rate during these three years was reduced to less than half of what it had been when obstetricians were managing births. The program was terminated, despite good results, because of opposition from the California Medical Association. Obstetricians again assumed control of births. During the next two and a half years, the hospital's neonatal death rate tripled.
("Reducing Neonatal Mortality Rate With Nurse-Midwives," American Journal of Obstetrics and Gynecology, 1971)


(midwives)  Woman's Way    and    Obstetric Way



Women's Way of BirthObstetric Way of Birth
Cultural definition of birth
  • Social event
  • Normal part of women's lives
  • Birth is work by the woman and her family and kin
  • The woman is a person passing through a major life transition
  • Potentially pathological process
  • Illness
  • Birth is work of doctors/nurses/midwives and other experts
  • The woman is a patient
The setting for birth
  • Home or other familiar surroundings
  • Informal system of care
  • In a woman's home or near
  • With other women of neighbourhood and family
  • Continuity of care
  • Woman free to change position and move about
  • Hospital, territory alien to the woman
  • Bureaucratic, hierarchical system of care
  • May be distant from woman's home
  • Woman is separated from those close to her
  • Discontinuity of care, e.g. shift changes/woman is moved from one room or one ward to another
  • Woman may not be free to change position and move about
Caregivers: the support they give and the conduct of labour
  • Older and more experienced women who are themselves mothers
  • See birth as holistic process
  • Shared decision-making between caregivers and woman giving birth
  • No class distinction between caregivers and woman giving birth
  • Equal relationship
  • Information shared
  • Personal caring - longer, more frequent, and in-depth prenatal visits
  • Often strong emotional support
  • Verbal and non-verbal encouragement
  • Familiar language and imagery used
  • Empathy
  • Cultural awareness because they are part of the same culture
  • Awareness of spiritual significance of birth
  • Believes in integrity of birth, uses technology if appropriate and proven
  • Young and older women who have often not themselves had babies, under direction of male obstetricians
  • Trained to focus on medical aspects of birth
  • Professional care that is authoritarian
  • Often class distinction between obstetricians and patients
  • Dominant-subordinate relationship
  • Information about health, disease, and degree of risk kept secret
  • Care depersonalized
  • Little emotional support
  • Lack of communication
  • Use of medical language
  • Threatening and often punitive behaviour, e.g. commanding, scolding, warning
  • Little cultural awareness of rituals, beliefs, social behaviour, values
  • Spiritual aspects of birth ignored or treated as embarrassing
  • Values technology, often without proof that it improves birth outcomes
Techniques used
  • Skills to preserve the physiological progress of labour
  • Usually intervention-free
  • Comfort skill, e.g. massage, hot and cold compresses, holding
  • Few resources to handle complicated obstructed labour
  • No skills to preserve the physiological progress of labour
  • Obstetric intervention
  • Drugs for pain relief
  • Skills and resources to handle complicated and obstructed labour, e.g. intravenous fluids, oxytocin stimulation, surgery

Birth is not only about making babies. Birth is about making mothers ~ strong, competent, capable mothers who trust themselves and know their inner strength.

~Barbara Katz Rothma

When you change the way you view birth, the way you birth will change. -Mongan

by on Nov. 20, 2009 at 12:13 AM
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Replies (1-4):
by on Nov. 20, 2009 at 1:15 AM
i never used a midwife.since this is my last baby;cuz im getting my tubes tied;i decided to try a midwife.i dont know yet how it'll be,cuz my appt's next wk.But when i find out the difference i'll let ya know.

family in the van~Johana~Wife to Johnny*Mommy to Jaylyn 6*Joshua 5*Jamyra 9 months*and baby #4 due June.

by on Nov. 20, 2009 at 1:22 AM

I actually had an OB for my prenatal visits and had a midwife for my delivery! I loved them both!! I actually got to deliver my DS myself.... at the hospital! I loved it!

If you have a normal pregnancy, I would go with the midwife for sure! That was the best delivery ever! I watched my 2 sisters have their babies under the supervision of OB's and they were much more strict to the business, hurry up and push him out already kind of guys. But my Midwife took her time, and let me push when I felt like I was ready! so great!

by on Nov. 20, 2009 at 10:32 AM

I am seeing a midwife. I also saw her throughout my first pregnancy. She is a CNM (Certified Nurse Midwife), so I still have the comfort of having a midwife, but in a hospital setting if I choose, so I will have everything there if I need it.

I think that midwifes are all in all more personal with their patients, which is what I love.

Wouldn't choose anyone else to take care of me and the bab. :)

Pregnancy ticker
by on Nov. 21, 2009 at 5:39 PM

Below is my midwive's bio. I have had 2 births w/ an OB and my last was w/ a midwife and this one will be also. The level of the quality of care you get w/ a MW is AMAZING! I go in at my appt time and see her then and have an hour if I need it! No cold offices or waiting forever or dealing mostly with just nurses. It's nice to feel like it's not a medical issue just being pregnant! Best of all, no one to just run in and catch the baby at the time of birth. It was so amazing to have her there w/ me during my LABOR (even though it was a short time, 1hr, by the time we got to the birth center). It's so great to feel like the person who will birth your baby really cares about you and your baby, in a way I've NEVER felt w/ an OB!


I do home births and birth center births. I have been a licensed Midwife for nineteen years. I have been a primary midwife, and/or a primary birth assistant at over 900 births. I have received professional certification by the Association of Texas Midwives. I have also been decreed by the North American Registry of Midwives as a Certified Professional Midwife (CPM). This is the highest educational honor given by the Midwives Alliance of North America. (MANA) I have also taken and passed the midwifery course offered by the Texas Department of Health. I believe that pregnancy and childbirth, if given the opportunity, are normal functions of a woman’s body. God created a woman’s body to carry and birth babies. Healthy, low risk women, in my opinion, deserve the right to birth their babies without interference. To choose a home birth is such an option. The labor and birthing process is given back to the mother with wonderful results at a home birth. My philosophy is one of prevention and education, rather than intervention and control. Through nutritional counseling, consistent prenatal care and open communication, I believe one can be guided in caring for self. I believe it is important for each parent to take responsibility for the health and education of the complete birthing family. This would include consistent attendance of prenatal visits, childbirth classes and follow-up care. These steps will give the best opportunity for parents to experience the joy and fulfillment a home birth can bring. I want your family to be as involved in your pregnancy and birth as they want to be. It is not uncommon for the children to be on the exam table with mom to help me “feel and hear” baby. Dad’s also having the option of catching their own babies if they chose. It is such an honor to assist families in adding a blessing to their household. I will do whatever I can to serve you and assist you with the birth you desire.

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