Why A Birth Center and Midwife

I want to be clear first: I think modern medicine and hospitals are awesome. Seriously, they have been my good friend this pregnancy. Rehydrated me 6 times now due to hyperemesis. My son bashed his chin open a few weeks ago and the wonderful local children’s hospital glued him back together. I had repeated tonsillitis and ear infections (so bad it was damaging my immune system) in college, my amazing ENT took out my tonsils and my hospital took great care of me afterwards. Seriously, wonderful and totally awesome when you need that kind of treatment. But I don’t view a pregnancy with no major complications as a something that needs that kind of treatment.

 

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Jack was a few hours old, both of us doing good.

Jack’s birth was good. Nothing horrible happened and we were both given reasonable care. It was very standard Medical Model of Care. They followed protocol and did all they could to ensure we both were healthy and alive. I gave birth in a very busy county hospital, so some resources took longer to get. But when they did come, they tried hard to give us good care with the limited time they had. Overall, I say it was just good.

However, now that I am more educated on birth, I want better than good. I want my requests respected (within reason). I want the Midwife Model of Care this time. In a nutshell, the Midwife Model of Care believes that birth is a natural process that your body already knows how to do on its own. You just need a little guidance and enough time to relax to do it. There is still medical care offered—a midwife doesn’t just leave you alone for 40 weeks and only show up if you have a problem in labor. Standard procedures like blood tests, ultrasounds, and exams are offered. The key difference is you build a closer relationship with your midwife, so you feel comfort and trust her during the birth process.

That last part was what drew me to midwife the most. My OB with Jack was not the person who delivered him. I adored her and wish she had delivered him, but that’s not how my clinic worked. The on-call OB at the hospital at the time delivered Jack. I had no idea anything about her, only her name and that she was a doctor. I didn’t know her stance on natural childbirth practices, c-section rate, or anything else. And I had no choice but to just trust this random woman when I was the most vulnerable. It was worked out okay, but it’s not something I want to do again. There are a few things I want to avoid now that I know better.

First of all, when I got to the hospital, they did not believe me that my water actually broke. The triage nurse looked at me like I was lying…despite the fact that I was carrying a SOAKED towel between my legs. She left me standing next to the bed leaking and gave me no instructions. I had a contraction, so I leaned over the bed and set my towel on the tray. She came back in and freaked out! Threw the towel at my husband and said NO NO NO! She immediately got cleaning supplies and sanitized everything again…leaving me hunched over wanting to cry from the contraction and still no instructions. Then she left again. I just grabbed the gown on the bed, got undressed, and laid down. She came back in and asked if I was having contractions. I looked at her crazy and said yes. I told her they were 2 minutes apart and 90 seconds long. She kinda rolled her eyes. She hooked me up and looked very surprised to see I was right. Then she asked for a urine sample. I told her I did not have to pee and really needed to lay down because my contractions were coming faster. She said I had to, they needed a urine sample to admit me. So Michael helped me hobble to the bathroom. I tried, but only got a big gush of fluid. I came out and told the nurse I couldn’t. She took the cup and said fine, she will check to see if it’s actually amniotic fluid. Then she announced it indeed amniotic fluid and without saying anything else really, she checked me. I was 2 cm. I was kinda bothered that she didn’t ask first, but it got me away from her faster so I didn’t argue. She left without saying anything again and came back close to an hour later. At this point, I was starting to transition. I couldn’t talk during my contractions and was started to shake. While Michael was asking if I wanted him to sign the epidural form just in case, I started to vomit. The nurse once again couldn’t believe it so she checked me again, I was close to 5 cm. They quickly took me to my room and I was so happy to be away from that nurse. Looking back, I can understand her attitude. She had to follow the Medical Model of Care and I was not following the procedure she was set to do. I didn’t come in as a women not sure if she was in labor who had the time wait as she checked all the boxes. That being said, she did have poor bedside manner.

In my room, I was progressing so fast and was exhausted. I knew I needed an epidural to relax. They needed my blood work results before the anesthesiologist could come. One nurse really fought for me. She put a STAT order on my blood work and refreshed the screen every 5 minutes to check. Then once the results came, she called the anesthesiologist immediately. She held me while the needle went in and stroked my hair when I had contraction at the same time. So, I know nurses can be very amazing and really help you when you need it.

 

Would you keep telling this face they need to flip on their back?
Would you keep telling this face they need to flip on their back?

However, there were some other issues. She and another nurse kept insisting that I had lay on my back for continuous monitoring. I physically couldn’t. That made contractions unbearable. Plus, I knew on your back is the worst position possible for labor progression. And continuous monitoring is unnecessary if there are no complications. I did go onto my back for a bit every hour or so to check if Jack was still okay, but flipped back on my side once they said it was good. I finally asked if there a major reason why and they said no, just protocol. Then they backed off. Once again, they didn’t do anything bad really. They had a system to follow, but my body’s needs didn’t fit into it.

 

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Taken the day I posted this. The red mark is permanent. It should have been our consent to give it to him.

I pushed for 1.5 hours and Jack was stuck with his 1 head inch out. The doctor stuck an external probe on Jack’s head to check his vitals since he had been in there so long. No one said anything to Michael and I, just told me to stop pushing for a second. At the time I didn’t really realize what she was doing. He was fine so she told me to push again. In general, I have no objection to having this done. He was stuck for awhile and it was important that she made sure he wasn’t in distress. But, it left a scar on Jack’s forehead. If anyone was going to make the choice to permanently mark our child, it should have been ours. I would have totally understood if they said “I’m going to stick this on his head to check his vitals, okay?” It was not an emergency situation, no one was rushing, they did have time to ask. I resent the lack of communication and consent, not the actual procedure.

 

About this time is when I saw what the IV bag said...
About this time is when I saw what the IV bag said…

After Jack finally came out, they plopped him on my chest and encouraged me to nurse him. I vaguely remember them saying my placenta came out intact and no excessive bleeding. I thought yeah yeah, I’m trying to feed my child. Then I looked up at my IV and saw the bag said Pitocin. I really wanted to get mad. I said out loud and in my birth plan that I did not want Pitocin unless it was truly necessary. They started a bag to get my placenta out quickly and never mentioned it to me. They gave me a medication I did not consent to. If they said something like, “We would like to start Pitocin right now to get your placenta out quickly because we need to make sure you are okay before the doctor has to leave for the next delivery”, I would have totally understood and said okay. I know this is standard Medical Model of Care, but I resent not being informed of what was happening to my own body.

I was one EXHAUSTED and stressed mama, don't let the smile fool you.
I was one EXHAUSTED and stressed mama, don’t let the smile fool you.

I also hated my hospital stay. The nurses were all super busy because the ward was full. Many of my questions and requests barely got answered. Also, being woken up to be checked every few hours stressed me out beyond all belief. I was exhausted and the hospital was not restful. The second night there, Michael went to sleep in the car because he was so exhausted and had to drive us home the next day. I was alone in the room with screaming Jack and so exhausted I couldn’t even think straight. I burst into tears and was shaking. The nurse came in and said I just needed to sleep. I explained that I can’t because he won’t calm down, and you are going to come back in shortly to check us. She just shrugged and left. I know there was nothing she could do, that was not her role and she was just following the Medical Model of Care once again. But it was stressful and hard for me in that moment. It made me feel like I was already a horrible mother.

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This time around, I know what I want in my birth experience. And unless there is an emergency, I don’t want the Medical Model of Care. There are women who truly need this type of care all along (my friend who has Sickle-Cell Anemia and fought infections most of her pregnancy definitely did). So, it is wonderful this type of care exists. However, I want something different this time. I want a connection with the person I am trusting to touch me when I am the most vulnerable and help bring my child into the world. I want her to know right off the top of her head that I do not want Pitocin. I want to labor on my side without question and not have to argue for occasional monitoring. And I want to recover in a relaxed, comfortable setting with my husband and newborn. I want my provider to believe me when I say something is happening. With the Midwife Model of Care at a birthing center, I get all this. They are not crazy things to ask for at all. I want to be respected, informed, and comfortable. All medical patients deserve this, especially women who just giving birth.

I really suggest you check out Birth Without Fear. It really changed my views on birth and helped me process some of the issues I had with Jack’s birth.

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