I am doing something quite different for this post. Instead of picking a topic, I've chosen a group of local midwives to write about. I am continuously sending natural birthing couples their way and I decided to make a post out of it. If you do not live in the Ft. Worth area, I suggest you use this standard in finding a similar type group in your area. I have nothing to gain by promoting this group, by the way. Simply giving information on a group of midwives who are working hard to provide Mother-Friendly care.
If you read my blog regularly, you know how I feel about homebirth. About 25% of the couples that take my class do give birth outside of the hospital. But that leaves 75% in the hospital. That is alright. I understand, having had 2 hospital births before my two homebirths, why couples want to birth in the hospital. The hospitals, however, are not all created equal.
Let me tell you, in a nutshell, why I am singling the UNT Midwives out for this post. They are all CNMs, or Certified Nurse Midwives, and there are five in the group. To be perfectly honest, some are more medically minded than others, as in any group.
There are three reasons I choose this group over the other CNM groups in the area:
1) They are doing water birth at the hospital. Even if you do not think that you want to have a water birth, the fact that you have this option is huge. It's all about options, really. They are not telling you, like the majority of the other hospitals, that they want you chained to a monitor in the bed. Water birth, or at least laboring in water (often called "a midwife's epidural") is a lovely option for moms and babies, and it's wonderful that it has become an option in a hospital setting.
2) They give you the full 14 days "over" your "due date" before they start talking induction. I have decided in my seven years of teaching that the majority of women truly believe that this won't happen to them. "Going 'overdue' and long labors are things that happen to other women, not to me." OK, it's not said outloud or sometimes even consciously, but it's real. So many women are not prepared for this possibility at the end of pregnancy. So much can happen in those extra days that the UNT midwives are willing to give you. A lot of other groups and/or hospitals have a 7-10 day rule. Me no likey.
3) They are VBAC friendly and so is the doctor that backs them. Again, huge. Even if you have never had a c-section and are not having a VBAC, this philosophy, mindset, and belief is important to all pregnant women. No one wants to have a doctor who has a no-VBAC policy. He or she is preoccupied with legal issues and does not believe in the inherent safety of birth. They have a what-if mindset. A woman with a doctor like that will have a c-section. Also, their back-up doctors believe in their midwives. There are other local CNMs that are not "allowed" by their back-up doctors to do VBACs. Huge. This might seem like a big who-cares, but it's not. It speaks volumes about what is going on in their hospitals.
Ultimately, you do not have to fight to have a natural birth. As long as you do not have drugs, you will have intermittent monitoring, allowing you the freedom to walk or be in the water. You will be encouraged to eat and drink. You will have very limited vaginal exams. Other hospitals require an IV, continuous fetal monitoring, no walking if your water has broken, and vaginal exams every two hours. These "policies" contribute to the high c-section rates.
I should mention that not every experience at Harris has been great. I have had a handful of couples birth there where I was disappointed in how things were handled. Overall, however, these instances have been few and far between. I also believe that they are working extra hard to lower their rates of intervention, including c-sections. Bottom line: if you are birthing in a hospital in the Ft. Worth area, I am most comfortable with how the UNT Midwives do things.
I had a couple give birth with the UNT midwives this past weekend and I would just briefly like to share why they did not have a c-section. I believe that just about any other hospital in the area, she'd be recovering from surgery this week.
This mom had been having some strong contractions about 7-8 minutes apart for about 4 days. She had had a difficult time sleeping and was exhausted by the time she showed up at the hospital Saturday morning. She had some Demerol to help her sleep and by late afternoon without a whole lot of dilation, she had an epidural. Eventually, she had pitocin to pick things up, but the baby didn't like that so much. Instead of doing a c-section -- as just about any care provider around would have done, calling it fetal distress and fearing a lawsuit -- the midwife turned off the pitocin and told this mom to go back to sleep. They'd try again later.
Eventually, the epidural wore off, after the mom had gotten in some good sleep, and she was able to squat her baby out! Her midwife believed in her ability to do have a vaginal birth. Except for exhaustion, mom was fine and baby was fine. She recognized what was working for them and what wasn't.
I also must add, when her doula showed up at the hospital, all the lights were on, monitors beeping loudly, and family all standing around watching this laboring woman. Her wise doula created an atmosphere of quietness, dim lighting, head massage, snuggle time with the hubby, and things moved along quickly afterwards. She probably should have been there sooner!
"I like my doctor" is not a reason to stay at your hospital. He or she will very likely not be at your birth. The nurses run the show at the hospital. You want nurses who are used to working with midwives and have a respect and belief in the natural process of birth. If all they ever see is inductions, epidurals, and c-sections, this is what they are comfortable with. Get the heck out of Dodge and run over to the UNT Midwives.
Now, if you decide to birth outside of the hospital, you have lots more options available to you. That's another story for another day!
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