17 October 2010

Choosing a Medical Practitioner

Throughout my pregnancy, I've had several people ask me why I opted to go with a midwife. In short, my living in New Zealand for a year was the real instigator. Pretty much all women have midwives there. The midwives are certified nurses who specialize in midwifery. They deliver in hospitals, and if there are any sorts of complications or problems, the midwives transfer their patients to an OB. (At least that was my understanding.) I was visiting my friend, Makereta, on a couple of occasions when her midwife came for a visit. I was impressed with the level of care Makereta received and with the friendly nature of the visits.

Somewhere along the way I started considering going with a midwife when I returned to the States. I wanted to be sure I found a Certified Nurse Midwife, and not some hocus-pocus-get-out-the-shoelaces-and-boil-some-water sort of midwife. I learned that in the state of Utah CNMs are allowed to deliver in hospitals. This was important to me because although the risks of delivering outside of a hospitals are generally fairly low, it is not something that I felt comfortable with.

When I learned I was pregnant, I looked for a CNM located within a few miles of my apartment who was also covered with my insurance. I only found one practice, and I decided to give them a shot. When I called, I just asked the secretary to set me up with whoever was available. Yes, I was nervous. What if I didn't like her? What if she would want me to go all-natural when I didn't want that? At some point I realized that if I didn't like her I wouldn't have to see her ever again - I could just choose another practitioner. Easy! Fortunately, I loved my midwife from my first appointment. I feel really confident with her, and I have a good relationship with her. I can tell that she loves what she does, and that makes me more confident in her too.

When some of Eric's aunts (Grandpa K.'s daughters) asked Eric why I opted for a midwife, he told them it was because doctors aren't as good as they used to be. Grandpa K. was an OB/GYN, and a very prominent one in the Salt Lake Valley for many, many, many years. I have been with him before when patients have come up to him and expressed their thanks for saving their lives or saving the lives of their wives and/or children. If Grandpa K. could deliver my babies, I would definitely let him. But he is 91. He retired some years ago, and I don't actually think he is very interested in delivering any more babies, even if they are his great-grandchildren. I think that it has become very challenging for patients to find medical practitioners who are as thoughtful and loving as Grandpa K., and I think that the bureaucracy of the medical profession has made it very hard for medical professionals to be as thoughtful and loving as Grandpa K.

While the personal care I receive from my midwife is a large part of the reason I decided to go with her, there was also a great deal of practicality in the decision. Midwives are cheaper than doctors, and I don't really need a doctor. If any aspect of my pregnancy were high-risk, I'd certainly go see a doctor, but I don't really need one. Truth be told, I see our medical industry in the U.S. gradually turning toward qualified medical professionals who are NOT doctors to handle routine medical care. I just happen to be on the beginning of that curve.

With all that said, I, personally, did not select a midwife because I want an all-natural birth. I am counting on that epidural. I did not choose a midwife because I want to have my baby at home. As I mentioned, that thought sort of freaks me out. I did not opt to go with a midwife because I would have a better chance of her delivering me on the big day; that turned out to be a bonus. (With only four women in the practice, I have a better shot than if I went through a traditional OB/GYN practice which usually has several more practitioners.)

And there you have it. You don't have to agree with my decision, and that's fine. It was mine to make. Having had no experience with birthing a baby, I can't really say that a midwife is better than an OB/GYN. (And even if I did have experience, that evidence would be anecdotal rather than empirical, so I wouldn't base all your decisions on it anyhow.) I think in the end it won't matter a whole lot, but this is the decision that I feel comfortable with.


Janssen said...

I so wish I could have a midwife birth in a hospital in Texas. Alas, not really an option.

Angela Noelle of SK said...

Good midwives rule. Oh, how I heart my midwife.

Heather said...

I LOVE my midwife!!! Used her for all 3 kiddos and still go to her yearly. I would never choose any other way. (Not that it matters... YOU are the one having the baby. YOUR opition is all that counts!!) Hope all is going well!!

La Yen said...

Excellent post!
In the Army hospital where I had to go, 99% of the maternity patients are seen by and delivered by certified midwives. As my OBGYN put it "You only want me there if there is a surgery." I loved these ladies, and was glad to have them for the 20 minutes before they decided I was way too high-risk and had to see a doctor. :)
And if you want a kick-A doula, I have got an amazing referral for you...