Decisions-decisions... it all started at my GP's office when my Dr. asked me "how would you like to continue your maternity care?" She doesn't deliver babies but she could offer me a referral to a team of doctors who do. Being that I was not considered hi-risk I wasn't likely to require an obstetrician but I could consider having a registered midwife. Dr. Baggoo said she had heard good things about a clinic called "Pomegranate" and that I might like to make an appointment to meet one of their midwives before making any final decisions. She offered a very objective description of each potential route and from there I started my research. Here's what led me to choosing a midwife...
-Midwifery care is covered by MSP.
-A registered midwife is qualified to be your primary pre-natal/delivery/postnatal care giver through education and certification. They typically spend 5 full-time university years specializing in the study of human reproduction and child birth. A doctor spends 7 years but has to learn the functions of the entire body.
-Midwives offer the option of a hospital or home delivery for low-risk pregnancies. I didn't know that they had hospital rights. Very important to me in my decision process.
-Midwives are experts in natural birth and possess skills and experience to assist women to birth their babies with minimal intervention and without the use of medications. However, they are not opposed to the use of drugs and epidurals when absolutely necessary. They are very knowledgeable and able to educate on the pros and cons of each potential medical intervention.
-For example: so many women think they should enter into delivery asking for an epidural right from the get go... I was one of them. I had no idea that by having an epidural you would be numb from the waste down. This means your natural contractions are weakened and so you can expect to add up to 4 additional hours onto your labour! Not to mention you often require another drug to induce artificial contractions... which can be rather painful regardless of your numb state. Plus you can become rather groggy from these drugs and in some cases so can the baby. You don't want the baby to be overly groggy for a number of reasons. One of which is that grogginess can weaken a baby's sucking abilities where-by inhibiting success in early breastfeeding. However, a midwife will tell you that in some cases an epidural is good. If you have had a long labour and are exhausted/unable to effectively push and are in the final stages of labour a numbing of the "nether region" can be just what you need to let that baby out without heading to the O.R. for a c-section.
-Fundamental principle of midwifery care~ informed choice. I like this a lot.
-If you choose to have a midwife you will alternate visits between two midwives. This way you are guaranteed to have one or the other present at your birth. They will be very aware of your ideal birth plans and will do all they can to see that things unfold the way you had hoped. Delivery doctors typ. work in pools of 4-5 doctors. You will have all pre-natal visits with one doctor but could have any one of the 4-5 doctors present at the birth. Not only do you lose the comfort of the person you've gotten to know but the doctor on call may not follow your desired birth plan. They likely won't have the time to read it and you won't likely be in any kind of shape to explain what you would like to see happen.
-If you are at all nervous about pregnancy and/or delivery... then you'll like the extra "hand-holding" (as my doctor called it) that you get with a midwife. They are all about explanation, choice and support (many general practitioners are also) but a midwife has more time as this is all they do. It's really nice to know they are available 24/7 by phone/pager from beginning to end. If you have any concerns you can call. Also, a midwife will typically come to your house and be with you during early labour. Then accompany you the hospital. They will be with you through all stages of labour and will stay for approx. 2-hours afterward, tuck-you-in (as my midwife said), and be back the next day to see you off from the hospital. An on call doctor will typically be someone you haven't met before, will join you in the delivery room for the final of the 3rd stage of labour, take care of the delivery, and move on from there.
-Midwife clinic visits last anywhere from 30-45 minutes or longer if needed. Where as the average doctor visit will be 15-minutes.
-Every midwife visit will start with a urine protein test, blood pressure check, an abdominal exam, a listen to the baby's heart rate. From there a midwife spends time talking with you about any concerns you may be having. In the final trimester they spend lots of time working with you to develop your birth plan(s) and educating you on your medical options. They also order any necessary blood work and can administer shots if needed.
-A note on medical routines: I am surprised by the number of medical routines that we don't realize are optional and aren't often necessary for you and/or your baby. Here is one example... Post WWII there was an outbreak of chlamydia. Babies born to mothers with this disease developed eye infections. If these infections were not treated properly then babies went blind. So this led to a country-wide ruling for preventative eye drops to be routinely administered to all new born babies. If you know you do not have chlamydia then these irritating drops are not necessary- baby can forgo the puffy blurry eyed side effects. In my opinion medicines are great when needed but typically come with some sort of side effect. Why would I want my new baby to be given any drug unnecessarily?
-In studies where midwifery care was compared to physician led care midwifery clients have been proven to experience lower rates of forceps, vacuum extractions, cesarean sections, episiotomies, infections and babies born requiring resuscitation.
-Less medical intervention results in less chances of a required c-section. There are a number of reasons you may want to avoid a c-section. For one, babies born by c-section have a higher rate of respiratory illness later in life. A vaginal delivery compresses baby's chest, releases fluids from the lungs and helps the baby to start breathing naturally. Also, with a c-section you often lose the super-important skin to skin 1st-hour of bonding as the baby is routinely whisked away for evaluation. Sometimes the baby will be kept for some time and lose the opportunity to breastfeed for colostrum- a substance that coats the baby's stomach and offers important antibodies. If the baby is kept away too long they can even be offered formula by the nurses... this will reduce the effects of any colostrum they will later ingest. Many women today are booking c-sections for convenience and to avoid the pain of a natural birth. What they don't always realize is that a c-section is a major surgery and so recovery time is much lengthier. All this said, it's great to know that in an emergency a c-section is always available.
-Once the baby has been delivered a midwife will carry out postnatal visits to monitor yours and your baby's health. These will consist of 6 visits to your home over a period of 6-weeks. Yes, this too is covered by MSP. I love the way midwives weigh babies during these postnatal visits. No cold stainless steel scales and crying babies here. Take a look below. :) 
SOME USEFUL LINKS:
Pomegranate Midwives (my chosen midwifery clinic)
http://www.pomegranate-midwives.com/index.html
BC Midwives Association (find a midwife/clinic near you)
http://www.bcmidwives.com/
Canadian Midwives Association
http://www.canadianmidwives.org/index.htm
College of Midwives
http://www.cmbc.bc.ca/
Midwives in Vancouver
http://www.midwivesinvancouver.ca/
-
0 comments:
Post a Comment