Call the Midwife Part 2

I’m back for Part 2 of call the midwife! If you are just tuning in, be sure to read Part 1 here. Spoiler alert, I had such an amazing experience using a midwife for my prenatal care and Annabelle’s birth! I wish I would have seen a midwife with my first two babies!

In response to a comment on Part 1, my mom and I want to quickly distinguish the difference  between a Certified Nurse Midwive (CNM) and a lay midwife. We recommend that women considering midwifery care choose a CNM and encourage all women to ask questions of potential care providers, both doctors and midwives prior to making their decision. Topics you may want to discuss include the provider’s cesarean delivery rate, episiotomy rate, and practice and philosophy related to activity during labor, pain relief measures, fetal heart rate monitoring, oxytocin use for stimulation labor, immediate skin-to-skin contact following birth, and breastfeeding. Discussion about the birth location and the ability to respond to an emergency is also important. Obstetricians, anesthesiologists, and neonatologists may be immediately available in large medical centers and teaching hospitals but not so in smaller community hospitals. Researching your options will help you make the best decision for the birth of your baby.

So, now let’s discuss my experience with a CNM.

I loved the doctor I was seeing when I was pregnant with Hudson, my first child. He was kind, supportive, and listened to me. I ended up having a c-section due to Hudson being breech…and he was nothing but amazing. He ended up leaving the practice shortly after Hudson was born, so when it was time to have Sadie I switched to one of his partners. I had a VBAC with Sadie (you can read all about it here) and had an amazing experience. My doctor stayed with me the entire time I pushed and was just so great.

So…why did I switch to a midwife? When it was time for baby #3, I learned that my doctor’s office changed their on call policy. Previously, your doctor would deliver you if you went in to labor during office hours. Outside of office hours you would get the doctor on call. I was very lucky with Sadie that I was in labor all night and my doctor came in the next day to deliver me. The new policy was that only the doctor on call would deliver your baby….and they had like 12 doctors in the practice. To me, that seemed like way too many doctors with zero chance of me getting to know all of them. So, after talking it over with my mom who is a Clinical Nurse Specialist specializing in labor and delivery (lucky me right?) we decided I should switch to a doctor she knew really well who worked with three midwives. It turned out he also is the husband of the doctor I used to see for general care before having babies. He had told my mom on several occasions how happy his patients were with the midwives in his practice. He even said the midwives did a better job than him!

Having a relationship with my caregiver was something that was really important to me, especially after having a VBAC and realizing how much I depended on my doctor to coach me through the process. I felt like I trusted him…which is huge when you are in such a vulnerable position….literally.

I was a little nervous about seeing a midwife at first. Would she push me to have a natural birth? Would she know what to do in an emergency situation? What if my uterus ruptured? (a risk when you have a VBAC). SO MANY QUESTIONS. So I decided to go in for an appointment to see how I felt. But before I could even get to that appointment I had some bleeding. I didn’t experience any bleeding while pregnant the first two times, so of course I panicked. It was on a Sunday morning (of course) and Jon was scheduled to fly to Chicago that afternoon for work and was going to be gone for a few days. Talk about the worst timing ever. I decided to call the office and left a message on their weekend voicemail. A few minutes later, Sarah, one of the midwives, called me and she was so re-assuring. I hadn’t even met her yet but she really calmed me down. She told me to call her the next day (Monday) if the bleeding hadn’t stopped and I could come in. Thankfully the bleeding was short lived and had stopped that afternoon. But on Monday a nurse called me to check in….and offered to let me come in anyway just to check things out (which I did, and everything was fine!). Right then I knew I was at the right place.

Seeing a midwife was a lot like seeing a doctor. You have the same appointments, same tests, and go over the same information. It was just done in a much more relaxed and comfortable way! Midwives are clinically trained professionals that can do almost all of the same things a doctor can do. They can prescribe medication, perform exams, and deliver your baby. The only thing they cannot do is perform surgery (i.e. a c-section). The midwives I saw worked closely with a medical doctor. So I saw the midwives for all of my pre-natal care  and would see one of them for labor and delivery (except for one visit was with the doctor so that I could meet him!). If I needed a c-section or there was an emergency then the doctor would be paged to come in and take over. My main concern was since I was having a VBAC I was at risk (a VERY small risk) for rupturing my uterus. Learning that a doctor would be able to assist at a moment’s notice really helped calm my nerves.

All of my appointments were in the doctor’s office, but instead of in an exam room I met in the midwives’ office….so I just sat on a couch and we would chat about the baby, my other two kids, whatever! The midwife would weigh me, take my blood pressure, and do any other tests needed. It just all felt so much more personal this way! The midwives (I primarily saw just two of them) would take their time with me, so I never felt rushed…and they really listened to me. Now, since this was my third baby, I didn’t have that many questions….but I can see how a first time mom would really LOVE this attention and care!

So let’s chat about the actual delivery, shall we? You can read Annabelle’s birth story here: part 1 and part 2. What was different for me this time around was that my midwife, Sarah, met me at the hospital when I was in labor. Usually a doctor just shows up when it’s time to push, so this totally blew me away! I remember I was in a wheelchair and so uncomfortable that I had to get out of it and walk….Jon was parking the car so Sarah carried my bag and walked with me. She helped me take off my boots and get in to my hospital gown (well….Jon first tried and he couldn’t figure it out, ha!). She checked to see if I was dilated and inserted my IV. She did it all! She also ordered my epidural (midwives are very epidural friendly….they just want to do what is best for you and the experience you want to have!). I remember Sarah walked with us up to the labor room and stopped in the hall along the way when I would have a contraction. She was just amazing. Midwives are trained nurses…so their approach is just so different from a doctor. They really want to care for you and help you in any way that they can. Sarah was with us all night (she would leave to take breaks here and there) but she was so present.

Now, if you’ve read Annabelle’s birth story then you know that I had a really bad periurethral tear that would not stop bleeding. It got so bad that Sarah had to page my doctor (at 2am!). Luckily he lives right by the hospital and was there within minutes. However, another doctor on call in the hospital   actually beat him to the scene. When you have a VBAC, a doctor who is able to perform a C-section must be immediately available in case of emergency.  The hospital where I delivered has at least one doctor present in the hospital at all times…..so even if my doctor wouldn’t have made it in, someone would have been there to take over.

The final thing that was different for me with seeing a CNM was the postpartum care. With my first two babies I had follow up appointments with my doctor 6 weeks after birth. They did an exam, gave me a script for birth control, and I was on my way. However, this time it was so different! Sarah offered to see me 3 weeks postpartum if I wanted to, (I declined) and then saw me at 6 weeks…during which she spent an hour with me discussing and processing the birth! She held and loved on Annabelle during the appointment. We talked about my scary tear, and she remembered Every. Single. Detail. We talked a little about how I didn’t have that euphoric feeling after the birth that I had with Sadie….and how I was frustrated being tied down with all the monitors after the birth. It was very therapeutic for me to talk about the birth with someone who was there! Sarah even shed a few tears during our conversation! She was really invested in me and was sad to hear how frustrated I was….but was happy to hear that my recovery had been great.  I’ve NEVER had that type of relationship with a caregiver. Ever. I opened up to her and admitted (probably for the first time) that I was feeling a little depressed. I was mostly feeling unmotivated to do anything but sit in my house and love on my baby. I didn’t really feel that way after Hudson or Sadie, but I knew my feelings were normal. Sarah throughly assessed me for post part depression,  discussed taking some “me time”, and let me know that my feelings were validated. She knew that Annabelle was our last baby, and helped me see that some of my feelings were related to knowing it was the “last” time I would ever do this.

We also discussed breastfeeding and Sarah offered to check/help with latch if needed. Annabelle is a breastfeeding champ and this isn’t my first time so I didn’t need her to…but man, that would have been SO nice when I was a new mom! Any additional support is always good in my book. Finally, we discussed postpartum sex….which I have NEVER really talked to a doctor about. Obviously I know the drill, but if this would have been my first baby it would have been so nice to hear that I was normal, if you know what I mean. All around it was just a more comfortable, safe space for me.

 I know there are amazing doctors out there. And amazing midwifes. It is important that you do what is best for YOU and your baby. Just know that you have options, do your research, and select a caregiver that is best for YOU. I loved having a midwife for my care and would highly recommend it (in fact, I loved it so much that I have referred three of my friends!). If you have any questions please leave them in the comments or send me an email at thegirlintheredshoes @gmail