Would you give birth in a midwifery led unit?

Interesting to see that when I voted it was over 70% in favour of midwife care :clap: I chose that for my first birth and am heading there for my second (any day now would be good, not that I'm over being pregnant at ALL). I loved the fact that in the room were me, my partner, the midwife and then our baby. So simple. I felt really lucky to have this choice, knowing that if needed I could be transferred to the hospital where I would get any specialist care I needed. It worked really well for us.

buliej,

my youngest son is an IVF baby, my first 3 were not and yes, in the end, it didn't make any difference to my pgs or births.

I voted 'yes'.

Wouldn't choice be a lovely thing?

What we'd truly like is a home waterbirth, with a midwife. Not sure if we'd be able to afford that, though. So, next preference is for a birth centre with midwives. (Hopefully still in water!)

Mind you, hubby and I are still a little while off TTC... we're still sorting out a visa so that we can be in the same country! (Distance does get in the way somewhat.) ;)

I voted undecided.

I used a private ob in a private hospital for the birth of my DD. Due to placenta praevia I needed a c/s, but we were given until 37 wks to see if a vb was possible. Because I went that far along in the pg without knowing I would wonder how I would have fared finding and trusting an ob in such a short space of time. And I loved my ob and the hospital we went too, so I would choose him again.

HOWEVER the world is not perfect and if he were unavailable for my 2nd child I would look at all options, including midwifery-care.

I can't imagine giving birth any other way! Midwifery-lead care is extremely undervalued and underestimated! Not to mention misunderstood. I've come to realise that many of my family and friends are under the impression that Midwives are not medically-trained proffesionals and that they feel more 'safe' under the care of an obstetrician. It's sad, since the intent of obstetrics is really to manage high-risk occurences, NOT normal birth! And we ask ourselves why women feel disempowered after a highly managed birth where they are no longer the ones in control? There IS a better way for normal, uncomplicated birth, and it's definitely Midwifery-lead care!

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And we ask ourselves why women feel disempowered after a highly managed birth where they are no longer the ones in control?

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I totally agree - women are disempowered in birth - majorly!! Why are we not more confident in the abilities of our bodies to do what is only natural? Weve been doing this for thousands of years afterall... why do we need a doctor to tell us what to do?

I too felt my hospital wasnt a particularly empowering place to be. As soon as I rocked in when I was in labour, I felt like i was spoken down to by the random midiwfe who was on duty. Midwife was being an arse and when I was squatting when I had contractions (because its what felt good at the time) the midwife told me "what are you doing, why are you doing that, get up on the bed". It was more her tone that made me feel little. It was in the regular labour ward as the bookings person pretty much told me to use the labour ward not the birth centre (another disempowering moment from them).

On a bit of a side note, when I told people I was pregnant, one of the first things people asked (after when the baby was due) was: "oh are you going to XXX private hospital? I've heard its really nice" as if its just normally expected to go to a private hospital under the care of an obstetrician (no offence intended to people who choose this option, it was just wierd that everyone seemed to expect me to do it). People thought it was a bit strange that I didnt see a doctor at all for my pregnancy and saw (and planned to see) midwives only.

Karina - I had exactly the same experience as far as people's reactions to my choices. People couldnt beleive I hadn't seen an Ob, or that i hadnt even seen a GP. They actually made it sound like I was making an irresponsible decision!! The fact that i was a young mum (I was 24 when my little boy was born) meant that alot of people didnt take me too seriously either, and felt it was their right to tell me what I was doing wrong - very frustrating!!

And when I say I had a water birth I get a mixture of incredulity and (sometimes - rarely) jealousy (from those who didnt know it was even available!). Also, the fact that I was only in the birthing suite with my midwife for half an hour before my son was born (so therefore no time for pain relief!) people almost fall over with shock! Apparently i'm incredibly irresponsible for staying at home so long (shock horror!) :lol:

Trying to explain my decision was like hitting my head against a brick wall :wall: - people are so brow beaten and terrified by the medical profession that I eventually just gave up trying to explain myself - all I hit up against was peoples judgements and fears. With this baby I think i'll be much more prepared for peoples reactions, and maybe i'll manage to bring a few people around to my p.o.v. - you just never know!! :D

I had a homebirth and still get raised eyebrows and "Well, i guess you were among the lucky ones" when i mention it. I tell people "I didn't base my decision on newspaper stories or other people's fears, i looked at peer-reviewed medical research. It seemed a more intelligent way to assess risk." and leave it at that. There are no papers proving how dangerous homebirth or midwifery-led care is, because it isn't. It might be cruel of me, but i'd rather they realised they are being irrational than let them go on thinking i am.

Bx

*bump*

I am putting this in my submission to the government shortly, any other votes/comments?

Not only would I choose midwifery led care again, but when I recently found out that I was pregnant again, my first call went to my midwife (well after telling family and a few friends). And I am ecstatic that most likely, I will have the same midwife looking after me that was with me all through my first pregnancy, DD's birth and after.
When I tell people about the post natal support I got from my midwife, their jaws drop. They can't believe that it is possible for your midwife to spend 4-5 hours with you every day (in your own home) to make sure that BFing is working out and to help wherever necessary. If more women got this type of support, not only would we reduce the incidence of unnecessary c/s, but also increase the success of BFing.
I cannot imagine giving birth any other way.
OBs are wonderful and necessary for complicated births and emergencies. Midwives specialise in "normal" births, which is the vast majority of births. But when you talk to people around you who have been through the normal hospital system (especially some private hospitals), you could get the impresion that most births are high risk and very complicated, life threatening even. I wonder what these people think has happened in our evolution to warrant that view that we have lost the ability to birth our own offspring.
I am looking forward to having the same people attend to this birth that were there for Maya's birth: My midwife, DH & my mum. Just this time, DD will be there, too. I am actually really looking forward to the labour and birth part. The way I have experienced it, it was amazing. Painful, yes, but magical.

Sasa

Sasa

Just wanted to update that I am SO SO SO GLAD I went with the midwife care/birth centre delivery option. Im half way through my pregnancy and have such an awesome rapport with my midwife already. I have no fears about anything to do with the preg/delivery, the home ante natal visits are so helpful considering I have 2 small children and live 20min from the hospital on a good day, I feel so much more relaxed in this pregnancy compared to my other two. I contribute it entirely to the individual care Im getting :)

I have had 2 midwife led births, and will be doing it again in June!! I dont see the need for a OB in an uncomplicated pg, they are specialists, and would you go to a orthapedic specialist if you had perfect feet? No, they would kick you out! So why go to an obstetric specialist when everything is perfect? It is a wase of time and money IMHO. Many midwife led birthing units teach women to trust their bodies. How many women who use Ob's can say they have had a drug free birth? Not as many as use midwives only.

I would also like more public labour wards to do the research on the biology of waterbirths, the babies dont breathe until they feel air on their faces, so there should be more availability for women to see that it is a very safe, naturally pain relieveing way to birth!

I think the BIGGEST problem is lack of education, hence the results of an Obstetrician conducted survey! I wonder how that Ob selected his survey families? I wouldnt mind betting that the 90% were his patients and the 10% were people he just noticed in the waiting room of the hospital :rolleyes:

I had my baby without medical assistance (no dr no mw) . 5 weeks ago. It was perfect!

I think a midwifery led unit is a great idea. However I do disagree that even if you have a trouble free preg you shouldn't need a specialist. As a health woker in the public system, I think it relieves the pressure off of the public system if people who can afford it, pay private health insurance and see private Dr's. All my preg were fairly trouble free, but I had obstetric care beacuse we had privatre health insurance so why not use it?? I was then not taking up a bed in the public system. Our maternity unit at our one and only public hospital here often overflows into surgical and medical wards. So yes, midwifery care is great - but if you have private health insurance why not use it! Oh and for the record,I had drug free vag births. ;)

I think that it would be great for PHI to cover private midwives, instead of poeple with PHI needing to use an Ob to take the strain off the public system.

Stemming from Shellbelle's post - why should a woman with PHI (of which I have) be pidgeon holed into OB based care when its well documented that you have a higher incidence of c/s and intervention? just because there are a FEW of us that have had drug free vaginal births, Im betting we are the minority. Everyone should be entitled to use public system. Going private isnt cheap even with PHI and in this economical climate I just couldnt afford paying to see my OB for 40wks AND a planning/management fee for a labour she most likely wouldnt even make on top of thousands of $$ a year just to have midwives deliver my baby, which will happen anyway. Plus I wanted a waterbirth for my final baby and going public is the only way I'll get it. I use my PHI for everything else so I figure I do my part to relieve the strain on the public system, I dont feel the least bit bad about going public to deliver my baby this time if it means I get the birth I want.

So maybe the opportunity here is PHI covered midwifery led care, or increasing the maternity services/birth centres of all hospitals.

yep, i think we have come across something here. PHI i found, just means that you get a choice of choosing OBs. I wish there was the option of a birth centre under PHI. i mean, if it costs sooo much to have birth centres under a public system then why dont we at least have the choice under a private system?

I am bummed that i dont really have this choice. I am leaning towards the public system next time around so that like what AnnaT posted i get the chance to have the birth we want (ie with m/ws in a birth centre). however, with such restrictions on what is deemed a 'low risk' birth, i would be worried about someone telling me that i am 'suddenly' unable to birth there (if i even get in in the first place). here in melbourne the choice is very little in terms of midwife led care if you want to birth out of the home and that's shameful.

Shellbelle, I understand your point. But I do think it's a shame that OB led care is the only widely available choice for people with PHI. Why aren't independent midwives cvered? Why aren't homebirths covered?
There are a few options for people with PHI, at leat here in QLD there is Nambour Selangor Private Hospital which has an excellent reputation and offers midwife led births and waterbirths. It is extremely popular and people travel there not only from all over Australia, but also from other countries. So it is quite obvious that there is a need for this type of institution. It must also be financially viable, so I don't understand why there are not more PH like this springing up in other parts of the country.

By the way, I cannot believe that it is more expensive to pay for a midwife's services, even if it includes multiple home visits, than it is to pay for an obstetrician, assistant, anaesthetist, paediatrician and a midwife which would be necessary for a c/s delivery which is proven to be more common in OB led care models. So, if saving money is the ultimate goal, then pushing midwifery led care is the best option. But there are obviously other interests at play here.

Sasa

Thanks Ali, good point, private midwives covered by PHI is a great idea. I didn't say that if you had PHI you SHOULD be using the private system. Was just saying that women who didn't mind having an ob are relieving the pressure. Was saying in our case here with only one public hosp it is always overflowing. I think the standard of care is excellent, and the new birth centre is an excellent idea. In my instance I didn't mind how my baby was born, as long as they arrived safely so I spose it never worried me. I had a great ob, and great midwives. Anyway, is an individual choice, just supporting the women who choose obs and Private helath care - seems they are always the ones getting bagged.

No worries Shell, I just dont like it when Ob's interfere when it isn't needed.

I totally agree and have seen it so many times - first time Mums getting induced beacuse obs going on hols :rolleyes: we all know how the birth is most likely going to end up! But, on the flip side - good preg, no issues, PHI, good ob - why not private? Works for some! Anyway - back to the original topic - midwifery led units are great, wish ours was around previously and also wish it was bigger!

Shellbelle, yes, I can see what you mean, when it comes to online communities like this, it could seem like everybody is against the OB system and people who choose it.
For what it's worth, most people here aren't judgemental, but I'm sure ou know that seeing that you're a member here.

But to be honest, out in the real world, I find the opposite to be true. If you don't choose a private hospital and an OB, then everybody just looks at you funny and assumes that you care more about your own birth experience than the health of your baby. I have actually had people call me selfish for wanting a natural birth. I didn't choose it for my own sake, though, but because I did my research and it showed that a natural birth was safer for both, mother and baby. You probably agree with that, seeing that you yourself had drug free vaginal births. But from what I had heard from the people around me, I was going to get more support for my choices from a MW led unit then from the OB led private system. So this is why I made the choices I made.

Sasa

Shellbelle - one thing you're overlooking is that OB's are specialists in complications, not normal pregnancy, and in my wildest dreams I would never advocate that anyone having a normal birth go to an OB just because they have PHI...it's a statistically great way to have a normal birth become a complicated one. This is not bias, this is clearly illustrated in the figures from the past two years, that came out recently.
For the sake of the wellbeing of mother and child, it would be cheaper to cover midwifery with PHI, instead of sending them to OB's when there is low risk. Why would I go to an orthodontist when I just want a check-up that a dentist could give me? Well, there IS one reason...I'd probably get an orthodontist appointment sooner ...

Hmm, sorry Mayaness have to disagree that OB's are specialists in complications, not normal pregnancies????? As defined obstetrics is "The branch of medicine concerned with pregnancy and childbirth, including the study of the physiologic and pathologic function of the female reproductive tract and the care of the mother and fetus throughout pregnancy, childbirth, and the immediate postpartum period." So who delivers babies in public hosp?? I believe obstetricians are there.......

I'm a firm believer that women deliver their babies, everyone else spectates unless it's a CS ;) Maybe when OB's stop saying they 'deliver babies' will be the day they realise there isn't a real function for them in normal birth!
I just don't believe that normal birth belongs in hospital, so this will always colour my idea about where Ob's belong in normal birth.
If an Ob's job in normal birth is to be 'hands off'...then what the hell are you wasting money on then? Doesn't this overload the system, when they are booked for women who don't need their skills? I'm pretty sure most Ob's don't study so that they can sit on their hands and be paid for it - and that's all Ob's need to do with a normal pregnancy. I don't care what definition they give themselves so that women believe they are absolutely necessary in something women were designed to do. You don't need an engineer to build a shed. Especially when your chances of having the shed fall over are increased by hiring the engineer, when a local handy-man will do the job beautifully.
If an Ob is caring for a pregnancy that won't need their specialist skills...a midwifery team would be cheaper, give more continuous, time-rich care and cost the community less.
And if you think my views are 'extreme', you haven't seen me being labelled 'moderate'!

Mayaness, I totally see where you are coming from, I think the earlier point of PHI covering private midwives would be fantastic. I also agree midwifery led care such as birth centres with allocation of a certain midwife for visits etc is also great continuity of care. I just think obs also have their place also. Just my personal opinion. *Exiting thread & ducking for cover*

I am also a strong believer that Ob's have their place - a handy man never built a skyscraper! They have their place, for sure, and without them I would have some friends who wouldn't otherwise be here, nor their children (where my friends were homebirth transfers, or where there were risks during pregnancy) :)