I'm like HotI, finding the perfect midwife and ignoring the cost. We'll make it work, and most are open to payment plans. I'm still paying my doula off at almost 11 months later She is fine with that, she cost almost as much as an IM anyway, but was so worth it. This time we'll most likely be having her again in top of an IM. Like HotI said, a Medicare funded midwife will have a lot more restrictions than one without it, for me, we went through a hospital (aka Medicare) HB program, which was good, but not something I want to do again. Too many policies that didn't gel with me.
Can't comment on the funding issue - sorry. Totally different system here!
About tearing - there are a lot of theories that people swear by, and you can certainly try them out!
Some say taking vitamin E throughout your pregnancy will improve all skin/tissue elasticity, and reduce tearing.
Some say that using evening primrose oil vaginally in the last few weeks will help. (A friend of mine just delivered her fifth baby, first one without tears, and she credits the EPO.)
Some use olive oil on the perineum during labour and crowning.
Some use warm compresses.
Some ask the mother to support the area with her hands as the baby emerges.
Some ask for all hands off the perineum so that a rough touch won't tear the delicate tissue, and use panting to slow down the baby's descent. (pant until the burning stops, and then you should be OK to push again, gently.)
Water birth has a lower tear rate than "land" births.
Squatting is sometimes shown to have a higher tear rate, compared with semi-reclining, or all-fours.
I'm very thankful to say that I haven't torn with any of my babies. My first doctor used hot compresses, and got me to pant through a couple pushes, and things stretched enough to be fine. The nurse had the episiotomy scissors ready to cut, but the doctor stopped her, thankfully! I've heard from many mothers that there's a big difference in how you feel postpartum with tearing and without. (understandably so!)
i apparently had a minor tear with DD1, so the OB stitched it...i have to say that the painful part was dealing with the swelling due to the stitches. with DD2 i had another minor tear and we opted to leave it alone and i didnt even notice it!
I certainly noticed not being stitched as opposed to being stitched. I was more comfy getting around with stitches. I still would prefer to heal without them though
That's an interesting point about squatting cricket. My first birth was on a birth stool, which are shown to have a higher rate of tearing- due to the squat and the pressure build up with the stool pressing back up against you. Second time I was learning forward more like on all fours, but my body naturally pulled a bit more upright at the end.
I think the thing with squatting is that it lets the baby down so quickly that the perineum doesn't always have time to stretch. That's why it's a great position for a large or stuck baby - opens things up nice and wide - but not the best for keeping the perineum intact always.
She is fine with that, she cost almost as much as an IM anyway, but was so worth it. This time we'll most likely be having her again in top of an IM. Like HotI said, a Medicare funded midwife will have a lot more restrictions than one without it, for me, we went through a hospital (aka Medicare) HB program, which was good, but not something I want to do again. Too many policies that didn't gel with me.
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