The midwife I apprenticed with before I moved has started doing more of these kinds of births. Here's a brief description from an email conversation we had about two years ago:
My midwifery partner and I have done a few births this summer in which the parents did not want to be bothered with at all...no heart tones, no vag checks, etc. OK...so that's what we did. Many first time moms, too. When mom was getting away from herself and feeling out of control, I would go over to the tub, get to eye level with her and tell her she was strong and powerful, and that this is normal. She is doing fine. Then I would give her a drink (Dad, too) and give her a cool cloth...then back to couch! Same when baby was out...mom caught her own baby and sat back w/Dad to admire their son. We checked that baby was breathing without difficulty and pinking up, Mom didn't look too bloody, so we retreated to the couch again until they called us to get out of the water.We need more midwives like you!
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ReplyDeleteOh Rixa, that is the kind of midwife I need to find. My husband is still adamantly against UC, but I want someone who is completely hands-off. Really, not just lip service. I guess I have lots of interviewing to do, though I really, really hope I can get Jon to just agree to the UC.
ReplyDeletethanks so much, Rixa. from you that is a huge compliment!
ReplyDeletei've had some women ask to not have heart tones checked unless they ask...and you know what? it always works out perfectly. i apprenticed with a mw that listened to babies EVERY 15 MINUTES from the time that contx were q 5mins. it killed me. towards the end, when a woman saw us coming with the doppler, she'd be like, "oh not again!".
i usually listen every 30 minutes, but i tell women that they have every right to say no.
i appreciate the work you do, Rixa. I cannot wait to hug you in March!
Heart tones are something I always wonder about...as a UCer, I chose not to listen during labor. I could have, I supppose, with my fetoscope but I had other things to focus on. I also *knew* completely that the baby would be born healthy so listening would have been a formality in my case.
ReplyDeleteHave you ever attended a birth where all seemed well but heart tones were really off? What clinical value are they to you? If something isn't within normal, how do you know how to interpret them? I've read through Anne Frye's chapter on heart tones a few times, but she almost immediately turns to EFM tracings to illustrate the patterns, and frankly I don't know how much use those would be to a home birth midwife using a doppler or fetoscope for very short periods.
Heart tones was a major issue for me, I didn't want to be touched and that obviously means fetoscopes and dopplers as well. We talked a lot about it early on at prenatals, and I made a compromise for my midwife's sake.
ReplyDeleteOn the upside, this strengthened my resolution to stay tuned in, and call her as late in labor as possible. She got to check twice, once on arrival, and the next time about 30 minutes later, when she saw that I was pushing.
The only good it did was that it made her nervous to get 60 during pushing... she didn't say anything and I never looked at her so I didn't know. I did feel a sense of urgency, an adrenaline rush, for that final push.
I do wish my midwife would read sage femme's and/or rixa's blog, but she is rather averse to the internet :)
(Maybe if she did, she would have better understood my stance on baby hats too!)
Speaking as a midwife, I listen to heart tomes every 30 mins or so, depending on what is happening. However, you have to appreciate the pressure that's on midwives to bend to medical regimes such as more frequent monitoring. In the unit where I work you're lucky not to be continuously monitored. I have to admit, after 20 or years, I have got very tired fighting the fight. Cheers Sarah
ReplyDeleteI had a fantastic UC, but I would be happy to employ this kind of midwife for my next birth. I am really enjoying your blog! :)
ReplyDeleteI would not honor a request to never monitor. Why you ask? Well because I have seen the homebirth mama who turned on my midwife after a bad outcome and wants to sue, trash her reputation and put her out of business because the midwife honoring her desires didn't lead to the perfect birth. This may be out of guilt or pressure from family or who knows what, but it is completely unfair and happens alarmingly often. Midwives are in enough danger out there(esp. homebirth ones). While I respect your right to want "nothing done", you need to respect a midwife's right to feel comfortable attending you. If you want nothing then be truly brave and go UC. If your husband isn't on board then you have to work it out with him and not try to put one over on him by tying a midwife's hands.
ReplyDeleteHi Anonymous,
ReplyDeleteI am surprised at the level of emotion (anger? fear?) this provoked in you. Thing is, "doing everything" is also no protection against lawsuits. Obstetricians are the most highly sued medical profession and they certainly "do" a lot of monitoring. So I guess the deeper issue is one of trust, communication, realistic expectations, and responsibility. No matter where or with whom they give birth, women need to accept total responsibility for the consequences of their choices. (Now, if other people are making choices *for* them, or if coercion is involved, that's a different story).
I agree with you that both parties need to feel comfortable with what is going to happen at the birth. Some midwives won't feel comfortable being hands-off (which I define as little/no monitoring, staying in another room the whole time, mom/dad catches baby, minimal or no presence postpartum, etc). Some will, entirely. To each her own.
And for the record, I DID go UC because that was the only way I was able to have the birth I wanted. I would not have felt at all comfortable with the available home birth midwives in my area.