I can now happily say I have given birth to two beautiful children, and both were incredibly unique experiences, partially because of who I chose to be my primary care giver in this wonderful time. I hear debate all the time about OB's vs. Midwives, and now that I have experienced both, I'd like to chime in and give my two cents. Because what is a blog for if not to share your viewpoints with everyone. :P
First off, I want to talk about the things that were similar, and then we'll talk about the things that were different, and whether or not I liked them.
With both caregivers, MW and OB, I found that my care was thorough. In Canada, they are required to run all the same tests, keep all the same records, and give the same options. I never felt with either care giver that my care lacked in any way.
That was about were the similarities stopped.
Right from the moment I stepped into my midwives office... I knew it was different. The waiting room, rather than being a typical waiting room, was filled with comfy wicker chairs and toys for little ones to play with, which was great for Wiggles. At my OB's, they had a tiny waiting room packed with 13 chairs so tightly pressed together it made you feel like a sardine in a can. The atmosphere at the midwives was totally different, and a lot more relaxing, at least to me.
This also carried over into each caregivers interactions with me personally. I found that I got to actually know my midwife as she was a lot more warm and open, where my OB was in and out and very clinical and never really interested in how I was actually feeling or how things were going beyond me passing my routine tests.
2. Value As Human Being
At the OB, I never felt like my OB really knew me. This was confirmed when she saw me in the emergency room, and was like "I think you're my patient, aren't you? What's your name again?" I was seeing her every week. On the other hand, my midwife called on her holiday off to make sure that Miah had turned from transverse because she knew it was causing me a lot of pain.
3. Explanation of Care
I had the option to refuse any care with a midwife, and had things thoroughly explained to me before I made any choices. This was a huge one for me.
With my OB, I was put through lots of tests. Glucose tests, GBS swabs, weigh ins, ultrasounds... name it. I never really got solid answers from her about why these things needed to be done. This culminated in my birth, when I was given a 3 inch episiotomy with little or no warning, and no explanation of what it would mean for my long term care or recovery.
Where as with my midwife... I did all those same tests, but voluntarily. I was given my requisition sheet, and I had the option to go or to not go. They would thoroughly explain the reasons of why I should, and why I might choose not to... and then let me decide. This culminated in while I was in labour with Miah, being thoroughly explained why she thought she should break my water and stop the back labour so I could move on and get the baby out. I was also informed of the risks and the consequences if nothing changed. I felt much more... in control with my midwife. This made me much more relaxed, and much more able to cope with the stress of labour and pregnancy.
4. Illness Driven VS. Pregnancy Driven
I found that with my OB, pregnancy was looked at like an illness. A list of 'symptoms' adorned her walls, and she was always looking for something wrong, and honestly seemed to believe that being pregnant was something that needed to be controlled and fixed as much as possible. Not only did this go against my own belief system that pregnancies and babies are a gift from God, and my body was made to do this very special thing... but it stressed me out every time I went there as she listed off all the things that could go wrong at any point.
With my midwife, I found that my pregnancy was viewed not as a sickness, but as a blessing. It was never assumed that something must be wrong because I was pregnant, never assumed that my 'symptoms' needed to be replaced with medication. There was no pressure to conform to the perfect pregnancy, no feeling that somehow there was impending doom looming around the corner.
5. Who I Saw
My cities OB's have a system set up that one OB is on call for all the babies born on specific days, and they rotate. Which means you have a 1/12(at least) chance of actually seeing your OB for your birth. Most likely you'll be seen by an OB you have never met before.
My midwife was there for me every step of the way, and I had no doubt that she, or my choice of other midwife if she was truly unavailable, like at another birth, would be at my birth.
6. Induction Vs. Natural
When Wiggles was born, I went into the hospital the day after my due date thinking my water might have broken. When the OB on call discovered I was dilated 3 cm, they asked if I wanted to induce. I was an idiot and said yes. This led to an incredibly hard labour.
With my midwife, even though I was uncomfortable and huge, she explained to me the reason she couldn't even sweep my membrane for the last week, and how my cervix was far back, and how she knew yes, it hurt and yes, I was miserable, but this baby would come in it's own time. He ended up coming three days later, and his labour was so much easier.
This point should really have it's own post. There's that much to say in here.
We already addressed who was actually at my birth a little bit, but there was more to it than that. With my OB birth and induction, there were constantly people in the room, checking me, prodding me, making sure the many chords that were attached to me weren't getting tangled... everything. This made it pretty much impossible to move to help the contractions not be so painful, and was very effective at making me feel very small and alone. I labour for 13 hours with Wiggles, 7 of those medicated with the epidural because the pitocin made my contractions so strong that even nitrous oxide(Which was pain relief enough for transition during Miah's birth) wasn't working for pain relief during first stage labour. When I was finally fully dilated, Wiggles wouldn't turn so she came down the birth canal. Instead of telling me to stop pushing, the nurses let me push for 1 1/2 hours before the OB finally came in and said "Why are you still pushing, baby isn't going anywhere." This led to me being so swollen and sore that at 5 weeks postpartum I was still wincing in pain when I sat down. After they had to use forceps to deliver her, Wiggles was taken away from me and I was stitched up, which stressed me out cause all I wanted to do was hold her.
With my midwife, I labour for several hours at home before we went to the hospital, and when we were there, it was Caleb, my MW, and I in the room. Twice a nurse came in, once to take my blood for a MRSA test, and once to check on Miah after he was born to make sure he was ok caused he had pooped inutero. There was a secondary midwife who was there, which was nice. I never once felt like this was something scary, at least not coming from them. When I was so scared to push without drugs(cause of what it did to me with Wiggles) that I begged for the epidural, my midwife very calmly looked at me and said "It's to late, but you can do this. You are doing so great." An hour later I was pushing and it was such a relief. I wanted to push, and it felt good. not horrible like I expected... anyways. After labour I had no stitches needed, and I got to hold him indefinitely with no pressure to feel like I had to rush to get out of the bed or to give him up for testing. It was wonderful.
After Wiggles was born, we were stuck in the hospital for 2 days, and until I had a bowel movement, they wouldn't let me leave. It was possibly the most painful and utterly humiliating thing I have ever done to have my bowel and urinary movements tracked by a nurse, for no reason that I knew of. I got some pretty hard pressure from the nurses to give Wiggles formula, and they were adamant about some of the tests that needed to be done, that honestly I didn't feel needed to be done, but I couldn't leave without them.
With my midwife, we gave birth at 11:23, and I was gone from the hospital by 2:30. There was no reason for us to stick around. I was feeling well enough to walk, and Miah was measuring well... there was no reason for us to stay, and it was SO nice to go home and sleep in our own bed, and eat our own food.
9. Post-Post Labour
My midwife comes to my house on days 1, 3, 5, 2 weeks, 4 weeks, and 6 weeks, to measure me and baby and make sure everything is ok, plus more if something if felt to be 'off'. This is wonderful as it means we're not leaving the house with two struggling little kids in the cold to go to the office. It also means that I get A LOT more personal care than I ever did post partum with my OB.
My OB saw me once at 1 week, and once at 6 weeks. Unless I had a serious concern, then I was to go to the hospital. I had to go at 3 days to a maternal care clinic in the hospital, which was an awful lot of walking for a new mom, as it was in the basement and a long way from the parking. I had a public care nurse who came and saw me at 1 week, but all she really did was give me pamphlets on what I should be feeding Wiggles, and lecture me about how I should force her to sleep on her back, even though she hated it and would cry so hard she choked on her own tears everytime we tried to move her off her front. It was super frustrating that when I felt I might have been getting an infection, or when my healing was going BADLY... I didn't feel I could call my OB. I wouldn't hesitate to call my midwife now.
I would totally go with a midwife again, assuming I had another low risk pregnancy. OB's are great, but they have a place, and that place is not in a low risk pregnancy. They don't know what to make of it other than treat you like you are high risk, but you aren't. :) I would totally recommend a midwife to any pregnant mom, and natural birth to anyone. Yes, it's kinda scary, but my recovery is so much better, and overall, the pain actually worked out to be less than with pain meds in labour. :)
In short, this entire post is about why I loved my midwife. XD