Do I trust birth?

I have told many people in my office when they sit down for an interview and say, “I’ve read your blog!” that it’s a little embarrassing…this blog is ME, unfiltered, uncensored, raw.  I don’t edit my posts beyond a spellcheck – I sit down and speak from my heart.  If you read my blog, you know me!  And I hope that anyone who is close to me would be able to back that up.

That being said, there are some movements happening within the birthing community with regards to birth and midwifery that I would like to respond to…raw and unfiltered.

34494_134550286579834_6172327_nTRUST BIRTH

One of the things going around is a “trust birth” initiative….the group’s idea is that licensure for midwives is a BAD IDEA.  The leader of this group can feel free to correct me if I mistakenly misrepresent her as that is absolutely not my intention…but her basic premise is that licensure or any regulation of midwifery is bad, it limits a woman’s right to choose who will be at her birth.  She claims that a midwife isn’t doing anything MEDICAL since birth is not a medical event…therefore nobody should have the right to tell her who she can and can’t have at her birth.

First off, nobody is telling the family who they can and can’t have at her birth – what they are doing is saying what the midwife can and can’t do as a health care provider.  And yes, I view myself as a health care provider.  I see no difference between midwifery and any other medical provider – why can’t I have WHOMEVER I want perform my plastic surgery? Why do they need a license?  Why do you need a prescription for drugs?  Why does a family doctor need a license?  Why can I not sell an organ –it’s my body! I agree with less regulation and if all of us had free access to medications, medical proceedures, etc…then I’d be 100% for deregulating midwifery.

I do more than catch a baby….and often it’s the DAD that even does THAT!  There *ARE* medical things that I do such as drawing labs, ordering ultrasounds, resuscitating a baby, giving pitocin if she is bleeding uncontrollably after the birth, fixing up a perineum when she needs it.  I do pap smears and contraception counseling, I diagnose with urine cultures and blood pressures…I do more than catch a baby.  Birth is a natural event, sure…and you should be able to have anyone there you want, and that I agree with.  But to call a midwife “not a health care provider” because birth is a natural event is to strip her of all of the other things she does.

The leader of this movement says that a midwife shouldn’t be licensed because she doesn’t do anything medical…I asked her if she saw a midwife as anything different than a doula?  She has yet to answer that question and became hostile towards me.

The thing that I find ironic is that this woman runs a leading midwifery school!!  She has an amazing curriculum educating midwives across the country – and let me tell you, BOY is it comprehensive!!  Truly impressive!  I find it ironic that she has such a medically comprehensive school, she educates midwives so that when they leave her they have such an extensive medical knowledge it’s incredible.  Yet she claims that they are not health care providers.  She teaches emergency procedures, suturing, detailed information on prenatal testing and procedures…but midwives are not health care providers.  It really is quite confusing to me.

She says that licensure puts restrictions on the midwife – keeping her from attending VBACs in many states, or breeches or twins.  My argument is that what it allows a midwife to offer her clients is even greater (certain medications, O2, diagnostic tests, suturing, etc).  Rather than attacking licensure….attack the restrictions within the license.  Allow midwives to keep her ability to do the medical care and expand on THAT – rather than restrict her by stripping her of her license and making it so that she can’t perform any true medical things and must refer to a physician for EVERYTHING!

28455767-young-family-are-awaiting-for-childbirth-symbolUNASSISTED CHILDBIRTH

There is a movement even more drastic called Unassisted Childbirth (UC) – those who believe that birthing with a care provider there is detrimental to the process and that it shows a lack of faith and trust in the birth process (and in some circle, God).  One of the original founders of this movement is someone that I know and respect (like the founder of the Trust Birth initiative – someone I know and respect even if I disagree).  Like the trust birth initiative, however – I have to disagree with the UC’ers.

I agree in a woman’s RIGHT to birth alone….that’s not what I disagree with.  I disagree with the notion that having a midwife is saying you don’t trust the process.  I trust the process!  But I also know that there are things that, even when you are left alone, can go wrong.  Acknowledging things doesn’t mean you don’t trust.  I wear my seat belt in my car…I have faith that I won’t get in an accident or I wouldn’t have gotten into the car….but I put my seat belt on because I acknowledge that there is the possibility of an accident despite my belief I will be fine.

And more disturbing to me yet is the notion that you can have a party while giving birth – aunts, sisters, doulas, neighbors….so long as there isn’t a midwife present.  To me, that does not show trust in the process, it shows a lack of trust in the midwife.  You can’t trust her to leave you alone, to respect your wishes, to respect your autonomy in decision making, to grant you privacy…you’d rather birth without assistance than bring someone in that knows what’s normal and what’s not and is able to deal with what’s not – not because of how you feel about birth, but because of how you feel about US!  About midwives…meddling, bossy, overbearing, disrespectful midwives.

I view my role as a lifeguard…I sit on the edge of the pool and watch. I don’t direct the games, tell people how to swim or how to play…I merely observe.  Most of the time I never need to get my toes wet…but occasionally someone will dunk, gulp water, and get into trouble.  You have to trust the lifeguard to leave everyone to play as they want or the pool is no fun!  But you also have to trust the lifeguard to know when to jump in and take action if someone’s in trouble.

I have a hard time believing that UC’ers don’t think anything bad CAN happen at a birth….I think that they don’t trust midwives to keep the hell out of the pool and therefore are willing to risk having a bad outcome rather than risk having an interfering midwife there that they don’t trust!!

There are babies and children who are nursing, growing, going off to school – that I do believe are alive because I was there when they were born.  Babies that were born needing resuscitation, babies that had a prolapsed cord or that had shoulder dystocia.  I’ve seen babies born with a 1 minute apgar of ZERO (meaning not even a heartbeat present).  If anyone would think about accusing these babies of needing assistance BECAUSE I was there, they can stop reading my blog right now.  And if it wasn’t because I was there…then it would have happened if I had not been there in which case I did save that baby’s life.

When I had my baby #5, I knew my body could do it…I trust that birth usually goes without a hitch, and as a midwife I know how to resuscitate a baby or how to respond to a postpartum hemorrhage!  But I don’t want to – especially not with my own baby!  I don’t want to be the one to have to bag my baby if she needs it…I don’t want to be the one making the decisions in that moment of whether I need to transfer in for bleeding.  Instead, I found someone I am close to that I trust.  I found someone who I knew would respect me, respect the process, who would know when to help and when to leave us alone.

I believe firmly in my heart that most UC’ers simply can’t find anyone they trust…because I don’t believe that they are so naïve or stupid as to think that bad things CAN’T happen.  They can…in every aspect of life!

Do I trust birth?  Yes, I think I do, I trust that it usually goes just fine…but I also want a midwife that can provide comprehensive care…and a midwife that I trust as much as I trust birth.