I love obstetricians.

Sometimes I think midwives get a bad deal when it comes to our image. I won’t speak for all midwives with this post…but I will speak for myself. Let me make this clear – I am NOT anti-doctor, I am not anti-hospital, I am not anti-intervention. Please read that sentence again….thank you.

I would go so far as to say that I LOVE a good obstetrician!! I am so very grateful that when there is a woman who has complications or issues – I have someone qualified and ready to deal with those issues so that I don’t have to! When I have a client whose birth is not going the way we had hoped, when there are special challenges that need interventions in order to ensure a good outcome, then I am so glad that we have a hospital with those interventions available to us!

OBs are high risk specialists as well as surgeons. They are trained and experienced in dealing with those high risk situations that I gladly step away from and nudge towards them with a grateful smile – “Here….YOU deal with this…glad I don’t have to!”

So what is the benefit to choosing an OB over a midwife? If you have medical issues that could interfere with the pregnancy having a good outcome – you should see an OB! If there is a need for a cesarean – you need to see an OB! I am trained to identify these issues, but not to deal with them. You need someone with a totally different set of skills than I have. (notice: I did not say better…I said different.)

Midwives and doctors make up the complete ‘whole’ when it comes to maternity care. Midwives are trained in HEALTHY…how to maintain healthy, how to identify unhealthy, and how to determine if we can bring ‘unhealthy’ back to healthy or if we need a doctor. OBs are trained in UNHEALTHY…how to respond to unhealthy when it occurs, appropriate responses as unhealthy threatens mom and/or baby. Midwives are not trained in how to deal with the major problems of unhealthy…we transfer those people to an OB. An OB is not trained in normal, healthy pregnancy…they are not trained in how to respond to healthy and keep it healthy…their training is in the complications.

I gladly utilize the skills of an OB for my unhealthy mothers and babies! Why is it that an OB doesn’t gladly utilize the skills of a midwife for their healthy mothers and babies? Why is it that I’ve never gotten a referral from an OB? “This woman and baby are healthy! They have no reason to be at a hospital…they should be seeing a midwife!”

It’s a nice dream, though! OBs and midwives working together for the common goal we all share – the best outcome for this mom and baby.

I see some OBs right now squirming in their seats reading this…yelling at their computer screen the mantra that we hear so often, “But things can go wrong QUICKLY in a birth!! ALL women should be at the hospital in case those things go wrong!!”

To those OBs yelling at me right now (remember I love you!) – do you think we don’t know that there are things that can go wrong quickly? I know all about hospital births, have seen HUNDREDS…have you ever seen a single solitary homebirth?? Have you ever asked what equipment we bring? What skill set we have to deal with the big emergencies that can happen? Yes, midwives specialize in healthy and send to you the unhealthy women….but we also know that emergencies in birth can occur, and because of that we ARE trained in THOSE issues and are ready to respond to those issues in an appropriate manner while we transfer to the hospital. In other words, we start the response process you would have started in the hospital ANYWAYS…therefore the response is not entirely all that different than if they’d had a hospital birth. (oxygen and resuscitation equipment, pitocin, etc…yes, I carry all of that)

Here is what I don’t understand – why would you not want to see someone who is a specialist with what you are dealing with? If I have a heart issue, I’d like to see a cardiologist. If it’s a skin issue, I want a dermatologist. If I am dealing with an unhealthy pregnancy, I’d want to see an obstetrician….but, if you are dealing with a healthy pregnancy, wouldn’t you want to see a midwife? You know, the person specially trained in that area?

So what’s wrong with a birth center run by midwives that is attached to a hospital? Nothing! But what’s wrong with staying home? Why should a woman in labor have to leave the comfort of her home? If her home is not comfortable to her, then a birthing center is a great alternative! But if her home is where she is most comfortable, then why should she have to leave? I’m all about safety, and if it were safer to have your baby at a hospital or in a birthing center, I’d be all over that!! But it’s not. The empirical evidence shows homebirth outcomes to be as good as hospital outcomes.

steps up to her pulpet proudly, taking a moment to look over the crowd before clearing her throat to begin

I HAVE A DREAM! I dream of a world where midwives and OBs work hand-in-hand. Where healthy mothers and babies are happily encouraged to see a midwife, and unhealthy mothers and babies are happily encouraged to see an OB. A world where the common goal for healthy families bonds the two sides together through their mutual respect for each other. I dream of a world where there is TRUST – trust in birth, in the midwife that she will provide good care as well as transfer care when appropriate – but also trust in the doctors that they will not do unnecessary interventions but will ONLY respond to PROBLEMS.

It’s a beautiful world with flowers and a stream and wildlife grazing and a home built right in the middle…and an operating room around the corner. Won’t you join me there?