Monday, January 11, 2010

Mainstreaming midwifery

This isn't going to be a typical long blog post, more like a random thought:

Last night I started thinking about how I'd always longed to have my babies either at home or in a local birthcenter that offers midwifery care and waterbirth, but either didn't or couldn't for various reasons. I wholeheartedly believe midwifery should be the standard of care for low-risk women, and homebirth an option for women who desire it. And that got me thinking: what would need to change for midwifery care and homebirth to really become mainstream options in the US? How would it change the face of maternity care? Is it realistic to expect those kinds of changes? And how would the mainstreaming of midwifery change midwifery practice itself? Though I haven't completely thought through this subject yet, I realize the answers are not simple. I'll be exploring this more in future posts!


  1. I think that first, hospital-based birth centers would need to become more mainstream. They are rare, but for many of us, they seem to offer the best possible option: access to both pain meds and emergency care if necessary, but also a holistic birth experience that does not treat pregnancy like an illness. I think there is a big, untapped market for this among women who want a normal birth but do not want a home birth. As this becomes normal, it will become less of a step to think about a homebirth.
    But what I think is key is not location or care provider. We have to stop treating birth like an illness, all of us: the medical community, pregnant women, the entertainment industry, etc. It is so hard to slip into thinking about it that way, especially when the "healthy baby" rhetoric ignores that how the baby comes out (and when) might play a role in the healthy baby. I was talking with my midwife about how the maternal-fetal medicine clinic where I get my ultrasounds is super cautious--even when things are normal but on the margins, they keep having me back for scans. She said that she *know* that the doctors there believe in keeping the baby in cooking as long as possible but that their practices don't reflect that ideology. (She also made me feel like I wasn't nuts for suspecting they were over-cautious). it is such a hard mindset to break. Another example: my husband is a pediatrician, which means he was at a lot of deliveries during residency but they were all high risk. He's never seen a natural childbirth. During my pregnancy with #1, the main thing he asked for was for me to labor with an IV (i wanted an epidural, so that was going to be a given), so that it would be there in case of emergency. He could only think in terms of what would be best if something went wrong. Now that I am trying for a VBAC and have gone all crunchy on him :), he understands that his frame of reference needs to shift. But it's just not how he was trained!

    The midwife model encourages us not to think about birth as an illness. And there are OBs who understand that. It is up to all of us to change.

  2. I'm not sure how I found your blog, but I want to applaud your voice!

    I am a mother of five: 1 hospital birth (natural), 1 birthing center birth, and 3 home births. You can read about my fourth birth here:

    I am also a marriage and family lecturer (I hesitated to say "minister" due to what that may conjure up, and I am not liscenced as a counsellor, though my husband and I do counsel). We teach marriage and parenting classes, seminars, and personal counselling.

    I am passionate about homebirth and informed choice! I have more than once considered becoming a childbirth educator.

    All of that to say, "Right on!" ;)I will be back to check in.