Why We've Chosen a Midwife

May 11, 2012

I'd like to preface this post by saying that this in no way is attempting to pass judgement on any woman or how they have chosen to give birth. Everyone is different, holds different desires and convictions, and has the freedom to choose how they want to bring their baby into the world. I do, however, hold some strong convictions about what seems to be a  trend in some L&D units and why I am choosing a different path. 

Even before I became pregnant, I knew what I believed about birth and my philosophy surrounding the amazing event. From reading birth stories and watching several documentaries, to researching the normal labor routine with an OB, I had already formed what I believe and know exactly the kind of birth I want to have.

 One of the documentaries I've watched is the The Business of Being Born, a film that takes a look at modern labor and delivery, and how it seems to have become just that- a business. This is the usual scenario in L&D units that are not choice or mother-friendly: A mother comes in in labor but does not progress enough for the hospital's pleasure (due to needing to empty beds, hitting some kind of statistic, etc). They insert an IV, which pretty much constricts you to a certain area if not just the bed, and start Pitocin to "get the process moving". Because Pitocin actually induces worse contractions than what your body naturally will do, an epidural is needed for the pain. Because the epidural leaves you numb and barely able to push, more Pitocin is needed to further the contractions. Because all of this is so stressful on the baby, the heart rate is affected. The mother is so knocked out on the drugs that she is rarely involved in the decision making process. Suddenly what one might have hoped to be a vaginal birth turns into a "needed" C-section because of "complications"...complications that arose because of the circular process they began to "get things rolling".

I know this process does not describe every situation in which these medicines are used, but it does seem to be a sad trend for both hospitals and women who want "convenient" births. I also recognize that there are amazing OBs out there who truly want the best for their patients and allow them to make their own choices, however unorthodox they may be.  There are many valid reasons women need to have C-sections and even possibly choose them. Women either choose these type of births and view the process very differently than I do, or they simply don't know that there is something different! Many women have no idea that they have a choice in their labor. They assume what their OB says -goes. 

I want something different. We want something different. To us, birth is an amazing journey, not something to be scheduled or rushed. We chose a midwife, specifically the program through Vanderbilt, because they encourage natural, intervention-free birth (unless necessary), relying on your body to know what is right for you, and being free to give birth in a safe, non-restrictive environment. They focus on holistic care first, and resort to other means if necessary.

All of the midwives have a Nursing Degree and a Master's Degree and are trained and certified in midwifery, with years of experience and literally hundreds of births attended to. We are assigned a primary midwife who will attend the birth, but also are cared for by the entire team of midwives for visits, etc.

Here are some of the things that we're wanting for our birth, and that the midwives provide:

  • Birth in Vanderbilt's L&D unit. When most people think of midwives, they think of the mid-1800's and home births. Our midwife provides all the care of a traditional midwife, but in an environment that comes with natural supports should anything go wrong or should we need surgical intervention. 
  • Limited intervention. This means no IV unless medically necessary due to dehydration, etc. Intermittent heart rate monitoring. No inducement. No pain medications unless absolutely needed by the mother. They will not even discuss breaking membranes until the mother is a week or two past 40 weeks. I believe women's bodies know when the time is right. Unless something goes wrong or our baby is at risk, we will let him or her come when it is the right time.
  • Freedom to move around. Because I won't be hooked up to an IV, I am not limited to the bed. I am free to get up, walk around, use the restroom, take a shower, stand, kneel - whatever position best provides me comfort from pain and ease of pushing when the time comes. We plan to take a class that reviews several birthing methods and choose the one that best suits me and my needs for pain relief- massage, water, movement, position, etc.
  • Options for the birthing tub. By the time our little one will arrive, the L&D unit will have two rooms that provide a birthing tub. I'm excited to try to get one of these rooms and utilize it! 
  • A choice in what happens right after our baby is born. We are choosing to delay cord cutting until it has stopped pulsing. We will choose to have our baby put immediately to my breast, skin on skin. I plan to breastfeed for awhile. But don't worry, not as long as THIS lady!  We will choose a bedside bath. Our baby will NOT be taken out of the room to go to the nursery. Our baby will be given a checkup in our room. 
  • A choice in "normal" procedures and vaccines. Did you know that the only reason they put the eye drops on the baby is "just in case" he/she has come into contact with an STD from the mother on the way out of the birth canal? Are you kidding me? We are choosing to opt out, with the support of our midwife, of the eye drops. We also are considering delaying vaccines. Not skipping out completely, but waiting a few weeks after our baby is born before we begin that process. We also are discussing the entire vaccine schedule. With autism on the rise and the convincing linkage to vaccines given around a certain age, we plan to thoroughly research this before making a decision.  
 We plan to write a detailed birth plan that informs everyone involved, including the hospital, of our intent and desires, from who is in the room with us to every step we'd like to happen. I know that sometimes things don't go the way we hope, and I will try my best not to be disappointed or have such high expectations for perfection, should things not go according to plan. I want this to be a peaceful experience. One that I will be alert for- one that I will remember amidst the pain and pushing and emotions. I can't wait to bring our baby into this world. I can't wait to find out who he or she will be. I am so glad we have the support of professionals who encourage our plan and view the miracle of life as highly as we do.

This doesn't fit everyone. Many choose to experience their birth differently. We are so excited that we have found a place that can provide us the type of care that we want and that we feel is best for me and our baby.

Some great articles:


  1. Hey Kelsea! Don't know if you remember me - used to be Kristen Price. I knew you from RVCS and then homeschooling. I stumbled across your blog by accident and was so excited to see what all is going on in your life! Congratulations on your baby!!! I just had a little boy this fall, too. And we did a natural nurse-midwife birth that was awesome. Wouldn't trade it! :) Looking forward to keeping up with you 3. :D

  2. I had an extremely natural birth in the hospital with an OB with absolutely zero interventions and got everything I wanted (skin to skin and no IV and other things - some of which you mention, others that you don't), so I'm proof that it can happen. I also had a doula though, which I think was a huge part in that, and she was an awesome support person to me. If I had to choose between a birth with a midwife without a doula and a birth with an OB with a doula, hands down I would choose the OB with the doula because that doula was the one who really, really helped me when I was in labor. Oh by the way, in some states newborn baby eye drops are required by law - it's a dumb law when you know the reason that they're for, but I happen to live in one of those states. I do have to say that I am glad you're open to intervention. One of my friends who recently had a baby ended up having a c-section - she had been going completely natural and even without pitocin and with moving around and everything like that, her baby still wasn't tolerating labor well. She said that was the hardest decision she ever made because she really, really didn't want a c-section, but her baby was in distress. Sometimes in even the most ideal of situations, even where you are doing everything natural and everything you can to help labor progress, it still ends in an outcome that's less than desirable sometimes.

    1. Melissa, I am so glad that you were able to have that experience with an OB! I in no way meant to insinuate that a natural birth can only be accomplished with a midwife. I've read story after story of a successful natural birth with a regular OB, often with the help of a doula or other support person. I mostly was trying to explain overall differences for the friends and family that gave me a suspicious look when I mentioned "midwife". I really want to try to stay open during the whole process. If something is not working, or the baby does need intervention, I want to be able to make that decision with peace and not guilt that everything didn't go exactly as I had hoped. The outcome I ultimately want is a healthy baby - the rest I realize may not always be up to me. I think the major thing women should realize is that they CAN have the birth that they want and it shouldn't always just be up to the doctor. I think a good, solid birth plan and having a voice is so important, whether with a midwife, doula, or OB. Thanks for the comment!

    2. Oh yes I definitely agree! I just feel that so often the natural birth community (not you, but a lot of other people) really give OBs and hospitals and everything a huge stink eye, which to me kind of feels unfair to lump them all together as being the same or even similar (just as other people give all midwives and such a bad rap). That's I guess why I always want to say something because women need to realize that they have so many choices. A midwife wasn't the way for me to go (with this birth - possibly with another child living in a different place I would feel differently) but I still got the natural birth experience I wanted. And yes - healthy baby is the best outcome - I think that's what everyone wants (and after that, healthy momma!). And yes, you absolutely can have the birth you want without bowing down the almighty system that thinks it knows what's best, despite the fact that that's not always best. And yes - having a voice was so important to me too, which is part of the reason why we chose to have a doula. Oh and by the way, I have started reading your blog so :)