Deciding whether to choose a midwife

21 May

Did you know that in nearly every industrialized country except Canada and the U.S., maternity care provided by midwives is the norm? I’m talking about places like Scandinavia, New Zealand, and the Netherlands. Not exactly the backwaters of the world. Many of the women in those countries would probably assume you’re having some kind of high-risk pregnancy if you told them you were being cared for by a doctor during your pregnancy.

And yet, it seems that here in Canada many people (especially those who don’t happen to be women of child-bearing age) are surprised or even horrified at the idea of having a midwife. Last year, a man actually left this comment on the Yukoners for Funded Midwifery blog:

“We should be moving forward, not backwards, which is why we should fund hospitals, doctors and nurses and not archaic practices like midwifery.”

I was completely flabbergasted. This kind of comment really brought home to me how little awareness some people have of midwives.

The tide is turning to some degree. Midwifery is becoming more and more accepted — and more in demand — as more provinces start funding and regulating midwifery. For better or worse, Yukon is one of the last places in Canada where midwifery is both unregulated and unfunded.

As I’ve mentioned in past blog posts, even though I’ve been active in the Yukoners for Funded Midwifery advocacy group for the past two years, when it came to this pregnancy, I suddenly didn’t know whether or not I wanted to have a midwife. Initially, I think this was because of the jitters I had about the pregnancy, worrying about the possibility of a second miscarriage. Now, though, it’s mostly about the money.

Both the local midwives charge $2,500 for the care they provide, from prenatal care through to six weeks post-partum. Given the time they put into the appointments (often an hour or more, compared to a 15-minute visit with the doctor) and the fact that they can only take so many clients at a time, I certainly don’t think the rate is unreasonable. Heather’s been practicing in Whitehorse for almost 10 years and I don’t think she’s ever raised her rate.

But still, you know… it’s $2,500.

In some ways, I feel I don’t need much prenatal care at all. I breezed through Jade’s pregnancy, and I’ve got a bit of “been there, done that” going on. I know, I know. Every pregnancy is different. (That’s almost cliché.) But still.

I’m not afraid of the labour and delivery part. Again, perhaps I’m cavalier because it was so quick and easy last time (and, say it with me, “every baby is…”). But I definitely wouldn’t want to do it without support. And having a midwife is my best bet to have a birth that is as non-medicalized and natural as possible. Although I don’t have regrets about Jade’s birth, I hated being attached to an IV and sometimes wonder if it was really necessary. But is it worth $2,500 just for the birth part?

Every woman I know who has had a midwife is absolutely thrilled with the care she has received. I know quite a few women who’ve had both doctors and midwives (for different babies, I mean) and still it’s no contest.

I really like Dr. Gudapati, though. She’s sharp, competent, and sympathetic. She’s also pretty supportive of midwifery. And, this being the unregulated Yukon where midwives are not recognized as part of the health-care system, Dr. Gudapati would still technically be my maternity doctor.

Then there’s the fact that we’re doing renovations. A new shed that will probably run about $6,000. New flashing and eavestroughs. Fixing up the other room in the house as Jade’s bedroom (we’ll need a new big-girl bed for her)…

A frivolity: $2,500 would be just about the right amount for a new electric piano, which I’ve been fantasizing about for some time. The one we have has a few temperamental keys and is also a bit awkward to transport for gigs. Then again, once Nugget makes his or her appearance, I won’t be performing anywhere for a while. Want ≠ need.

The more I mull it over, the more I’m leaning to the midwifery side. There’s the fact that the prenatal care will be so much more than pee-in-a-cup-take-blood-
pressure-listen-to-heartbeat-ask-if-there-are-questions-now-see-you-
next-month. And there’s also the fact that I’m finding the idea of a homebirth appealing. (Lots of places have midwives practicing in hospitals, but they don’t have hospital priviliges here, obviously.) We wouldn’t have to worry so much about what to do with Jade, and she could be a part of the birth so that Nugget would be “her baby”, too. Interventions would certainly be a lot less likely. Michael wouldn’t have to sleep on an uncomfortable little chair.

Wow, I’m long-winded tonight. Anyone still with me? Do you see why I’ve been having a hard time making that final decision?

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12 Responses to “Deciding whether to choose a midwife”

  1. Mr Lady May 21, 2008 at 9:34 pm #

    Two things. One: If you can just keep that kid in there for 5 more years, I’ll be your midwife.

    Two: I had baby one with a MW, baby 2 with an OB and baby 3 with a MW again. Baby 2 was the only one who’s delivery I didn’t love. Why? Craptastic OB. I LOVES me some midwives.

  2. jonathan May 21, 2008 at 10:49 pm #

    both would be ok.. but being with doctor is the safest.. cause midwife is only good for the baby not for the mother.. what if the mother labor a cheld but she’s not too strong for that.. doctor’s cares for the both.. that’s only my opinion.. no offense..

  3. IndyComp0T1 May 22, 2008 at 5:20 am #

    Can you have an OB AND a mid-wife? I’ve heard of a few people who have both a mid-wife and an OB at the same time, though granted, it’s for high-risk pregnancies. I wonder if you can pull that off for *normal* pregnancies?

    Also, if cost for a mid-wife is an issue, how about going with a doula? I just don’t know if they cost more/less than mid-wives. Obviously it doesn’t replace the need for an OB or a mid-wife, but you could go with an OB and a doula, thereby getting that extra-personal touch from the doula that you’d probably get from the mid-wife. PLUS, she’d totally be on your side re: the natural birth thing.

    BTW, if you didn’t get a chance to check out my response to your comment yesterday on my blog, I posted a link to HypnoBirthing for you. Here it is again: http://www.hypnobirthing.com/.

    While I myself am going with an OB for my pregnancy, I would certainly consider a mid-wife if I were to have a 2nd child, just due to the fact that the care is more personal. Fawn, you’re lucky that your OB appointments are a whopping 15 minutes long, because, apart from my appointment last week with my new OB, my appointments with my old OB lasted a meager 5 minutes!

    PS: For everyone out there who thinks that mid-wifery is some crock practice from the Dark Ages, mid-wives DO have to go through training (i.e. school). So it’s not like it’s some fly-by-night operation. If you don’t believe me, check out these two (Ontario-centric) links:

    http://www.cmo.on.ca/
    http://www.aom.on.ca/

    As I’d mentioned earlier, if a pregnancy has any complications, then mid-wives will send you to an OB. Even in those cases, you can keep on seeing both healthcare professionals. At least that’s how it is in Ontario.

  4. Malva May 22, 2008 at 6:17 am #

    I had baby1 with a gp and baby2 with a mw in a hospital. I’d pay the $2500 out of pocket if I needed to, it’s definitely worth it. I’d beg/borrow/fundraise it if I didn’t have the money

    I respectfully disagree with jonathan above. With a midwife, you actually have someone mothering you and you’re getting a ton more support than with a gp. It’s been my experience that they truely have YOUR best interest in mind.

    With *hopefully soon* baby3, I’ll have a homebirth if possible. Last time felt like a waste of time to drive 20 minutes to the hospital, give birth 20 minutes later, stay there for the mandatory minimum of 3 hours (to the minute, we were all watching the clock waiting for the ok to leave), then drive 20 minutes back home. We were gone for exactly 4 hours, in the middle of the night. Kinda pointless and spending your transition time in a car isn’t great.

  5. Kara May 22, 2008 at 7:30 am #

    Don’t feel bad if you don’t go for it- that is the reason you are part of the group asking for funding for midwives!!

    When I had Hunter, I didn’t even get doctor or midwife care. Up in the arctic where we were we didn’t have a doctor. My husband (a nurse) did all of my prenatal care. I saw a doctor for a 10 minute ultrasound and then I saw one when I flew out to Edmonton to have him. I was worried about the labour so I hired a doula and she was wonderful. I did have a lot of complications and when the doula said ever so gently “sweetie, I think you need to get the epidural” I didn’t feel so bad for taking it. Good thing I got it too! I had actually tried to line up a midwife for my month out of the arctic when I had Hunter- but they all turned me down!! They said unless they could see me throughout the whole pregnancy they wouldn’t take me. I was so upset about that. But the doula was amazing. I think I would get one again- however I have been instructed that when I go into labour I am to walk into the hospital and say “hello- my name is Kara and I am a bleeder”. Ack- do I really want to go through that again!!!!

  6. MommyTime May 22, 2008 at 8:58 am #

    This is a very hard and personal choice, and I don’t know what I’d do. I loved my OB and had great experiences with both births (in hospital), but here the midwife option is so much less feasible that I don’t really know what I was missing. I would say that if the money can’t come from “disposable” income, then the choice is relatively easier. If it can, then you should be guided by your heart. Good luck!

  7. shannon May 22, 2008 at 10:40 am #

    i have an extremely strong opinion about this and i’m in a hurry, so i’ll be blunt: get the midwife. i think that you would have preferred to stay home with jade this past year, but for monetary reasons you went back to work. and i think that “splurging” on the midwife is a well-deserved reward for that difficult decision you had to make. do you pay the minimum on your mortgage or are you paying extra? if extra, then WHAM! there’s the money right there!

    fawn, you’re so passionate about midwifery care, i really think you’ll regret it if you don’t do it. i am actually not 100% convinced that my midwife was god’s gift to birthing. so many things went wrong and so many people feel that there were big signs that the midwife should have acted on LONG before she did. she acted on them in her own way, but how was she to know the extent of maggie’s issues? i don’t know; maybe a doctor would have known. there are many questions to what happened to me/maggie that will remain unanswered forever. i would get a midwife again, but i would also keep my eyes open MUCH wider a second time around and i would do much more research beforehand and make a birthplan with every possible scenario imaginable and have an extra copy in case i get handed over to a doctor again.

    all that said, i am still 100% convinced that this is right for you. i’ve seen your life fawn, you’re thrifty and make your meals at home. this is important to you on so many levels – it seems like a no-brainer to me. the way you feel about your dilemma is the same way i feel about vitamins. DAMN they’re expensive! and its not always obvious that they’re making the difference i want them too , and there are so many other awesome things i could do with the money, but they are important to me and in this life we have to honour what is important to us!!!

    let’s put it this way: get the midwife or get the piano. look at it as an opportunity cost! you deserve something don’t you? of course you do. OF COURSE YOU DO!!!!

  8. Nita May 22, 2008 at 2:56 pm #

    We use the rocking chair test on all our big decisions and it’s never failed us. When you’re old and in your rocking chair, will you look back and regret that you spent the money on a midwife and had that experience? Or, will you look back and not regret that you did not spend the money and did not have the experience? Only you and Michael can answer that.

  9. rabbatphotography May 22, 2008 at 7:39 pm #

    Wow, I can’t believe midwifery isn’t funded in the Yukon. I had a great homebirth experience with a midwife in Ontario. I blogged about it here if you’re interested:

    http://rabbatphotography.wordpress.com/2008/02/16/julias-birthday/

    If you have any questions, I’d be happy to answer!

    There are TWO midwives at every birth-one for the mother and one for the baby.

  10. ripplebliss May 22, 2008 at 8:46 pm #

    I am probably the only woman in the world who is glad, in hindsight, that she DIDN’T get a midwife. I know that if I had set my heart on having a midwife deliver a home birth with Evvy, I would have been even more disappointed in her birth method than I actually was. ( For those who don’t know Evvy was a planned c-section because she was very, very breech).

    That being said, every friend I have spoken to who has had a midwife just raves about the care and attention she received. If I did the baby thing again and knew I could have a VBAC, I would totally do the midwife thing.

    I also relate to the hard-financial-decision thing. Life is full of those – and $2500 is expensive. Is it tax deductible at least? The money I paid for my Doula was.

    I agree with Shannon, you deserve to spend a bit of your hard-earned cash on an experience that you’ve been wanting, and what is more important than the experience of giving birth?

    Good luck with your decision!

Trackbacks/Pingbacks

  1. Deciding to choose a midwife, Part II « Fawnahareo’s Place - July 23, 2008

    […] May, just before all hell broke loose with Jade, some of you, dear readers, may recall that I was trying to decide whether to make the leap and go for midwifery care. I’d already started thinking that […]

  2. Choosing a midwife, Part III « Fawnahareo’s Place - August 23, 2008

    […] know that in my initial musings I wondered about how much pre-natal care I really need and what a midwife would have to offer […]

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