Doctors Suck, But So Does Your Midwife | Indie Birth

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Doctors Suck, But So Does Your Midwife

November 15, 2014

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We are mamas and birth workers who decided to do birth differently– and bring others along with us. We are kind, fun to work with, and great at (lovingly) calling people on their bullshit when necessary. With 11 children and 16 years of midwifery between us, we’ve learned a thing or two along the way, and Indie Birth is our space to share it all with you.

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I hear from women regularly about their homebirth experiences. And being in the business of rabble rousing and questioning the status quo, many of these women who seek us out are unhappy with the care they received from their midwives, not just OBs. There are plenty of variations on the same theme. Midwives aren’t listening to women anymore. Midwifery care feels just as cold and clinical as OB care, just with a rocking chair and some nice music in the background. The rules and regulations are more important than the mother’s wishes. The midwife says she is hands off, or flexible, but when it comes down to it, she really isn’t, and the mother is left with few options at the end of pregnancy or during the birth – maybe the baby is breech, or she is getting closer to 42 weeks, or doesn’t want to transport but the midwife is unsupportive. Seriously. EVERY. WEEK. I hear stories, get emails, talk in person or on the phone to these women. They thought that they were hiring a midwife, and that meant they would get holistic, evidence based care, and flexible care that was woman centered. Well, they were wrong, and they are pissed. This is why I wrote “A Midwife is Not a Midwife is Not a Midwife” and why Maryn wrote “4 Questions You Must Ask Your Midwife”.

But it bears repeating, and maybe more articles means more women find this. Midwives are not all the same. It is an unfortunate reality that you cannot trust someone to help you in a woman centered way just because they are a midwife. If you think you found an awesome midwife, you still need to put on your sleuth hat and do some serious digging. If she is offended by your skepticism or questioning, she is probably one of these crappy midwives who will treat you like an inconvenience later on when you ask for something that she doesn’t want to do for whatever reason (you don’t want vaginal exams, you want less or no fetal monitoring, you want to birth your breech baby at home, you want to wait a few more hours in a long labor, you name it). An awesome midwife who will support and serve you however you see fit will have no problem with you asking questions and giving her the 3rd degree (no pun intended birth nerds). An awesome midwife will be GLAD you are asking questions and taking responsibility for your own experience. She will want you to be sure that she is the right fit. If you interview with a midwife, she should give you the names of all the other midwives in your area and encourage you to interview with them too so you can find the best fit. If she doesn’t do this, it’s a great sign that midwifery is just a business to her, and you are just a dollar sign and a slot filled in your due month. I wouldn’t want to work with someone who would have had a better, more supported, more fulfilled experience with another midwife or birth attendant because the relationship between birth attendant and mother is KEY to a respectful, pleasant experience. Without that, what do midwives think they are doing?

Unfortunately, if you’re reading this, you have likely already experienced this yourself, and you are no longer one of the people that needs the warning. I want to find a way to get this information to women who are having their first babies and have become enamored with their crappy midwife because they just haven’t asked the right questions yet. I want to get this information to women who are planning their first homebirth and think anyone is better than the OB they saw for their previous pregnancy/ies. How do we make this clearer to these women? I really don’t know the answer. I have tried all manner of subtlety – suggesting they interview other people (usually met with confusion about why they would need to if they already hired a midwife), saying that I’ve heard both good and bad things about the person someone has hired (usually a lie since I’ve probably heard only bad things), telling them they should take our class (in efforts to prompt them to ask their midwives the hard questions once they learn more about the hot topics). None of these has worked particularly well. What do you think Indie Birth mamas? What brought you to the dark corners of the internet to find us? Is there something that could have, or did help you see through the smoke and mirrors of modern midwifery?

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  1. Kristen Edwards says:

    I’m currently about 37 weeks along with my first baby. My husband and I first had a really tough time finding ANY midwives in our area or even close. The ones we did get ahold of were booked up around my due time so we had to settle for a midwife team of 2 over an hour away. Because of all this searching, we didn’t get to see them until we were about 16 weeks along. (Looking back, all of this struggle was the universe sending me the first sign that I needed to go unassisted!) Our first meeting with them was an interview where I had 2 pages of detailed questions for them. While they seemed sweet and open to discuss anything I had to throw at them, there was also a sense of “this is our protocol for every birth we attend and this is the pattern you will be following”. As someone who has NEVER fit with the “norm”, this gave me an icky feeling, but I ignored it because I thought this is my only option and after all, they are midwives! Of course we share all the same ideas on birth! Wrong! At this point, I didn’t know unassisted was an option or even existed. We did see them once after this for our first official visit and the first chunk of money was given. I had stumbled onto your site at some point during all my alternative birth research and couldn’t get enough! I started to realize more things they said weren’t sitting right with me like, “Well when the baby starts to come out, I’ll have my hand on your perineum and she will be catching the baby” as if I had no choice in the matter! There was also so much starting to pop out of all those hand outs they gave me that began to frankly piss me off. All things trying to put me in a box. It was later on our drive there for the second visit that they called to cancel and I had my final sign that they had to be dropped. I had gained so much confidence in my own intuition and the simplicity that birth can actually have when you trust it and stop listening to the outside noises, that I felt more than 100% positive that this was the path my baby and I were destined for and honestly, the path I feel he or she led me to. I can now say that this pregnancy has been unassisted (with the exception of the first check up visit with the midwives) thanks to your site. I have felt absolutely wonderful this entire pregnancy and really, healthier than ever from the inside out. No concerns have popped up and I feel more prepared for this event than any other in my life because I am the one owning it all. I wish I remembered exactly where I found your link. I also wish I had an answer for how to get this information out to the masses. All I can offer is my complete gratitude to both of you women who have changed my life in such a magical way and encourage you to continue sharing to as many people as you can! I have suggested your site to many pregnant women now and will continue to. Now that this has turned into a short story, I leave you with a huge THAAAAANK YOU!!!!!!!!!!!

  2. Margo Nelson says:

    Thanks so much for the encouragement Kristin! That is an amazing story, and is super touching to know that our information has touched your life in such a real way. We love featuring stories like yours here on the site so be sure to email us (margo@indiebirth.com and maryn@indiebirth.com) if you’re open to sharing either you unassisted pregnancy or unassisted birth story (or both!).

  3. Kristen Edwards says:

    Gosh! What an honor that would be! I’d absolutely love to. Shortly after this baby decides it’s time to arrive, I’ll be sure to work my stories up and send them your way. 😀 Your reply just made my week!

  4. Brittnei says:

    What steered me away from even thinking anymore about going to a licensed midwife in my state was the fact that when I asked if I would have to transfer to an OB at 42 weeks even after having paid my midwife, I was told all midwives in my state were required to transfer me to an OB if I didn’t go into labor by 42 weeks. No, I don’t want to try to “naturally” induce if my baby and body aren’t ready at your deadline! So basically I could end up paying a midwife and an OB if I don’t deliver when they think I should. No thank you. That was a huge red flag for me and I’ve noticed how medical midwives make birth and I think all the births I’ve seen with one there they are doing way too much for my liking. I wanted unassisted meaning I touch my baby when he or she comes out. No vaginal exams. A lot of what you mentioned here. And then I started listening to Maryn’s podcasts and I said to myself “why can’t I do this myself?” And I wondered if I would have only been going the conventional way out of fear. I’m very thankful that me and my husband are at the point where we feel confident to do it alone at home together. We are in the 3rd trimester now and I have absolutely no fear about birthing at home. You ladies have been great and very informative. Thank you.

  5. ilovespring says:

    Wish I had found your website before the birth of my first child! But I’m just happy I found you before I’ve had my last child (who knows when that’ll be)! This post is so true though, exactly what happened to me because I never thought to take full responsibility for my birth and ask the right questions/insist on what I wanted, and one of the reasons why I will be going unassisted next time. I think the best way to share this is word of mouth, I saw someone mention your website on facebook so I looked you up and fell in love with this concept of owning your birth, trusting the process. Thank you, a million times!

  6. lizzy mackay says:

    This is something I hold dear to my heart. I am a midwife but can clearly recognise that we are all at different parts of our journey with midwifery. Some midwives will be better suited to a particular couple that resonates with them. In the UK generally self employed midwives are generally referred to as independent midwives. I always try and reiterate to people to interview several because Every midwife is different, just because they have chosen to work outside of the system does not mean they will have any particular thing which the woman may be looking for. This could be seen as discouragement from people employing other midwives but on the contrary I would much rather that someone did not choose to book with me if they felt another midwife would benefit them. Birth is an opportunity for us to learn about ourselves, and someone that resonates with our story is far more likely to have a satisfying experience, what ever the outcome. I trust that the right clients will come to me but I totally agree, how can you convey this to the world?

  7. Cindy says:

    Great article. I posted on Hearthside and my private student midwive FB…we’ll see what shakes down:)

  8. Kristine says:

    Please understand that there are regulations and state laws many midwives in many states have to follow otherwise losing their license is a very real possibility. As much as I may want to stay at home with a client who is breech, before 37 weeks, after 42 weeks, more than 24 with SROM, I CANNOT due to my regs! SORRY! I risk my livelihood in a state where midwives are constantly being turned in. I raise my son alone and this is how I make a living! I am sorry I cannot risk my job because you fall out of my protocols. I didn’t make them up, the state did. It is not MY fault if you fall out of my protocols – that is putting the responsibility back on me! If you truly want to be responsible for your birth then don’t blame me if you fall outside of the protocols because it is NOT my fault.

  9. Margo Nelson says:

    No, it isn’t your fault that they fall outside the rules and regs, but it is your fault if you didn’t educate them about that possibility throughout their pregnancy and help them come up with a better plan B. These women are being left in the lurch, going to the hospital for no reason, and facing the consequences of that. Be clear about that with your clients, and don’t lie to them about the overstated “reasons” for those rules. So when someone wants to stay home and not transport, find another option for them if you really can’t help them – an unlicensed midwife, unassisted birth, etc. So many midwives pretend that they are sad/upset that their “hands are tied” but really they are happy to get rid of women that fall outside the box, either because they like the false security of rules and regs or they have an acute misunderstanding of the true risks involved. And if you have a conscience, then maybe you should work on those ridiculous rules, and come together with others in your state to change them….or better yet, get rid of them altogether. At the very least, don’t pretend that your care is woman centered then if it is actually rules centered. There isn’t a nice way to say this stuff, and I’m done with all the excuses. If you truly explain this to the women under your care, maybe they will all get angry enough to do something about the bogus restrictions themselves. Keeping it a secret and pretending everything is fine is not the answer.

  10. kayla frawley says:

    Hello, I appreciate this article and perspective. I have worked at a few birth centers as a midwife and have been very disappointed with certain protocols, rules, ways in which women are communicated with, specifically when it comes to ‘babying women’.

    I am also slightly enraged at the rules in which we have to work, and of course know that any marginalized population will be greatly affected by the way they are oppressed.

    I think it would be very helpful if you published a list of questions for your midwife-for women that may not know what to ask-information that can tell her she is in good hands. I love clients that ask questions and feel confident in clients care when they feel they are in charge. I would love to share that information. Thanks for the article.

  11. JulieBeth Lamb says:

    I have seen midwives who practice like doctors and a few doctors who practice like midwives. When my doula client asked me about it I told her that sadly not all midwives follow a midwife model of care. They should all do that but in reality both hospital and homebirth midwives vary greatly.

  12. Emily says:

    I love the conversation you are opening up. I feel like alot of this issue comes down to responsibility. Mainly with the client but also for the care provider. Unfortunately our culture has moved away from that and replaced it with blame for others, fear based decision making and following the crowd. Women are putting their trust in others. For some they trust a doctor because they have access to medical technology for others they trust a midwife because she doesn’t. But what we really need to do is trust ourselves and take responsibility, after all birth makes us a mother. I am reminded every day that I have little people who I take responsibility for and who look up to me with a deep trust. Keep doing the work you do, it is getting through.

  13. Rosey Smart- Vaher Adelaide Aust says:

    You are talking about Medwives – those don’t even realize they are using hospital rules for their practice.
    In this litigation market what you wanted is not as important as how she responded to her professional responsibilities – which are more important than you or your needs. If you write a plan of what sort of care you expect & list all the things outside of this that is the usual in the system that you have done your research & will open questions in labour if you realize some editing to the plan may need to occur.
    Also separately write a letter with some info on you – your life dreams, plans, philosophies etc & why you have come to your plan to birth outside hospital & why you chose her and you understanding of the role she will
    take and that you are aware of her skills & equipment (list these) & that you will invite her into inner circle & be clear what you need from her e.g. support, back rubs, cup of tea/ food etc, Doppler etc etc & level if voice to be used.
    Print this in large font, 1 1/2 line spacing and a different colour paper each page, with summary labour, birth, baby, postnatal. Know this so well that if you need to refer to it you know which page you want – laminate as close to birth as possible yet have all pages for late editing & place sticker on laminate to remind edit added.
    Cheers Rosey

  14. Lisa says:

    I LOVE your idea, Rosey! What better way for midwives to really know their moms, and to be in a position to work out any conflicts in her plan well ahead of time. This is a great tool – a questionnaire can be given to the mom during her first prenatal appointment. She can fill it out and it can be a very valuable resource for both parties from the get-go.

    Conversely, it is a great tool the other way too- You, as a Midwife give to your prospective clients at their first appointment an informational sheet about YOU… your own brief story and journey into midwifery, your passions, what your’e about, your perspectives and protocols regarding birth, and lastly, the constraints you must work within, if any. Just lay it all out there on the table, so your clients will know everything to expect up front, and understand you as well. This will help them in making their decision about who they choose to attend their birth, and whether what you have to offer will work for them.

    It is also an invaluable tool for knowing and understanding one another. The relationship between a mom and her Midwife is very intimate, sacred and special. It is so important as a birthing mom, to be with someone you have a strong connection and bond of trust with. How strong and comfortable this relationship is is a huge determining factor in how the mother’s birth experience will be.

    Margo- In reference to the last paragraph in your article above, I feel strongly that educating moms is of the utmost importance in helping new moms “see”. When I was pregnant with my first child back in 1980, home birth was was just starting to become a movement, but was not yet on the average young mom’s radar. I knew nothing. I went to a doctor a friend of my mother recommended and found myself in front of a very old-school doctor who quizzically starred over his half-eye glasses and said “I suppose you’re one of THOSE mothers who plans to birth naturally and breast feed your baby.” He said it as if it were rebellious to want such a thing, but at that moment I knew in my heart that WAS what I wanted! My heart sang, and my soul knew. I didn’t know what I didn’t know, but right then I immediately knew what I didn’t want- a man like that “delivering me” when the time came- on my back with my feet in stirrups. I never went back to my next appointment. I asked around and finally found a very highly regarded non-interventive OB to attend my birth in the hospital. But even that was disappointing. I felt I did not receive much support at all during the birth, just annoying nurses checking me every so often, then leaving me all alone when the going got rough. I remember finally crying out “Where IS everybody??” at the peak of transition. I felt so lost and alone. Even though my husband was there and supportive, he was so worried too. My Doctor pretty much showed up right near the end, caught my baby and handed her to me… it was then that my life changed forever!!! I had no idea I could feel so much love for my tiny lavender baby girl. He helped me deliver the placenta, and then stitched me up since I had a perineal tear. I had no idea you could avoid tearing by preparation before-hand, as he never told me about it. I had a successful natural birth, but something huge was missing. I followed my heart, and this led me to reading, conversations, meeting like-minded people, and eventually a referral to an amazing midwife who assisted me at the births of our remaining five children. I’m so thankful I found the right path for me to give birth. Now my daughters are following the same path with the births of their own children. All women, every one of us, in our heart of hearts, knows what we want and need… We may not have yet figured it all out, but we will know it when we are exposed to it. Therein lies the key. To give that exposure through education, opening women’s eyes to a different paradigm. There will always be some who tenaciously cling to the box of conventional birth. They have no desire to deal with it, they just want it over. We all know them, and nothing we can say will change their mind. But there are more and more who are searching. We can reach them through support networks just like you have here with Indie Birth! A network of sister-mothers who are committed to giving their baby the best possible start in life, of feeling empowered through birth, and choosing to trust in nature, not medicine. To view birth as a natural process and not a disease you need to be helped through by a doctor. To know that your body was made for this! The work you are doing here is amazing. I can’t tell you how much I wish there had been a support network like this when I was a young mother. But now I want to do everything I can to share the message, to wake women up to their birthright, to empower them to trust in themselves and become free.

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We are mamas and birth workers who decided to do birth differently– and bring others along with us. We are kind, fun to work with, and great at (lovingly) calling people on their bullshit when necessary. With 11 children and 16 years of midwifery between us, we’ve learned a thing or two along the way, and Indie Birth is our space to share it all with you.

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