Midwifery!

I recently became a voting member of the Maryland Friends of Midwives , volunteered to help write the entire info section for the website and volunteered myself as the Baltimore regional coordinator. Have I completely lost my mind?! It’s entirely possible but in all honesty, if that’s the case, it didn’t start here!

If you’ve been reading me or have known me for any time at all, you know that midwifery and all that comes with it is a cause quite dear to my heart. I am an “aspiring” midwife, as a matter of fact, and unless something changes, my goal is to offer my services to my community as such in the future. In the meantime, I mostly provide a lot of emotional support online in various communities and participate in a lot of online discussions (from which I have learned SO much). I’ve been called “the internet doula” by more than one person. It always leaves me with the curious mental image of attending a birth online…which I have done, incidentally, though not as a doula! So really, volunteering for the MFM was a total no-brainer for me and I’m really excited about it!

I believe, with all of my heart, that the midwifery model of care should be the default model of care for most pregnant women and their babies. My reasons for this start with the fact that childbirth is a natural part of life that is not inherently pathologic. They end with the reality that women and their children cared for by the experts of normal birth fare better statistically than their mainstream-care counterparts. With the US ranking 45th for maternal and perinatal mortality (despite spending more money on healthcare than any other nation!) among other developed nations, and a full third of our women undergoing cesarean section (despite the WHO recommendations that the cesarean rates remain below 10-15% of all births) and articles circulating around the nation with titles such as “It is now more dangerous to give birth in CA than it is in Kuwait or Bosnia ”, I think it’s fair to say that we have a problem. Something is seriously wrong with our current approach to pregnancy and childbirth.

When we look at the nations with maternal and perinatal mortality statistics in the top ten, we notice an interesting trend: more of their women are attended by midwives, more of their women choose out of hospital birth and far, far fewer of their women are having primary and subsequent cesareans. It is very hard to ignore these glaring differences! For me, it comes down to a very simple, thoroughly sobering fact: Women and their babies are being needlessly put at risk by our current obsession with high-tech births. Despite ACOG’s constant underlying message to the contrary, this isn’t about having a “pretty birth”. The midwifery model of care has been proven over and over again, in very large studies, to be a better approach to obstetrics than our current model of care (for low-risk, healthy women). One of my favorite examples of this fact is found in the Netherlands. There is no competition there between the mainstream obstetrical professionals and their midwife counterparts. They work together in one of the most successful maternity systems in the world. 30% of their women give birth at home, the rest deliver in hospitals or birthing centers, with 45% of those women attended by midwives, with only 43% attended by Obstetricians (the remaining 11% are attended by General Practitioners). The obstetricians in the Netherlands are specialists and deal with the higher risk population as a general rule. Even still, their perinatal stats are still extremely low, including the high-risk population they deal with (still hovering around 1%). The midwives attending hospital deliveries have perinatal stats even lower (as they are not attending high-risk deliveries) at around .09% (clareloprinzi).

I believe American women, their babies and their families deserve a system like this. We deserve to have every possible option for reducing risk and increasing the safety of birth at our fingertips. And I know that midwifery is the answer. Again, my passion for this does not stem from the hippy-dippy parts of my soul. It comes from the rational desire for evidence based care for our mothers. I know that we all deserve a system that honors our autonomy, strength and natural ability to birth. A system that recognizes the normal process that birth is and doesn’t create problems meddling with that natural process.