Today’s guest post is Part 2 in a series about midwifery and was written by Denise Rubinfeld, RN, CNM, APN, a nurse-midwife at Women’s Health Specialists in Reno, Nevada.
In the first part of my series I shared the basics about midwifery care. In this part I’ll share a little more about our philosophy as midwives.
During labor and birth, midwives are trained to respect the natural processes of the body. Midwives have lots of tricks up their sleeves, and thus women who choose midwives are less likely to have many interventions, including a cesarean section, than those taken care of by OB/GYNs. This year, our midwifery practice had a less than 10% c-section rate, as compared to a 33% c-section rate nationwide.
I know a lot of wonderful OB/GYNs. I am lucky enough to work in a practice with two very kind, patient doctors so I don’t mean to make OB-GYNs sound like the bad guys or make any woman feel poorly for having a C-Section. It is important to know that OB-GYNs are there when and if we need them. That’s the beauty of our practice. Our philosophy is to use interventions sparingly and not as a regular part of labor or birth. A friend of mine, a physician who birthed her two babies with midwives, said, “With midwives, you would have to prove that your body CAN’T do it, instead of having to prove that your body can.”
Clients of ours, when asked what brought them to midwifery care, often say that they came to us because they want a natural birth. What many mean by that is a birth that respects the power of a woman’s body over the latest bells and whistles that conventional prenatal care has made the norm. Our clients often want freedom to move around in labor, without being attached continuously to IVs and monitors. They want to use water as pain management rather than narcotics or the ubiquitous epidural. They want to labor in whatever position feels right, and push in the way their body directs them to. They come to us because they want a provider who has supported women through countless normal vaginal births rather than an OB/GYN who, quite possibly, has not witnessed many normal deliveries where interventions have not been present. They’re looking for someone who is an “expert in normal”- who has the confidence to observe patiently while things are going right, but who uses their expertise to intervene in the rare instance it is necessary for the safety of mother and baby. And when we need to intervene, we are lucky in our practice to have collaborating physicians available 24-7 for that rare cesarean delivery. It’s the best of both worlds.
It’s also important to note that natural birth can mean different things to different women. Some of our clients don’t worry about whether they have pain medication in labor or whether they can push on all fours. Quite simply put, they just want someone nice. These clients have not felt heard by their care providers in the past. Some have felt rushed, dismissed, even sometimes abused. They want a care provider who will take the time to listen to their needs and support them in their choices, whether they’re deciding how they want to birth, what kind of contraception is right for them, or if they need some help with symptom relief through the perimenopausal years.
Many women are not aware that midwives not only provide pre-natal care, but also normal gynecological care like prescribing medications, birth control pills, and performing procedures such as IUD placements and Nexplanon insertions. Our gynecology clients come to us for a more holistic approach to women’s health, and they find that we take the time to get to the bottom of the issue they present. We are likely to recommend diet changes or acupuncture, not just a magic pill. We love seeing our clients for annuals or preconception visits and then seeing them through their pregnancy and birth or their post-baby years!
So, next time you’re pregnant, need an annual exam, have something funky going on “down there,” or want to discuss the ever changing landscape of your hormones, think about scheduling a visit with a midwife.
For more information about midwifery care, please visit http://ourmomentoftruth.midwife.org/
Denise Rubinfeld, RN, CNM, APN is a nurse-midwife at Women’s Health Specialists in Reno, Nevada. She was thrilled to join the practice of Lynn Anderson, CNM in the spring of 2013. She and Lynn care for women throughout Reno and beyond. For more information about the midwifery practice at Women’s Health Specialists, please visit http://www.womenshealthnv.com/ or call (775)- 688-5850.