Thursday, May 13, 2010

The First Call with a Midwife

Ohmygoodness. I am in love with my potential midwife. [insert swoon]

I was so nervous about calling her (unfortunately, that's how my shy self rolls), but I mustered the courage to do it. I always hate those initially awkward calls ("Um, I'm the one who e-mailed you last week? Sara? Do you know what I'm talking about?") And there's always that pregnant pause (ha!) while the other person desperately tries to remember who the heck you are and what the heck you want. Oh, how I hate that.

But anyway. I called her, and she's amazing. The bad news is she's down-sizing her practice. She's 68 years-old and she is finally trying to balance her needs with her clients' needs. I so get it. (I referenced a conversation I read over on Katie's blog about her own dilemma with the demands of midwifery.)

I asked her about any nutritional recommendations she has for the pre-conception period. She said no processed foods (like "pop-tarts") and no empty calories. She's also not a big fan of cow's milk and instead recommends that I get my calcium from leafy greens, almonds, and almond milk. I asked her if she thought my vegetarianism would be a problem for my pregnancy and she said she's seen some of the healthiest placentas come out of vegetarian women. Woo-hoo!

Matt and I have an appointment scheduled with her for a one-hour conversation about home birth (she no longer delivers at a birth center). Once I get pregnant, I go in for a 3-hour consultation. After that, the visitation schedule is the same as it would be with an ob/gyn (although she also visits the home a couple times in preparation for birth).

Her total price is $5,600, which is definitely high for a midwife. However, she's helped deliver more than 1,600 babies. In my mind, her experience is worth the extra money. If I'm going to birth outside the mainstream medical establishment, it makes sense to go with someone who has so much experience.

She also requires that I hire a doula. She recommends three doulas in Houston, all of whom are able to monitor the baby's heartbeat and do vaginal exams if necessary. The one thing that worries me is that she and the doula will trade off monitoring me if the labor is really long. I understand the need to be awake and alert during birth, but I would be a little nervous not to have the midwife there at all times.

I feel so ecstatic about this whole process right now. I so often leave doctors' offices with such a frustrated feeling. I finally feel like I'm working with someone who believes in a holistic approach to health. She gets that nutrition matters. She gets that the body is an integrated whole. How comfortable we are during birth, for example, will have a huge impact on how the birth goes.

Honestly, I am so nervous about veering off the accepted American birth path. It's one thing to get weird looks and skeptical sighs when you say you're planning a $2000 wedding. It's an entirely different thing to have people think you are putting your life and your baby's life in extreme danger.

I'm going to ask her very hard questions when Matt and I go in for our initial meeting. I'll start brainstorming ideas and bring them to you for revision!

Thanks for being out there...

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Mish in Melbourne said...

Congratulations- she sounds awesome!!

Also, I secretly love that you spent $2000 on a wedding, and plan to spend $6000 on a home birth. I think it's a gorgeous, practical example of the things that you value - I applaud your integrity and authenticity!

Elsa said...

She really sounds great! After we met with a potential midwife we both left with a very similar feeling as well. Congratulations!

Sharpiegirl said...

I hope that you find the birth experience you want. I'm too terrified that there would be issues with the cord wrapped around the neck and other things that I've read about on blogs to go the home birth route myself. There was one on not too long ago that didn't end well, but I am limited on my computer at work so I couldn't find it to give you a link.
I'm hoping (if we make it that far) to get to labor naturally at home as long as possible then move to a hospital setting for delivery without any medical intervention UNLESS the baby is showing signs of distress then give me medical intervention up the wazoo if need be because the main goal isn't about my personal birth experience it's so I can finally have a baby in my arms.
As for spending more on building your family than your wedding. Uh, isn't that what we should be doing?

Brite Lines said...

That's fantastic! Thanks for sharing your conversation with her - I'm psyched about the almonds, I've been eating a couple handfuls a day lately in my lead-up to potential pregnancy. Being a veggie, I was also glad to hear that its a benefit. Thanks also for your recommendation of "Taking Charge of Your Fertility" - it makes so much sense! I just started charting, we'll see how it goes. :-)

Laura said...

I think it's wonderful that you are looking into the home birth option! I thought you might be interested in this: (if you don't know already, that is) has been running a series about home birth stories that have all been beautiful reads.

Kirst306 said...

Hi Sara! This sounds so great and promising.
How exactly did you find this midwife or any that you are considering? I'm not having much luck online in my area and I don't know anyone locally who has worked with a midwife.

Ms. Loaf said...

So glad your conversation went well and that she is pro-doula....

I'm confused, though, because in all my training and everything I've read and the DONA website (the major certifying org for doulas), it specifically states that doulas do not perform medical tasks like vaginal exams. We're non-medical caregivers, so I'm surprised the doulas she suggested are allowed/able/willing to do those things. Curious. It's something I'd inquire about.

It's sad that homebirth is so expensive, but it is SO WORTH IT. I don't know if you read Farmer Femme (, but she and her partner are planning a homebirth for any day now.

Good for you for being so proactive!

Anna Hope said...

Hi Sarah,
Congratulations on taking the step and calling the Midwife. I am the daughter of a mostly retired CNM and spent many nights at the hospital, the birth center and women's homes helping bring new folks into the world.
I am getting married in September and have already started working towards being "ready" for the whole baby process myself. I live in a city where homebirths and birth center births are if not "normal", are fairly common. I work in emeregency medicine as a paramedic and ER technician. I see the scary things these days. I don't see the beautiful peaceful births I used to attend so frequently because they don't need any of what I do these days. I have found it silently breeding fear in me. 'I' the truest of believers in a heathy woman's ability to have a healthy pregnancy and healthy birth without "the machine that goes bing", am now a litte nervous about the what ifs.
I still plan on birthing at home as long as we live close in to the city (a 10min car ride and 4min ambulance ride to the hospital). I still plan on using my midwife (I have long seen a midwife for my primary care needs. Since about 13 I think), I still think my husband (also a paramedic) will have some emergency stuff stashed in the Jeep or worse, will have some friends of ours ready and waiting in an ambulance at the park down the street so he can feel like he has done everything he can.
I understand the anxiety and the unknown but that fear and that anxiety tends to sabotage the otherwise healthy strong pregnancies and births. I have recomended this book before but I really think you should read it before you and Matt get pregnant.

There are statistics for our number hungry brains and real, not for TV movie stories from real women in this book. It is a good read. It is a rather straight on view about one woman's birth experince and the research she did about the CBID (Child Birth Industrial Complex) for better and worse.
I did not mean to lecture. I just hear a lot of myself in your list making and worrying. I know I need to focus on doing what I can to stay out of my own way so that the healthy strong woman at the heart of it all gets her chance to shine.

Best wishes and thank you as always for the insightful, honsets posts.


sue said...

Speaking from my own experience of birthing in Australia, where the medical system is a bit different - we birthed in a birth centre attached to a large research hospital. For us, this was the best compromise between being allowed to labour naturally and having medical help if needs be. In the end we had a long natural birth and a healthy (heavy 4.4kg) boy! But we did most of this on our own and at home. Here in Oz we are encouraged to stay at home for as long as possible as this is were you are in theory the most comfortable and relaxed. When we got to the birth centre, the midwife also largely left us alone because my body and baby didn't need the guidance... until the last stages of labour and that is were she came into her own. So don't worry about not having the midwife there the whole time. You'll need your husband (mine actually slept through most of it), a doula if you want (we didn't), and your own body. You'll need the baby and you're key vitals monitored now and then and you'll want to retreat into your body to birth your baby. You only really need the midwife at the end to guide the finer points and you'll want her well rested!

good luck and relax!!!

Anonymous said...

I haven't seen you comment over at Project Subrosa so maybe you don't read her - Cate has just finished the last post on her home birth storey. It is fantastic, honest and detailed.

Blue Moon Mama said...

Hi! Just found your blog through Kelly Rae's Flying Lessons course. Thought I'd stop in and say hi!

I had my first baby 4 months ago and I wish you all the luck in the world with concieving and delivering with your midwife.

I had dreams of delivering naturally with a midwife too. Unfortunately for me it didn't work out that way. My baby was 12 days overdue & for various reasons my midwife said we should induce. She, luckily, could work through a nearby hospital so we still intended to have her deliver the baby, just at the hospital. I spent 16 hrs with a huge dose of pitocin and the baby wouldn't budge. Eventually both she and I were in distress & the midwife made the call to have an obgyn check us over. Everyone decided we had to have an emergency csection. After all that time and pain I hadn't dilated past the 3 cm I started out at & the baby wasn't moving. When they did the csection the obgyn found that the baby was in the wrong position, had an arm over her head and the cord was wrapped so much around her neck and head that she couldn't have come out on her own. Without the csection both of us would have died. Luckily, after the csection both she and I were fine. I had the fastest, easiest recovery ever and my baby is wonderful. The point of my story is that you can make all the plans in the world but don't get your heart set too much on one thing. Sometimes they don't turn out as planned. You might want to tour your local hospital and have an emergency plan in place, just in case.

Good luck and I wish you a healthy, easy homebirth!!!

Joselle said...

Good luck and enjoy this special, exciting, and sometimes overwhelming time!

I do need to reiterate Ms. Loaf's concern with the role of the doulas you mentioned. I am a doula and a future nurse-midwife. In all my training, I've learned that a doula is never to offer medical monitoring or advice to the mother. Even if the doula is trained as a nurse or doctor, the power of the doula is diluted when they must offer medical support in addition to the emotional support they are supposed to provide. Especially since traditional ob/gyn care and maternal care is SO focused on the body and on physical exams, having a doula who also does exams defeats their purpose and can create confusion and conflict if they interpret your clinical signs differently from your health care providers.

A nurse who acts as a doula AND a nurse at the same time is not a doula; he or she is monitrice. I encourage to clarify what the doulas you are considering actually do and what their training is. If you want a monitrice instead of a doula, great. But the power of a doula is such because they are solely there for you, your emotions, your comfort. A midwife, doctor or nurse can attend to those things too but their primary concern is with your health and that of the baby.

Check out The Birth Partner by Peggy Simkin for great labor companion tips and a sense of what trained doulas do and don't do.

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