I'm sorry this is so long - please go easy on me! 
I wrote this out not only for myself, but also for anybody who is on the fence about making the decision to choose a midwife or even a natural delivery over traditional obstetrics and hospital birth. I'm a writer and got carried away! 
This is especially geared to my fellow U.S. moms, who have been taught from a young age that simply put: you deliver your baby on your back, in a hospital, no questions asked.
I hope this info helps others in the U.S. who really aren't sure where to turn. I was at a crossroads just two weeks ago, and one appointment with the midwife was all it took for me.
I figured a journal like this is best suited for this forum, where people are seeking advice regarding natural birth. I'm not trying to be an attention whore, just want to share what I've learned
I am a first time mom in the U.S. My first 3 prenatal appointments were with an obstetrician who does deliveries at a hospital.
On Monday, I attended my 12 week visit with the midwives, who operate a birth center with three very homey rooms, each containing a tub, yoga rope (from the ceiling), birth stools, and herbs.
I'm choosing the midwives, and this is my journal on why. . .
____________________
I started out having my first 3 appointments in Obstetrics care. The office itself is wonderful - and in my opinion a diamond in the rough when it comes to having prenatal care and delivery done in a traditional setting. The Dr. herself was phenomenal.
However, it really bothered me that until the 3rd appointment, I did not meet the doctor. . .only nurses who could not answer my questions and simply had a laundry list of 'do this, not that' directions that I've read in every book. The model of care in such a setting is 'we're here to look for problems'. The fact that I had three appointments before hitting the 12 week mark, and over $3000 in fees billed to our insurance company (depsite having what they finally diagnosed as a normal, boring, healthy pregnancy), tells me that is at least partially true.
It was insanely frustrating to me that they would run test after test, push vaccinations and procedures on me, already had the chat about inducing at week 40, etc.
They have a file of medical information on me bigger than my collection of paperwork for 2010 taxes, and yet, unless there is a 'problem', none of it is my business. They were unwilling and unable to share information with me - including my blood counts, blood presure, the results of an ultrasound where they looked at my overies, uterus, etc. in depth.
My medical history, well-being, and results were not for my eyes, and they made that pretty clear; I only needed to worry if there was a 'problem'. I was not allowed to ask even general health questions (I'm inquisitive) like 'please show me what my fibroid looks like ' (on the ultrasound as they were looking at it). They responded with 'it doesn't matter, it's normal and not a big deal. . .'
When they required me to get a Rhogam shot, there were no doctors on staff at the time and the nurses could again, not answer my questions. They were flustered that I even was asking questions, and not just doing as I was told.
The visits are short, and while the staff is friendly they are running a well-oiled machine; pee in a cup, stand on the scale, blood pressure cuff, poke you with a needle (AGAIN), sit in a room, wait for a nurse who can't answer your questions but will scold you for losing a 3 pounds (uhh, first tri morning sickness) and not getting the flu vaccine (again), schedule the next appointment.
On Monday, I made the official switch to the midwives at our States only birth center. . .and the level of care, and personal attention, and information is eons, lightyears away from my experience in obstetrics.
First off. . .they see childbirth as a normal, healthy process. Not something that is 'treated'. . .but rather something that they encourage and support you through, helping you make the right decisions to having the most healthy pregnancy you can possibly have. They support you and educate you in both medical and non-medical ways - instead of sending you on your way and waiting for a problem. . .the key with the midwives is 'PREVENTION'. Very different.
The office is much like a doctors office, with a waiting room and staff and those ridiculous bed things with the stirrups you see in any OB office. . .BUT. . .the walls are painted, there are books everywhere, music playing, and boards FULL of beautiful birth announcements from their clients. It's warm and friendly.
They taught me how to use the scale - so I weigh myself and tell them (they don't weigh you).
At the first appointment, I saw both a nurse AND one of the centers five midwives, whom I will meet each one. They were friendly, open, and SAT in the room with us for nearly an hour, answering questions, getting to know us. Every appointment after that is at least 30 minutes. They listen to the heartbeat at every appointment, measure the fundus, etc. just like an OB. They gave me a HUGE packet. In that packet:
An Essay Questionaire. Both hubby and I have to fill this out before the next appointment; they want to know what our thoughts really are on parenting, our relationship, childbirth, the pregnancy. I think this is a beautiful thing - they are not only getting to know us, but in a sneaky way, giving us the excuse and reason to sit down together and be on the same page. This level of commitment to you personally, and your relationship is NOT found in traditional obstetrics.
Nutrition information. We're not talking 'don't eat hot dogs', we're talking 'here is what we know about having a healthy pregnancy. You should get this much protein (and here is how to get it), this much calcium (milk, yogurt, etc.), etc.
Food Tracker. I have to write down my food intake for at least a week before my next appointment (again, they focus on prevention, not problems). They even gave me a sample menu, and WOW. .. it looks yummy. 3 meals, 3 snacks, 2600 calories (WOWZA. . .that's a lot). The whole idea is to stuff you so full of yummy goodies that are healthy for you and baby (eggs, protein, fruit, veggies, yogurt, cereal, etc.) that you have no desire, or room, to scarf down an entire box of brownies.
They are showing you how to keep your blood sugar in check, how to keep your energy levels up, and what to eat so that you and baby both feel good and have an easy, safe delivery with a lower risk of excessive weight gain, gestational diabetes, and even GBS (they encourage probiotics).
They practically require 3-5 liters of liquid, mostly water, daily. I do believe that more women would have healthy, easy pregnancies if they followed this rule - it seems like a lot until you get used to it. A liter of that might be raspberry leaf tea, half a liter of skim milk, some juice, and the rest water. They don't frown on the occasional latte or ice cream
Unbiased information (pros/cons) of things like the Heb B shot given at birth, as well as Vitamin K shot and Enthromycin ointment for the babies eyes. All these things they do at the hospital without giving you the valuable information YOU as a parent should have to make those decisions - the midwives give you the information point blank and let YOU decide. None of these are 'standard' proceedures at the birth center; they inform you and then ask for your consent before administering them. In the hospital, we'd have to fend the nurses off with a stick, and defend our position - in the birth center, they respect our decision, no questions asked.
The midwives have a library of books you can check out. They WANT you to be educated. They WANT you to ask questions (even dumb ones, like, 'at 12 weeks, how much amniotic fluid surrounds the baby?).
They offer classes, one of which is 'healthy pregnancy'. . .which I will take in two weeks. It's free, and it's two hours where you get to chat with other first trimester/early second tri moms and the midwives about being healthy, being pregnant, etc.
At 12 weeks pregnant, they are already talking to us about the delivery - that discussion is not saved for the third trimester, but rather becomes an integral part. . .the whole reason for the care we are receiving. One thing we tend to forget is that the process of a natural birth, or any birth, starts early in pregnancy. It's not something to be saved for discussion in the third trimester.
When you do your glucose screening, they give you juice. Not that orange glucose concoction that mimics absolutely nothing about a normal diet and makes the pharmaceutical company a boatload of cash; just juice.
When delivery day comes, you labor at home until you are in active labor - much later than if you were to be in a hospital setting. By the time you go to the birth center, you're usually 5-6 cm dialated - so the early parts of labor are spent at home, with YOUR stuff, in your tub or shower, on your bed, walking in your neighborhood. (They do teach your DH how to deliver the baby, just in case
)
One you arrive, they may or may not check your cervix - but you are allowed to do whatever you want. No monitors, no IV's (unless you are GBS+). You can sit, squat, walk, EAT, drink water, drink tea, and sit in the tub.
They don't do pitocin. They don't do episiotomies. They don't do epidurals. They don't do vacuums or forceps, and because of their emphasis on birth positions, maternal health, and eating/drinking during labor, they don't ever need too. They don't require you to be hooked up on monitors, or to deliver splayed out on your back with your whoo-ha in the midwifes face. Their c-section rate is less than 6% (compare that to the national U.S. hospital average of 38%, or just over 1 in 3).
When the baby comes out, they DON'T pull on the head (unless the rare circumstance requires it) as the shoulders are being born (this is a pretty standard hospital practice, and can seriously injure your newborn if done incorrectly) - if you are in a good position, there is no need to do that. As soon as the baby is out, it goes on your chest. . .no rushing around, no taking the baby, no cutting the cord right away. After the placenta is delivered and the cord is cut and you are all cleaned up and relaxing on the bed, they will do the newborn exam on the bed with you there. . .they NEVER take the baby out of your sight unless again, rare occasion there is a problem. Very different, again, from being brought into the world in a hospital setting.
The average stay? 9 hours from the time you arrive. Most deliveries happen within 4-5 hours, you stay and relax for 4 hours, and then you go home. You, DH, and baby. Back home, with YOUR things, your smells, your bathroom, your bed. . .spending those crucial first days bonding at home, not in the hospital. I think this is a beautiful thing.
So there you have it ladies - this is my honest account of my experience. In the OB care, I was scared of the delivery - scared of the hospital and interventions and of my labor stalling because I was in an uncomfortable place.
Now that I'm with the midwives and the birth center, and they are helping me and teaching me how to have a healthy, happy pregnancy, and a healthy delivery, I'm actually EXCITED about the delivery. I'm confident and unafraid. . .and in my opinion, that feeling comes largely from the type of care I'm receiving. . .even if you are terrified of childbirth, you might find that the right support and care is all it takes to help you build your confidence.
All that said - there is always the chance that something goes horribly, legitimately wrong. The decision for me comes from the fact that if I'm going to have an intervention, I don't want it as a result of another intervention, but rather because I landed in that small percentage of people who have a genuine problem in delivery. Anything can happen of course - and I believe that you can be both open to that, and still be very open and willing to deliver your baby naturally and without complications.
Educate yourself ladies! ASK questions! Be involved, and do what is best for YOU. This is about YOU and YOUR baby - you are NOT a statistic, you won't follow a graph or chart, you ARE special.
I wrote this out not only for myself, but also for anybody who is on the fence about making the decision to choose a midwife or even a natural delivery over traditional obstetrics and hospital birth. I'm a writer and got carried away! This is especially geared to my fellow U.S. moms, who have been taught from a young age that simply put: you deliver your baby on your back, in a hospital, no questions asked.
I hope this info helps others in the U.S. who really aren't sure where to turn. I was at a crossroads just two weeks ago, and one appointment with the midwife was all it took for me.
I figured a journal like this is best suited for this forum, where people are seeking advice regarding natural birth. I'm not trying to be an attention whore, just want to share what I've learned
I am a first time mom in the U.S. My first 3 prenatal appointments were with an obstetrician who does deliveries at a hospital.
On Monday, I attended my 12 week visit with the midwives, who operate a birth center with three very homey rooms, each containing a tub, yoga rope (from the ceiling), birth stools, and herbs.
I'm choosing the midwives, and this is my journal on why. . .
____________________
I started out having my first 3 appointments in Obstetrics care. The office itself is wonderful - and in my opinion a diamond in the rough when it comes to having prenatal care and delivery done in a traditional setting. The Dr. herself was phenomenal.
However, it really bothered me that until the 3rd appointment, I did not meet the doctor. . .only nurses who could not answer my questions and simply had a laundry list of 'do this, not that' directions that I've read in every book. The model of care in such a setting is 'we're here to look for problems'. The fact that I had three appointments before hitting the 12 week mark, and over $3000 in fees billed to our insurance company (depsite having what they finally diagnosed as a normal, boring, healthy pregnancy), tells me that is at least partially true.
It was insanely frustrating to me that they would run test after test, push vaccinations and procedures on me, already had the chat about inducing at week 40, etc.
They have a file of medical information on me bigger than my collection of paperwork for 2010 taxes, and yet, unless there is a 'problem', none of it is my business. They were unwilling and unable to share information with me - including my blood counts, blood presure, the results of an ultrasound where they looked at my overies, uterus, etc. in depth.
My medical history, well-being, and results were not for my eyes, and they made that pretty clear; I only needed to worry if there was a 'problem'. I was not allowed to ask even general health questions (I'm inquisitive) like 'please show me what my fibroid looks like ' (on the ultrasound as they were looking at it). They responded with 'it doesn't matter, it's normal and not a big deal. . .'
When they required me to get a Rhogam shot, there were no doctors on staff at the time and the nurses could again, not answer my questions. They were flustered that I even was asking questions, and not just doing as I was told.
The visits are short, and while the staff is friendly they are running a well-oiled machine; pee in a cup, stand on the scale, blood pressure cuff, poke you with a needle (AGAIN), sit in a room, wait for a nurse who can't answer your questions but will scold you for losing a 3 pounds (uhh, first tri morning sickness) and not getting the flu vaccine (again), schedule the next appointment.
On Monday, I made the official switch to the midwives at our States only birth center. . .and the level of care, and personal attention, and information is eons, lightyears away from my experience in obstetrics.
First off. . .they see childbirth as a normal, healthy process. Not something that is 'treated'. . .but rather something that they encourage and support you through, helping you make the right decisions to having the most healthy pregnancy you can possibly have. They support you and educate you in both medical and non-medical ways - instead of sending you on your way and waiting for a problem. . .the key with the midwives is 'PREVENTION'. Very different.
The office is much like a doctors office, with a waiting room and staff and those ridiculous bed things with the stirrups you see in any OB office. . .BUT. . .the walls are painted, there are books everywhere, music playing, and boards FULL of beautiful birth announcements from their clients. It's warm and friendly.
They taught me how to use the scale - so I weigh myself and tell them (they don't weigh you).
At the first appointment, I saw both a nurse AND one of the centers five midwives, whom I will meet each one. They were friendly, open, and SAT in the room with us for nearly an hour, answering questions, getting to know us. Every appointment after that is at least 30 minutes. They listen to the heartbeat at every appointment, measure the fundus, etc. just like an OB. They gave me a HUGE packet. In that packet:
An Essay Questionaire. Both hubby and I have to fill this out before the next appointment; they want to know what our thoughts really are on parenting, our relationship, childbirth, the pregnancy. I think this is a beautiful thing - they are not only getting to know us, but in a sneaky way, giving us the excuse and reason to sit down together and be on the same page. This level of commitment to you personally, and your relationship is NOT found in traditional obstetrics.
Nutrition information. We're not talking 'don't eat hot dogs', we're talking 'here is what we know about having a healthy pregnancy. You should get this much protein (and here is how to get it), this much calcium (milk, yogurt, etc.), etc.
Food Tracker. I have to write down my food intake for at least a week before my next appointment (again, they focus on prevention, not problems). They even gave me a sample menu, and WOW. .. it looks yummy. 3 meals, 3 snacks, 2600 calories (WOWZA. . .that's a lot). The whole idea is to stuff you so full of yummy goodies that are healthy for you and baby (eggs, protein, fruit, veggies, yogurt, cereal, etc.) that you have no desire, or room, to scarf down an entire box of brownies.
They are showing you how to keep your blood sugar in check, how to keep your energy levels up, and what to eat so that you and baby both feel good and have an easy, safe delivery with a lower risk of excessive weight gain, gestational diabetes, and even GBS (they encourage probiotics).
They practically require 3-5 liters of liquid, mostly water, daily. I do believe that more women would have healthy, easy pregnancies if they followed this rule - it seems like a lot until you get used to it. A liter of that might be raspberry leaf tea, half a liter of skim milk, some juice, and the rest water. They don't frown on the occasional latte or ice cream
Unbiased information (pros/cons) of things like the Heb B shot given at birth, as well as Vitamin K shot and Enthromycin ointment for the babies eyes. All these things they do at the hospital without giving you the valuable information YOU as a parent should have to make those decisions - the midwives give you the information point blank and let YOU decide. None of these are 'standard' proceedures at the birth center; they inform you and then ask for your consent before administering them. In the hospital, we'd have to fend the nurses off with a stick, and defend our position - in the birth center, they respect our decision, no questions asked.
The midwives have a library of books you can check out. They WANT you to be educated. They WANT you to ask questions (even dumb ones, like, 'at 12 weeks, how much amniotic fluid surrounds the baby?).
They offer classes, one of which is 'healthy pregnancy'. . .which I will take in two weeks. It's free, and it's two hours where you get to chat with other first trimester/early second tri moms and the midwives about being healthy, being pregnant, etc.
At 12 weeks pregnant, they are already talking to us about the delivery - that discussion is not saved for the third trimester, but rather becomes an integral part. . .the whole reason for the care we are receiving. One thing we tend to forget is that the process of a natural birth, or any birth, starts early in pregnancy. It's not something to be saved for discussion in the third trimester.
When you do your glucose screening, they give you juice. Not that orange glucose concoction that mimics absolutely nothing about a normal diet and makes the pharmaceutical company a boatload of cash; just juice.
When delivery day comes, you labor at home until you are in active labor - much later than if you were to be in a hospital setting. By the time you go to the birth center, you're usually 5-6 cm dialated - so the early parts of labor are spent at home, with YOUR stuff, in your tub or shower, on your bed, walking in your neighborhood. (They do teach your DH how to deliver the baby, just in case
)One you arrive, they may or may not check your cervix - but you are allowed to do whatever you want. No monitors, no IV's (unless you are GBS+). You can sit, squat, walk, EAT, drink water, drink tea, and sit in the tub.
They don't do pitocin. They don't do episiotomies. They don't do epidurals. They don't do vacuums or forceps, and because of their emphasis on birth positions, maternal health, and eating/drinking during labor, they don't ever need too. They don't require you to be hooked up on monitors, or to deliver splayed out on your back with your whoo-ha in the midwifes face. Their c-section rate is less than 6% (compare that to the national U.S. hospital average of 38%, or just over 1 in 3).
When the baby comes out, they DON'T pull on the head (unless the rare circumstance requires it) as the shoulders are being born (this is a pretty standard hospital practice, and can seriously injure your newborn if done incorrectly) - if you are in a good position, there is no need to do that. As soon as the baby is out, it goes on your chest. . .no rushing around, no taking the baby, no cutting the cord right away. After the placenta is delivered and the cord is cut and you are all cleaned up and relaxing on the bed, they will do the newborn exam on the bed with you there. . .they NEVER take the baby out of your sight unless again, rare occasion there is a problem. Very different, again, from being brought into the world in a hospital setting.
The average stay? 9 hours from the time you arrive. Most deliveries happen within 4-5 hours, you stay and relax for 4 hours, and then you go home. You, DH, and baby. Back home, with YOUR things, your smells, your bathroom, your bed. . .spending those crucial first days bonding at home, not in the hospital. I think this is a beautiful thing.
So there you have it ladies - this is my honest account of my experience. In the OB care, I was scared of the delivery - scared of the hospital and interventions and of my labor stalling because I was in an uncomfortable place.
Now that I'm with the midwives and the birth center, and they are helping me and teaching me how to have a healthy, happy pregnancy, and a healthy delivery, I'm actually EXCITED about the delivery. I'm confident and unafraid. . .and in my opinion, that feeling comes largely from the type of care I'm receiving. . .even if you are terrified of childbirth, you might find that the right support and care is all it takes to help you build your confidence.
All that said - there is always the chance that something goes horribly, legitimately wrong. The decision for me comes from the fact that if I'm going to have an intervention, I don't want it as a result of another intervention, but rather because I landed in that small percentage of people who have a genuine problem in delivery. Anything can happen of course - and I believe that you can be both open to that, and still be very open and willing to deliver your baby naturally and without complications.
Educate yourself ladies! ASK questions! Be involved, and do what is best for YOU. This is about YOU and YOUR baby - you are NOT a statistic, you won't follow a graph or chart, you ARE special.
That is REALLY sad. . .how many women hear that nonsense from him and just think 'well, this is how it is supposed to be, just like in the movies and on all the childbirth reality shows. . .' and don't further educate themselves? Meanwhile, he's making boatloads of cash off of all those extra interventions, and making your recovery so much harder. I'm so so sorry you had that experience, you are a strong and smart woman not to put up with it! 
Lucky girl! 
