Midwives vs. Doctors

on May 19, 2008 @ 10:39 pm

I am wondering if any moms on CA has experience with midwives? I've been under the care of obstetrician so far but I feel I'm not developing a relationship with my obstetrician. It's not that my doctor isn't nice, but she's always so rushed during our appointments and when I have questions, I feel like I have no one to turn to for answers. Also, since my doctor belongs to a group of obstetricians in a clinic, she might not even be there for the birth of my baby. I hear from several people that they never hesitated to call their midwives whenever they have questions and their midwives took very good care of them during labour. I've also been reading online on this subject and I guess the midwives continue their care for you up until 6 weeks after your baby is born, whereas my own obstetrician has already told me (during our first meeting) I need to contact my own GP to take over the care of my baby since my baby needs to see a doctor 4 days after he's born. Overall, I just don't feel like my doctor know me very well. I'm just a patient among the crowd.

If anyone here has a personal experience with midwives (good/bad), I'd love to hear the stories!! Having insights from experienced moms would really help me make this decision!!

Thanks a lot!!

13 Replies

strange advice on May 20, 2008 @ 09:09 am

I have only used an OB (and I have 3 kids). My experience was similar, in that I was with a group. In only one of my 3 deliveries did I actually have the doctor I was signed on with, but in the end it didn't matter as I received excellent care from all of them. 6 or so weeks later I went to my OB for my post-natal, and in 2 cases actually went in sooner due to questions/concerns about my healing process. My babies were seen by their new pediatrician in the hospital, and then I took them in after 1 week to the pediatric practice. Personally, I would prefer the pediatrician take over their care as opposed to a doctor/midwife from another specialty.

I too felt like I was one of a zillion patients in the practice. My docs were hurried though professional during my appointments. I guess it comes down to your comfort level. In retrospect, I would have liked to take on a doula (birth coach), especially since my husband was less helpful than I had hoped during the labor process.

I have heard great things about midwives and doulas, but in my case I was more concerned that an accredited doctor oversee the process. You can ask around in your area about cooperative care between a midwife and OB, because not all docs are ok with having a midwife sticking her oar in. A doula is more like the most helpful birth assistant and in most cases is available for pre and post-natal care. You call them when you go into delivery and they come (they don't send a substitute) day or night. They are also much less expensive, but do have less training.

My first 2 births went well/were normal, but my 3rd had complications and I had to have an emergency C-section. I was very glad to have the doctor present, even though in this case, I had never seen this particular doctor in my prenatal checkups! Still, a good experience considering the circumstances.

In the end, it really comes down to your comfort level. If you are still in the early days (20-25 weeks), I'd say there's still time to switch. Personally, I wouldn't want to switch any later because it'll take time to get to know a new person (who you may not click with), and some practitioners don't want to take on someone who's further along unless there are special circumstances. These are huge generalizations of course, so take my advice with a grain of salt. Go with your gut; labor/delivery is a tough enough job that you shouldn't have to worry if your doc will forget your name while encouraging you to push!

Best of luck to you!

My 2 cents... on May 21, 2008 @ 10:39 am

I've not been pregnant yet but I'm planning on using a midwife when I do! I too have heard only great things and you can still give birth in a hospital where if an emergency develops, there is a doctor available. Also anytime during your pregnancy, you find out you will need a doctor (e.g. breach birth so you need a c-section), you can just go to an OB then.

How far along are you? Good midwives are in great demand and if you don't register for one as soon as you're pregnant or in the early months, it may be too late as there aren't enough to meet the demand.

Good luck with whatever you decide!

Thanks for all the advice on May 21, 2008 @ 08:39 pm

I've made an appointment to meet with a midwife tomorrow and I'll see how that goes. I think in general, I'd like the more personal care I can get from a midwife. I'm already 28 weeks along but when I talked to the midwife groups in town, everyone said it's not too late to switch BUT many of them already told me they are fully booked. So I have only 1 chance of getting a midwife this late in the game. If I don't like the midwife tomorrow, then I'm stuck with my doctor.

I know starting in the 3rd trimester, I'll be seeing my caregiver twice a week. So far, I've only seen my own doctor for 2-4 visits, no more than 10 min each time. Had I gone with a midwife, I would've had at least 30 min with her for each appointment. I know for the remainder of my pregnancy, the situation will not change with my doctor, so I feel that even if I switch caregiver now, I can still build a stronger relationship with the midwife than I ever will with my doctor. And the bonus is that I can rely on my midwife being there for me during labour while it's not something I can guarantee with my doctor.

Don't get me wrong, I like my doctor; she's friendly and cheerful. I trust her medical expertise as well as her colleagues in the clinic. But I do want a more personalized care. For example, I got sick a few times earlier on in my pregnancy and I got no help from my doctor. Once I had a very bad stomach flu (thought it was food poisoning which could be very serious). I was bounced from place to place at the hospital - the pregnancy clinic won't see me because I don't have an appointment, the pregnancy triage won't see me because I was only 19 weeks along (their cut off was I had to be at least 20 weeks along)...I was forced to go down to emerg where I was treated like scum. I was feeling very very sick and I was very worried about the baby...I felt so helpless! But I couldn't call my doctor because I had to go through the clinic to contact my doctor and the clinic sent me away, even though I begged them to let me see her. I know if I had a midwife, I could've paged her and she would've gotten back to me quickly. At the very least, I wouldn't have to run around the hospital trying to find someone who'd help me.

Having said all of that, there are particular reasons why I went with the doctor at this particular hospital. So if this midwife can't meet certain criterias, I probably won't switch even if she's the nicest person in the world. But I am definitely going to go with a midwife if we have a second child.

Anyway, I'll keep you posted on my decision! :)

good game plan on May 22, 2008 @ 02:12 pm

Sounds like you have a good handle on things. I hope it all works out for you!

I can hardly believe the shabby treatment you had with the flu thing! That is seriously screwed up. I never had to deal with that sort of issue during my pregnancies, thank goodness, so I can only imagine how frustrated you must have been!

Any decision yet? on May 23, 2008 @ 10:44 am

Bubblybunny,, how did the appointment go? Good to hear that you didn't miss the boat and you still have a choice between a midwife and a doctor.

Country Chick
Fabulous experience with midwife on May 23, 2008 @ 09:02 pm

I had a wonderful midwife with my first pregnancy. His name was Larry Lensky and he was unbelieveable! He was always available and took the time to answer my questions fully. When I went into labour, he came to my house at 3 in the morning! Things did not progress, so he recommended we go to the hospital 12 hours later. Long story short, my son was finally born 3 days later and all this time, Larry did not leave my side!!!! While I had the nightmare of first labours, Larry made sure I was getting the ultimate care. The thing I loved about midwives is that they want you to have the kind of birth you want. They do not try to talk you into having a home birth. I remember when I told Larry that we had decided to have a home birth, I was expecting him to get really excited. But, instead he replied, we work and plan towards a home birth.

In the end, I had an emergency C-Section which saved both of our lives.
I contacted Larry when I became pregant the second time. Unfortunately, he was in the process of moving to another province and so unable to act as my midwife. But, he did meet with me and discuss things. He told me not to feel guilty if I decided to have a planned C-section. I choose another midwife who I did not connect well with. After 22 hours of labour, I begged for a C-section and had one. This midwife experience was not great, but then, after Larry who could compare!
With my 3 pregnancy, I had to have a C-section, so I was under my family doctor's care. She was fabulous! While I was sceduled in for early June, I ended up with an emergency C-Section instead of a planned one! It was a holiday weekend, and my doctor came in from home to assist! She's one in a million.

I guess what I'm trying to say is; midwife or doctor, you can have a good experience either way. Just choose someone you feel comfortable with and don't be afraid to change providers if you're unhappy.

Best of luck. Keep us all posted!

Going with a midwife on May 24, 2008 @ 04:29 am

After meeting with the midwife, I felt really good about my decision to switch. It was definitely the kind of care I want, esp. for my first child. My husband is totally supportive in my decision. I think he felt better after talking to a few people who highly recommended the midwife option (esp. from people who've had both midwife and doctor care).

I think after talking to several people about my situation, I've narrowed down the main reason why I want to switch - it's the medical system, I just don't like the way they do things at the clinic. This is our overworked, understaffed medical system at work. When you have so many patience coming through everyday, it's no surprise that everyone is just another name on a piece of paper. I do see the doctors and nurses giving the patients their best...but only when that patient is sitting in the examination room and she is obviously their responsibility. That's the only time when they see a "real person" in front of them. The rest of the time, I'm just fat body floating around the hospital.

This impression was ingrained in me when I got sick. As I mentioned, I was bounced from place to place and trying to find help, in a hospital. The people there had reduced me to tears by the afternoon. The emergency doctor who finally saw me was super nice and he kept telling me not to hesitate to come to emerg if I feel sick again b/c I'm not taking space away from someone with heart attacks or anything like that. He told me I'm sick and I need medical attention too. In fact, he thought I was sick enough that I should stay home for the next few days and he wrote me a doctor's note for my boss!! He was super, but the rest of the hospital staff wasn't.

One thing about the pregnancy triage I will never forget: The clinic won't let me see my doctor but they said I could go to the triage down the hall and they could help me. I went there and I tried to explain to them how sick I was. The nurse asked me how far along I was...Jeepers, I don't know? 18-19 weeks, I said! I was too sick to count. I was trying to tell her that I threw up in their washroom no more than 5 min ago. I could barely walk for 5 min without having to sit down to calm my stomach pain. But she didn't listen, she just wanted my due date so she can calculate how far along I was. I couldn't believe they sent me away because I was 18.5 weeks and they only treat pregnant women who are 20+ weeks along. I was so upset. It's not like they were busy!! There were 3 nurses sitting at the triage, chatting, laughing, there were no patients around...and they wouldn't help me. The worst thing was there was this one nurse, she's also pregnant. She said to her coworker, "Well, I'm 21 weeks, there's no way she's 20 weeks yet. Send her to emergency." She never looked at me once. I was like, "What?!" This girl, about my age...she's pregnant and she works in the pregnancy triage...and she can't find an ounce of sympathy for a fellow sick pregnant lady...I thought she had no business being a nurse!!

I didn't have a bad experience with my obstetrician, per se...but I just don't like the way things are run at the clinic. It's the system I am not comfortable with, not the caregiver themselves. So if something goes wrong during labour, I'll trust the doctors to do everything they can to help me. I've never doubted my decision to have the baby at the hospital. I wanted to be in the hospital, just in case... But I also need someone who'll be there for me during the pregnancy and I think a midwife can give me the care I need better than a doctor can.

I want to thank mamaluv, country chick and lichee for all your supportive comments. It's good to hear other people's experience. The more I hear, the more comfortable I'm with my decision.

You're welcome! on May 24, 2008 @ 11:52 am

I'm glad to hear you are happy with your decision. I can totally understand how our rushrush system is not the best; even though I never used a midwife, I certainly didn't appreciate the "take a number" approach that you usually get (be it from an OB or a walk-in clinic or whatever).

As a preggie, I would have wanted to slap that nurse's smart mouth for such an asinine comment. What a cow!

Anyway, best of luck to you! Just being happy with your situation will ultimately make your pregnancy and childbirth that much more relaxing and stress free. Let us know how it all turns out!

On another note, I've never heard of a "midwife" named Larry - lol! It's not exactly the most politically correct job title, is it?

Never had kids on May 27, 2008 @ 02:45 pm

But my Godfather was an OB who handled a lot of problem pregnancies. It always angered him because he had to pay a lot of insurance money, as all doctors do, while midwives do not. If something were to go wrong during a pregnancy a midwife is not responsible, as they are not doctors. And when they eventually ended up on his table if anything went horribly wrong he would be the one held responsible, not the midwife, despite not being in charge of the mother up until that point.

I think the health system in Canada created too few doctors - med school is hard to get into! And many do not want to stay here, so I think it more a reflection on the medical system than the doctors - many do wish they were able to give more time to their patients.

That said I too would like to have someone on hand to guide me, especially if it were my first and I was unsure. But I would probably want a hospital birth, just in case. I come from a country where my father's generation were all born at home to a midwife. But I understand it isn't practical in every circumstance, and often things happen at the last minute.

I don't believe in 'the miracle of birth' or think of it as something miraculous or special - I understand many mothers see this as a magical moment, but I am much too practical for that! I have seen too many animals give birth for it to be 'special' for me. All I want is a clean space to have my baby, with DRUGS!!!!

I think it is all about what you expect from birth, and what you need. Some people need it to be personalized and special, and that's okay. I am sure midwives are competent - they have, after all, been doing this long than doctors.

Good points on May 27, 2008 @ 07:48 pm

Thanks for sharing the OB's point of view, Nessie. I don't know if I stressed this point enough: for me, I like my OB, I just don't like the system. My doctor was very nice and so were the nurses. But when I don't even have access to my doctor in between visits to answer my questions, I felt lost and that's why I've decided to switch.

Having said that, there is no way I'm having a home birth. I work at a hospital and I've been volunteering at the hospital since I was a teenager. I am extremely comfortable being in the hospital, around healthcare professions. In a strange way, I'm extremely comforted by all the little machines there and all these smart people who save lives everyday. I also have zero pain tolerance, so you won't ever hear me say no to drugs! :P

One of the qualities I was looking for in a midwife was her willingness to listen to me. She outlined what normally happens during labour and what her approach is. When I asked her what happens if I want to head to the hospital before she feels I need to be there, she said the decision is entirely up to me. She also said pain management methods are entirely up to me as well. She will only give suggestions but the final decision will always be mine. She has also made it very clear to me what she is or is not qualified to do and gave me examples of when I'll need to be transfered to a doctor's care. I am also doing a lot of research on what the role of a midwife is and what she's qualified to do. I am going to make sure I'm well informed in this area.

Anyhow, I'm getting a lot of valuable insights from everyone on CA!! :) I hope you gals can keep them coming because I really want to know what other people think of this!! :)

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