The gentlebirth.org website is provided courtesy of
Ronnie Falcao, LM MS, a homebirth midwife in Mountain View, CA

Health Administrator Supports Midwifery

This is for all of you considering a midwife. (No, I am not one myself, but a health administrator and STAUNCH midwifery advocate for the past 20 years.):

Why choose a midwife? Well, where do I begin?

How about because the U.S. ranks BEHIND 23 other industrialized nations in infant mortality, and most of those 23 countries that rank higher than we do use midwives as primary obstetric providers?

Or how about because midwives focus on a "high touch, low tech" approach to birth that is safe, satisfying and cost effective? (Midwives spend an average of 40 minutes at EACH prenatal visit, and come to the LABOR and birth, not just the birth. How many docs do you know that do that? And midwives have half the cesarean rate that physicians do--12% versus 25%--and a 68% VBAC rate as compared to 25% success for Vaginal Birth After Cesarean for physicians. And, if midwives provided care to only 25% of all pregnant women in the US, the cost savings for fewer technological interventions such as epidurals, forceps, episiotomies, etc., which all carry greater risk for mom and baby, would be $300 MILLION annually!)

How about because families who use midwives feel empowered to make decisions as partners in their maternity care, as opposed to tacitly accepting what they are "told" to do? Families are also strengthened because of better infant health (fatter babies and better breastfeeding rates) and a strong sense of bonding.

Don't get hung up in the labels; some midwives are trained as nurses first, others come from other professional backgrounds, and no one is trying to "force the public" into believing midwives are legitimate, because THEY ARE LEGITIMATE PROFESSIONALS. They get third party reimbursement from insurance and have malpractice coverage and all that cool stuff. And all midwives in the United States work in COLLABORATION with physicians to provide a full spectrum of care to their clients should a complication arise.

As to your worries about complications, the ones you see on TV are just that: made for TV. In real life, midwives focus on the normalcy of pregnancy, labor and birth, and are ALWAYS watching out for indicators of risk which require a referral to a physician prior to the situation becoming an emergency. Midwives can handle most complications short of being allowed to perform Cesareans, so your midwife can provide any life-saving measures mom and/or baby might need until a surgeon (OB/GYN's are surgeons) or other physician arrives. There is usually plenty of time to bring in higher tech interventions when necessary, and having a doctor as a provider will not guarantee that you won't have an emergency complication. And, if your hospital is not a teaching hospital, it won't have anesthesiologists in attendance, so whether you have a doctor or midwife, you will first have to wait until the anesthesiologist gets there before you can begin any surgical procedure.

Midwives can write prescriptions, either on their own or with standing orders from a physician. It varies from state to state and according to the arrangements particular midwives have with their collaborators. I suggest you direct your questions to your midwife; I bet she'll be happy to answer.

As for what happens if more than one woman is in labor at the same time? Same thing as if a physician were your care provider. Assuming both women are giving birth in the same hospital or birth center, the provider goes from client to client. In fact, a midwife would spend MORE time with the moms than a physician would, who usually waits until the labor nurses call and say, "She's ready to push." It's unlikely both babies will arrive at exactly the same moment, and labor is usually plenty long enough for a midwife to attend to both clients. There's nurses present, as well as other support people (like the father, and/or other family members), and what a laboring woman needs most is support, not clinical intervention. With a normal labor and birth, even you could catch that baby. Taxi drivers and toll-booth keepers do it! (My husband says that's why they have the E-Z pass lane in New York....)

All I can say is TRY IT! You'll LOVE it. Having my babies (now grown) with midwives quite literally changed my life. For the better.