Midwifery, Pregnancy & Birth :: Frequently Asked Questions
Are midwife attended births safe?
Research has shown that for essentially normal, healthy
pregnancies and labors, midwifery care is just as safe as physician care.
In fact, midwife-assisted births are associated with decreased infant
mortality and intervention (including cesarean) rates.
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What if something goes wrong?
Allowing labor and birth to progress naturally, with as few interventions
(including pain medication) and as much physical and emotional support
as possible, makes it less likely that something will go “wrong” in
the first place. In addition, there is a very wide range of situations
that can be considered “normal” during childbirth, and a care
provider’s reaction to those events can make a big difference in
determining if something really is a problem. However, since some complications
can’t be avoided, obstetricians are on call at all times.
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Do midwives attend out-of-hospital births?
Many Certified Professional Midwives (CPM) attend birth in the
out-of-hospital setting. A much smaller percentage of Certified
Nurse Midwives (CNM) attend birth's in the out-of-hospital
setting.
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Will my insurance company cover midwifery services?
Most major insurance companies will. Depending on your specific plan,
midwife services may be included as network providers or “out-of-network” providers
(paying a reduced benefit). Some plans include midwives that are billed
under an obstetrician’s name- and only the doctor will be listed
in your directory of providers. Call your insurance provider’s customer
service number to find out!
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I wouldn’t have my tooth pulled without anesthesia– why
would I have a baby without it?
Having a tooth pulled IS NOT the same as having a baby! While there are
times when pain medication is compassionate and even necessary, most often
women need to know that they can deal with it, that they have support,
and that it will end soon! We won’t tell you that labor and birth
isn’t hard work or that it isn’t painful. However, there are
many reasons, both physical and emotional, for bringing your baby into
this world without medications. First, there are risks associated with
both types of pain medication used today– the epidural and narcotic
drugs. Second, the pain of childbirth has an important role to play in
preparing your body and your baby for birth. Finally, you do not need
to be superwoman to deal with childbirth! Women are made to give birth
naturally. Not only does the body know what to do and give the laboring
woman internal resources to deal with pain, but there are very effective
natural ways of helping to reduce the need for medications.
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What are the risks of using pain medication?
Depending upon the method and specific drug used, they include low blood
pressure with associated nausea and vomiting, nerve damage, toxic drug
reactions, breathing difficulties, and severe headache for the mother,
as well as problems such as trouble breathing or nursing for the baby
. Potentially more disturbing, however, are the increased “intervention” rates
associated with these methods of pain control. Well-established complications
of epidurals include increased use of forceps, vacuum extraction, and
cesarean section. Having an epidural also requires that you have an IV,
get hooked up to an Electronic Fetal Monitor, and stay in bed. In other
words, using pain medication is an intervention that opens the door to
a wide range of problems that can lead to further complications and interventions!
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Are there really benefits to going through the pain of childbirth?
There is both physical and emotional value in natural childbirth. First,
your body has been designed with an elaborate hormone-nerve feedback process
that helps labor progress efficiently and prepares the baby’s body
for the stress of birth and life. Feeling increased stretching (and pain!)
signals the cervix to dilate which causes more stretching (and pain!).
This system also creates the urge to push when the baby stretches the
birth canal. When you numb those feelings with drugs, the feedback process
is disrupted and left vulnerable to complications. Birth is also a very
powerful rite of passage that leaves you with memories that last a lifetime.
You have the opportunity to make that experience one that you remember
with pride and awe- that you were strong and gave your baby the best possible
start in life. Many women today are committed to living their lives in
awareness and being active participants in what happens to them. This
is your chance to start motherhood the same way.
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How do women deal with the pain?
A positive birth experience begins with prenatal care. Good nutrition
and adequate hydration during pregnancy are essential. Your confidence
in yourself and the natural birth process is also critical. It isn’t
just something that other women do: YOU can do it with the proper support
measures! Getting up and moving around (lying on your back is the most
painful way to be in labor!), relaxing in water, using imagery and breathing
techniques, having the physical and emotional support of a doula, acupuncture,
and hypnosis are all great alternatives to drugs. Plus, your body will
produce endorphins, which are natural painkillers, in response to labor.
While none of these measures will completely numb you the way an epidural
probably will, consider whether you really want to eliminate the powerful,
sensational experience of the birth of your baby!
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How can water be used in labor and childbirth?
Water can be very relaxing– particularly to a laboring mother. Soaking
in a tub of warm water during active labor (after 5-6 cm) can ease pain
and help speed along dilation. In fact, this method of pain control is
so effective it has been called the “aqua-dural” by some midwives!
Giving birth in the water is also an option. This allows the baby to be
born into a warm, familiar environment that eases the stress of birth
and provides a gentle entry into this world of bright lights and loud
sounds. The baby is then immediately brought to the surface and placed
on the mother’s stomach. It’s first breath is stimulated by
air contact, so the baby will not breathe in water. There is also very
little risk of infection to the mother, provided the water is clean. Think
about the stress-relieving qualities of water next time you take a warm
bath at the end of a long day!
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What is a doula and why would I want one if my husband or partner
will be there?
A doula is a trained labor assistant who nurtures and assists the laboring
and postpartum couple. A doula does not replace a woman’s partner
but works with the whole family to promote the best birth experience possible.
As one childbirth educator explains, “Asking your husband to be
your sole guide through labor is like asking him to lead the way the on
a climb of Mt. Everest. He may be smart and trustworthy, you may love
him, but in the Himalayas you’d both be a lot better off with a
Sherpa!” Using a doula can also be a very effective method of coping
with labor pain; having a doula present at birth has proven to result
in a 60% decrease in mothers’ requests for epidurals and a 30% decrease
in their requests for pain medication.
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