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Why I Picked Midwifery Prenatal Care Despite my C-Section

By Danielle |

When I found out I was pregnant with my third child, it was a huge surprise in many ways. My husband and I were basically done having children, at least for the time being, but our daughter had way different plans for us.

In the weeks after our discovery, I panicked not knowing what kind of provider I was going to see, or what my plan for my pregnancy would be. With two previous c-sections, it doesn’t really leave options open, despite the newest recommendations for Vaginal Birth after 2 Cesareans, also known as VBA2C.  While this was typically frowned upon in the past, new research showed it is a safe and viable option to most women. Of course they would have to look at each individual woman, and weigh the risks and benefits, and of course the comfort level of the mother.   But to have a large medical organization like ACOG come out and say, VBA2C is acceptable… was a big deal.

It got me excited at first, and I started interviewing providers left and right to find an OB/GYN or midwife practice that would allow me to have a trial of labor with two previous surgical deliveries. After my first birth experience I had little desire to go back to an OB/GYN at all after my experience. I had no desire for the short appointments with long waiting times, the invasive tests that were repeatedly ordered even if I declined, and feeling bad for my educated choices when it came to my informed refusal.

When it came to the care I got from midwives, I made the calls. I had long appointments in which all my questions were answered… I was treated as a face, and a name, not a number on a chart, and I built an amazing relationship with my providers. Not only that but I got better care with a more hands off approach, exactly what I needed after what I went through with my oldest son.

I interviewed different midwives, and decided even if I could not have a trial of labor for my third child, I still wanted to do all my prenatal care with midwives. It is what was most comfortable and appealing to me. And what is exactly what I did.

I worked to make special arrangements with my midwives who I saw with my second son for prenatal care, and of course a c-section delivery for birth with one of the OB/GYN’s from the practice that backed them. Here I am at almost 32 weeks pregnant with a c-section date scheduled with not only the OB who will deliver the baby, but also with my midwife who will be acting as my doula, and advocate in the operating room.

It took me a long time to come to terms with how I have to deliver my babies, and I am sure there will be some people out there who will disagree with me, or my choices for medical care, or call me some kind of hypocrite for being a natural birth advocate who is having a scheduled c-section, but those people are the extremists I have no interest in working with anyways.

Would I love to have a home birth, or never have had a c-section with either of my older children?  Of course, I think about it every day.  But would I rather have harmed by children or self in the process?  Of course not.   Sometimes the only safe way, is the way we may not view as safe.

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About Danielle

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Danielle

Danielle Elwood is a straight-shooting Florida based mom of three and emerging indie author. Read bio and latest posts → Read Danielle's latest posts →

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14 thoughts on “Why I Picked Midwifery Prenatal Care Despite my C-Section

  1. NW Mama says:

    I enthusiastically opened this link only to find a very vague testimony riddled with editing errors. I’m so happy this mom is getting her prenatal care the way she wants and feels comfortable. Midwives can be amazing. But, I’m left with questions. Maybe this was a teaser for a follow-up article? :)
    I recently had a successful VBA2C, for which I had to fight for my right to labor, despite the new ACOG statement. I love to hear stories about women taking charge of their healthcare, their bodies, and advocating for their babies. Excited for more, in depth articles regarding similar subject matters.
    Thanks, Babble!

    1. Danielle625 says:

      @ NW Mama – I am the author, and I have written several posts on why I picked a repeat c-section over trying for a VBA2C. You can see them :
      http://blogs.babble.com/being-pregnant/2010/10/20/choosing-a-c-section-my-fear-my-anger-my-acceptance-my-empowerment/

      http://blogs.babble.com/being-pregnant/2011/01/24/i-dont-want-your-pity-i-want-your-support/

  2. Jessie says:

    Midwives are essentially less trained and come to your house. You can have a natural birth under a real Dr’s supervision. That is the safest way, you really should note the women who have lost babies from home birth that would have otherwise easily been saved. http://hurtbyhomebirth.blogspot.com/

  3. Elizabeth says:

    Jessie,
    You comment is about 95% inaccurate. Midwives are not “less trained” and they don’t come to your house, necessarily. They are trained using a different approach to birth. They ARE a safe option. As a matter of fact, following the midwife model of care has been shown over and over to be the safest way to give birth for MOST women regardless of where they give birth. Midwives deliver babies in all settings; hospitals, birthing centers, and homes. “Natural birth” has many defintions, as many as there are women who choose that way to birth. Some versions are not possible or are very difficult to attain under the direction of a physician. Babies have been lost at home and in hospitals. Either way is tragic. There’s no way to know if a home birth could have saved a hospital-born baby or if a hospital birth could have saved a home-born baby.

  4. Andrea says:

    Danielle, I am so proud of you – you made a powerful informed choice that was right for you. Thank you for acknowledging the strength of midwifery care, for understanding the role of a midwife, regardless of where or even how birth happens. Your decision to repeat CS was brave, considering the evidence. Jessie’s comment ‘You can have a natural birth under a real Dr’s supervision’ is faintly ridiculous – I sure wouldn’t want to have a natural birth under a fake Dr! Midwives are not medical doctors – and neither do they wish to be. Midwifery is a distinct art and science that is complementary to the practice of Obstetrics when interprofessional relationships are mutually respectful. This is the way to improve care and outcomes for mothers and babies. Asking an obstetrician (surgeon) to care for women in natural labor is as unrealistic as asking a midwife to perform a C-section – sure, I know the theory but its not my role, responsibility or desire to do so!

  5. Danielle625 says:

    @Jessie- You are clearly uneducated about midwives and midwifery care. No, my midwives do not come to my house, nor am I having a home birth… Take your anti-home birth propaganda else where…

  6. JM says:

    Danielle, since you’re using an anonymous name anyway, could you please tell us what led to your decision to have a cesarean? And I read both of your linked articles and all you said was “this was the best choice for me.”

    It’s hard to expect blind support, especially from strangers–you have to give reasons for people to support you. Furthermore, it would help those in the same situation to have some perspective from someone that’s been through it.

  7. Danielle625 says:

    @JM – First off, my name IS Danielle. It is not an “alias” I use for blogging… Second, my own medical reasons and history is what led me to decide to have a c-section, because after my two previous deliveries, both c-sections… it is the safest option this time around.
    I don’t expect blind support, I have blogged at length as to why I have decided on a c-section, especially on this site.

  8. JM says:

    No, you haven’t. You haven’t said why. You just said, based on my history and past births. You haven’t said what about them lead you to that choice.

    And Danielle, your LAST NAME isn’t known is what I’m getting it.

  9. Danielle625 says:

    @JM – Yes, I have blogged about it :
    Here are the laundry list of posts …

    http://blogs.babble.com/being-pregnant/2010/10/20/choosing-a-c-section-my-fear-my-anger-my-acceptance-my-empowerment/

    http://blogs.babble.com/being-pregnant/2011/01/24/i-dont-want-your-pity-i-want-your-support/

    http://blogs.babble.com/being-pregnant/2011/02/11/why-i-am-not-happy-with-my-scheduled-c-section/

    http://blogs.babble.com/being-pregnant/2011/02/02/c-sections-vagina-preservation/

    And if you look right in the sidebar, you will see my bio, including my last name which is Elwood… :)
    I am not nameless, I am a blogger who does not, and have never hidden who I am.

  10. Katie says:

    Jessie-
    The stories on the page you referred to are so sad. My heart goes out to all of those women. However, to group all midwives into such a category is unfair and inaccurate. There are plenty of midwives who strive to make pregnancy and birth a safe and unforgettable experience for both mother and baby. There are so many midwives who are well trained and follow very specific guidelines to provide safe and evidence based care. I have worked in OB for several years–in the roles of an RN and later as a CNM. I have witnessed very few births in which “natural birth” was actually facilitated by an MD–usually when an MD is the provider the RNs are in charge of the labor room for most of the process. I am sure that there are MDs out there who advocate for natural birth, but I just want people to be aware that CNMs are a SAFE and realistic option. I am not trying to minimize the loss that the women in the blog experienced, but please realize that there are options available other than using an MD–and as Elizabeth noted–often midwives are the “safer” option when looking at statistics. Look at some of the numbers from Europe–when planned and regulated appropriately homebirth and birth with a midwife is a safe and very realistic and healthy option!

  11. Cait W. says:

    I’m not trying to be rude at all, but I have an honest question. Why do you NEED a doula in the operating room? I don’t get it. I had a medically necessary emergency C-section (I had undiagnosed vasa previa), and while it wasn’t the best birth ever, it was certainly the one I needed in order to have my son.

    What does a doula offer in the OR? Will your spouse be with you? I really don’t get it. I understand you are a natural birth advocate, but a c-section is different.

    Thanks for your time.

  12. Danielle625 says:

    @Cait W – My husband for the most part will be with me until delivery, and then be with our daughter. Our doula, who was also the midwife for my last delivery will be able to stay with me for the entire delivery, and also be able to talk me through it, and help to keep me calm. In most cases, doulas are not allowed in the OR.

  13. Cait W. says:

    Again, I’m not trying to be insensitive at all. I am trying to understand.
    Will she be there to help you with your emotional health during the surgery? To me, the surgery was the least stressful and painful part. The recovery isn’t fun (especially when you’re running back & forth to the NICU and the post partum nurse AGAINST YOUR DIRECT INSTRUCTIONS gives you a laxative you don’t need, which causes severe problems…).
    Maybe you’ll understand my confusion if I tell you my birth story (I hope it isn’t too long winded).
    Honestly, my c-section was no picnic. After a totally uncomplicated pregnancy, my water broke at 32 weeks. The night before, I had had food poisoning and severe vomiting. 2 hours after we got home from the hospital for that, my water broke.
    I had an OB I trusted. He was actually a natural birth advocate, of all things. He’d even delivered vaginal breech babies and told me that women “don’t need epidurals. They’ve been doing this for thousands of years. If you need one, you can get one, but I don’t recommend them.” My doctor told me (before and after the birth) that he expected I would have a swift and uncomplicated delivery.
    I had considered getting a midwife and giving birth at a local birthing center; I had been devastated that the local Bradley instructor had moved away. This OB was my next option. The birthing center was 45 minutes away; the hospital (a certified baby-friendly hospital) was 10 minutes away. It didn’t seem like a bad option, and I knew plenty of women who had completely natural births there.
    After 2 weeks of hospital bedrest, my doctor gave me cervadil. At 34 weeks, the risk of infection to the baby outweighed the benefits of keeping him in the womb without any amniotic fluid. I had only had 1 contraction, and the only sign of labor I had was a broken bag of waters. I wasn’t softened or effaced, but the risk to the baby was too great to go any longer. He had really stopped developing and the infection risk was going up and up.
    The morning after the cervadil, I made it less than 30 minutes into the induction. When the doctor was placing the internal monitor on the baby and the amniotic pump (to cushion him from the contractions), his heart rate fell precipitously and stayed down. It rose in the OR right before the anesthesiologist got there. I was very close to having to go under general anesthesia. I was shaking. I wasn’t so much scared of the surgery as reeling from the pain of being manually dilated and seeing my son’s heart rate drop.
    The doctor and my nurse (whom I had grown to know well over the course of the 2 weeks) held me up while I got my spinal. They calmed me down; both knew how frightened of the spinal I was.
    I was prepped, and the c-section began, with the NICU team in the back. My husband came in, and my baby was born…and then I heard the terrible words, “Have you ever seen this before?” come out of my doctor’s mouth. My son had a very malformed placenta and umbilical cord, which had put him and me in danger the whole pregnancy (Vasa Previa).
    As I was being stitched up, Dr. instructed my nurse to show me the placenta and he described what it was. In the recovery room, he was with me while he wrote his report and he described exactly what happened and what the risks were.
    I guess, in short, I feel like I was respected and taken care of from day one by my provider. I feel like all the nurses (except for the one that gave me an unwanted medicine which caused 12 hours of severe intestinal pain less than 24 hours after a C-section) treated me well. I had one nurse who had me up and walking at 5am the next day.
    I guess I just never felt like I wasn’t being respected or informed, and I am having a hard time understanding and empathizing with women who feel otherwise. My c-section was lifesaving and necessary for both the baby and me, and I think that has colored my view of them.

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