A Midwife for Every Mother

"A Midwife for Every Mother" read the blue bumper sticker on the back of the blue minivan.  I was glad to see it, because I was driving rapidly up to Rochester to attend a birth myself.  I sped up a little to see who was driving, picturing a midwife (and since I know most of the local midwives, I assumed I would recognize the driver.)  But it was a middle-aged, rather handsome man, and that made me smile even more.  We definitely need men to be behind the midwife thing, we can't do it alone.

The birth I attended ended up being a C-section.  The baby had been transverse, but momma went into labor and the baby turned to breech.  In the old days, when doctors still delivered breech babies, this wouldn't have been a problem, and I'm sure the baby would have been born vaginally; but doctors are no longer trained in breech births, so C-section it was.

So what would a midwife have done in this situation?  Well first of all, once she discovered, through palpation, that the baby was transverse, she would maybe perform an external version.  If she thought that was too risky, or she wasn't confident that she could do it, she might contact a local acupuncturist to put needles into specific locations to help the baby turn.  If neither of those things worked, she might bring a chiropractor into the mix to do some work on momma to see if that might help move the baby.  There are also many exercises and different positions that can be tried to get the baby into the right position to be born.

But do hospital staff try any of these well known ways of getting babies to turn?  Of course not.  In the hospital, we typical go right to a C-section, bypassing much less minimally invasive steps that could potentially get a baby into a good position for birth.

Our birth culture needs to change.  I think, even hospital staff, recognize that.  I have seen, in recent years, some really positive improvements in the hospital-birth world.  For one thing, breastfeeding is on the rise, I think in part because many maternity nurses are now trained to be coaches and advocates of breastfeeding.  Most hospitals now employ lactation consultants who see each new mother and baby, and try to encourage breastfeeding.  At the birth I was just at, I was impressed by the staff knowledge and support of breastfeeding.

We encourage active participation of family and friends in births now.  We no longer keep babies in nurseries and mom down the hall somewhere.  I think it is great that we have rooms where the whole family hangs out, and gets lessons on baby care, before sending the family home with their precious little bundle.

All of those things are huge improvements.  However, I do think we have a lot of work to do.  When midwives are trying things that have been shown to work, that doctors aren't even considering, something is wrong.  

How do we fix this situation?  I'm not really sure.  But I think we could start by looking at the maternity systems that are in place in England and Canada, for one.  In both those places, midwives are front and center in every birth, unless a surgery needs to happen, in which case a doctor is brought in.  The holistic, midwifery model of care is standard, and surgery is reserved for serious emergencies.