Miscellaneous Questions to a Midwife
Frequently Asked Questions:
I'm the writing-midwife for this blog. I write to provide health information regarding pregnancy, birth, baby, and the early days of parenthood; so that parents may soak up this journey with full joy and only a little fear.
I get asked lots of questions when people find out that I am a midwife, and I love it!
It’s encouraging to see people’s eagerness to uncover more about an important and under discussed topic. Perhaps, an over mentioned, over regulated, and over judged area, but when do we fully give people the time to delve into the psychology of their fears and goals, discuss the physiology behind their experiences, or explore the nuances in the metamorphosis into parenthood?
Information inconsistency seems to be a staple in this area. Or overly vague information. The most efficient way to find an answer you need, is to ask a question! Drop a message with the question that’s been buzzing in your mind: an experience, a thought, or a clinical query. I won’t give clinical advice, but we can debrief and deconstruct for a more thorough understanding.
Hey, since you’re a midwife, can I ask...?
Can I only have a home birth?
Long story short:
Short story elaborated:
It depends. It depends where you live. Midwives can practice in any setting: home, hospital, birth centre. If you let them. Or if they want. In some regions, hospital bureaucracies and insurance mazes may prevent midwives from practicing in those settings. Some midwives choose to work in the community and avoid the hustle and bustle of a medical institution.
You can choose your birth place, or choose a midwife who offers support in your preferred place of birth.
Do I HAVE to have a natural birth?
No, because we can’t control what kind of birth we have!
You don’t have to be planning a non-medicated birth. Usually, you would also not be planning a cesarean section birth.
(This doesn't mean you are not "allowed" to need, or choose a c-section as your pregnancy or labour progresses. You just normally would not be set on a cesarean birth at the beginning of pregnancy!)
Can I still have an epidural?
We should always talk more about pain than jump to avoiding it, but the epidural is definitely a tool we can use.
Can I have an epidural at home?
No. The medications used and the procedure of getting an epidural requires a hospital space, and an anesthesiologist, the pain-reliever doctor.
What is an epidural?
Epidural is a pain relief option during labour. A blend of medications (local and regional anesthesia) is given similar to an IV, into a space in the spine. The anesthesiologist performs this task by: numbing the skin on your back with a tiny needle and some pain medications, inserting a needle into the correct space on your lower spine, and then feeding a plastic little tube into this space from which it will remain for the rest of the labour!
What you want it to do: An epidural takes away the feeling of pain from the waist down. That’s your entire pregnancy belly! You can rest, move around in the bed, sleep, all while your body continues working with the contractions. You should still feel pressure, like when your baby moves down lower, possibly shuffle yourself to the bathroom for pee-breaks, and jump into all different acrobatic positions to help your baby wiggle their way down when you start pushing.
As all things in life, what we want is not always what we get.
Will there be a doctor in the room?
If you are at home? Then no, unless you have a doctor who is a part of your support team and you wanted them there.
At the hospital? Only if they needed to be there. Midwives help people deliver their babies. The person they’re helping is YOU. Or whoever is their client. Midwives are capable of managing the birth. When everything is progressing smoothly, an obstetrician does not need to be involved in your care.
If your midwife anticipate baby needing extra help at birth, a pediatrician may come into the room.
If you want an epidural, your midwife will call the anesthesiologist into the room.
If your labour goes off the rails a bit, your midwife will consult or transfer care to an obstetrician.
What is the difference between a midwife and a doctor?
A midwife’s specialty:
Facilitating the normal, physiologic process of pregnancy and birth, so that you give yourself the best chance of a natural birth, and an empowering experience.
Providing well baby and well woman care after your birth.
Supporting and you and your babe through your transitions the first few weeks after birth. This includes breastfeeding support. Lots and lots of breastfeeding support.
Family Physician (GP):
They are the experts in having a general overarching knowledge in everything.
For pregnancy: Normal, healthy pregnancies. Much similar to midwives, but some conditions that overlap with their general knowledge will also be manageable by the GP.
Well-baby care. I think well-baby care under most circumstances could be translated to: weigh the baby.
An OB/GYN’s specialty:
Most obstetricians are also gynaecologists. They specialize in women’s reproductive health, young to old, menarche (start of periods) to menopause, and also in avoiding pregnancies (birth control).
Surgery - removing fibroids, cysts, hysterectomies, ectopic pregnancies and cesarean sections.
Specialists when the birth does not go according to plan: prescribe medications to increase your contractions, help you out with vacuum or forceps assisted deliveries.
Specialists when you have some pre-existing medical conditions in pregnancy that needs special attention.
Note the lack of “baby” under their area of speciality. At the time of birth, a second nurse or a pediatrician will be called in to be the baby expert .
The baby specialist for when babies get sick!
All the other specialities:
There are many doctors in different fields that the midwife or obstetrician can call upon. If you have diabetes, endocrinologists may be involved, if you have a pre-existing heart condition, a cardiologist might be called.
What is the difference between a midwife and a nurse?
This question is more relatable to people who live in regions with a maternity care system set up like Canada or USA. Instead of hospital midwives, we have labour and delivery ward nurses who work with the obstetrician to support you in labour.
Labour and delivery ward nurses - they provide labour support and monitor your labour. They do all the nuts and bolts of the work: start IVs, listen to your baby’s heartbeat, internal exams if needed, and call the obstetrician if they spot something amiss or it’s simply time to have a baby. The obstetrician steps in for the birth, the birth of your placenta, and any clinical aftercare.
A midwife, or a midwife-nurse team will do all of the above, but there is no need to call in the obstetrician when your baby’s about to be born and all is normal. The midwife continues with all aspects your aftercare.