Rather than beat around the bush, it seemed to make the most sense to just start our blog with the taboo discussion…where to give birth. Let’s face it, when people mention “Midwife” they automatically think of homebirth. As a midwife who has attended home and hospital births for years, this is one touchy subject. It drives us crazy that people think you have to have a homebirth if you have a midwife! The reality is Midwives don’t actually care where you give birth; in fact, sometimes we are the ones to tell you that homebirth is not appropriate in your particular situation. We want you to deliver where you choose, where you feel safe and where we can provide the best care for you and your baby. For some women, this will undoubtedly be the hospital. For others, birth will only feel safe in an out of hospital location surrounded by the people they trust, often their own home. In Sudbury, the Sudbury Community Midwives attend approximately 75% of our deliveries at Health Sciences North hospital. Translation: nearly 300 hospital births and 100 homebirths are attended by midwives in our practice each year.
Is it safe? Another sensitive question, and what I would like to ask in return, is why would we attend homebirths if it wasn’t? Midwives actually really like their clients! We know our clients and we want you to have good outcomes. We want you to love your birth experience and have the least amount of complications possible. This, my friends, is why we discuss nutrition, exercise, lifestyle modification etc etc. The reality is that for a low risk pregnancy in a healthy woman the risks of complications are VERY low at home. Complications are largely caused by intervention; sometimes necessary and sometimes not, and at home elective interventions cannot happen http://www.theguardian.com/lifeandstyle/2014/may/13/pregnant-women-home-births-midwives-baby. If the labour and birth don’t progress normally, then we move into hospital and intervene there. If bad things were happening at homebirths then why have we been successfully attending homebirths for over 20 years?
What if something goes wrong? Yet another sensitive area. While many of us would love to be thought of as ‘hippie earth mothers’ the reality is that each of us have extensive university education with backgrounds in biochemistry, physiology, nursing, neuroscience, nutrition and many other disciplines. In addition, midwifery in Canada requires you to complete a 4 year Bachelor of Health Sciences degree, followed by one year of supervised practice (much like a residency). Midwifery education includes courses in pathophysiology, pharmacology, and anatomy, as well as hands on training and emergency skills workshops. We maintain those skills by taking the same courses physicians do, like A.L.A.R.M http://sogc.org/events/advances-in-labour-and-risk-management/welcome/.
We work hard not to be too medical and “sciencey” as this can be intimidating to many, and is often what people are trying to avoid. Having said that, midwives still do believe that a pregnancy can only be safely monitored by having regular appointments, appropriate prenatal testing (blood work ultrasound etc) and monitoring of you and your baby in labour. This has nothing to do with where you deliver. We bring medical equipment with us wherever we go, and if a complication arises we are prepared to deal with it. While we do love the show “Call the Midwife“ www.pbs.org/call-the-midwife, it is far different in today’s world, and in Canada. For example if you start to bleed heavily after a home birth, your midwife will start an intravenous and add medication to it to control your bleeding (just as she would in hospital). If your baby needs extra oxygen or its mouth and nose suctioned at birth, then we have just those things set up and ready to use. Midwives deal with common emergencies every day in all birth locations. It is our extensive training that helps us anticipate complications and move to a more appropriate location if we think additional intervention or support is needed.
Choice of birthplace is a personal one, and one that you should not have to justify to anyone. Regardless of our own personal choices I would encourage you to support your family and friends in whatever decisions they are making. They aren’t crazy, they are informed, and their reasons may be personal. If someone you know is making a choice that makes you uncomfortable then take the time to learn more, or even better, ask to come to their midwife appointment and ask us!