When it comes to child birth women may have more choices than they are aware of. Learn what your alternatives are.
Pregnancy is one of the most exciting times in a woman's life. It can also be one of the most confusing! There are so many choices to make, to research, to learn about. Today women have more choices than ever when it comes to where and how they give birth to their babies. Unfortunately, many women are railroaded into the OBGYN/hospital scenario of birth simply because they don't realize that there are other options out there! It's so important to fully understand and realize that there are choices! Below are four basic options that each woman should at least consider when trying to make the best choice for herself, and her baby.
1.) Certified Nurse Midwife (CNM) or OB/GYN assisted hospital birth:
This is the option most people think of first. Giving birth in a hospital with a doctor or CNM in attendance has become the standard most Americans live by. Women generally see their chosen practitioner at their office or at the hospital throughout pregnancy. Hospital procedures and requirements vary greatly from hospital to hospital, and it's very important to take a tour of the hospital you are considering delivering at to see if they will support you in the choices you wish to make. Your OB will only have a limited amount of control over the type of care you receive at the hospital, so it's VERY important to determine the atmosphere where you will be giving birth.
Hospitals/ OB's provide the highest level of medical care available, and should be able to handle any crisis situation that may arise during labor and birth. OB's are trained to handle high risk* pregnancies and complications. Many are not trained on how to handle a pregnancy that progresses without complication, or in natural childbirth. The hospital birth scenario generally offers women the most technology available. Babies are monitored throughout labor and after birth with machines, mothers are generally given IV fluids instead of food or oral liquids, pain relief is immediately available, and mother's have the option of letting the nursery staff completely care for their new baby during their stay. The downside to this high level of medical management is that a lot of parents are left feeling out of the loop and without many choices. They are processed through the system instead of being treated like individuals with individual rights and needs.
2.) Certified Nurse Midwife (CNM) or certified Professional Midwife assisted Birthing Center birth:
In some areas Birthing Centers are becoming very popular. They offer an environment that is much closer to a home like setting, while still having some medical technology on hand. They are generally not as well equipped as hospitals and are unable to handle all medical emergencies. They also may not be able to provide the same spectrum of pain relief during labor (such as epidurals). Patients generally see their practitioner for prenatal visits at the Birthing Center. A much stronger emphasis on natural birth, breastfeeding, and family bonding is usually found at Birthing Centers as opposed to hospitals. Tours are readily available and should be taken by all perspective clients. Be sure to interview all the midwives that practice at the birthing center and select the one that you feel most comfortable with.
Birthing centers may also offer special amenities not found at hospitals such as labor pools and equipment designed to help women cope with labor without drugs. Care is generally more relaxed, and women are allowed greater freedom to follow the needs of their bodies during labor and birth than at a hospital. Because there is a lower level of medical technology on hand, Birthing Centers generally require that their clientele be fairly low risk. Which means, not all women will be accepted as clients.
3.) Certified Nurse Midwife (CNM), Certified Professional Midwife (CPM), or Direct Entry Midwife (DEM) assisted Home Birth:
There are many variables in the type of care offered by a midwife that provides services for home births. The amount of medical type prenatal and labor care provided will depend completely on the midwife you select. Some midwives are as medically oriented as OB/GYNs, others view pregnancy, labor and birth as completely natural and treat it as such.
Enough emphasis cannot be placed on the value of researching the midwife you choose! Speak with her in detail about your views on birth, the type of care you wish to receive, and request references. Research her medical training and her credentials, and inquire about her amount of experience with various situations. Speaking to past clientele is a great way to get a true feel for how a midwife practices.
Most midwives also practice with at least one assistant, or apprentice midwife. Be sure to meet all her assistants and see if you like them as well. Prenatal visits will either be done at the midwife's office if she has one, or at your home. Again, the level of medical care provided will vary greatly depending on the type of midwife you choose.
Midwives are generally able to handle a wide range of complications, and will bring the medical equipment necessary to handle those complications to your home during the birth. Because not all complications can be handled at home, midwifes frequently work with a back-up OB who's care you'll be transferred into if you have a complication that would prevent you from being able to give birth at home. Women generally choose a midwife assisted homebirth because it offers them a great deal of freedom, but still affords them the security of having a medically trained professional on hand. Because midwives are unable to handle higher level medical complications they may screen out women they consider to be high risk* and refuse to provide care for them. It's also important to note that although midwives are generally assumed to be greater supporters of natural childbirth, they may not be as hands off as some women expect.
4.) Unassisted Childbirth:
Unassisted Childbirth offers women the ultimate in freedom and control over their own pregnancies. Women either provide their own prenatal care, or seek limited care from outside medical sources (OB's or midwives). A great deal of emphasis is placed on trusting the natural process of pregnancy, labor, and birth. All three are viewed as normal, safe, natural events that do not require medical care. Women have the innate ability to give birth to and care for their own babies without a trained medical assistant on hand. By choosing to give birth without medical assistance, women have complete freedom in all aspects of pregnancy and birth and follow the urgings of their own bodies instead of medical doctrine.
Women generally labor and birth at home with their spouse, close family and friends, or alone. The choice is left up to the pregnant or laboring mother and what she feels is best. Intuition and instinct is used to handle any problems that may arise. Some women choose to have medical backup made available ahead of time in case there is a problem. Other women feel that nature will resolve all issues, and see no need for medical back up. Risk factors determined by the medical community are no longer an issue because women who choose to birth unassisted generally see these "risks" simply as variations of normal instead of inherent problems.
By Elizabeth Anderson
