This is a guest post by a friend of mine who is a midwife. She is also an amazing woman, wife and mother. She supports all women’s choices in birth, but at the same time always practices safe and competent midwifery, as you will see here. For those that want to know how midwifery works, how home birth is safe and what happens when it’s time to change plans, this post is perfect for just that. ~Mrs. BWF
When Midwifery Works
I recently attended the long anticipated birth of a dear friend of mine. This birth was a planned HBAC. Her first birth was a c section at 35 weeks due to problems with one of the babies. Those babes are now robust, fun 7 year old girlies. I was with her during that pregnancy from the day..yes the day those babies were conceived on a camping trip.
I was delighted to be asked to be midwife this time around. We’ve been through some ups and downs in our friendship over the last three years but when it came down to it, she knew she could trust me as her midwife and I knew any differences we had in the past had nothing to do with her desire for a healthy pregnancy and vaginal birth.
Of course when you live some place where homebirth and midwives are not the norm, you get looks and comments but this mama was having none of it and put everyone who offered a differing opinion in their place with a firm “It’s MY choice so shut up”. Love.
Labor commenced at 40 weeks 2 days. I was excited and went to check on her when her water broke in the early morning. She labored beautifully all day as I went to check on another midwife and her client and came back again.
She labored all through the day and into the late evening with no cervical change at all. As I examined her I could feel what I thought was a forehead and not an occiput (back of the head) and I had estimated a 9 ½-10lb baby. We tried everything I know of to get little big guy to turn but he did not.
Around 11:30pm I offered my opinion that the hospital was where we needed to be. No one was in distress, but obviously with the position of this baby I felt that intervention of a variety I could not offer was necessary. We left for the hospital around 12:30am.
We were well received and that is the reason we chose this particular hospital because they treat homebirth transports with respect because they know we do not want to have to be there. It wasn’t part of the plan.
After 2 doctors and a sono confirmed the same presentation my palpation led be to believe was true was confirmed mom opted for a repeat c section and a beautiful 10#6oz baby boy was delivered face up, brow presenting just as I had expected.
Some may see this as a failure. Of her, of me, of midwifery. I do not. I see this birth as a success of midwifery because midwifery is not about catching babies at home. It’s about Midwives caring enough to choose the safest passage and recognize when help is needed and make hard calls that will maybe crush long anticipated birth experiences.
I spent a lot of time doubting myself and my skills, of wondering if maybe I wasn’t cut out to be a midwife of grieving this loss for my friend. Until I realized I was exactly right, and that this birth was a success because I protected my friend, protected her scar, recognized a situation that was beyond my abilities and made the call to go for help before anyone was even remotely close to being in trouble. Despite my knowing how the situation was going to be received and all the “I told you so’s “ that are likely to come from it, I put mother and baby first and chose what was best for her.
Midwifery works when midwives make hard calls. Midwifery works when despite all the doubt in your head you know what is right and you put your big girl panties on and deal with it. Midwifery works when you knowingly walk into a place that may receive you with hostility because they do not agree with your path or choices or midwifery but its what’s best for your client. And a lot of the time midwifery works when you lovingly and sweetly guide a new baby from his mother’s body into his daddy’s hands. Midwifery just works.
{ 28 comments… read them below or add one }
Thank you for sharing! <3 That's so wonderful!! And I love that you were able to tell with your hands what they needed expensive medical equipment to tell.
Stands up, applauding. Yes! Exactly so!
Beautiful! Thanks for sharing your story
That is what I am talking about. Yes it DOES.
Thank you for writing such an awesome blog.. Each word rang true ..
Wonderful!!!
Wait, why couldn’t baby be born vaginally just because of this position? Am I missing something?
This baby wasn’t coming vaginally because in approx 15 hours of good strong labor, the moms cervix remained at 2cm & in a complete posterior position. She was a VBAC & I wasn’t willing to risk her scar at home.
On transport in the hospital she was offered labor w pit, epidural & close monitoring due to her VBAC status or a repeat c section. SHE chose the c section , it was her right & her choice but in my professional opinion, this babys position along with his size of 10#6 21″ there just wasn’t room for him to get repositioned well. We tried but I could not manually reposition his head they her cervix bc it was only 2cm & posterior.
Not every mother can or will choose the difficult birth of a brow presenting baby. I also notice this us much more difficult in a woman who has never given birth vaginally before.
But in thus case, w vbac with ROM , 15 hours of labor with no cervical change = transport.
“lovingly and sweetly guide a new baby from his mother’s body into his daddy’s hands” …Love it!
This post makes me want to get preggo again already, just so I can experience her brand of midwifery, lol. No, really, though, LOVE the story, especially the end, since it was completely unexpected and rings with truth. Yes, OBs, hospitals, and expensive equipment are all there IF we need them – but are unnecessary in most births. With this one, I’m glad the midwife/friend realized she was in over her head and got help before any signs of big trouble occurred. Once my daughter’s older and I have a support system, I may well look into becoming a midwife myself – or at least a doula. I’ve become a birth-story junky…
Love stories like this. I agree with Kellan, makes me want another baby! I’ve had a wonderful midwife experience and would love another one!
Thanks for sharing. I recently had my first. Had a doula, supportive doctor and was ready for a natural hospital birth. But after 48 hours post water breaking, I was still 1.5cm dilated and baby was -2. I found out after my c-section she was posterior. I often wonder if I had been at a home birth if things would have been different. So your post brings me some comfort and reassurance.
Wonderful post! I love hearing the other side of when it’s the right thing to make that hard call, even when mom wanted natural oh so much. I hope I will be that kind of midwife…able to see the bigger picture. Midwifery works…and will thrive, if we have more midwives like you!
Lovely!
But from your answer about why the C-section was necessary it seems that some women might have opted for the more difficult vaginal birth and succeeded in birthing the baby naturally.
I can’t help feeling your “fear” for her coming through. And I believe that fear becomes a self fullfilling prophecy. I wonder what would have happened if she had had no negative vibes around and just labored until the baby was born….Could she have had a vaginal birth? From what I have learned over 50 years of childbirth information the answer is yes, she could.
From: http://www.birth.com.au/A-posterior-labour/About-posterior-position?view=full
Posterior labours have an increased chance (but are not guaranteed) of:
Having a longer prelabour, before getting into the stronger labour.
Producing more pain in the woman’s back, rather than in her front.
Taking a little longer, as the baby rotates around to the front.
The baby’s head being ‘deflexed’ (or looking forward), rather than ‘flexed’ (and looking down with their chin on their chest), meaning that the baby’s head may not fully engage, until the labour is established.
Taking longer to push the baby, out as their head rotates, and flexes.
Causing the mother to tear if the baby’s head is born in a posterior position.
Progressing just as efficiently as anterior labours, especially if the woman has good contractions, assumes forward leaning, active birth positions and has a positive attitude, with the baby turning to become anterior, before being born.
You speak of making the choice for the mother. I believe the mother’s wishes should take precedence as long as she knows and accepts the consequences.
This is NOT a criticism of your management of the labor. But it is meant to show those reading this article that there is another view to be considered.
@ Bonnie, I don’t know what you were reading but nowhere here does she say that she made any decision for the mother. She offered her opinion that the hospital was the place they needed to be and the mother opted for a c-section even after being offered a closely monitored vaginal birth. The mother’s wishes did take precedence and it was the mother who decided her baby would be born by c-section in a hospital. Try actually reading instead of skimming and then posting your criticism.
Pam, this is the sentence I was referring to in my post above.
“Despite my knowing how the situation was going to be received and all the “I told you so’s “ that are likely to come from it, I put mother and baby first and chose what was best for her.”
She said SHE CHOSE WHAT WAS BEST FOR HER.
yes, the mother did opt for the C-section. When fear is present the mother is very likely to respond to it. Unless she is EXTREMELY sure of herself and her facts she will defer to authority.
I have had so many years of experience and heard so many stories. Forgive me if I sometimes forget how much that huge body of knowledge and experience colors my thinking.
When I was having babies I knew very little even though I thought I did know. For instance I knew almost nothing about home birth. It makes me sad as I would have been a perfect candidate for home birth and yet I never had one.
I did not mean any disrespect to the midwife or the mother. I was just making comments based on what I have observed. One thing I have seen again and again is how one person’s fear can infect another.
Not all midwives Trust Birth.
Bonnie, while I appreciate what you are saying and would normally agree with you, I know this midwife personally and her fears do not effect her supporting women. She supports all women’s choices from having an unassisted birth to a planned cesarean. There are very few midwives I would ever let attend my birth and she is one of them.
Bonnie, both of my children were born at home with the help of midwives, but I don’t want a midwife who “Trusts Birth.” I want a midwife who respects birth. Based on the little I know of the story, it sounds like that’s exactly what this midwife did. It doesn’t help the homebirth cause to imply that if you’re unafraid everything will be ok.
thanks for sharing.
I think you made the right choice, and I would like to think more midwives should follow in your footsteps. You protected a laboring mother and her baby with your knowledge. And that, to me, is exactly what you’re supposed to do as a midwife.
You should be proud.
This is beautiful. No shame whatsoever in using the hospital as what it is MEANT to be—a last resort choice. Well done Midwife and Mama
Hey Mrs. bWF-
I am just curious. It sort of surprises me to hear you say that there are very few midwives that you would let attend your birth. Why is that? Like I said, it just surprises me to hear you say that.
On another note, I think that fear came through, too. But I think that is OK. This just read as sort of a catharsis to me and I think that is just fine. Personally, I think that erring on the side of caution is ok especially when the lines of communication are wide open. I personally would have probably chosen to labor longer but that is just who I am. I don’t fault or judge another woman for making a different choice.
APPLAUSE for this midwife!! wonderful story, happy ending, responsible provider!! YAY!!
We lost our first baby boy during delivery…full term, otherwise healthy. We were a planned home birth with a midwife turned hospital transfer story. Our little boy passed away due to what we feel was a hospital error; the external monitoring reading me instead of him, the OB being observed being indignant and throwing things for being called in a 2am, the lack of collaboration with our midwife.
Our midwife gave us extraordinary care…and she knew when to change delivery locations because what was happening at home wasn’t working. She transferred a healthy, stable baby. Most people think that because we lost our baby during delivery of what started out as a planned home birth is a reason to not deliver at home and to me…
~ It is the perfect example of midwifery done well ~ a sign of healthy decision making and proactive care ~
Thank you for writing about this topic
Amy, I am so sorry for your loss. (((hugs)))
I loved this post. Congratulations to the mama & the midwife on a successful birth. Homebirth is frowned upon by all my friends (except one). I’ve been investigating having a homebirth, but my husband is very against it, so we have decided on a hospital birth attended by a midwife & doula. There’s a great hospital near our home where they are pro that option.
Bonnie’s comments concern me (I agree with Ashley). I would rather be attended by the midwife whose story this is than by Bonnie any day. I believe this midwife made a good decision based on the knowledge she had on hand. I would rather this than a midwife whose primary aim is to deliver at home at (seemingly) the expense of the mama & baby’s health.
Thanks for this blog. Love reading it.
What a great story!! It’s great to hear from responsible, smart midwives like this, I wish she lived in NY so I could hire her for my next baby!! And Amy, ((((hugs, hugs, hugs))))) I am so sorry for your loss.
Mrs. BWF,
Thank you for sharing this story. I do not see “fear” in any sentence of your story. What I see is a midwife who was able to recognize a situation that needed to change and made the responsible decision to share her concerns with her client and allowed her client to make the final call and feel supported and loved through the process.
Bonnie, When a midwife transports or transfers care to access appropriate technology, it is not a difficult decision, it is actually an easy decision because as midwives, we are guardians of lives at the most vulnerable time of life for that woman and her baby! In a good midwifery relationship, the mother trust’s her midwife to make that call and the midwife trusts that mother to understand why that call must be made.
In a good midwifery relationship, there is mutual respect for that intuitive knowledge that we as women all have. Yes, it is sad when a birth plan is scrapped but what is worse to me is that we (as the alternative birth culture) have decided that transporting equates failure! We will go so far as to chastise a midwife or mother who opts for transport and throw the “fear” card at them.
Consider this mother…On one side she is taking it on the chin from the alternative birth community for transporting and on the other she is taking it from the hospital community for attempting a home birth. Where is the love? Is this how we treat childbearing women!!! As an aging midwife I can tell you that there is still nothing more precious then watching a mother hold, nurse and love her new baby…no matter where it is born or under what circumstances. There is also nothing more heartbreaking then to see a mother with empty arms because someone’s ego got in the way (whether it is a midwife or a physician). Who are we to judge that mother or that midwife when we are not in their shoes?
Excellent call Mrs. BWF. Not every midwife could recognize that big ole brow and protect that uterus and scar so this baby could be born healthy and mom be well enough to hold him! Having seen two hospital ruptures in the past few years that both lead to life saving cesarean-hysterectomy (one received 28 units of blood product), she is fortunate to have you as her midwife! Mrs. BFW, your mother can have more babies! Isn’t that awesome! You are a great midwife!
People, we need to realize that there is a time and a place for appropriate use of technology and it is not AFTER someone has ruptured…