Birth and Postpartum Care with a Midwife

There were a lot of things about my labour and delivery with The Heir that were different than the way things went with Petit Prince. The most obvious difference would have been in my choice of care provider. I’ve already talked about how my prenatal care with a midwife differed from my prenatal care with a group of physicians, but there was so much more to it than just the prenatal care I received. No two births are the same, but there were some things about birth and postpartum care with a midwife that were just SO different. Those things were nothing short of amazing (for me), and I wanted to take some time to share them with you. Maybe you’re considering midwifery care or maybe it’s something you just could never fathom choosing for yourself. Hopefully I can explain what made the choice to have a midwife the right choice for me, and answer some questions about midwifery care that you might have!

1. Choice. When under the care of a midwife, you have choices when it comes to where you want to give birth. Is a hospital birth something you want? A midwife can do that. Maybe you know you want a home birth. A midwife can do that too. Here in Calgary, there’s also a third option: a birth centre. The only option when under the care of an OBGYN or family physician is a hospital birth. Midwives provide you with options, and that’s awesome. I was pretty sure that I wanted to have a hospital birth for my second baby, but I also wanted to learn more about delivering at a birth centre on the off chance that was something I wanted to do. In the end, I went for a hospital birth because that was what King Dad and I were most comfortable with. Regardless, it was pretty great just to have options!

2. Midwives Come To You. When I was in labour with The Heir, we drove off to the hospital three different times. Three different times we were sent back home. THREE TIMES. Now this was completely our own fault in a way. Never having been in labour before, I had no idea what it would feel like when it was really go time (what first time mom does?). All I really knew was what I learned in our birthing classes: go to the hospital if your water breaks OR when your contractions are four minutes apart lasting for one minute for at least one full hour (4-1-1). So, when I had a slow leak of my waters but no sign of contractions, off we went to the hospital. They sent me home almost immediately. When my contractions were fitting that magical 4-1-1 rule, off we went to the hospital. I was only 1 cm dilated and we were sent home. When my water really broke and my contractions were now 2-1-1, off we went to the hospital. I was still only 2-3 cm dilated and we were told to come back in 2-3 hours. How would that have been different with a midwife? When my waters had a slow leak, I would have paged my midwife and spoken with her over the phone. She then would have determined if she needed to come to my house to check me. Then I could have just gone back to bed. That’s right. A midwife comes to your house to assess you, even if you’re going to have a hospital delivery. Why? Because this way they can check you out where you’re most comfortable and you don’t have to head off to the hospital until you’re definitely in active labour.

With my midwives during my labour with Petit Prince, my water broke at 3am. I paged, she called me back, and she was able to determine that it was just fine for me to wait for contractions to start at home. If I’d been with the group of physicians again, you can bet I would have had to go in to the hospital to be assessed and I would have been sent home (again)!

3. Contact During Labour. Midwives coming to you isn’t the only advantage during early labour. My midwife actually called ME. That’s right, she phoned me to check in on how things were progressing. She had given me a time to call her in the event contractions didn’t pick up, and she called me a good hour before that time just to check in. Not only that, but I was in pretty constant contact with my midwife over the almost two full days I was in early labour with Petit Prince. Anytime I had a question or a concern, I paged her. It was great.

4. No Hospital Monitoring. If you’re in early labour for a good long while and you’re under the care of a physician, you’ll need to go to the hospital, head up to labour & delivery, and get monitored while in triage with a bunch of other women all in various stages of labour. Maybe that’s not how it works at your hospital, but that’s exactly how it works here. Because my early labour with Petit Prince took a fairly long time, my midwife wanted to check things out to see how it was progressing. Instead of meeting her at the hospital for monitoring, instead, I went to my midwife’s office and was monitored there. She had everything she needed to monitor my contractions (which were barely noticeable) and check on baby’s heart rate. As a bonus, it was a Sunday, so we were the only ones in the office.

5. Labouring At Home. They say that women progress through labour more quickly when they are in a safe and comfortable environment. What better place to progress through labour than in the comfort of your own home? This probably isn’t for everyone, but one thing I loved about having a midwife was being able to go through the early stages of labour in my own home. If you’re opting for a home birth, you’re obviously going to stay home throughout your entire labour. For me, it was just really nice to be able to get through a good chunk of my labour in my own space.

6. You Skip Triage. This is one of the greatest things about having a midwife. If you’re under the care of a physician, you have to go into the triage room when you arrive in the labour and delivery ward. In this room there are a large number of beds (10 to 15 give or take) each separated by a fabric curtain. There may be a lot of women in there. Some might be there for monitoring, others are there to be assessed for how far into labour they are, others are in active labour waiting for an available delivery room. There’s machines beeping, women moaning, doctors and nurses coming and going, and just one bathroom for everyone. It’s just as lovely as it sounds, I assure you. If you have a midwife, you skip all that entirely. When I was finally in active labour and we arrived at the hospital, we simply met the midwife on the labour and delivery floor and she walked us right to our delivery room. There was no mandatory pit stop in the triage room.

7. You Get a Tub! This is obviously going to vary from hospital to hospital or birth centre to birth centre, but here, if you have a midwife, you get the ONE delivery room that has a bath tub. If you want a water birth in the hospital, you can do that!

8. Less Poking and Prodding. Despite being in labour, there was actually very little poking and prodding of my cervix with a midwife. With The Heir, I was checked for dilation more than half a dozen times, probably close to ten times. With Petit Prince, I was checked twice. Once when we arrived in the delivery room, and once when I felt the urge to push (even then she only checked because I didn’t believe I was already at 10 cm). Why the difference? My midwife explained this to me when I was in her office for monitoring the day before Petit Prince was born. Since my water had broken, she would not check my dilation until it was clear that I was in active labour. The reason for this is because each time she heads on up there, she could be introducing bacteria to my cervix. The more times you’re checked, the more chances there are of introducing bacteria, and that can result in infection (this has a lot to do with why physicians will want a baby out within 24 hours of your water breaking, all that checking greatly increases your risk of infection). All that aside, when I was not having any contractions or they were so mild I could barely feel them, there was no point in checking how dilated I was. I clearly wasn’t in active labour, and knowing if I was 1, 2, or 3 cm dilated wouldn’t actually predict how much longer my labour was going to last.

9. Support. There’s really nothing like the support of a midwife during labour. My midwife was cool, calm, and collected throughout the whole experience. She was exactly what I needed, when I needed it, and her support of me and her belief in my ability to birth never faltered. She was there with me the whole time, but I never felt crowded or rushed. She really let me labour the way I needed to labour. Best of all, she knew what I wanted for my labour and delivery because she was the one I discussed my birth plan with at length throughout my pregnancy. I didn’t need to bring a print out of what I wanted or needed. She already knew!

10. Continuity of Care. One of the two midwives who cared for me throughout my pregnancy was there for the birth and caught Petit Prince. Although in the moment of pushing a baby out of you, it doesn’t really matter who catches the baby as long as somebody does, it’s also really nice to have a good rapport with the person delivering your baby. With The Heir, I met the doctor that delivered him literally while I was pushing. Did it matter in the end? Not really, but it sure was nice to not be introducing myself to someone in between contractions.

11. Immediate Skin to Skin. To be fair, this is now becoming an option in some hospitals when the woman is under the care of a physician, so this isn’t necessarily exclusive to those who have a midwife. With The Heir, I did get to have skin to skin contact with him right away briefly while the cord was cut, then he was whisked away for a couple minutes, and then he was brought back to me. It was fine. There seemed to be a bit of a rush to get me to breastfeed him right away and then hop in the shower so I could be moved to the recovery side of the floor. With Petit Prince, I had immediate and constant skin to skin with him for a full hour. His cord wasn’t clamped until it had finished pulsing, and no one was rushing us to get a move on. During that hour, the room became incredibly hushed. The midwives did the Apgar testing with Petit Prince on me, and they spoke to each other in hushed whispers. He was weighed and measured at the end of that hour, after we’d had a chance to start breastfeeding on our own when we were both ready.

12. Discharged The Same Day. With The Heir, I stayed overnight in the hospital. King Dad wasn’t allowed to stay (the recovery room was shared), so it was just me and The Heir that first night. With my midwives, we were discharged from the hospital two hours after Petit Prince was born. Maybe this seems crazy, but it was actually pretty great. We were able to get right home, settle in with our new little boy, and sleep in our very own bed with Petit Prince in his bassinet right beside me. Of course, my midwife was just a quick page away if we needed anything at all!

13. Six Weeks of Postpartum Care. Midwives continue to care for mom AND baby for six full weeks after baby is born. SIX WEEKS people. I can’t even begin to express how amazing this was, and I’d be willing to bet that the majority of moms who had a midwife would tell you that the six weeks of postpartum care is the BEST part of having a midwife. It is amazing. After The Heir was born, we had a check up one week after he was born and that was it. We were “discharged” from the care of that group of physicians and handed over to our family doctor (who we wouldn’t see until The Heir was at least one month old, and who, incidentally, we had actually never met). I didn’t realize I was only going to get one week of postpartum care with my physicians, so it came as quite a shock when I asked them when I should come back only to be told not to. Not only did my midwives continue to care for me and Petit Prince for six full weeks after he was born, but they actually came to me. My midwife came to my house to check in on Petit Prince and I on day one, day three, and day six. I also can’t stress enough that they also were caring for me. This is where I felt my physicians really let me down. The doctors weren’t asking about my recovery, about how I was feeling and coping. With my midwives, they really cared about both me and the baby. Each time they came to my house in that first week, they stayed for at least forty five minutes. We could chat openly about how things were going and how I was feeling. After that first week, I went to their office for a check up at two weeks, four weeks, and six weeks postpartum. Not to mention, I was still able to page them at any point during those six weeks if I had any concerns.

14. Encouraged Breastmilk Donation. If you’ve been reading my blog for any length of time, you’re probably aware that I donate breastmilk to the NorthernStar Mothers Milk Bank here in Calgary. I have my midwives to thank for that. Although I knew about breastmilk donation and was considering donating before I discussed it with them, my midwives encouraged me to go for it. They talked to me about how to go about applying to be a donor, and gave me some tips about pumping effectively. There was some paperwork that they needed to sign in order for me to be approved as a donor, and they made it so easy to get that done. I didn’t need an appointment, I could just pop in on their clinic day and they would get it signed for me.

All in all, my experience with my midwives was nothing short of incredible. Throughout the whole process, I felt listened to, cared for, respected, and empowered. The postpartum care was so great, especially at a time when the last thing I wanted to do was pack up my brand new baby and cart ourselves off to a doctor’s office for a wellness check. I know midwifery care isn’t for every woman or every family, and, to be honest, I wasn’t entirely sure it would be for us until we had a midwife. In the end, it was absolutely the best care for me and Petit Prince, and I wouldn’t have it any other way!

Have you had or do you have a midwife? What did you appreciate most about your midwife? If baby hasn’t arrived yet, what drew you to midwifery care?