[lugnutz]

Sorry this is a little long....

I have been reading posts for the last couple years but this is my first post (as you can see). I absolutely LOVE everything that comes along with midwifery. I am an extreme advocate for women's choices when it comes to her own body and what she wants to do with it, how, where, etc.... I am also a CNM wannabe. My dilemma is that I do NOT think I could do home deliveries. I've heard all the statistics under the sun and I realize that as a midwife doing home deliveries you can choose your clients, but I know of several people who had NO risk factors who fall into either category: A) had their little one pass away before they made it to the hospital (which was 5 minutes away). or B)already delivered one baby vaginally with NO problems but next delivery had major issues that without immediate interference (and I mean STAT!) would have resulted in tragedy for both mother and child. I really think I would only be able to practice within the scope of hospitals, birthing centers, etc... I truly believe that the experience you have while delivering makes a huge impact on both mother and baby and would love to provide that for people who don't have the luxury of having a midwife ( or just don't know that much about it). My question is...am I being hypocritical? Does my thinking oppose what midwifery stands for? BTW I'm not dissapproving of home births, I just know myself and even after delivering 500 healthy babies, if just one..... Any advice would be great!

[beckinben]

No one will force you to do home deliveries. You might not even get the chance to do so while in school, depending on what school you attend. Remember, 97% of CNM births are in a hospital setting.

As far as your feelings about home birth - as long as you can remember that it is a woman's choice, and that it is a choice that is supported by research to be as safe or safer than hospital birth for low risk women, I don't see you as a hypocrite. There are CNM's (in all honesty) that feel like you do. As long as you respect the choice of women to home birth.

For every home birth horror story you can tell me, I can tell you an equally bad hospital horror story. And when you've been out there, you might change your mind - and that's OK. Some perspective only comes with experience.

Just remember that working in a hospital will not save you from seeing bad outcomes. And being able to be "with women" for those bad outcomes, and not fall apart yourself, is an important part of being a midwife.

Becki

[lugnutz]

Becki,
Thank you for your input. As I mentioned, I am familiar with the statistics on healthy low risk deliveries being safer at home. That is why it is scary to think of taking on a client with no risk factors, only to have a bad outcome. I know there are more hospital horror stories for every home birth, but I guess I feel that in the event things begin to go bad, I will have more resources in the hospital and feel like I did everything I could. I don't know if I would feel the same way if a home birth went bad. Maybe I am crazy or just projecting, which is why I need some advice! My whole reasoning for wanting to become a midwife is my firm belief in women's having the freedom to choose when it comes to their body period, including pregnancy and delivery. You make a valid point in that part of being a midwife is being able to support the women when things do go wrong. I will keep that in mind as I continue to consider midwifery as a profession. AK

[caliotter3]

You are the one who chooses where you will apply for a job and why. For that matter, if you do not want to disclose your views, you are not obligated to do so. Please do not downplay your ability to make a contribution based solely on your preference. And it is quite commendable that you have considered this before the situation arises. Many never give a second thought to possible conflicts with self. You might even find, that over time and experience gained, you might at some time change your viewpoint. Good luck to you.

[beckinben]

The fear of the bad outcome can be a powerful force, and leads to many unnecessary interventions in the hospital setting (and sometimes even at home). Interventions that have never been shown to eliminate the bad outcomes, and probably contribute to them. Not that a good OR doesn't have it's uses....it just gets used too much.

Not being afraid of birth is very, very important to being a good midwife. Women will depend on you to trust birth so that they, in turn, can not be afraid of birth. Time and experience help with that.

Becki

[BAtoCNM]

AK,
You might want to read Born in the USA by Marsden Wagner. He offers a lot of evidence for why birth with a MW (even home birth) is often safer than the highly medicalized alternative for mom and baby.

[lugnutz]

Thanks to all. I certainly don't want to use unnecessary interventions and I want to reduce the many medical alternatives which are used in hospitals. Maybe that is why I am so drawn to it in the first place. I would love to make the hospital experience as home-like and stress free as possible. There are many women who for various reasons choose the hospital, and I guess I feel as though they should be able to benefit from the positives of midwifery just as those who chose it in the first place. I have had an argument with my sister on that subject. She only wants to help those who choose home-births because she is so caught up in the statistics of it ( hence why I know so mcuh about them I, on the other hand, feel that every woman has the right to the best birth experience possible, even if it means being in a hospital. What do you think?

Also, I will be sure to read that book!

[beckinben]

Originally Posted by akowal

I, on the other hand, feel that every woman has the right to the best birth experience possible, even if it means being in a hospital. What do you think?

Also, I will be sure to read that book!

I feel exactly the same way, which is why I do births in the hospital. I trust my colleagues - primarily CPM's but some CNM's - that do home births to care for the women that choose that option. I feel I'm more needed in the hospital setting. Doesn't mean it isn't frustrating at times.

Marsden Wagner's book is excellent. Dense, but very thought-provoking. A more personal account (if you can find it, I think it is out of print) that I love is Catherine Taylor's Giving Birth: A Journey Into the World of Mothers and Midwives.

Becki