The family I used to babysit for had beautiful photographs of her home births on the wall in her bedroom. It was where my love of midwifery was born. I dreamt of becoming a midwife, but in the end, decided on nursing school.
When I was pregnant with my first I knew without a doubt I wanted midwifery care. I believed in the autonomy they allow women, but also the proven low-risk care they deliver. The continuity of providers was important to me. From prenatal visits to delivery to postpartum care, I have had the same three main caregivers for all three of my children. Relationships have developed and any opinions or concerns I had about my care, even when the midwives were in disagreement, was ultimately met with respect.
I’m a strong believer that permanent, uncapped funding of midwives, for Albertan women is in the best interest of everybody. I believe it benefits women, and ultimately I believe it benefits the whole system. It would take pressure off obstetrical practitioners as well so that they are able to continue to specialize in what they do best; high risk care. I hope that funding would allow midwives to be fully integrated into the medical system allowing for seamless care between practitioners, and hopefully, less of an us versus them attitude.
Recently a social media campaign was launched to promote midwifery. I’ve cheered from the sidelines as this profession gets some of the recognition it truly deserves. I’ve also cringed a little because inherently when you promote something as being good, human nature assumes the flip side is bad. I realized that I had a lot of mixed thoughts and feelings on the issue.
When I first started working on a busy Labour and Delivery floor I walked in with horror stories of obstetricians on my mind. I viewed them as greedy and cruel people who jumped at opportunities to dole out c-sections and episiotomies in their effort to victimize women. I had read one side of the story. Midwives were amazing, therefore, doctors must be terrible.
I was wrong.
While obstetricians function from a different philosophy of care than mine, I can no longer villainize the amazing people I have worked side by side with to bring many babies into the world. I have seen them save lives and give empathetic care over and over. I have seen them advocate for patients when teaching residents, tell nurses to have patience (that one goes both ways!) and give women the tools they need to make informed choices. They rush from delivering stillbirths more often than any human should, to performing c-sections in minutes to save a baby’s life.
Is it always this way? Of course not. I know many stories of abuses of power, inexperience, mistakes born out of busyness, and terrible attitudes. I didn’t find that to be the norm, though, rather the exception. Likewise, I’ve heard stories of midwifery care gone wrong. Any labour and delivery nurse will be quick to tell you, there are no guarantees in birthing babies.
I think every woman in Alberta deserves to be heard. They deserve to have their fears acknowledged and the time to discuss options. I’m aware this often doesn’t happen. Women typically don’t even meet their obstetrician until they are nearing the end of their pregnancy. Even low-risk maternity clinics are often difficult to get into. Funding midwives would not only allow women who want this type of care better access, but it would hopefully allow other practitioners to be less rushed, less overworked, ultimately giving women not just choice in care, but better options.
My fear, though, in setting up a paradigm of midwives vs. doctors sets us all up for failure. It creates a false positive of midwifery care. Because it’s touted as the best, people who wouldn’t necessarily choose it, do, and are frustrated when it doesn’t fit the picture of care they had in mind. Likewise, women who are unable to have midwives for medical reasons see doctors as less than their ideal care.
I know I’m a perpetual optimist and dreamer and my dreams rarely look remotely close to reality, but I would love to see women being able to make educated choices about their care whether they have midwives or not. Studies have shown in other areas when parents feel a part of their choice in caregiver, and part of the choice in which interventions they want, ultimately they are more satisfied. Even if the outcome isn’t necessarily positive. When women are unable to feel like they have a say in their care, they become frustrated and feel victimized and ignored.
So yes, I proudly stand for midwifery. I have read the research, I have experienced the care. It was totally worth the $3600 I paid out of pocket for my first and I think that it’s appalling that anyone should be denied care either because they can’t afford it, or now simply because there just aren’t enough spaces due to capped funding. There are patients demanding midwifery care, and midwives willing and eager to provide it. It’s a huge cost-saving measure for the government and has the potential to improve care across the board for all Albertan women, not just those seeking midwifery care.
I also stand for celebrating diversity. Many women require an obstetrician to navigate their complex medical issues, some women simply feel better under the care of an OB. Family doctors also provide excellent low-risk care as well as continuity of care. We are so privileged to live in a country where we have good care. We don’t have to hike miles in labour to the nearest hospital, where if things go wrong, the one full oxygen tank will be used for us and our baby set aside, where if we hemorrhage after delivery, we would join the ranks of the equivalent of two jumbo jets falling out of the sky daily, of women who die every day around the world in childbirth. I think we can be grateful for the care we have available to us, and use it as a jumping off point for how we can be even better.
I would love to see changes to the whole system, changes I believe start with us, women who have birthed, or will birth, or who assist with birth. When we begin to value women’s voices we change the system. I hope that as midwives model this delivery of health care, more and more it will become the norm. Most of the OBs and doctors I have worked with are great people. They care a lot about taking care of their patients and delivering healthy babies, even if their philosophy of care is different.
I think it’s important for women to keep sharing their stories. All their stories, as every story matters. To holistically begin to repair the system I believe people need to hear the bad stories. It’s important to talk about where the system is failing. It is equally important to hear the good stories. What is working? What makes women feel heard and empowered. We can’t always control the trajectory of birth, but I believe all women deserve to be active participants in their care.They should be given the opportunities to celebrate the parts that were amazing, and grieve the things that didn’t go as planned.
So my solution? Tell your story. Don’t sensationalize it, tell it honestly and truly, embrace the good parts, and cry over the bad. Don’t compare, we all have unique experiences. I have had two different women tell stories of love and hate for the same practitioner. Examine your story for what needs to change and find an outlet for it. Blog about it, write a letter, maybe to your MLA, maybe to your doctor, midwife or the unit you delivered on. Tell a friend, tell your mom. It’s ok to get angry, it’s ok to cry, even if your baby was fine. It’s ok to acknowledge you were not. Then find ways big and little to advocate for that change whether it’s being your sister’s support person to help her find her voice, or whether it’s petitioning for change on social media, writing articles, or becoming a doula, childbirth educator, midwife or doctor.
You never know who is listening to your story and it might just be the inspiration they need to change their practices. If I can think of one thing over the years that has made me a better nurse, it is the stories I have heard from mothers about how they felt. I have listened to stories where people felt powerless and frustrated and examined my practice. When I hear stories of women feeling empowered and cared for I’m inspired. We need both.
I desperately want the system to be better too, but in the end, all I can truly control is my actions and words, so I put my words out there in hopes that they too can convict and inspire. I hope you will too.
(our midwife Christy with my second daughter on her birth day)
Why I wrote this article:
