Midwifery focuses on physical, emotional, and social wellbeing of pregnancy and parenthood
by Aszani Kunkler CNM
Many people see midwives as an outdated concept, more relevant during the turn of the century than in today's fast-paced, highly technological society. And yet, midwives practicing today have excellent maternal and fetal health outcomes, low rates of medical interventions and extremely high rates of consumer satisfaction. So what's the difference between midwifery care and standard obstetric care, and why does it matter?
Julia Vocke, her husband David and 2-year-old Miette toured the Madison Birth Center when Vocke was newly pregnant. Vocke desired a water birth, which turned out to be one of the birth center's specialties. " I was immediately drawn to the beauty and sense of calm at the birth center," Vocke reports, "but the most amazing thing was that Miette jumped into Aszani's arms right away. Miette is outgoing, but she has never done this before. I knew that Aszani was a person I could trust."
Routine midwifery care at the Madison Birth Center includes one-hour appointments, focusing not only on physical wellbeing, but also on the emotional and social aspects of pregnancy and parenthood. The development of personal relationships with clients is highly valued, and families feel very comfortable with their midwives and birth assistants by the time they are admitted to give birth. When asked what she valued about her prenatal care, Vocke said, "I never felt rushed, and I felt genuinely cared about. David and I looked forward to our visits, and often talked about the issues the midwives brought up after we returned home." Vocke noted that with her last pregnancy, "I spent more time in the waiting room than talking with my providers. My OB was a nice person, but there was no real personal contact."
Vocke had often mentioned that Miette's birth was scary. "We went to the childbirth classes offered by the hospital, which basically talked about the 'window' when we could get an epidural. The philosophy basically was, 'Labor will suck, just ask for drugs.'" Vocke was induced because her OB was leaving for vacation. She eventually requested an epidural. Miette did not breathe spontaneously at birth and was taken into an adjoining room for treatment. She was returned in good health but was taken to the nursery for the night a short time later. "I literally had to walk down to the nursery the next morning and beg for my baby," said Vocke. "I got no breastfeeding support and was sent home with no follow-up."
A deeply held belief of midwifery care is client education and support for decision-making throughout the maternity care cycle. Madison Birth Center is one of three "Baby-Friendly™" facilities in Wisconsin, and every aspect of care is centered on supporting the breastfeeding relationship. Vocke and David took the Natural Childbirth Classes at the birth center, and Vocke noted that the classes reaffirmed that the staff was highly skilled and "we were in good hands." "I really knew what to expect during and after the birth, and realized that I trusted the midwives because they were trustworthy, and not because their qualifications forced me to depend on them.
"The 'Complications Class' was especially helpful," she says. "After Miette was born, I thought she was dead, and no one was talking to me. The class put her birth in perspective. I learned that babies are born blue, and pink up with their first breath, which should be almost immediate. I learned about neonatal resuscitation, and that blue hands and feet on a newborn are normal! It may seem like second nature to medical people, but new parents don't understand these basic principles unless someone takes the time to educate them!"
Vocke also came to believe more strongly in natural childbirth, which lowers the risk of breathing and breastfeeding problems at birth by avoiding fetal exposure to narcotics.
The night of the birth, Vocke, David and Miette were admitted to Madison Birth Center with Vocke in active labor. The labor progressed quickly and Miette's support person didn't make it until after the birth. Miette calmly stood next to her mother laboring in the tub, soothingly stroking her head and telling her, "You're doing a good job, mommy." Vocke notes that her birth was empowering, with "no doors opening and closing, no one asking inappropriate questions, no bright lights or monitors. … If I needed something, it was done, otherwise the birth felt calm and like a normal, everyday activity." The baby was born in the birth tub and handed immediately into Vocke's arms. "I bonded with the baby right away - it was much stronger than (at) Miette's birth. My experience showed me that birth technology exists for a reason, and sometimes we need it. But it's not necessary much of the time, and it often gets in the way of mother-baby bonding and breastfeeding."
And why is midwifery important? In an e-mail to me, her midwife, Vocke said, "All I know is that we are beyond grateful for you and the staff of the Madison Birth Center. There was no way we could have gotten the kind of personal, gentle, loving attention we received at MBC had we birthed at a hospital." Although this kind of care is not for everyone - some women will choose to go to the hospital to "get their epidural" - the support, education, and yes, love, that midwives provide, make for healthier mothers and babies. And that's why we're here.
Aszani Kunkler is a certified nurse-midwife, certified lactation counselor and owner of the Madison Birth Center, Wisconsin's only nationally accredited free-standing birth center. You may reach her at Aszani@madisonbirthcenter.com or find out more about the birth center at www.madisonbirthcenter.com.
