I love midwives. In fact, I think MIDWIVES ROCK. Midwives deliver over 50% of the babies in our birth unit. When it comes to normal birth, they are the experts. Let me explain.
As OB/GYN physicians, we endure a very extreme four-year residency training program. We learn how to deliver babies in the most intense environments and difficult situations. We take care of very sick women while they are pregnant. We learn the art of intervention. We fix things. We come to the rescue. We save the day. We have many tools – vacuum, forceps, versions, cesarean. If things aren’t going well, we can make it better.
Midwives are different. In their training, they learn the art of normal physiologic birth and find pride in maximizing the patient experience in the birth process. They coach and labor support the patient when she wants to deliver without medication. They focus on education and wellness during the pregnancy. They offer options such as intermittent monitoring, birthing bars, labor hammocks and waterbirth. They also care for patients that end up with epidurals and c-sections and they provide support through that process.
So here’s the thing. Not all birth is fluffy with hearts, flowers and rainbows. Midwives know that and so do Doctors. Sometimes the shit literally hits the frickin’ fan… and that is where I come in. Though I am not always viewed as a superhero, the midwives do a great job of pumping me up before I even enter the room.
“She does the best c-section. Don’t worry, her incisions are tiny,” I’ll hear them tell the patient from outside the room.
“It’s okay. Dr. S. will come and see if a vacuum can’t give that babe a little help…”
So sweet. They are the best. This is the stuff I live for. I want a challenge. My training afforded me that. No offense, but normal birth isn’t really my thing. I have bigger fish to fry. There’s the patient with the ectopic pregnancy in the ER or the horribly sick pregnant patient in the ICU. All problems outside the scope of midwifery practice. All problems inherent to my training.
In a perfect world, we divide and conquer. We focus on the things we are good at and stratify. It’s a practice model I try to help my colleagues understand. We are experts in different things and we complement each other. Our patients can only benefit from our willingness to work together as a team and keep the lines of communication open.
Yesterday, while on-call, I had to attend to a bleeding patient in the postpartum ward. I left my laboring patient to the midwife on-call.
“I’m so sorry, can you catch her baby in case I am stuck downstairs?” I asked.
“Of course, be happy to,” the midwife replied.
I slipped downstairs and evaluated the bleeding patient. On my return, I watched the midwife perform the delivery on my patient. The lights were turned down. The bed was still intact and had not been broken down. She had my patient pushing on her side and the babe slowly eased out while the midwife coached her through the process. It was beautiful. I was so happy that my midwife partner could provide such a special experience for my patient while I was pulled to attend a more critical issue. I felt comfort leaving my patient in the midwife’s hands.
To my future patients… indulge in your mosaic tubs. Hang from your birthing hammocks. Open your pelvis with birthing yoga. Bring your doulas and your five-page birth plans…
Bring it. Were ready. We will love you for it. We want you to have the birth experience of a lifetime. MIDWIVES ROCK.
But remember, if the shit hits the fan. I’ll be there. Waiting in the wings. Ready.
Disclaimer: Medical stories are fictionalized.