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Friday, August 15, 2014

10 Reasons to Have a Midwife-Led or Midwife-Assisted Childbirth

When you are considering your options for labor and birth, you might wish to consider having a midwife lead or assist at your birth. This article details ten reasons for having a midwife at your birth. There are certain medical conditions, described below the list, that may prevent you from having a midwife led birth, but some of the benefits below will also apply to a midwife assisted birth (where you have a midwife work with your obstetrician at your labor and birth).

So, if you are interested in having a midwife but are unsure of the benefits to you, here are the top 10 reasons to have a midwife led or assisted labor and birth.

1) Lower maternity care costs. This may not apply if your deductible is very low or waived for pregnancy. However, you are likely to still pay about $2-3,000 for your co-pay or deductible depending on your insurance if you have a natural birth in a hospital. If you have an elective or necessary C-section, your co-pay is likely to be closer to $7,000.

2) Reduced mortality and morbidity rates due to a lower rate of cesaereans and other interventions.

3) Lower rate of interventions, including forceps and vacuum assisted delivery rates.

4) Fewer recovery complications

5) Flat rate pricing, which will often include gynecological exams, preconception care, labor and delivery support, newborn care, as well as birth and labor education and breastfeeding education. This flat rate is often lower than your co-pay or deductible out of pocket expenses for a hospital birth. Those co-pays do not include the cost of your hospital stay.

6) Provides hands on assistance and support during labor and birth. The midwife will also monitor the physical, emotional, and overall wellness of the mother throughout labor and birth.

7) The midwife will provide post-partum support, such as counseling and breastfeeding education.

8) The midwife can help reduce pain in the laboring mother by making suggestions for non-pharmacological interventions such as a warm bath, chaning positions, certain herbs and juices, etc.

9) A midwife led birth held out of a hospital will not be subjected to the same time limits as a hospital birth often is. In many hospitals, labors have a set time limit, after which interventions will begin. Such interventions can include induction of labor (where certain of the induction medications can cause their own complications including uterine rupture and fetal distress), forceps and vacuum extractor deliveries, as well as C-sections. As indicated above, C-sections can lead to complications in later births, and may be best avoided in situations where they are not medically necessary.

10) A midwife is also likely to suggest certain pre and post birth activities that will reduce later pain during labor as well as pregnancy itself. Such suggestions are likely to include pre-natal massage, pre-natal yoga, as well as post-natal massage. Post-natal massage has been known in other countries such as India to speed recovery time, enhance milk production, as well as enhance the bonding of the newborn with its mother. Pre-natal massage and yoga have both been shown to reduce complications and interventions.

The medical conditions that generally require obstetric assistance or intervention are the following: preeclampsia (which means high blood pressure in the mother); epilepsy, heart disease, and non-gestational diabetes are also conditions which will make your pregnancy be considered high risk; placenta accreta, percreta, and increta (where the placenta implants too deeply into the uterine wall), and placenta previa where the placenta covers the opening of the cervix.

While placenta previa is not necessarily a complication requiring a surgical delivery (as many midwives have attended these births), the former three types of placental implantation require surgical intervention and have been positively linked to one or more previous C-sections. See the page about placental problems on the American Pregnancy website here . In addition, most obstetricians will tell you that the presence of multiples (i.e. twins) is also a reason to have a cesarean section. However, the latest Summer issue of Midwifery Today is centered on the topic of twins, with many stories of twins being successfully delivered by midwives.

The decision to have a midwife or an obstetrician be responsible for your childbirth and prenatal care is a very personal one. However, there are also medical and physical reasons to consider having a midwife involved in your birth. A future article will discuss the benefits of a doula, so that if a midwife is out of your price range, you can also have a doula, who is a birth assistant there to help you.

This article referenced several websites that speak about the benefits of having a midwife for your birth. American Pregnancy’s article can be viewed here, the BabyCenter webpage can be found here, and Pregnancy Corner’s website can be found here.

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