Where have the midwives gone?

Did you know that only 10% of laboring women in the US are attended by midwives? That compared with 70-80% in most other developed countries. And that midwife-attended births have comparably positive outcomes, when you look at the number of healthy mothers and babies, as births attended by OB-GYNs, and considerably better outcomes if you consider the much lower levels of unnecessary medical interventions (delivery by cesarean, forceps, or vacuum, episiotmy, use of drugs, etc)?

Besides that, I have NEVER heard anyone who delivered with a midwife say, "I sure wish I had gone to the hospital to have an epidural. My delivery experience was less than satisfactory." (and I know several midwife-delivered women personally) On the contrary, many women who deliver in hospital with an OB wish their labor would have had fewer interventions. Although that's not the way it is usually put. They might say, "I wish I could have moved around more during labor." (They couldn't because of the IV, used for hydration if they weren't allowed to eat and drink during labor, or the epidural drip, or the fetal monitors)

So, why is it that we now consider midwives to be outdated and home birth to be dangerous and primative? There is absolutely NO evidence to support this feeling.

FEAR. We no longer view our bodies as capable. We don't view the pain as useful and necessary. We think labor will be too hard and too long, excrutiating. We are convinced that something bad is going to happen (when, in fact, only about 2% of interventions become medically necessary and hardly ever emergent).

As a woman who has chosen to labor with midwives, I feel personally rebuffed and offended when someone asks me incredulously, "WHY??" (as though I am somehow harming myself and my baby for refusing to be brainwashed into the culturally accepted idea that the hospital is the only place to be to have a baby). Why not?! It is better, safer, and more comfortable laboring with a woman in attendance who knows me and the mechanics of birth intimately, who cares about my and my baby's well-being, and who does not feel it is necessary to poke and prod me every hour or to hook me up to a variety of machines to measure my progress which would restrict my mobility, comfort, and progression of labor.

Now, I am not saying that one shouldn't go to the hospital. Some women are more comfortable surrounded by doctors, nurses, med students, machines and monitors. To each their own. But perhaps the reality is that women are misinformed. Misinformed about the safety of home birth (or birth anywhere with a midwife). Misinformed about the real risks (or lack thereof) to their baby with each method of care. That is sad.

If women educated themselves on all their options, would not more chose a midwife-attended birth out of hospital? I think so.

For further information on your birthing options, statistics of labor and birth, medical interventions used (with good reason or not) during labor and delivery, and a broad look at obstetrics through the centuries, read:

'Ina May's Guide to Childbirth' by Ina May Gaskin, leading American midwife in practice for over 30 years. (In her practice, only 2 women out of 324 gave birth by cesarean, compared with the nearly 30% c-section delivery rate nation-wide).

'Stand and Deliver' by Emma Mahony. A funny, non-graffic, and informative look at all types of birth with positive outcomes.

'Pushed' by Jennifer Block. An eye-opening account of current labor and birth practices in the US.

...and watch 'The Business of Being Born.' Obstetrics today truly is a business.