I haven’t written much about this pregnancy or the stuff going on around it. It’s all just too normal and boring really. In a good way! But there have been some interesting goings on in terms of my care provider which I feel may be good to share, possibly useful for women looking to find a midwife to support them in birth and all that goes with it.
As you might know, I gave birth to the Dude in a pool in my living room just over three years ago now. I planned a homebirth from the get go and wouldn’t have had it any other way. Given the epic nature of the birth and what I withstood in order to keep to my plan of having my baby at home (38 hours from first contraction to birth with 10-12 hours of active labour, most contractions during that time without a break as Dude apparently turned from breech to head down during labour which meant incredible pain in my sides between contractions), it would have taken something pretty full on to get me to go to a hospital to have my baby. And that hasn’t changed. There are really only a few very rare medical problems that would compel me to seek guidance from an obstetrician and give birth in a hospital. Things like complete placenta praevia or placental abruption, life-threatening haemorrhaging, or serious infection. Real medical problems. Not just being in pain or feeling tired. I have more faith in my body than that, and I am extremely robust and strong physically. Especially after having the Dude, I have absolutely no doubt in my body’s ability to give birth and I don’t need any assistance or pain relief, it just works.
Anyway, having moved to another state when newly pregnant with this second one, I couldn’t seek out the same (awesome) midwife this time around. I did a bit of reading and research and discovered that in Victoria we have an abundance of midwives available for pretty much any birth scenario a woman might choose. How fabulous, I thought! Some midwives work in practices, some individually, some have practising rights in hospitals, and there are a very large number of independent midwives in general. In addition, there is more than one GP who supports women to give birth anywhere they choose, even at home, and getting that pesky Medicare referral signed is pretty easy.
I felt so relaxed this time round, couldn’t really think of any requirements I had for birth. I just wanted a midwife who had the same ideas about birth as me and would support me at home. Easy! Or at least, that’s the way it seemed. I only met a few, and only dealt with two practices, but it was hard to meet more as a lot of them charge for even a first consultation and they are all really nice, it didn’t seem like it would be a hard choice. Anyone would do. I must admit I felt rather corralled (Mr Chewbacca’s very apt description) during my initial consultation with one of the midwives, but I was already about 12 weeks pregnant and wanting to get my midwife sorted. I was keen to have that first ultrasound and blood test done and then just sit back and relax into pregnancy. I let the midwife I saw do what needed to be done, even though I made it clear that we hadn’t made our choice yet. We met with two other midwives, one from a different practice, who was lovely, and another from that first practice, again lovely. We ended up choosing the latter, not for any reason in particular, perhaps just because we chatted a little more freely and had a few more things in common, but there was really nothing in it. Mr C did mention he thought the practice we chose felt ‘clinical’ when we first walked in, but I dismissed this without really thinking. After all, his only real experience of birth is what we had with the Dude, at home, so a midwifery practice office is going to seem more clinical in comparison. Certainly nothing even close to a clinical hospital environment. He has good instincts for this sort of thing, though, and I really wish I’d been more open to hearing him and shopping around a bit more. Not that I regret choosing the midwife we did, but in hindsight I don’t think it was the right choice.
Fast forward to the next appointment, a real prenatal check. It was fairly relaxed, a nice conversation, the usual listening to the baby’s heartbeat, blood pressure check. Midwives generally are easy to chat to, especially about pregnancy, birth and babies, and this one was no exception, so there was nothing really wrong, just different from what I’d experienced previously where I went to my midwife’s house and she had a cosy little room with all the midwife paraphernalia and it felt so comfy. I was a bit taken aback when my midwife suggested I make my next appointment with one of the other midwives in the practice with the aim of getting to know a few of the others. I wasn’t really sure why I would but I got the impression it was because one of them would be the back up midwife, the second midwife, which I was assured would be there for the whole birth as much as possible. This was also weird as I just had the one midwife last time and although there was a backup who I’m sure would have come along if need be, I never actually met her. I gathered the these midwives I’d signed up with worked in more of a group style practice and I didn’t think much more about it. I ended up meeting not just with that other midwife (who turned out to be the one who’d corralled us at the first appointment), but yet another midwife who I hadn’t previously met. The reason for meeting the third one was that after booking in with my primary midwife, I got a call before the appointment to say she wouldn’t be there and I’d either need to reschedule or have my check with a different midwife. So I chose the latter. Again, didn’t really think much about it.
After my second appointment with the corralling midwife, I decided that although I respected and actually liked her, I didn’t want her at the birth unless something went seriously wrong and I had to transfer. She seemed far more interested in training student midwives and rabbiting on about risks or things that didn’t pertain to me than actually providing one-on-one woman-centred care. So I made it clear to my primary midwife at our next appointment exactly how I felt. She was understanding and said that would be fine. But then she dropped a bombshell: she said she was going to be ceasing work as a midwife and wouldn’t be renewing her (undoubtedly very expensive) insurance and therefore wouldn’t be able to do any of my pre or post natal care. She said she’d come to the birth, which kind of made sense as independent midwives are exempt from insurance for birth at home so she wouldn’t need it for that, but alarm bells began to ring for me when she said I’d need to book in with another previously unknown midwife in the practice to cover the rest of my care. Another one! So that’s now four midwives I’d have seen. I agreed, more just because I was a bit shocked than anything else, but as I made my appointment with this other person I’d never heard of, I began to feel uneasy. Later when I received a call to say that midwife actually didn’t work out of the local practice and I’d need to book in with yet another person I’d never heard of, I realised that none of this was sitting well with me. It suddenly dawned on me that the model of care that this practice worked with was not like that which I’d previously experienced; I would never get that personalised, cosy, woman-centred, one-on-one care I needed with this practice, and I suddenly became acutely aware of how important that was for me. It was the very reason I’d chosen to birth at home with an independent midwife. Needless to say, my brain went into overdrive, thinking of possible scenarios and options.
I spoke to Mr C about it all, my mind reeling, beginning to panic and worry about how this would all pan out. I was 31 weeks pregnant, on the home stretch, and all of a sudden I didn’t know who would be at my birth! This might not even be a consideration for most women who are booked into the public system. You rock up in labour and whoever is rostered on is who you get. When there’s a shift change, new midwives come on board. You might be lucky if you get a lovely one who stays on a bit longer after her shift ends to support you through to the end. Or you might have numerous people coming and going throughout. However for me, birth is private and sacred. I don’t want a whole bunch of randoms I hardly know hanging out and influencing things. I want to know who will be there so I can relax and do what I do best. And I want to be sure my philosophies and choices are respected. There had been a bit of talk about ‘pain relief’ during some prenatal appointments, and I found this rather odd as it’s not something I felt I needed assistance with. Surely at home you just give birth, and yes, it’s painful (for some it isn’t, just intense), but you make it through and it’s this incredible feeling of elation and achievement straight afterwards. I began to think about this and how the suggestion of pain relief was a bit at odds with what I thought I’d explained about my own philosophies and choices.
After a couple of days mulling it over and chatting with Mr C, it became pretty clear that I needed to find a new midwife. I thought back to the one we’d met from the other practice, and I knew I had to contact her. I had to return a book I’d borrowed when we first met which I should have done ages ago, so I thought that was a bit of a sign that I needed to get back in touch. But when I called, her phone went straight to voicemail. I suspected she was at a birth or sleeping one off, but in fact it turned out she was overseas – oh no! She returned literally a couple of days after I called and we had the loveliest conversation over the phone. By some miracle, even though August is the busy time for birth, she turned out to be free for the whole month and beyond into September! And she said she would be happy to support me. Wow! I was blown away and so relieved. I met her and the other midwives last night and feel already so much more connected to them than the ones I have been seeing at the other practice. I can’t express how glad I am that I’ve managed to make this choice and get what I need for this baby. There’s only one thing left to do: speak to my original midwife and explain that I won’t be using their services any more. That is scary! I am terrible at confrontation! I don’t want to be a bother and I’m a bit worried about what I’ll have to pay to get out of it, but I think the fact that they’ve changed things on me gives me more of a leg to stand on in that respect. Anyway, I have to make that dreaded call today and arrange for my records to be copied so I can bring them across to my new midwife next week when we meet for our first prenatal check. I will be 33 weeks then!
I hope anyone who has managed to get to the end of this story will find it useful in their hunt for the right provider. Everyone has different needs and a different picture of their pregnancy and birth care. I hope that no matter where, how and with whom you choose to have your baby, you experience what works for you.