"LSU Grad of '89" wrote in message
...
OK, this really bothered me so I will share it in hopes that I am just too
used to the "modern" way. A woman at work is having hr first child, she's
~5months and has had no visits to an OB or Doctor. She is completely
relying
on a midwife. She will have a natural birth at home with the midwife and
husband in attendance.

I just can't identify with it. I LIKE knowing I've done tests and
ultrasounds and stuff to make sure - with modern technology - that my baby
is progressing fine. I just don't believe that a midwife can catch
everything - right ?
[snip]

I obviously agree with a lot of what has already been posted (or I wouldn't
be planning a homebirth) and add as follows:

(1) I went into this pregnancy assuming that the medical model of care is
best for the baby (I live in the US) and set out to research what tests and
prenatal and labor protocols were best for my baby and secondarily, myself.
I was fortunate to have some free time on my hands to do this, something
most employed women don't have. I was self-employed and made it a priority.
I was shocked when my very competent, intelligent and generally non-asshole
obstetrician had very little interest in my well-researched and reasoned
judgments about what treatment I will request and what treatment I will
refuse. I think this is why it is sometimes said derogatorily that
obstetrics is "myth based" not "outcome based." A colorful example is the
giving of a 40-week "due date." Some guy made that up a long time ago based
on *moon cycles* not research. And it's still stuck around.

My midwife *wants* to do what research and common sense indicate are best
for babies and mothers AND for me as a mother of a particular child in a
family with particular values. Big difference. If she is not up on a
particular issue or doesn't come down strongly either way, she admits it.
She is always reading and learning after decades of practice. She has a lot
fewer patients than my OBs and has time to do that, plus she only needs to
know a small subset of obstetrics since her job is healthy mothers and minor
complications. Both my OBs, probably in an attempt to instill confidence,
simply start talking out of their asses when they fall out of their range of
knowledge. I forgive them, these guys have jobs. Very demanding jobs. I
don't expect them to have exactly the same knowledge base I have. And they
would be able to do their jobs a lot better if they didn't have to know how
to do EVERYTHING, e.g., they delegated healthy normal births to midwives.

(2) I did go see an obstetrician regularly during the time I have had
co-care with a (non-nurse, homebirth) Certified Professional Midwife. The
OB is very handy for things like prescriptions and lab slips within the HMO
type system. They also are pretty easy to reach in my experience compared
to primary care doctors. But bottom line, what I need the OB for prenatally
my family practitioner could have done for me, and most of the tests that I
needed done were due to my particular medical history and my Rh- status, so
may not apply to your friend. It was good to get to know the OB in case I
have to transport to the hospital during labor (or risk out prior to labor)
and that was important to me, but must not be to your friend.

(3) Finally, while the obstetricians will tell you (against the evidence)
that homebirths are not safe, you are risking X, Y, and Z, here's what the
*other* doctors in my life had to say.

My family doctor (female, late 40s, MD, two children): I think your
interest in homebirth is well-reasoned. I wanted to have my children at
home but my husband wouldn't agree. I will come give the baby a checkup at
your house in the first 24 hours if you want.

The pediatrician I interviewed (female, early 30s, MD, one child): Oh,
homebirth is no problem. You can call for an appointment to bring the baby
in the next day. We might have a problem since we don't keep Vitamin K
here. Wait, no, we can write you a prescription.

My dermatologist (female, early 30s, MD, one child): You are brave to not
get an epidural. Me: You're a doctor, you know how the hospital is, would
you really check yourself into a hospital if it wasn't medically necessary?
Dermatologist: (Pause) maybe not.

-- Dagny
EDD 10/6/03