Midwife vs Doctor

My first prenatal appointment with my new OB/GYN went fairly well. She was personable, gave time for answering questions, and talked with me about what kind of schedule I was looking at for tests, etc. I asked about birthing options and she basically broke it down to drugs or no drugs. Induction and/or a c-section was possible, but wholly dependent upon the circumstances of my labor (or lack there of) near term. I didn't really know what else to ask about, so I took my prescriptions for prenatal vitamins and progesterone (I had a history of miscarriages), made an appointment for the next month, and went on my way.

I was really interested in having a water birth, but quickly learned no hospital in Phoenix allowed for water births. However, there was a free-standing birth center that would. Bethany Birth Center (now Bethany Women's Wellness Center) was comprised of two buildings, an office for Women's health care and a birth center where women can give birth in a calm, home-like environment without the aid of drugs or fear of surgery. Better yet, water birth was not only an option but highly encouraged. BBC had four midwives and two OB/GYNs, but the OBs would only deliver in hospital. If I wanted to give birth at the birth center, I would have to become familiar with what exactly a midwife is and does. After about 3 months with my doctor everything seemed to be going well for my pregnancy, so I contacted BBC for my first appointment, all the while reading as much literature as I could about midwives, water birth, and natural birth. I still scheduled my next prenatal appointment with my doctor, just in case I found myself uncomfortable with the birth center.

My first appointment with the midwife was similar to seeing the doctor, and yet different. Instead of urinating into a cup and then sticking into a little alcove for the nurse to take and test, I was given a cup and a test strip, then told to follow the directions posted on the bathroom wall. I tested my own urine for protein and glucose, which meant I knew my status without having to ask later (the doctor, incidentally, had not told me what the urine samples were for). I was weighed and had my blood pressure checked, just as had been done at the doctor, except the nurse encouraged me to write these stats down and keep them logged. I was given a little purple log that would hold the stats for the length of my pregnancy. When I finally got to the exam room it was carpeted instead of tiled and much warmer than the doctor's office. The nurse practitioner saw me and talked to me about what they do at the birth center and the different classes that were offered and required. My doctor did not have birthing classes that ran out of her practice, instead she had referred me to the hospital in which she contracted with. The birth center provided the classes as well as support groups and a 24-hour number in case I had questions or concerns. I had been instructed by my doctor to go to the hospital or call 24-hour nurse line (not associated with her practice) if I had concerns or problems that occurred outside of normal office hours. The difference between the birth center and the doctor came down to a feeling more than anything else. I felt like I was in control of my pregnancy at the birth center and that my voice was important. At my doctor, I felt like just another number with a voice that needed to be silenced when heard. Thus began my prenatal care with nurses and midwives.

When you are pregnant time seems to slow down. Because you are counting every day of every week, you wonder if you will ever make it full term. Birth classes help with the waiting. I attended 5 different classes at the birth center on various things. "Body Works" was a class about what changes happen during pregnancy, labor, and delivery. "Baby Works" taught pregnant moms and soon-to-be-dads about basic baby care for the first three months of life. "Labor Day" included an introduction to all the options available at the birth center, as well as what to expect when you came in during labor. My partner and I also attending a breastfeeding class and a relaxation class. I spent hours putting together a six page birth plan that covered everything from episiotomies to having myself or my partner with our newborn at all times after birth. I read up on everything I could think of related to being pregnant, giving birth, nursing and newborns. When I ran out of new information, I dragged my partner to the hospital tour of the hospital that contracted with the birth center in case of emergency (or patient choice). My partner painted the nursery, my sister threw me a baby shower, and we had just about everything we could possible need to take care of a baby. And yet, after all of this preparing I still felt unprepared.

I was nervous about all the possibilities of labor and birth. I was nervous that I wouldn't be able to nurse for whatever reason, that I wouldn't naturally find myself attached once my daughter was born. Emotionally I was ripping myself to shreds with worry and doubt. At 34 weeks everyone around me was anxious for me to give birth, including my partner. People would ask me if I was ready for to give birth and for pregnancy to just be over already, but I would shake my head and tell them I was enjoying pregnancy and hoped it lasted full-term. I gave excuses like "Never before have I been so healthy and happy" or "She has everything she needs in the womb, why would I want that to end for her?" But really, I was just terrified of becoming a mother, of the new vulnerability that my baby would have once she was naked in this world. Instead of sharing my feelings, I just kept smiling and telling everyone I was in love with being pregnant.

From listening to other pregnant women and mothers, I gathered that on average OB doctors don't ask you about how you feel about being pregnant, and when they ask you how you are they are generally looking for a positive, blanket answer that will not involve them personally. This is not only accepted by most women as normal, but is expected since your OB specializes in female parts and delivering babies, not feelings. But as a pregnant woman I expected a whole lot more from everyone around me, including my prenatal care provider. This is why when the midwife asked me how I was feeling at 36 weeks pregnant, I said I was nervous. If she had been a doctor I imagine she would have told me some stock line like "there is nothing to be nervous about, you are healthy, your baby is healthy, and if anything happens then my staff and I are here to make everything go as smoothly as possible." This answer would have made me even more nervous and uncomfortable, because it wouldn't have addressed why I was nervous in the first place. But I was talking to a midwife, not a doctor, and her reply was a question "why are you nervous?" Suddenly the tears started falling and I realized that I had no idea what all the built up tension was from. So we worked through it. "Are you worried that something will happen to you or the baby?" "No." "Are you worried about being a mother?" "Yes." "Why?" "Because I don't have my mother and I don't really know what mother's do anymore, it's been so long..." BINGO!

We talked for maybe 20 to 30 minutes about my fears and worries, leafing through thoughts that had troubled me in the middle of sleepless nights but had been buried without bothering to talk to anyone about them. The midwife hugged me a few times and gave me an assignment, to express my thoughts and worries through art and bring it in to talk about the next week. I did end up writing, but I never brought it in to show the midwife. Instead we talked each time until I felt better about giving birth and becoming a mom. By my due date, I was anxious to meet our new daughter and ready to begin motherhood.

I started laboring at home the night of my due date, moving into all kinds of positions to deal with the pressure and pain of labor. I labored for three hours before heading to the birth center to meet the midwife. Once at the birth center I labored for another 30 minutes, standing and moving around, until I felt the urge to push. My partner had prepared the bath tub soon after arriving and after reluctantly letting the midwife check to make sure I was fully dilated, I told her I was heading for the tub, striped off the last layer of clothing I had on, and got into the tub to labor another 30 minutes of pushing. My daughter Madilyn was born in the water at 3:33am. My partner Ishmael caught her and lifted her out of the water, then promptly placed her across my chest for warmth. He cut the umbilical cord and I stayed in the water holding Madilyn while I gave birth to the placenta. The only people in the bathroom while I was giving birth were Ishmael and the midwife. There were no monitors beeping or nursing rushing about. In fact the only person touching me was Ishmael, who had his arm around me. Occasionally the midwife checked the baby's progress and told me what she could see and feel. When the baby's head was crowning, she let me know so that I could reach down and feel it for myself. The feeling helped me concentrate and focus on pushing. Throughout the labor and delivery I felt in control. After all, I was the one doing all the work, I should be the one in control of what is happening.

I so enjoyed the birth of my daughter Madilyn that immediately after giving birth I wanted to do it again. During my pregnancy I had told many different people, friends and strangers alike, that this would be my only child, mostly because I was so afraid of labor and delivery. After giving birth I was no longer afraid. If anything, I was motivated. I was home and in my own bed 6 hours after giving birth, resting. For lunch we went to Olive Garden, so I could satisfy my craving for bread sticks, minestrone soup, and endless salad. I cannot imagine giving birth any other way.

Over and over again I have heard horror stories from women who have given birth in a hospital and never again want to give birth. I hear about pushy nurses who are nasty with laboring moms. I hear about doctors who are barely there during labor, some who order cesarean sections after a few hours of labor because they are tired of waiting for the laboring woman to progress far enough to push and some who induce on particular days so that their patient's labor and delivery won't interfere with their golf game or out-of-town vacation. What is common to all of the stories I hear is the feeling of helplessness that the woman felt, of being completely at the mercy of the doctors and nurses. They were told what they could and could not do, and believing that it was out of concern for their health they listened, only to find out it had much more to do with insurance and the "baby assembly line."

The "baby assembly line" is what I call hospital tailored births, because in a hospital birth it is all about protocol. Rather than consider the individual needs and wishes of a woman in labor, they look at her physical stats and proceed from there. Women are not allowed to eat or drink while in labor, no matter how long they have been in labor, just in case the doctor decides to admit the patient for a c-section. Reread that last clause. "In case the doctor decides to admit the patient." An IV is hooked up to every woman in labor to keep her hydrated. She is allowed to have ice chips, but nothing more. In some hospitals she is allowed to walk around while in labor, but once she is dilated past a certain point she is no longer allowed to leave the labor bed. While the midwife was checking my cervix I had to lay down on the bed in the birth center through one contraction, it was the most painful contraction of my entire labor and I was thankful that it was the only one. Many women have to spend their entire labor laying in bed dealing with that kind of pain... which is why many women ask for epidurals. When I consider all of the conditions that a hospital environment dictates to a pregnant woman, it is not surprising to me that so many women are afraid of giving birth, are unhappy with their experiences, and request so much medical intervention to combat what is already being forced upon them.

I am a woman who trusts her body, who listens to the needs of my body, and refuses to deny those needs to satisfy a doctor, or anyone else for that matter. When my body is healthy and functioning in a natural, healthy way, I refuse to relinquish control of my body to anyone. In this way, I take responsibility for my experiences and my happiness. I am more satisfied than most because of it. Pregnancy is a natural process for the female body and should be treated as such until extenuating circumstances change how well the body is prepared for such a complex process. All of the medical inventions that surround birth and labor came about in order to make child birth safer for those women who have extenuating circumstances, NOT to standardize birth so that every woman must endure the same medicalizations for the sake of time and money.

Vegetarian and Pregnant

Becoming a vegetarian was much more about my health than protecting the lives of harmless animals. A friend of mine was vegan and challenged my defense that he needed to eat some form of meat for nutritional value alone. He sent me countless links to various vegan and vegetarian websites, some filled with images of badly mistreated animals and others full of text about what animal farming does to the environment. Call me cold, but I was still not moved to quit eating meat. The world seemed much to big and my efforts much to small to make any kind of real difference. Who really cares if I eat a hamburger instead of a salad? As a last ditch effort he sent me one last site, a science article about hormones in beef. The article explains that cattle are often given testosterone surrogates in order to increase muscle mass, while many cows are given progestins to suppress their reproductive cycles in order to free up resources for muscle building. These hormones not only pass into the meat we consume, but also into the environment through animal feces. Among the consequences are links to cancer and reproductive abnormalities. Young girls are beginning puberty younger, more and more women are experiencing trouble conceiving and multiple miscarriages. The outbreak in breast cancer and prostate cancer can also be linked to the mass quantities of hormones that are taken in through not only beef, but chicken as well. As I kept reading, I stopped eating my chicken nuggets.

It took less than a month to go from eating anything that tasted good, to a vegetarian diet. I continued to eat eggs and drink milk, but even those were in smaller quantities. The following few months I dropped 40 pounds, going from the heaviest I had ever been, to the skinniest. A year later my weight had balanced out at the lower end of what is considered average for my height. As I gained energy, I also began feeling better about my body and made other choices toward Eco-friendly living. While my initial reason to become vegetarian was out of personal health, I began seeing how small changes can have big effects and began caring more about Mother Earth. I became more conscious about recycling and using biodegradable products. I tried to wear 100% cotton clothing and, when I could afford it, buy only naturally dyed clothing. After years of being a vegetarian, I still have a horrible time backing away from leather items, but hey, we can't all be perfect.

Then I became pregnant. My doctor was aware of my vegetarian diet and had supported it for over four years, but when I became pregnant it was a whole new ball game. Not only were my prenatal vitamins of utmost importance, taking in enough protein and calcium were vital to my baby's development and a vegetarian diet just wasn't going to support us both. Angry and frustrated, I did what I do best--I began researching. I not only found wonderful vegetarian recipes specific to pregnancy, but also found research that supported that a vegetarian diet might in fact be optimal to a growing fetus. Dark greens, beans (especially soy), yogurt, and nuts became much more important to my daily intake, but there really weren't many other changes. Being a vegetarian already gave me a fairly healthy lifestyle.

In the easy marriage of vegetarian and pregnant, I realized how my view of feminism had been far too narrow for too long. I had come to feel that being vegetarian was very much a part of my feminism because it encouraged a respect for Nature that I felt was innately feminine. What is more natural to the female body than pregnancy? Nature, much like woman, is cyclical and ever changing. Spring is all about birth and rebirth from the long winters. Pregnancy and birth are therefore what links us at our core to Mother Nature. Barefoot and pregnant in the kitchen no longer became such an awful phrase, instead it rang with beauty and comfort. Modern feminism is, or at least should be, about the ability to make choices. Being barefoot is the only way to go when you are pregnant, in fact I enjoyed my naked body much more while I was pregnant because I no longer felt trapped by media images of what femininity should look like. As for being in the kitchen, when you are pregnant food is your best friend, and because of heightened senses you have to really choose the food you eat to match how you feel. The negative connotation comes from the expectation that a woman is barefoot and pregnant in the kitchen because she is a slave to her husband--having his children while cooking his meals, shoes unnecessary because she won't leave the house--but as a feminist I believe in exercising free will and that includes the will to cook (or bake) naked while pregnant if a woman so desires.

Finding renewed confidence in my Nature-friendly decisions and my body lead me to make another big change: saying goodbye to my doctor and hello to a midwife.

Deconstructing Motherhood: Becoming a Modern Mom

At twenty-two years old I had big ideas about the reality of being a woman in a patriarchal society. I was minoring in Women's Studies, hoping to find my niche in the world by learning about the women who had already found their place in a phalocentric world. We were the daughters of the ultimate wave in feminism, our inhertance was anything we could dream of. We talked of moving off to big cities far from the Phoenix metropolitain area, having high powered jobs that would afford us the luxury of being financially secure without the aid of a man, or anyone for that matter. Having children and getting married were for those women who didn't go to college, or those who did and were only interested in earning their MRS. degree from a fellow student with higher ambitions then their own. To protect ourselves we became pro-contraception, pro-choice, and anti-marriage. Not only were we ambitious in our careers, but we would enjoy the same carefree relationships that our male couterparts often enjoyed without bothering to make a commitment. We, as women, had been oppressed for too long and now it was our time to shine, making sexual freedom, money, and power our reward for all our efforts.

They are great ideas, but not all they are cracked up to be when applied to the real world. It didn't take me long to realize that my power hungry female friends were not so different than my power hungry male friends, and I really didn't appreciate either. It was easy for me to buy into the no-commitments, no-children way of life because I had lost my parents at ten years old and was terrified of trying to learn how to love anyone after being isolated for so long. But that didn't really work out either. I was constantly looking for someone to share my life with, but my reservations about commitment kept me from ever truly trusting anyone, keeping myself closed off and lonely. I had big dreams about moving to New York, having my own flat, being an editor for a publishing house, and spending my life travelling and having as little responsbility as life would allow. Except I didn't want to do it alone. I was lost in ambivalence about what I believed I should be doing as a woman of the twenty-first century and what it was that I truly wanted to do.

The August after I turned twenty-two changed all of that. I was pregnant. The father of my unborn child was my parnter of six months, but I knew without a shadow of doubt he would be a wonderful father... more than that, I loved him and realized I didn't want to imagine my life without him in it. We did our share of talking and fighting and going back and forth about what bringing a child into the world would do to our relationship, our careers, and our personal lives, but in the end we both still very much wanted this little miracle growing in my uterus. So it began. Unmarried, still in school, and without much of a plan, I travelled blindly into the next stage of my life: Motherhood.

There are many "normal" thoughts that cross a woman's mind while she is pregnant, such as Will I be a good mother? and How will I afford a child? But I was unprepared for the bigger questions like How does this redefine my concept of Woman and Feminine? and Is becoming a mother giving into patriarchal expectations? For a feminist and a scholar, these are life changing reflections that not only alter one's perspective, but also reconstruct reality. I had been taught with such gusto that children and husbands cage a woman into domestic life, as if having a family were more like a prison sentence then a chosen pursuit of happiness. I didn't want to be the caged bird, but I realized, quite abruptly, that I did very much want to be a mother. (Deciding I wanted to become my partner's wife came a little later, but came all the same.) With my impending doom less than 9 months away, I set out to deconstruct what motherhood really means and how it is possible to be both a feminist and a mom.