Saturday, March 24, 2007

Where have all the midwives gone?

Even before I started thinking about getting pregnant, I knew that I wanted to have a midwife (instead of an OBGYN) see me through my pregnancy and (as they put it) "catch" the baby at birth. So a year before we started trying I switched over to seeing the midwives at the Takoma Women's Health Center and could not be any happier with them. I am always able to get an appointment quickly, they also call within two days of blood tests with results even if they are good, and I always get a call back within four hours for routine questions and one hour with emergency. Early on in the pregnancy I was having some pain that turned out to be that pesky fibroid but the Center was able to (within two hours of my call) call back, set me up a sonogram appointment and get me in the door for testing.

However, I also knew going into the pregnancy that I may want to deliver at a birthing center instead of a hospital and that my midwives only delivered at Sibley, a local area hospital. So this Thursday off Jason and I went to The Maternity Center in Bethesda. As I was leaving work early to get home, let Hunter out, and get back my supervisor mentioned that he heard that the Maternity Center was closing - news to me as I had just talked to them last week to set up our tour. But he was right, the first thing we learned upon getting there was that the Center was closing in May with some midwives going to another practice, some providing home births and one leaving for Doctors Without Borders. Although a bummer we decided to stay for an hour and hear the midwife talk about options for us as well as midwifery in general - it was VERY worth the trip.

A quick primer for anyone not familiar with midwife care. You can skip this section to get back to the life experience stuff if you are not interested.
What is a midwife: Certified Nurse-Midwives are experienced Registered Nurses who have completed a postgraduate obstetrical program. They have prescription-writing privileges so you can go to them for birth control, etc. They refer out for sonograms, amniocentesis, mammograms testing procedures to a local location where they have a partnership.
Why would Jenna (or anyone else for that matter) want a midwife instead of an OBYGN: Midwife's are not just for us "crunchy"type folks. Many women are opting for midwife care for many reasons, including lower medical intervention. Midwives (as an average) have only a 6% rate of Cesarean birth v/s U.S. average of 30% with the same type of statistics for epesiotomies and other medical interventions. Midwives also (again as an average - I don't want to speak for all midwives and OBGYNs here as yours may be different) allow you to eat, drink and and basically give birth any way that is comfortable for you. They also will not push epidurals if you do not want them but will not object to them if you do. The last main reason at least of for me, is they stay with you the entire labor process - helping to not only manage pain and labor but also fears and expectation during the process. As a midwife told me this week "We are not in a hurry during a birth. We look at it as a natural part of life." I could go on forever on this point, but if you are interested in learning more let Jason or I (yes Jason he is as knowledgeable as me on this now) know and we can send you all type of information.
What if you have complication or are at a high-risk?: All the midwives I have met have an backup M.D. both for consolation and help during birth.
End of midwife explanation section.

Also my current midwife at Takoma had just mentioned that her Center would be closing they thought in September or October which left me the option to follow her where she went next (if there was a place to go) or find another option (which was suppose to be The Maternity Center). Unfortunately, we have also learned since then that the Takoma Center will be closing April 13 (I got in under the gun with my next April 5 heartbeat appointment). So hence the title of this blog - Where have all the midwives gone - or in truth - Why are they all leaving!. This leaves a HUGE shortage of easy to find midwives in the DC metro area with the next nearest birthcenter in Alexandria, VA.

Turns out none of them are leaving because they want to leave. They are all leaving because the Center's that provide them employment can no longer financially sustain the practices as they do not get reimbursed by insurance the same way that an OBGYN's office does. At least this is what they told us at The Maternity Center. It is an overhead problem. I could rant on and on about the ridiculousness of this, but I am realizing just how long this post is.

This situation not only leaves us but hundreds of women (there were at least 20 couples at The Maternity Center session we were at) at a disadvantage for the way they choose to give birth. It is a pretty sad state of affairs if you ask me.

So where does this leave us and MBB. We can go with some of the midwifes from The Maternity Center to their new practice where they will only do hospital births. We can check out the maternity center in Alexandria (and a very small one in Arnold Maryland). We could check out home births. No matter what we end up doing, we have a lot of women to talk to and questions to ask.

Will post updates as we go along! Have a great Spring Saturday.

1 comment:

E said...

Please note that there is a wonderful birth center located in Washington, DC. It is staffed by 4 exceptional and experience midwives who deliver at the birth center or Washington Hospital Center. The contact information is: Family Health & Birth Center (202) 398-5520. I hope this info can be of some help!