Making some big decisions: Midwife or OB? Home birth or hospital?
Photo by Craig Pattenaude on Unsplash
Moving into the second trimester, there are so many things to think about. First up, you need to find a care provider once you leave your fertility clinic.
My first stop was back to the GP who confirmed she wasn’t a pregnancy expert and recommended I find someone else to be in charge of my medical care for the next few months. That left me with a choice.
To midwife or not to midwife?
In Ontario, you have a choice about which was you want to go with prenatal care. You can stick with the medical side of things and opt for a traditional OB or go with a midwife. OBs or obstetricians are doctors who specialize in birth. Sometimes you don’t have a choice about using them if your pregnancy is high risk or complex. And that makes sense. If your priority is the baby’s safety, you want the person who knows the most about your potentially more rare condition.
But for an average, low risk birth, you don’t have to choose a medically trained doctor. Midwifes are just as capable of handling those types of births and prenatal care. A midwife is a health professional who has been trained in the art of childbirth and prenatal care. Their job is to help you have a safe and healthy birth with little intervention. They can’t perform a C-section, for example, but they can help you have a natural birth if you want one.
With my age, I technically have a risk factor for this pregnancy. However, all other signs pointed to me being perfectly healthy so I could pick which way I wanted to go.
I highly recommend interviewing several potential health providers. If I learned one thing from the fertility world is your primary care provider really makes a big difference and I wasn’t going to make the same mistakes twice.
I decided pretty quickly I didn’t want an OB and would prefer someone who would help me champion a natural birth if I was able. That left me with a city full of midwives to choose from.
I set up several interviews and got to work. Here are my recommendations when selecting a prenatal care provider:
Ask about the team. Midwives work in groups in case one is called into a birth when you go into labour. I wanted to make sure I didn’t have a male midwife on my team and some do have mixed gender pairings if that is a concern.
Ask where they are located. You’ll be going for in-person check ups with increasing frequency as the pregnancy progresses so you want to make sure it’s somewhere you can get to conveniently.
Ask what hospital they have privileges at. Just like doctors, midwives will be associated with specific hospitals they’re allowed to practice at. You want to make sure your midwife matches up with the eventual hospital you’d like to use (if you want a hospital birth).
Ask what sort of care they provide. You need to know the ropes of what midwives can and can’t do and where. If you opt for a home birth, for example, midwives can help but you clearly can’t have an epidural if you need one. Know your options upfront.
Ask about their approach to informed consent. Midwives are big about informed decision making and giving you all the details and options. A good midwife should be teaching you as you go to ensure you know exactly what will happen at each stage of your pregnancy and what decisions you’ll need to make.
I really liked the midwife approach to a holistic birth as naturally as I wanted it to be. I felt like I had someone in my corner who wouldn’t pressure me into potentially unnecessary medical procedures if they weren’t warranted. The OBs I talked to were also great but I didn’t get that same sense from them. Medicine was their world and I felt like they’d jump more quickly to induction or a C-section than a midwife would.
Having made my choice, I signed on with a great midwife group.
If you’re in Toronto and looking for a midwife, here are a few of the places I interviewed to get you started:
The Midwives Collective of Toronto
Seventh Generation Midwives Toronto
Association of Ontario Midwives
Home birth, birth centre or hospital?
You’ll also need to start thinking about where you want to give birth. Home births are available and your midwife can assist you if you want to have your labour at home. There are many reasons moms-to-be choose to stay home. The environment is more relaxing, you’re in your own place of comfort, you have more control over what happens without medical professionals around, etc.
Personally, I had questions like, what about the mess? Who cleans up? What happens if something goes wrong? What if you change your mind and REALLY want those drugs?
Birth centres are also an option. They are usually closer to a hospital if you need one but try to mimic the look and feel of a home birth. You’ll have access to a birthing tub if that’s the way you want to go or a bed. They have basic medical supplies if you need them but no option for drugs. In the event of a complication, you are rushed to the closest hospital and things progress from there.
Lastly, you can have a hospital birth. Pros of this are you’re already where you need to be if something goes wrong. You have access to drugs if you choose to use them. And doctors are close at hand even though your midwife will be with you. Cons are, of course, it’s less comfy in a medical environment and doctors can be pushy.
Honestly, I opted for a hospital birth very quickly. My reasoning was, I wanted to be as safe as possible just in case anything went wrong. I also planned on a natural birth but who knows what labour will actually feel like? If I feel the need for an epidural, I want that option open to me.
Everyone needs to make their own decision
It’s a good idea to talk things over with your care provider and look at any potential risk factors you may have. Also think about what will make you the most comfortable when things really kick off. Then make the choice that works for you. This isn’t a one choice fits all scenario so go with what feels right to you.