Choosing our prenatal practitioner

For this pregnancy, we're seeing a certified nurse midwife (CNM) for our prenatal care. We stumbled upon midwifery by accident, really - we'd planned to see an obstetrician (OB), but we were very impressed by what our midwife practice has to offer. Here's how we made our decision...

I saw an OB/GYN when we lived in the midwest. She was great - kind, patient, didn't seem too rushed during my visits. She was often behind schedule, though, and I had to reschedule my appointments a lot - because she was off delivering babies :)

Since I was used to seeing a doctor, I set out researching OB practices when we moved to New Jersey. Two practices fell into my criteria - they accepted our insurance, they were relatively close to our house, and they had decent webpages.

I set up an appointment with an OB at one clinic. They misunderstood from the start that I just wanted to talk briefly with a doctor and get a feel for her practice - I ended up having a whole annual exam! (I was due for one anyway.) The doctor seemed rushed. When I asked questions about future prenatal care (office visit schedules, hospital affiliations, etc.), she said, "We'll deal with that when the time comes." But this was what really struck me - when I mentioned that I had very long cycles between ovulations, she immediately brought up drug therapy and trying to change things with medications. I certainly didn't feel like my cycles needed to be "fixed" - they were just long! I knew I wasn't going to be coming to this practice again.

I called the second clinic in the area and asked for an appointment with a doctor. The receptionist said I could come in and speak with a midwife - she could give me information on the clinic's practices and philosophies overall (the clinic is co-operated by doctors and midwives). Devon came with me to this appointment. The midwife that we spoke with was our age, which was cool. She explained more about midwifery care - they provide the same services as an OB, with the exception that they can't do surgical procedures. So for typical "non-risk" pregnancies, midwives provide the same prenatal care as an OB.

What piqued our interest was her description of midwife care during labor and delivery. You still give birth at a hospital, and the OBs in the clinic are there if any complications come up. One of the four midwives in this practice is always on call or at the hospital, and she will be there for your entire labor. She assists you with pain management and recommends good labor positions to speed things along. She helps you get through labor and delivery with no medications (but you can still have them if you want to). She encourages you to move around and eat if you feel like it. She'll monitor the fetal heartbeat, but you don't have to be hooked up to a continuous electronic monitor unless there is a problem. She'll help you start nursing soon after the baby is born.

Intrigued, we went to a seminar a few weeks later that the midwife group held at the affiliated hospital. We got to know the other three midwives. We got more details about what we learned at our first appointment. We learned that, even if our prenatal care provider was an OB, one of the four midwives would still be the one present for most of the labor; the doc would arrive when it was time to deliver.

To us, our decision was clear. I am not big on medications and would prefer to have a natural labor and delivery. I don't like things to be too far out of my control - I like the idea of managing labor with the help of an educated midwife and my husband. And, why not get to know the women who will be attending my labor ahead of time?

So far we've been happy seeing a midwife. She is very laid back... this is good and bad for my data-driven personality. On one hand, the midwife is very reassuring and confident that things are going well for me. On the other hand, she doesn't give me a lot of hard, fast information or reasons for things I might be feeling.

But I think the midwife philosophy has helped me view pregnancy (and the idea of labor and delivery) as a natural process that can be, for the most part, left out of my conscious control and up to my body to handle in the way it has been programmed to know best.