SO YOU JUST FOUND OUT YOU’RE PREGNANT!
Wahoo… After singing, dancing, jumping up and down a few times and sending a picture to your partner, what do you do next?
There are a few things you need to start organizing, even if it is really early on in your pregnancy:
- Decide if you want an Obstetrician or a Midwife
- Book your first appointment at a clinic within your catchment
- Book to see your family doctor for a physical and bloodwork (especially ferritin, B12, TSH and hCG just to make sure you are actually pregnant!)
- Decide if you want a doula (ie. birth assistant)
- Do another happy dance!
If you are unsure of the differences between a Midwife and an Obstetrician, read some of them below:
- only deals with low-risks birthing situations.
- can often delivery at-home, in a birthing center or in hospital
- is a team of 3 practitioners who may rotate for your appointments
- of the 3 midwives, often 2 will be present at the labor
- they are trained to perform a vaginal birth, cut the cord, deliver the placenta, clean and weigh the baby and assist with postpartum care
- they have hospital transfer authority to an obstetrician in case of complications
- they are trained in CPR and basic emergency techniques but will transfer you to the hospital if complications arise
- can manage low- or high-risk births
- are experts in high-risk emergency scenarios
- are able to perform c-sections and have forceps, vacuums in case of forced extraction
- see a high quantity of deliveries and are familiar with different kinds of birthing conditions
- have a team of nurses to support
- only perform births in hospital setting
When choosing your birthing physician, you will want to weight out the pros and cons for your particular situation. If you are a high-risk pregnancy (ie. high blood pressure, heart disease, diabetes, epilepsy or had serious complications in a previous pregnancy), you may not have a choice to go with a midwife.
Also, keep in mind that midwives often have a long wait list. They may not have availability for the time of your birth or you might live outside of their catchment (area of travel).
Personally, many of my colleagues and friends have used midwives and all have had a successful labours, some at home and others needed to be transferred to the hospital.
Despite midwife home-births being just as safe as hospital births, you must also take into consideration of bias. Only low-risk pregnancies are allowed to be done at home and so the chances of a serious complication or emergency is not as high as hospital birth. We all have our own biases, so make sure to meet with your health care team to find out what is the best decision for you and your family.
Here are some of the PROs and CONs to each birthing scenario:
PROS to Midwives:
- spend more time before and after labour supporting mom and baby (up to 6 weeks after baby is born and will come to you the few days postpartum)
- typically a more empowered relationship of birth choice, especially because it is with low-risk pregnancies
- most midwives will give you a choice to birth at home or in the hospital (and sometimes in a birthing center too)
- they create your birthing plan together, along with an worst case scenario plan.
- they are trained to notice any irregularities with the labour progression and have direct access to the local hospital and obstetrician if anything appears to be at risk.
- midwives are best if you are low risk and want a vaginal birth after caesarean (VBAC)
CONS to Midwives:
- they don’t deliver as many difficult pregnancies and may not be as skilled in emergency cases
- for problems during homebirth where there isn’t enough time to take the mother to the hospital, there could be serious complications or in rare cases fetal death (ie. shoulder dystocia, cord wrapped around baby’s neck). This can be helped by birthing in a hospital where medical staff are onsite ready to step in and perform the necessary emergency procedure (ie. C-Section)
PROS to Obstetricians
- they are extremely skilled in emergency and high-risk case labours
- they perform many more births than midwives
- they will always default to the safest decision for mom and baby
CONS to Obstetricians
- in hospital births are highly monitored, which also leads to more interventions (ie. epidural, c-sections, etc)
- the choice to birth in a pool, squatting or on hands and knees may not be available
- an extended labour may encourage obstetricians to induce and speed up delivery
- the obestetrician you met with when you were pregnant may not be the one doing your delivery
Midwives have been shown NOT to be riskier than hospital births, but only for low-risk pregnancies.
It’s important that you speak with your medical team about your particular circumstance and risks. Safety is your number 1 priority for you and baby.
If you are pregnant and haven’t booked your initial visit with a midwife or ObGyn, I would highly recommend you do so immediately, in order to reserve your spot.
Midwives are more than happy to discuss birthing options and give you more information according to your specific situation.
The most important part is that you feel safe and you trust the person who will be delivering your baby!