Midwives Misunderstod.... Again

Every time Augusto puts some midwife news from the SF Chronicle in my To Read pile by the toilet, I feel dread. Truthfully, the dread follows naïve excitement- ooh! Somebody is paying attention! Quickly I come to my senses. I remember that only a select group understands midwives. The mainstream media is not part of this group.

Glaring from the pile is the headline “Fewer options for those who seek natural births: Midwives becoming less popular as cesarean sections gain ground.” The empathetic (?) journalist covered the upcoming closure of Homestyle Midwifery. Homestyle is a popular, personalized in-hospital midwifery service. Contrary to the headline, I actually met two people in Hawaii who delivered with that service. After we passed on our homebirth practice, my former partner, Cynthia Banks, worked for Homestyle for a couple of years. She is an excellent midwife, and she loved that practice. Then California Pacific Medical Center came in, took over St. Luke’s Hospital, and the well-loved, extremely safe midwives are done.

It’s all very sad, but what is worse is that the media can’t get it right, so the general public doesn’t understand, and with the pressure of OBs who are threatened midwives will steal their normal birth- big business, i.e. medical systems like CPMC, follows suit. Let me state two facts:1.Midwives are autonomous providers. 2. Birth with midwives is safe. The article gets it wrong on both accounts. It’s a common misconception, as follows:

1. “For doctors, the decision to allow a midwife to handle the birth or to intervene medically is often a matter of weighing the potential risks against a woman's wishes during labor. The vast majority of births are trouble-free, but few doctors want to risk complications just because a woman would prefer to avoid a medical procedure, physicians say.” Doctors don’t decide to ALLOW a midwife to do anything. We have our own patients. If they meet set criteria for having a low-risk pregnancy, they choose us. When there is a concern of complication with a woman’s health, we consult with a doctor. That means we ask for their opinion, consultation, guidance, or to take over care of the patient- whatever is appropriate.

2. "Some women may say, 'I'm willing to risk a little in terms of safety to have the birth I want.'” Dr. Elaine Gates, vice chair of the obstetrics and gynecology department at UCSF made that statement. Birth with midwives has been shown over and over again to be as safe as or safer than birth with OB-GYNs when you match women of similar risk in similar settings.

It’s really a shame that midwifery is so misunderstood- since the research also shows that patients of midwives are overall more satisfied with their experiences than patents of doctors.