For a while now I’ve been wanting to talk about my experience with my providers during pregnancy. I actually had the opportunity to experience both midwifery care with Cynthia Banks and Hannah Weiss, as well as obstetric care through Kaiser. I think I received good care from both, but the care I received from my midwives was particularly thoughtful, compassionate and supportive so I thought I would talk a little bit about my experience and why I think midwives are so awesome.
When Kourtney and I went to the midwifery clinic in Oakland, we rarely saw other clients, there was no extended wait times, and we got our providers’ full attention. Every appointment started out with, “Would you like some tea?” The clinic itself has a very homey feel to it so you feel comfortable and relaxed. Our appointments were always at least 30 minutes long and sometimes up to an hour depending on how much we had to discuss. One of the things I really appreciated about these appointments is that the focus was not just on the baby’s health and progress but my own health and progress– not just physical but emotional. I talked about stressful experiences with my job, they asked me how my relationship with Kourtney was changing as we got closer to my due date. They took my feelings seriously.
Another important difference was how they committed to informed consent. Our midwives never told us what was to be done, they asked us what we preferred to do. They made it clear that I had a right to decline a procedure or a treatment, I had a right to ask for a second opinion, I had a right to know the pros and cons of every suggestion they had for my care, and they made sure I was aware of that throughout my pregnancy and postpartum. Also, their commitment to body autonomy was really refreshing. I remember at every appointment, laying on my back and lifting my dress up over my expanding belly, and Cynthia asking me “Is it okay if I touch your belly?” Every. Single. Time. Just because I said it was okay at my last appointment doesn’t mean I’m okay with it at this appointment. I received the same care during my labor and birth, and honestly I think in a hospital environment I would have been treated much differently.
Lastly, they took all my vitals at the end of the appointment. I just want to highlight this because I think it’s a really smart move! By the end of the appointment I’m calm and relaxed, so I’m less likely to get a high blood pressure reading, for instance.
At my 36 week appointment with our midwives we had a Birth Team meeting, where everyone who was going to be at the birth gathered to talk about expectations, ask questions, and get to know each other. It was great that my mom and sister got to meet our midwives and get comfortable with the idea of attending a home birth and it also gave Kourtney and I the space to talk about what support we thought we would need during the birth.
I described how things went during the birth in my previous posts ( parts 1, 2, 3 and 4) but I think the biggest takeaway is that laboring at home, on your own time, without the pressure to constantly check your progress or be talked into unnecessary interventions was amazing. Cynthia was pretty hands-off and let me labor how I needed to labor. I trusted her to talk me through any complications or issues (thankfully there were none), but she trusted my body to do what it needed to do to birth my baby, and that in turn helped me trust my body (turns out, my body is actually really good at birthing babies, who knew?).
The postpartum care that is standard with midwifery care was the deciding factor in deciding on homebirth if I’m perfectly honest. Here’s the lowdown: After birth, the midwives stayed for a few hours to 1) do the newborn exam, 2) give me a postpartum exam and 3) clean up. Birth is just inherently messy, but when they left there was no indication that I had just given birth in my living room mere hours before! Our midwives came to our house 5 times during the first two weeks postpartum. Five times! In the comfort of my own home! And then we saw them three more times at their office in Oakland. This was actually the deciding factor for me when we were deciding on whether or not to have a home birth. It is standard midwifery practice to see you multiple times postpartum, not just to check in on your new baby and check your healing, but to be a source of support for a family that is adjusting to life with a new little one. Those first six weeks were a whirlwind, and everything was so new/scary/exciting. I remember day 3 when Cynthia consoled me as I cried over Aminah’s latch, or day 10 when Hannah came over for an extra visit to weight Aminah to make sure she was getting back to her birth weight. I remember Hannah validating me when I talked about how hard it was to be constantly nursing, or when Cynthia suggested I use a sitzbath when I went to the bathroom which was a serious game changer.
If I had given birth in a hospital I would not have received the same care. The standard obstetric postpartum care is woefully inadequate. Childbirth is so intense, both physically and emotionally/mentally, not to mention the chaos of learning how to parent a newborn (or two, or three). So why do we get one appointment with our OB six weeks after we’ve given birth? As Diane from Blackish would say, that seems right to you??? So much can happen in six weeks. There are variety of complications that can become a problem after birth, including pre-eclampsia, retention of the placenta, infection, and more— these are all things that a midwife can spot during her numerous home visits and recommend treatment before they can become a serious or fatal issue. However, most parents are released from the hospital a day or two after birth and pretty much the bare minimum in recommendations, and if they start to feel sick they rely on the ER professionals to diagnose them– and if you’re a black woman you have an increased risk of being ignored, disrespected, and neglected by medical professionals. There’s a reason why black women are 3 to 4 times more likely to die in or around the time of childbirth than their white counterparts (spoiler alert: it’s racism). Call me crazy but I’m not inclined to opt in for that kind of experience unless I absolutely have to.
I can’t claim that racism isn’t a problem in midwifery care because it’s a problem in every profession. It’s important to remember that racism is woven into the fabric of society– this nation was built on it, and it’s embedded in our institutions and systems. But knowing how it impacts care in the medical care industry definitely influenced how I chose my prenatal care. I knew I needed providers who paid attention, who built their care on trusting women, trusting what they’re experiencing and holding themselves accountable for the care they provided. I found that in midwifery.