I didn’t labour at all with my first child, who was cut from me because he was breech. With my second child, I went into a fast, awesome labour and my baby was descending well (even though he was breech too) and they still sectioned me. Both the obgyn and my midwife told me afterwards that I could have delivered him naturally (WHICH IS WHAT I WANTED AND THEY KNEW THAT). My midwife went so far as to say that I would likely not have had any problems and that if I decided to have a 3rd baby, she would definitely support me in having a vbac — not what I wanted to hear after just starting to recover from my botched c-section 2 weeks earlier.

My own family doctor also told me that I should have just pushed my baby out and ignored the obgyn and midwife, but I really felt like I had absolutely no choice but to consent since my midwife did not seem like she was going to fight for my vbac after all. SHe was prepping me mentally for a c-section from my first call to her telling her I was in labour.

I’ve gotten over the angst of that experience; life gets busy and you just do. But it makes me so angry to hear about other women who end up going through what I did. It is just so wrong and doesn’t seem to be getting better fast enough.

There are a lot of competing considerations for doctors, but ultimately they became doctors to practice medicine, and surgery is often regarded as the highest form of medicine.

Both of my kids were born at BC Women’s – the first because we lived in Vancouver when I started my prenatal care and the second because the first had been. Comparing my experience to friends & acquaintances, I firmly believe that the key to a satisfying experience – whatever that means to you – is support. What your midwife did for you during labour with Nora was perfect – she knew what you wanted and she supported your choices and advocated for you.

Because I never have a family doctor I sought maternity care with both of my pregnancies. The first time I lucked out with the South Community Birthing Program, http://www.scbp.ca which is a fantastic mixed practice of midwives and doctors. It provides prenatal care in the form of a group prenatal class at the same time as the check-up; it provides support in the form of a group dynamic (you’re placed in a prenatal group with 10 other women who are due around the same time as you), plus a free doula, it was absolutely the best way to have a first baby. It’s only available to women in Vancouver but it is a model that I would so so so love to see done everywhere, all the time. My son ended up being delivered by a midwife – she was on call that day – and she fought her ass off for me every step of the way. She forced the OB to let me get out of bed and walk around instead of lying there with monitors on. She slowed everybody down, made them wait a few minutes to see what would happen instead of pushing the next intervention. I did end up delivering vaginally, with an epidural. It was the best possible outcome and I didn’t feel short changed in any way.

Of course, when I told my second maternity doctor this story, about having been induced because of low amniotic fluid, he told me that there’s research suggesting many low amniotic fluid situations are not as bad as they’re made out to be; if it’s a hot day and the mum isn’t drinking enough water, her fluid level will go down. He said had *he* been my doctor that he would have had me drink a litre of water and come back for another ultrasound, instead of admitting me and inducing me right away. So even at BC Women’s, there’s haste and unnecessary intervention; for many of the reasons your other commenters have outlined.

Jocelyn: I had always wanted a midwife, but honestly I was too lazy to do the legwork required to get one the first time around. When my family doc recommended the OB team at RCH I trusted that it would be fine to take the easy way and sign on with them. Stupid me. The second time around I wanted a VBAC and I didn’t trust that I would have a good chance with an OB, so I prioritized finding a midwife. My family doc didn’t think I’d be allowed to go with a midwife for a VBAC, and referred me to an OB to confirm that it was safe. Luckily the OB had worked a lot with midwives and he reassured me that it was safe, and even said that given my preferences it was probably a better choice than an OB! As for how I found the midwife … well we can’t all have sisters-in-law with connections to maternity care providers! I used you and Google, and discovered that it’s a lot harder to get in to a midwife than I thought. I was lucky to find an opening with Mama Love Midwifery (I just squeaked in).

Kathleen: Recent research suggests that midwife-assisted home birth is as safe as hospital birth for low-risk moms. If I wasn’t now considered higher risk due to the first Cesarean, I’d go that route. I am now convinced that many complications are due to hospital process disrupting a mother’s concentration, making her less relaxed. Nora was coming faster than we thought, and probably would have been born at home by accident if the midwife had been any later. When she went back up the birth canal, I think it was because we raced to the hospital and I was told not to push even though I felt the urge. I think we would have avoided that complication if we had just continued at home, and thus we would have avoided the other stuff too. In Wesley’s case, had I laboured at home, perhaps he might have righted himself before the water broke naturally. If not, if it would have been a C-section anyway, we would have had time to go to the hospital to get it done.

Buffy: it is definitely a fear of liability that fuels the rise in C-section rates. C sections are major surgery and as such there is a lot of post-op risk associated with it. But surgeons feel more comfortable with surgical risks than the random risks of natural childbirth. There’s also the fact that OBs are trained as surgeons. Natural childbirth is not really their area of expertise.

I hope your post encourages women to seek out the help of a midwife and to speak up for themselves with their doctors!

My major issue with the care I received was, quite frankly, the amount of care I received. At the Foothills Hospital in Calgary, of my 12 hour labour, at least 4 hours was spent in the waiting room and less then one hour each was spent in the triage room and my labour room. Prior to going to the hospital I didn’t even know there was a ‘waiting room’; they must have missed that chapter in my pre-natal class. Given the amount of monitoring I had, we were very lucky that nothing went wrong. What I really needed was someone to be providing care for me through the whole labour.

To me it is all symptoms of the same problem- the hospitals are over crowded, the doctors (and nurses) are over worked and the nurses are being leaned on for parts of post-natal care that they really are not trained for. (I won’t go into the care I received post-delivery, suffice to say I wish I had had a midwife for that care too.) Was every person who provided my care in labour and deliver and post-natal care kind, caring and trying to to their best? Yes. Were they equipped with time and training to do their best? No.

I think it is this lack of time and people in our hospitals that have caused the c-section rate to be so high. It is more expensive, yes, but sometimes easier then really supporting a women through her labour. Midwife’s seem to be the best solution right now, but I think ultimately was need to start really talking as a country about the quality of health care we want to provide in our hospitals.

My real point is that I completely agree with you about midwives. Both of my births were midwife-assisted, and I have not had a C-section. However, my first birth occurred unexpectedly at 34 weeks, so I was high-risk. I really believe that having a midwife present made all the difference in how that birth progressed. She absolutely intervened and advocated for me throughout the 9 hours I was there before my daughter arrived, and I was able to deliver almost exactly as I’d planned in spite of being preterm.

I would also like to add that many mothers find doulas to be very helpful. They are not medically-trained, and do not replace either a doctor or midwife. However, the support they provide in labour has been proven to be highly effective in reducing the rate of interventions, pain medication and C-section. My friends who used them rave about how great they are.

The only other suggestion I would make is for you to describe your decision-making process on how you arrived at a midwife the second time. As I recall, it wasn’t the first option and you did a lot of research and consideration to get to that point, with no small amount of opposition from medical people around you. Not to belabour the point – just to say for moms out there that you aren’t necessarily “born” a midwife patient, sometimes you evaluate your options and decide it’s the right choice for you. Also in your case you had difficulty finding a midwife, esp. in new west. Do you have any thoughts for New Westie moms who want to find a midwife? (other than to check the BC Association of Midwives website.)

I absolutely agree with you about midwives; Linda Peters was my midwife. She is one of the very few New Westminster midwives, along with Tracey. I recommend her n(and other midwives) for her guidance and support, not just during labour, but through the whole pregnancy and even afterward for 6 weeks.