Last night I had an interview with a first-time couple. They were referred to our practice from a couple that had a birth with me last year .
Upon talking with them and explaining our philosophy, it became clear that they worried about what it means to be a "hands-off midwife". In fact, another midwife in my area had said that I was "more hands off" whereas she was "more hands-on".
What does that mean exactly?
I think to a first time mother, this could mean that maybe her needs will not be met. That maybe I'll sit in the other room and not offer her help, support or advice. That she's basically on her own.
What does it mean for me?
That I have no mandatory procedures, policies or *shoulds* in my practice. From prenatal testing (even bloodwork) to doing blood pressure to listening to baby in labor to vaginal exams - it's all completely negotiable. My relationship with the mother obviously dictates how safe I feel about certain issues and situations, but nothing is mandatory.
It also means that I hold the space for women in a way that feels good and supportive for them. I default to sitting in another room and I'm honest with families that I do this. This is to allow the couple to work on their own - in privacy. I explain that an unobserved labor is one that progresses smoothly, that allows a woman to labor in positions that might be embarassing, etc. I also explain that my ears, eyes and intuition is on alert. I'm open and ready to hear what she is needing, saying or asking. I'm available to apply counterpressure to her back, to reassure her that what she's feeling is normal, to encourage her when her strength is diminished. I've been known to sit right next to a woman throughout her entire labor because that is what SHE needed.
My default is not vaginal exams, perineal massage, coaching, directing or interfering.
Still, I had to explain more today in an email because I feel like I didn't explain it well last night. She interviewed another midwife already - a midwife that is closer to my belief system than all of the others in my area. I am glad because it means that even if she doesn't choose me, she's choosing someone with more flexibility and trust in birth than some of the other midwives in my community.
I can't help but to think back on the other people I know were turned off by my "casual" attitude around birth. It's one reason why I love working with women who have very specific ideas about how they want their birth. The ones that know what they want, don't want and are so willing to step out of the norm.
what is a hands-off midwife?
Monday, August 14, 2006at 6:38 PM
Labels: midwife practice
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5 comments:
I nearly birthed my daughter into the toilet bowl at home, unassisted. It wasn't planned - but rather, a rapidly progressing birth that surprised us in the last few hours! No one was there with myself and my husband until the Doula showed in time to drive me to the hospital (Illinois. Few choices). Helena was born 45 minutes later.
I completely believe we could have done the entire thing ourselves. We WERE doing it ourselves. And I absolutely know that it went so easily because I was unafraid of anything or anyone around me. I felt safe.
I love hearing about your philosphy and the evolution of your practice. I once thought of many midwives as "hands-off", and they are, compared to doctors! But you have really hit the nail on the head. Sounds like a perfect balance to me. You are completely spoiling me though--if I have another baby I will never be able to find a local midwife who captures/understands what I want as much as you do! Keep up the awesome work. Your clients are lucky to have you.
my midwife, Miriam Medicine Prayer in case anyone knows her, called me four days after I'd taken a pregnancy test with my fourth baby. She was across the country. I hadn't seen her in nearly two years. I took the pregnancy test on the first day of my missed period. We'd told no one we were open to getting pregnant again. But she knew. I hadn't told anyone. But she called and the first words out of her mouth were, "You are pregnant, aren't you? Well, I'll be there!"
After three births together, that's the bond we'd formed. No vaginals -- I knew I'd know and that she'd know if we needed to do anything. During one pregnancy a "co-midwife" had asked me strongly to walk a LOT, and in the end really interfered. We all learned from that but after that I knew I wasn't safe from interventions even outside of the hospital, and walking a hill at midnight is an intervention!
Anyway, I've gotten longwinded and am just glad there is SOME midwife out there somewhere who is whatever you are.
so good you explained this because i have been concerned by the hands off status / language as well. It is fine if that is what a mom wants or needs someone sitting in another room but that is not what all women want or need.
a comment for contrary goddess I know miriam -- always a small world---
she showed me how to feel heart tones something she learned from an old granny she use to work with
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