We’re all for choice. One of the upsides of today’s maternity care is that women have more autonomy than ever in choosing the type of birth experience they want to have. That being said, childbirth has become increasingly medicalized, which does not always result in better outcomes for women and babies. There are many reasons people choose out-of-hospital birth with Certified Professional Midwives (CPMs). Here are a few of the things you can expect in your course of care with a CPM:
1. The midwifery model of care. Freestanding birth centers are usually run by midwives, either direct-entry midwives (often certified professional midwives (CPMs), licensed midwives (LMs), or certified nurse midwives (CNMs). While there are differences between types of midwives, all are trained within the midwifery model of care, which promotes the childbearing year as a normal life event, and birth as a normal, healthy process*.
Midwives see pregnancy as a normal life event and work with low-risk women (which account for most pregnancies). CPMs are trained to prevent complications by promoting a healthy pregnancy, recognizing early signs of developing complications, and performing emergency measures when complications arise unforeseen. With their foundation in normal birth, CPMs believe in the power and strength of women’s bodies, and the brilliantly designed process of birthing as nature intended.
2. Continuity and informed choice. You will work with the same team of midwives throughout your pregnancy. Your prenatal visits will often last forty-five minutes to an hour; you and your midwives will get to know each other very well over the course of your pregnancy.Your midwife will provide the majority of your prenatal care, and will be on call for your birth. In addition, she will stay with you throughout your labor, and for several hours after the birth of your baby. After the birth, you midwives will come visit you at 1 and 3 days postpartum, and care will resume in the office at 1, 3 and 6 weeks postpartum.
Midwives and clients work together as a team. Midwives are experts in normal birth and you are the expert in your own body, desires and needs. Throughout the course of your pregnancy you will be offered routine testing which is provided as a standard of care in hospital practice. This is referred to as informed choice, where we discuss the risks, benefits, and indications for a particular test offered. We provide you with the education and information and encourage you to do your own research and together make a decision best suited for your pregnancy. On occasion there are reasons your midwife my recommend a particular test in order to provide best care to you and your baby. Throughout the course of your care you will learn a lot, and gain confidence in your body and knowledge about pregnancy and birth.
3. Low intervention. There is no routine use of medication. No medications are used for induction or augmentation of labor. Your midwives use a hand-held doppler to listen to the baby periodically, rather than using an external fetal monitor. You are free to walk, to move, to dance.
The midwives are skilled in comfort measures for labor and birth, and would help you to find natural pain relief and ways of moving your labor along. Narcotics and epidurals are not available. There is no use of routine episiotomy. You would receive your baby immediately after birth, and you or your partner may even catch him/her yourself!
5. It’s safe. Out of hospital birth is safe for women with healthy pregnancies. Birth in birth centers or at home has been studied extensively and shown to be as safe as a similar low-risk population in the hospital setting. If a complication should arise and you should need medications or treatments that the midwives do not perform, your midwives would accompany you to the hospital and stay with you throughout, acting as your labor support and advocate. Remember that true emergencies in birth are rare, and that your midwives are trained to prevent complications by promoting a healthy pregnancy, recognizing early signs of developing complications, and perform emergency measures when complications arise unforeseen.