• Posted by Pregnant Stories
  • 15 Jun 2011

Here is a story from the LA Times

Fewer pregnant women and their partners are attending prenatal education classes these days and appear to be quietly following whatever advice the doctor or midwife recommends, researchers said Monday.

Doctors, led by Dr. Michael Klein of the Child & Family Research Institute and University of British Columbia, surveyed 1,318 healthy pregnant women. They found many seemingly unprepared to make their own decisions regarding childbirth options, such as whether to have natural childbirth or a Cesarean section.

Fewer than 30% of the women, all first-time mothers, said they had attended prenatal childbirth classes. Many said they used the Internet or books to become informed about childbirth. Still, a shockingly high number could not answer basic questions regarding the pros, cons or safety issues associated with epidurals, episiotomies, Cesareans and other childbirth options. The women who were receiving obstetrical care from midwives tended to be more informed about their options compared with women receiving care from a medical doctor.

“[E]ven late in pregnancy, many women reported uncertainty about benefits and risks of common procedures used in childbirth,” Klein said in a news release. “This is worrisome because a lack of knowledge affects their ability to engage in informed discussions with their caregivers.”

The study was published in the June issue of Journal of Obstetrics and Gynaecology Canada.

The type of provider mattered greatly in terms of what kind of care women received. The researchers published a related study in May in the journal Birth that showed younger obstetricians were much more likely to favor the routine use of epidurals and expressed more concerns about the safety of vaginal birth compared with older obstetricians. The younger obstetricians seemed to view C-sections as the preferred option for childbirth, the authors noted. In the United States, efforts have begun to reduce C-section rates. About one-third of all U.S. women have a surgical birth.

I have found the opposite to be true among women who network socially with other women online and in person.

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  • Posted by Pregnant Stories
  • 24 May 2011

Today women are more educated about their birth options, and while most opt to deliver in a hospital rather than at home or a birth center, many women aren’t aware that using someone other than and OB/GYN is an option.

The question is not whether to choose between a doula or a midwife but to realize that you can actually use both!

A midwife performs actual pre and post natal medical care and delivery.
A doula is there to support the mother and meet her needs.
An OB/GYN is a medical doctor that can perform the pre and post natal medical care and vaginal delivery, as well as handle any emergency birth situations such as would require a Caesarian section.

Your options are:
Just your OB/GYN
Just your midwife
A doula & OB/GYN
A doula and midwife

In a hospital setting an OB/GYN will be available if an emergency should arise.

There are varying levels of Midwifery – Lay Midwifery, Certified Midwifery and Certified Nurse Midwifery.
If you are foregoing an OB/GYN it is important to make sure you have a Nurse-Midwife. More info on this topic.

Midwives and doulas encourage a natural (non-medicated) birth and tend to be medically as hands-off as possible. Doulas are better known as a birth coach, they are there to support the mother as much as possible and both help to assist in postpartum care and breastfeeding.

Many midwives can perform doula services.

Most major insurance companies cover midwifery services– typically at a reduced “out-of-network provider” rate. Your lab charges, as well as physician charges, if needed, are additional and usually covered by insurance plans even if you choose an out-of-network provider.

Doulas are rarely covered by insurance and most require a up front one time fee. Often this fee can be paid or reimbursed from your Flex Spending Account.