Kristine Subasic Nichols, Mother
My children, now seven and five years old, were both helped into the world by certified nurse-midwives who were, at the time, part of the staff of Birthplace at West Penn Hospital. For me, certified nurse-midwives seemed the most sensible, minimally invasive, high-quality, professional health care choice as I was seeking prenatal, birthing, and well-woman care.
My reading about prenatal and birthing care led me to compile a list of questions that I used to interview OB/GYNs in an attempt to find the kind of care I wanted. My reading had led me to believe that, should the pregnancy and birth be normal, minimal intervention would be best both for me and for my baby. If it wasn't necessary, I didn't want an IV needle stuck in my arm during the hardest physical work of my life. Unless it was medically necessary, I did not want to be denied food and drink or have my mobility limited by constant monitoring which I was not convinced was necessary. While I am afraid of pain, I did not want an epidural, figuring that while labor pain would end when the baby was born, an epidural might interfere with the birthing process and might result in a days-long headache afterwards. And I most certainly did not want an episiotomy if it was not necessary.
During an interview with one doctor, I asked her how many of her birthing mothers had episiotomies. She looked very surprised at the question, thought a minute, then responded, "First time mothers? Oh, at least 95%." I contrasted that with the low episiotomy rates typical of mothers receiving care from certified nurse-midwives (the average for all certified nurse-midwives is 30.1%). The client orientation provided by the certified nurse-midwives made clear their professional medical qualifications, certifications, and experience, discussed birthing options and the care process, and discussed their minimal-intervention approach to such things as episiotomies. Happily, like most Midwife Center moms, the births of my seven pound and nine pound babies resulted in neither episiotomies nor perineal damage.
With the midwives, I was a full participant in my own care. I weighed myself and did some of my own charting at each visit. I always had full access to my file and chart. In other places where I've received medical care, I've had doctors snatch my chart out of my hands and hide it to prevent me from reading it. Such a thing would never happen with the midwives. The midwives have great respect for their clients, their intelligence, their right to full access to their medical information, and their ability to make sound decisions.
During my care, the midwives did careful health histories and asked probing questions; they listened to what I had to say, were on the alert for health problems that less diligent care providers might have missed. They taught me about warning signs for problems that I might encounter and gave me references for specialized care options. In spite of the fact that my first labor was very long and I ended up delivering in the hospital, the midwives stayed with me during the entire length of both labors and deliveries.
The midwives took the time to know me, my body, and my growing baby to provide a quality of care that I have never encountered elsewhere. They became the standard by which I judge all other medical care.
Kristine Subasic Nichols