Between midterms and picking the perfect Halloween costume, choosing a birth delivery method is probably the last thing on most Yale women’s minds. But according to four midwives who spoke at the Yale Women’s Center Monday night, it is never too early to start planning.
As part of Women’s Health Week, the Center hosted four specialists in midwifery for a panel discussion on the merits of alternative birth methods, which panelists said can empower women by offering more natural, lower-cost deliveries and a more personalized experience than clinical obstetricians currently offer. The four featured midwives — Christina Fleming C.M., Elise Resch C.M., Rebekah Wheeler and Christy Wilson R.N. — spoke to a gathering of 15 students, including two men, and reflected on their reasons for entering the profession.
“When I actually shadowed an obstetrician, it was clear that she approached a woman in labor as a woman who was sick and in an emergency,” Wheeler said. “These women aren’t sick; they might have complications, but certified midwives are trained to handle almost all of these problems. Every other developed country has midwives delivering babies, and obstetricians are essentially only surgeons.”
Fleming said she entered the profession because she views midwifery as a statement on a woman’s values. Obstetricians view birth as a high-risk situation, she said, and strive to avoid all potential harm to mother and child.
On the other hand, Fleming explained, midwives emphasize birth as a natural process of life. Under midwifery, she pointed out, mothers are not thought of as patients, but rather as autonomous women taking ownership over their own lives and the lives of their children.
Midwifery presents mothers with a range of birthing choices. Fleming said a few mothers prefer an “unassisted home birth,” where the only people present at the birth of the child are the mother and father. Most others seek some degree of experienced help, ranging from unschooled but practiced community midwives to certified professional or nurse midwives.
All four panelists emphasized that thinking about issues of women’s health and autonomy before getting pregnant is the best way for women to approach birth. In the moment, they said, obstetricians essentially dictate the terms of a woman’s birth — using the mother’s concern for the child’s health to justify any action that guarantees an expedited and painless birth.
“ ‘For the safety of your baby’ are the only words needed to convince parents to undergo unnecessary procedures,” Resch said.
Even mothers who witness their daughters giving birth can influence the birth process, Wilson explained, by insisting on medications for their daughter during the painful process of childbirth.
“Way before childbirth, women must consider the politics of women’s health care,” Resch added.
But Resch said midwifery faces challenges, the biggest of which is the malpractice suit; a huge portion of a midwife’s salary pays for malpractice insurance, she said. And states all have different regulations governing the profession, Fleming added.
Another problem is reimbursement. Resch said despite the fact that a midwife delivery leads to an average of four fewer hospital days and a less costly delivery overall, insurance companies are less willing to reimburse seemingly non-medical services.