Voices: What Story is Your Birth Story Really Telling?

I recently had the opportunity to share the story of my son’s birth with a university class on Child Development during Infancy (conception-3 years). The students are in their early twenties and many had never seen a birth before nor had any prior exposure to the basics of childbirth.

As I wrote out my story, I became increasingly aware that I couldn’t just tell it the way I remembered it. I had to bear in mind that the students would be forming impressions about childbirth from my words. I had an opportunity to cut through the noise of birth as pain and talk about what else it can be, beyond just a physical experience. I realized that to be taken seriously I would need to acknowledge that birth IS painful but I also decided to focus on the experience itself: preparations, perceptions, emotions. I spoke about why I chose to have a homebirth in a rational way so that my words would not be brushed aside as those of someone “brave” or “radical.”

I had to make very calculated decisions about what to say and what not to say and I got to thinking about the stories our birth stories really tell. Is it a story of fear, pain, control, joy, courage, triumph, peace, dignity, sorrow? Do the details we give and the words we use convey what we intend? Are we aware of our audience when we casually explain about the day we gave birth? Do we pay attention to the fact that there might be a young pre-teen girl there who is soaking it up? What do we want listeners to take away from our tales?

In a culture where birth is a medical event, we owe it to future families to tell a positive empowering story if we can. Young women today are bombarded with stories on tv and in the media of childbirth as being so painful and dangerous that the only way they will get through it is by putting their trust in the authorities, giving up the power in their bodies and taking the multitude of drugs offered to manage their birth safely. We can help shape future mothers’ perceptions of birth by carefully choosing our words when we talk about ours. Regardless of the circumstances—whether it was a blissed out waterbirth or a cesarean for breech presentation—we are the ones who tell our stories. We can choose to be positive and inspiring or to instill fear and dread. It’s your story.

What can I expect from my appointment with a midwife?

In most cases your appointments with your midwife will run about 50 minutes as opposed to the standard 10 minutes with a doctor. This means that your midwife has more time to explain procedures and tests to you so that you can truly give informed consent (if you choose to). It also means that you get to know your birth team a little better and therefore, may feel more comfortable voicing any concerns you may have.

In the first two trimesters, appointments are once a month and increase to about once a week near the end of the third trimester. Many midwives also offer a few home visits during the first two to three weeks postpartum where they monitor the baby’s health, your recovery and the initiation of breastfeeding.

A typical appointment will include explanation of upcoming procedures and tests and your right to waive any of these that you are not comfortable with or that you deem unnecessary, opportunity for you to ask questions and voice concerns, a routine physical exam that includes measurement of your belly from top of the uterus (fundus), testing your urine, listening to the baby’s heartbeat, taking your blood pressure and occasionally checking your weight. Your first appointment will also include a full medical history.

Midiwves often work in teams of two or three. This means that you will alternate clinic visits between your midwife team so that you have ample opportunities to get to know them. One of them will be on call at all times so that you can access care whenever you need it. As well, they alternate call and you can expect that one of them will be at your birth. Two midwives attend a home birth (one for mom and one for baby) but typically one will attend a hospital birth and be assisted by the hospital nurse.

What is Midwifery?

Midwives are healthcare practitioners who specialize in normal pregnancy, childbirth and post-partum. Midwifery is now regulated in many Canadian provinces (including British Columbia, Alberta, Saskatchewan, Manitoba, Ontario, Quebec, Nova Scotia, Northwest Territories and Nunavut, with legislation pending in some of the Atlantic Provinces).

In Canada, though all are known as midwives, we have nurse-midwives, direct-entry midwives and lay midwives. Nurse-midwives are former nurses who took additional training to become midwives. Direct-entry midwives have trained in a clinical setting (midwifery school or university) specifically to become midwives without first training to be a nurse. Lay-midwives trained as apprentices or through self-study, do not have formal clinical training and are un-licensed or un-certified.

Midwives treat birth as a normal physiological event which does not require managing and which proceeds best when intervened with as little as possible. Midwives are trained to spot and mitigate problems and complications in the pregnancy and birth. They may work in conjunction with other practitioners including physicians and obstetricians should the need arise and in some cases may need to transfer care if serious complications develop.

Midwives believe that the mother should be an active participant and decision-maker in her care. Midwives are entitled to hospital privileges, can prescribe medications and standard tests and offer choice of birth place (home, hospital or birth center depending on the province).