Choices

So, St Johns Pleasant Valley no longer allows midwives in the delivery room at their facility. This includes even ASSISTING physicians during births. They argue that in the name of "safety" all midwife attended births need to occur at St. Johns Regional Medical Center because they are equipped to handle complications that may arise because they have a NICU. This sounds sadly familiar to the ban that many hospitals have placed on VBAC's in their facilities.
I am still having trouble grasping the concept of a hospital not being equipped to handle an "emergency" should it arise.
I have had a number of friends who have seen midwives throughout the duration of their pregnancies and subsequently had happy, healthy deliveries performed by a midwife. Midwives are trained professionals who not only provide an immense support to women throughout their pregnancy and delivery but are professionals who are trained to recognize emergency situations before they start and who know when the time is appropriate to allow a physician to step in and take the lead.
Statistics just don't seem to back up either of these bans...and again...I am all for "safety" but when the numbers don't add up you have to wonder what is the REAL motivation behind these policies? My bet is on money.
Because midwives are trained to recognize complications early on and because frequently they will not deliver high risk pregnancies without a physician in attendance infant mortality rate for births attended by a midwife or having a midwife assist are 19 percent lower than births attended by a physician alone and the risk of deliverying a low birth weight baby was reduced to 31 percent where physician delivered babies ran a 33 percent chance of having a low birth rate.
Prenatal care performed by a midwife arguably is more intense than care provided by a physician. Midwives spend on average 11 minutes longer on each patient appointment than the physician, have 5 more patient visits, perfrom twice the number of ultrasounds and focus not only on the physical needs of a patient but on the emotional needs as well. Care provided by a physician is episodic, often times rushed and typically dictated by an insurance company. Care provided by midwives is usually not.
Women who have midwives in attendance during their labor were 1/3 less likely to request use of an epidural and almost 50 percent less likely to need labor inducing drugs such as Pitocin during the laboring process. Midwives were 43 percent more likely to try alternative interventions such as manipulation, use of birthing balls and frequent change of positions than physicians to encourage a natural labor. All of these add up to less money for the hospital but a happier and healthier birthing experience for mother and baby.
With all of the statistics poiting favorably in the direction of midwives and VBAC's there is another motivating factor occuring and it most definately is not the safety of the patient.