Mommie Dearest: Pregnant Women In The U.S. Deserve Access To Midwives

Earlier this month, the National Institute for Health and Care Excellence (NICE), a U.K. organization that provides national health care advice and guidance, released a report on the care of healthy women and their babies during childbirth. The report stated that low-risk women would actually be safer delivering with a midwife — either at a birth center or at home — than with a physician at a hospital.

Ever since the report came out, there has been a lot of discussion as to how it might impact birth here in the United States. In fact, this week, The New York Times published a statement from their Editorial board, asking “Are Midwives Safer Than Doctors?”, and suggesting that many women would benefit from midwifery care. Like the Times, I too hope that NICE’s report will have an impact on the care received by those who are pregnant. I should note that I have a double stake in this issue. I’m currently working on my second book, this one delving into the concept of the “Perfect Birth.” I’m curious about the way we think about, talk about, and experience birth. I’ve teamed up with Deborah Wage, a Certified Nurse Midwife currently practicing at a university hospital. Together we’re looking at the research and data already out there on birth in this country as well as gathering our own, along with the stories of those giving birth to see how it all weaves together. The stories I have heard so far that span the spectrum of birth experiences is overwhelming. The way we treat women in this country is only magnified during the birth experience, where any semblance of control and autonomy is ignored, and marginalized women are treated poorly, resulting in poor birth outcomes for themselves and their babies. Just look at the basic facts and you can’t help but understand we have a problem. The U.S. spends the most when it comes to birth in the world, despite the fact that we’re the only developed nation whose maternal mortality rates continue to rise. Clearly, there is a systemic issue that needs to change.

But my interest in this is also personal.

Eight years ago, I delivered my son under the phenomenal care of a midwife. The OB-GYN practice I was a patient of also offered midwives as an option, and I opted in. I was amazed at the level of care I received. Unlike my previous experiences under physician care, my appointments with the midwives never felt rushed or as if I was stealing time from my provider. We were really able to take the time to individualize my care together, and by the time I delivered my son — in a hospital — my midwife truly knew me and my body well, and together we had an uneventful, smooth birth. A few month later, when my OB-GYN office decided to pull delivery privileges from their midwives, relegating them to only prenatal and well woman care, I volunteered to help find a way to get the midwives back into the hospital delivering babies. I’m happy to say that our local hospital currently has an entire midwifery care office, and many more women are now able to deliver under their care.

The midwifery model of care is unique in that it is patient-centered and thrives on the patient/provider relationship. It’s not simply about providing skilled care, but developing a solid relationship between patient and the midwife, resulting in a more supported and confident birth. The NICE report from the UK noted specifically that it is safer for low-risk patients to birth with midwives outside a hospital. It lowers a patient’s chance of intervention and ultimately surgery as well.

And yet here, in the US, only 9 percent of people who give birth do so under the care of a midwife. Our system is simply not set up to support this model of care. We live in a society that pushes a for-profit model of healthcare, which doesn’t always mean that patients get the individualized care best suited for them. While it would be ideal to tell people to just go out and get themselves a midwife, our current set up does not provide for that option, seemingly in the face of best practices.

I hope the UK’s report is truly a wake up call for those of us here in the US. This isn’t about midwife versus doctor or hospital versus home birth. It’s about a broken system that treats pregnancy as pathology and women as inferior, and that needs to change now.