How The Difference in Pregnancy Providers Can Impact Your Life

​There’s a big difference between Midwifery care & Obstetrical care.

 Mom has a pregnancy that has been difficult but low-risk. She’s dealing with some perinatal depression (for whatever risk factor -pick one) & she recognizes it. Provider recommends antidepressant. Mom doesn’t want to take said pharmaceutical because she doesn’t feel safe with the risk. She goes to her prenatal appointments with her OB that are quick & lack any sort of connection, bond, or trust, and gets pushed through the system as just another number. She gets 20 minutes in an office where the focus is on the health of the baby only. She doesn’t want to take up the Doctor’s time or be seen as THAT [annoying/needy] patient. Instead she goes in, pees in a cup, gets her vital signs done, hears her baby’s heart beat and has her belly measured. Easy-peasy. ‘Any questions? No? great we’ll see you at your next visit!’ … She isn’t asked about how she’s been feeling, what has been going on in her personal life, if she has any concerns. She leaves feeling isolated and discouraged.

She goes on to have her baby in the hospital – a typical hospital experience. Sterile, cold, many busy staff members, maybe she got some say in her experience, maybe she was never even asked. At best, her experience was decent. At worst, she feels traumatized. But, “at least she got a healthy baby”. She goes home after 24-48 hours with this brand new baby. Breastfeeding is harder than she thought. She has to leave her home to take the baby to the pediatrician. Pediatrician says “maybe your baby just can’t suck properly or maybe they’re “allergic” to your milk or something you’re eating. Formula is probably the best option.” So Mom is second guessing her ability to even feed her child. She decides she should just do what the Pediatrician recommends. She feels mom guilt x100. She secretly feels like she isn’t even bonded to her baby (‘Why didn’t I cry at the first sight of my baby like everyone else does?’). More mom guilt. The depression and anxiety are heightened. She feels like no one else understands when they always respond with “Well at least you & baby are healthy!” Maybe her partner can tell her mood is off but just chalks it up to the hormones. Or maybe she doesn’t even have a partner. She struggles with what to do. She asks in her Mommy Facebook group. But there are so many responses it is overwhelming. She still has no idea. She fears asking anyone in her circle because she feels embarrassed. She wonders whether she should ask for a pharmaceutical medication now. Maybe she does, maybe she doesn’t….

Baby doesn’t sleep good, so neither does Mom. She starts to feel the impact that has on her mood. She can’t wait to have a moment away from this baby. More mom guilt. Her house isn’t getting tended to. More Guilt. She doesn’t even have time for taking care of herself. Self-shaming. This also means she isn’t able to get a decent meal, enough water, or even some sunshine. These all begin to impact her mood too. She doesn’t feel she can even care for this child, like she isn’t a good Mom. It has been 6-weeks & she is returning to work…. More mom guilt, still struggling with her mood. She goes to her 6-week appointment, the Doc says “Well, you’re all healed up! You can return to your normal life now!” (‘Normal life, what the hell is normal about any of this?! Who I am I now?’) Going to work adds even more stressors to her plate: finances, time away from her child, exhaustion, lack of self-care, lack of support, higher expectations, the list goes on…. The family continues to struggle and just get by. They believe this is the new normal. The relationship between Mom/Baby may or may not improve, Mom’s mood may continue to suffer, and her relationship with her partner may suffer or even end because the stressors are just too much.

Mom has a pregnancy that has been difficult but low-risk. She’s dealing with some perinatal depression (for whatever risk factor -pick one) & she recognizes it. She is stressed about how much this pregnancy & birth will cost out of pocket, but she knows the value in this personalized care. She knows it will all work out somehow. She goes to her Midwifery appointment… She sits down with this woman and the first thing she is asked is “How have you been feeling?” She explains she thinks maybe she is dealing with some perinatal depression. The Midwife asks her questions that show this Mother is at higher risk for a perinatal mood disorder; “Have you ever struggled with it in the past? What is your relationship with your partner like? Do you have any family or friend support? Any recent stressful events in your life? What has your nutrition been like?” They discuss these things in detail. The Midwife relates and shares a story about her own struggles. She may recommend things like: A few changes in her diet, additional nutritional supplements, a local mother’s support group, a local counselor, more sleep, journaling, some lab work to find deficiencies, holistic methods like energy work, acupuncture, or homeopathy. The Midwife asks her which of these things she feels like she wants to do (thus empowering the mom to make decisions about her health.) They have a plan and the Mother is pleased with having options! The Midwife makes note to keep an extra eye on this woman in the postpartum period as well. An hour later, they have assessed her health holistically.

At each subsequent appointment they discuss the Mother’s mood and make any necessary changes, but the Mother decides she feels comfortable managing without the help of a psychiatrist or pharmaceutical. The Midwife sends her a text in between appointments to check in on her and to see how she is doing with the plan they created. At her final appointments they have topics of discussion, things they recommend mom does some research on, the Midwife can answer questions the family has, give a different perspective and educate. The Midwife encourages her to create a plan for her postpartum. People she can rely on, resources, postpartum supplies and encourages her to create a meal train. The Mom is excited because she never thought of this before.

Mom gives birth in the space she chooses (home or birth center). With only supportive staff and family/friends, those who are well equipped with the knowledge and tools to help her have an empowering, enjoyable, safe & healthy experience. In a warm environment. But she still feels a little weird about not feeling bonded to her little one yet. The Midwife discusses this with her and lets her know it can be normal and gives her tools on how she can increase the bond between her and baby. The focus is on BOTH Mom and baby.

Mom struggles with breastfeeding, she didn’t realize it would be this hard. The Midwife relates. The Midwife assesses baby for any physical aspects that might prevent baby from getting a good latch. Oral ties? Needing chiropractic care? Mom’s nipples? Small mouth? Early baby? Or the more basic struggles? Midwife gives recommendations to: La Leche League support groups, online resources, a local IBCLC, someone who can release oral ties, a chiropractor, and teaches mom how to express and feed baby her milk through another method to get her through the struggles. Midwife might even connect her with someone who has some donor breastmilk should she need any sort of supplementing.

Midwife sees baby on days 1-3 of life and weeks 1, 2, 4, & 6. They discuss Mom’s mood, how bonding is going, how her physical healing is going, and they work through any struggles. She assesses the baby for their health & well being. She welcomes mom with warm tea, a smile, a hug, and a little goody bag. She reminds the family that Mom needs to stay in bed for at least the first week and around the house for the second & third week for optimal healing. The Mom shares that she has to return to work at 6-weeks so they discuss: pumping, taking it easy upon returning to work, offers to write her a letter for light duty, reminds her that her housework can suffer for a while, reminds her that nutrition is important, and reassures her that her and baby can still bond as well as Mother’s who stay home. She asks how things are going between the Mother and her partner. She shows interest in their personal life.

So, what is your experience worth??