Even though midwives used to be the person to attend a birth, the word "midwife" has become a loaded term in the United States. Sometimes considered antiquated, other times considered an eccentric fad of GOOP readers, there a lot of things people assume when you use a midwife instead of a doctor. Things that, let's face it, have no actual basis in reality.
I delivered my first son with the assistance of an OB-GYN. I didn't really plan on using a midwife, or set out to use one, when I became pregnant with my second, but after some research I decided I was open to one if that happened to be the provider I liked the most. The thing that was most important to me was finding someone who would support my choice to attempt a vaginal birth after cesarean (VBAC), for which my first OB-GYN had already declared I was a good candidate.
This actually wasn't terribly easy, because contrary to the recommendations of the American College Of Obstetricians and Gynecologists, many OB-GYNs dismiss the possibility out of hand. If I felt like an OB-GYN wasn't going to legitimately and wholeheartedly help me go for my VBAC, I wasn't going to be seen by them. I was also living in New Jersey which, circa 2014 and when I was pregnant, was the state with the highest C-section rate in the entire country. So there weren't a ton of VBAC friendly providers. In fact, my midwife was the first I found.
So while I was thrilled beyond measure to have found someone who was going to assist me in having the birth I wanted (and could safely have), I also had to navigate the often outlandish assumptions people made when they heard I was using a midwife. Like, for example, the following:
You're Bougie
I found that people automatically assumed that if you used a midwife you are wealthy. And, yes, midwives can be expensive, but there are several factors to take into consideration. For one, if you don't have health insurance, a midwife is probably going to be considerably less expensive than going to an OB-GYN. A midwife will typically cost somewhere between $2,000 and $4,000 for the entire pregnancy and delivery, whereas an OB-GYN can run in the tens of thousands of dollars. Even if you do have insurance, depending on coverage and deductible, this may still be a more cost-effective option for you.
In some cases, insurance will cover midwifery services, and some people luck into really awesome insurance, like I did. Even going out of network, my entire pregnancy with a midwife cost a few hundred bucks.
You're Going To Have A Homebirth
Sure, maybe, but that's not something one can really assume. In fact, more and more hospitals are working with midwives to give patients more options in their healthcare. I personally delivered in a hospital (having had a previous C-section, I was considered higher-risk and advised to deliver in a medical facility).
You're Secretly Judging Everyone Else's Birth
There are going to be a-holes from any group who will judge you. People who go with midwives. People who use OB-GYNs. People who don't have kids. People who have a dozen kids. But most people really aren't judging, largely because they just don't care. Live your life and don't worry and please be assured that someone using a midwife does not de facto mean they have Very Strong Opinions on how you should or should not be giving birth.
You're "Going Natural"
Ha! Yeah, no. Granted, if someone is opting for a midwife-assisted birth the chances are probably higher that they're going to be forgoing medical pain relief, but let me assure you that some of us loved hard on those epidurals. Not only that, my midwife was all about them! She thought they were a great option for some people.
(My epidural wore off, meaning I sort of "went natural," but I promise it wasn't on purpose or preference.)
You're Don't Trust Doctors
I love doctors. They're like body magicians! I saw a doctor for my first pregnancy and was actually looking for one for my second, but just wound up falling hard for my midwife. It wasn't an issue of "I must stay clear of all the evil, money-hungry doctors because they hate women and babies!" It was more like, "Oh, I like this provider. Oh, she's a midwife. Cool, cool. I guess I'm going to a midwife then."
You Don't Like Modern Medicine
Again, I love it. But I've heard a lot of people assume that if you choose a midwife you're also, like, a vaccine skeptic and use elderberry syrup instead of antibiotics and all that. And, again, I'm willing to bet that there's more overlap between "natural wellness folks" and "people who choose midwives" than for people who choose OB-GYNs, but it's hardly a perfect circle. I'm moderately crunchy when it comes to medicine, but I've never used colloidal silver for anything and my kids follow the Center for Disease Control and Prevention's vaccine schedule.
Your Midwife Has No Medical Training
OK, so this is a tricky one because it can depend. Technically, anyone can call themselves a midwife. There's no single governing body that hands out the title. However, not all midwives are created equal. A midwife may have any number of different professional "letters" after her name. A "CNM," for example, is a "certified nurse midwife" who received a primary degree in nursing, followed by a degree in midwifery and was certified by the American Midwifery Certification Board.
That means "midwife" can range from "this person has extensive medical training and has admitting privileges in a local hospital" to "that's Linda — she likes babies and she'll help you push yours if you promise to water her plants while she's at Burning Man next month." It all depends, and you can't really make sweeping generalizations based exclusively on the term "midwife."
A Midwife Is The Same Thing As A Doula
Doulas are there to help support your choices in birth and, perhaps, provide pain management techniques. They do not make medical decisions for you, give you medical advice, or deliver your baby. Doulas are there for mom. Midwives are there for mom and baby.
You're Being Reckless
Again, based on the fact that regularly practicing midwives nowadays generally receive some sort of certification, a person probably isn't being reckless or bucking the advice of a medical professional if they choose to have a midwife assist their birth. Is it possible? Sure. Is it your business even if that's the case? Really, it isn't. So keep your thoughts to yourself but, honestly, it's a good rule to just trust people to make their own medical decisions.
You're An Idiot
*insert Spongebob meme here* yOu'RE aN idIOt!
