13 Things Your Doctor Won’t Tell You (But Your Midwife Will)
When I shared a photo of my breakfast that served as a replacement to that awful tasting glucose drink on my Facebook page, the comments came rolling in.
“Oh I wish I had known back then, I was so sick while pregnant and that nasty drink did not help.” ~ Karla C.
“Wish I’d known there was an alternative, both for my health, my daughter’s, and for the simple awful taste of that garbage!” ~ Chelsea R.
“That stuff is so gross! If I knew then what I know now…” ~ April H.
“What!!! Thank you!” ~ Amanda J.
It never occurred to me how many women were in the dark about pre-natal and birthing options but then I remembered that with my first pregnancy I had no idea what I now know for my second. It’s really quite sad that birthing babies has become such an industry — for the lack of a better term — and so many of us don’t know the options we have. I think birthing a baby should be all about empowerment, knowledge, and support… and unfortunately in the United States, birthing a baby for the mass majority of women is far from those three things.
After reading all the comments about women not knowing they had an alternative, I had the burning desire to create a resource that helps Mama’s navigate through this crazy baby industry. It is our bodies, our babies, and it is our right to be 100% educated on all the options so we can make a decision that we feel comfortable with.
The most important thing you can do
In my Facebook post, a good number of women had tried to ask for an alternative and their doctor either said there was no alternative, or basically threatened their pre-natal care at the office. I asked my midwife Katie if it was legal for doctors to do that, and unfortunately, it is. The only thing you can do at that point is to find a different care provider. For some moms, this may not be an option.
That is why it is incredibly important to make a list of everything that is important to you (things you don’t want to do and things you do want to do) before you start checking out health care providers. I know it seems kind of funny, but going to see where you’ll spend the next 9 months of your pre-natal care is sort of like choosing the right job for yourself. There is NO harm in “interviewing” your doctor and asking what their stance lies on the important things you want to skip, find alternatives for, or take part in when it comes to the pre-natal care, labor and delivery, and post-natal care of your pregnancy.
Remember, it is YOUR body and YOUR baby and you absolutely have EVERY right to see that your wishes be respected through the duration of your pregnancy and birth.
During the “interview” time if you meet with a doctor who doesn’t believe in giving alternatives or respects your wishes for your pregnancy, it’s best to say, “Peace out!” and continue looking. By doing this “interviewing” in the first few weeks of pregnancy, you won’t have the abrupt pressure or fear when you’re halfway through your pregnancy and all of a sudden your doctor is putting the brakes on what you don’t want to happen.
So, without further ado, here are 14 things your doctor won’t tell you (but your midwife will).
1. There IS an alternative to the chemical shit-storm glucose drink
I didn’t have to take that nasty, genetically modified, artificially sugared, preservative-filled glucose drink. Instead, for my glucose screening, I had a 12oz glass of organic orange juice, two scrambled backyard eggs, and a piece of sourdough toast with more than a moderate amount of butter and fig preserves. There are alternatives to ask for but if you get denied for an alternative, know that you either have to take the drink or find a different health care provider.
2. The umbilical should NOT be cut immediately after birth
From my post, 6 Things I Wish I Would Have Known Before I Was Pregnant with Baby #1:
A study published in 1995 showed that infants who had delayed cord clamping end up with 32% more blood volume than infants who have their cords cut immediately — without any increased health problems. A few more recent studies can be found here and here.
It is NOT life threatening for you to stay connected to your baby until the cord stops pulsing. Don’t let your doctor tell you otherwise!
3. Eye goop in newborns is (most of the time) unnecessary
At my latest midwife appointment, I had asked my midwife Katie what her thoughts were on the eye goop that is routinely given to babies after birth. She said originally it was because of babies being infected with gonorrhea and/or chlamydia. Since pregnant women get tested for these STDs before the baby is born, if the mom test negative for these diseases, there is absolutely no reason a baby should get the antibiotic goop in their eyes.
Katie also said that the antibiotics could be for any other infections that may happen, but it’s best to deal with the infection — if there even is one — at the time of notice, instead of routinely administering it. Here’s a great article on the risks and benefits of administering routine antibiotics eye goop to all newborn babies.
4. There ARE other options when it comes to the location of birthing your baby
Considering you are a low-risk pregnancy, there is no reason why you couldn’t birth your baby at a birth center or at home. When we went to our first birth center visit, I was amazed and a little shocked because I had no idea how radically different the settings were from a hospital. It was in a quaint little building that felt warm and welcome when you stepped into the doors. When they showed us the birthing rooms, they felt homey and comfortable — not sterile and white like hospitals are.
Another option would be to have your baby at home. I talk more about why I choose to have a home birth in this post.
5. Low risk women are better off having their babies outside of a hospital
The moment you step into a hospital to give birth, you automatically have at least a 30% chance of having a cesarean. Isn’t that insane? The truth is, doctors are on a schedule. They need you in and out, so they can wheel the next Mama in. If things aren’t progressing to their liking, they could recommend — or even scare you into believing — you need to have a cesarean.
6. It is perfectly normal for a woman to push for hours when having her first vaginal birth
Labor is different for every woman. There is no standard curve you can apply to everyone for the amount of time labor and birth should take. Don’t let your doctor make you feel rushed, because that can also inhibit labor progression.
7. For low-risk pregnancies, multiple ultrasounds are unnecessary
I know, it’s super exciting to see your baby’s face and little fingers and toes develop as the weeks go by, but for low-risk pregnancies, multiple ultrasounds are unnecessary. I’m guilty of this with my first baby, and even got the 4D photos and video. However, after I read about the possible dangers of exposure to ultrasounds, I decided for my second baby the only ultrasound we would get was to determine the sex.
There are studies showing that exposing your baby to the sound waves from the ultrasounds can be unhealthy. This was the eye-opening post I read about sonograms and why I decided to opt for only one this time around.
See also: 17 Scans in One Pregnancy
8. YOU are in charge
You deserve to be informed so that you can choose what’s best for you and your baby. Period.
9. Babies don’t need to be washed right after birth
The “stuff” babies have on them when they are born is actually very beneficial. There is no medical need to wash the baby.
10. In fact, babies don’t need to leave your chest at all for at least the first hour
What they call “skin-to-skin” or “kangaroo care” is incredibly crucial for baby AND mom. Read more about skin-to-skin care here. The World Health Organization recommends an hour of uninterrupted skin-to-skin time, but if you can go longer, do it. All the measuring, weighing, etc., can wait. There is no dyer need to get that done.
11. One week late is NO reason to induce
Sigh, I really, really, really wish I knew about this for my first. I was a week late and the doctors automatically scheduled me to be induced. Not knowing any better, Scott and I agreed; we just thought that’s what you do. We didn’t get to go through the natural laboring process and now looking back, it was awful. The photo below is me on my “due date.”
The truth is, according to Evidence Based Birth,
The traditional way of calculating the estimated due date (40 weeks after the last menstrual period) is not evidence-based. Instead, it is more accurate to give women a range of time that they will probably give birth:
- About half of first-time moms will give birth by 40 weeks and 5 days after the LMP, with the other half giving birth after that time poin
- About half of moms who have given birth before will give birth by 40 weeks and 3 days after the LMP, with the other half giving birth after that
- An ultrasound before 20 weeks is usually more accurate than using the last menstrual period, and the accuracy of an ultrasound is highest if it is done between 11 and 14 weeks.
There is a rise in the relative risk of stillbirth starting at about 39 weeks, depending on which study you are looking at. However, the overall risk is still low up until 42 weeks. At 42 weeks, the risk of stillbirth rises to about 1 in 1,000 in babies who are not growth-restricted. The risk may be higher in some women who have additional risk factors for stillbirth. (source)
12. Continuous fetal monitoring during labor is not necessary
There are two main types of fetal monitoring: continuous electronic fetal monitoring or EFM (87% of U.S. women) and intermittent electronic fetal monitoring (4% of U.S. women) — both of these fetal monitoring ways have mom attached to machines. Learn more about the differences of the monitoring here. The theory behind the reason for monitoring mom’s contractions and baby’s heart is to identify oxygen problems in the baby so that you can intervene and prevent complications such as cerebral palsy, brain damage, newborn seizures, or death (source).
3% of U.S. women actually use intermittent auscultation. With intermittent auscultation, the monitoring is done by using a fetal stethoscope or a handheld doppler device — this means mom is not attached to a monitor the whole time she’s laboring (which also can prohibit movement during labor). According to evidence of this study, the best method for women to use is the intermittent auscultation.
In Evidence Based Birth’s article Evidence-Based Electronic Fetal Monitoring, they state,
There were no differences between women who received intermittent auscultation and those who received continuous EFM in perinatal mortality, cerebral palsy, Apgar scores, cord blood gasses, admission to the neonatal intensive care unit, or low-oxygen brain damage. These findings were consistent in both low-risk and high-risk women. There was a lower risk of newborn seizures in the continuous electronic fetal monitoring group; however, overall, seizure events were very rare (0.2%)
Women in the continuous EFM group were 1.7 times more likely to have a Cesarean and were slightly more likely to have a forceps/vacuum delivery when compared to women in the intermittent auscultation group. Women in the continuous EFM group were also more likely to require pain medication.
Interestingly, the researchers found an interaction between Cesarean rates and continuous EFM. This means that in hospitals where there are higher Cesarean rates, continuous EFM may lead to an even higher risk of Cesarean delivery. (source)
13. Eating and drinking during labor is very beneficial
I remember my doctor telling me the day before our scheduled induction at 41 weeks that I wasn’t allowed to eat anything past midnight. I also remember being hungry and thirsty while I was laying in the hospital bed laboring and only being allowed to eat ice chips. Once Andrew was born, I was extremely hungry.
The truth is, I could have eaten and drank water through my labor — even with an epidural and pitocin. The only reason doctors don’t want laboring women to eat or drink anything in the hospitals is because of the risk of aspiration — breathing in stomach contents if you vomit under anesthesia — (which is extremely low) if they need a caesarean. Researchers looked at 11,814 women who were given the freedom to eat and drink during labor, with some women requiring emergency C-sections. There were zero cases of morbidity or mortality reported from aspiration pneumonia, even though 22% of women had eaten solid food (source).
When you think about it, how is a woman supposed to successfully push out a baby when they have no energy because they haven’t eaten for hours and hours? Could this be related to the high caesarean rates because of “failure to progress?” Now that is a good question.
MORE NATURAL PREGNANCY POSTS YOU’LL LIKE
All About Midwives and Home Birth: A Q+A With My Midwife Katie
I am a gynaecologist. And I do say all that to women (and some more things)
Thank Toni – In the county where I practice we do not have this privilege. It is so heartwarming to know that there are doctors like you out there.
I was just going to add that my doctor has actually told me all those things and THEN some. She’s very helpful and understanding of anything/everything I want when it comes to having my son, especially the delayed cord clamping and waiting to wash the baby. She told me they would do whatever the mom requests. Maybe you just had a bad hospital experience? Either way I think there are a lot of variables involved and that yes some hospitals are up our butts about everything, but I do think there are other hospitals that are actually very accommodating.
With the midwife…I’ve known many women who have hired a midwife and their baby’s have actually died because the midwife could not take care of them the way a doctor/hospital could. Just recently I had another friend who had to be rushed to the hospital after 48 hours of labor because she was dehydrated and couldn’t keep anything (water, etc.) down. She was about to lose her baby but fortunately she reached the hospital in time and they gave her an IV with fluids to stabilize her. Besides the IV in her arm she continued to have a natural labor and eventually had him.
My comment really is that as women we have the right to go to a hospital or hire a midwife/doula, whatever we want really. It’s our body that is having to go through it all, but I think it’s SO important to research and really know the hospital/midwife you’re using :). It was nice to read this post!
Yet you spelled gynecologist wrong.
That’s how it’s spelled in Britain and other English-speaking countries, fool. That’s the ORIGINAL English spelling. Maybe learn something outside of your US-centric ignorance? Maybe don’t assume you know more than an actual doctor? This comment is so embarrassing. I’m embarrassed to be from the same country as you.
for my second child I chose to take my blood sugar for 5 days 2x a day. One fasting and one after a meal instead of doing the nasty drink. I felt like it was more acurate because the midwife and i could looknat what i ate and see how it affected my BS instead of shocking myself with sugar and seeing how my body handled it in that one instance.
I love how you question status quo of the birthing routine. I hope you will research the current belief in water fluoridation and its effect on morning sickness, inhibiting progress of labor, reflux and neurological harm in newborns on formula made with tap water. Potential harm totally outweighs any theoretical good.
Thanks for bringing that up Susan. I will have to look into it.
everything is spot on except #7…midwives following a gentle birthing for mum and baby will help to coach the mum to let her body do the work and to not push for hours, hell not until the baby is ready to come out…tiring strain on both mum and baby.
Most of these my doctors told me. I think it is good to know there are options out there, but it is also important to discuss things with doctor and not just decide things because an internet list said so. Sometimes certain things are necessary. Like I was induced because I had high blood pressure and border line pre eclampsia and being past 36 weeks, inducing was the safer option. I did get taken off the monitors in order to walk around, but after ,my water broke, baby;s heart rate kept crashing and elevating too high, so again it was the safer option to stay hooked up. Then after about 20 hours, I had to have a c section as my contractions were inconsistent in every way, my labor was not progressing, and my baby’s hear rate was too low. Again, sometimes these things on this list are true, but I feel like my doctor’s main goal was a healthy mom and healthy baby and not their convenience. I might be more defensive about these things since I experienced them, but these lists come across as critical to women who have tho have those things.
I’m a doula and a student midwife. You posted some very important points that I wish more women knew. Thanks for compiling this list…and certainly there are other points to add to it. There are so many resources “out there” for women to refer to, it’s hard to be discerning for some who are new to this season of life. I’d recommend they start doing some reading in Spiritual Midwifery by Ina May Gaskin, Immaculate Deception II by Suzanne Arms, & The Complete Book of Pregnancy & Childbirth by Sheila Kitzinger. Of course, there are heaps of other great books re: holistic pregnancy & birth, but these are great ones to begin with. Thanks for your awesome contribution toward dispersing the truth re: birthing options.
My children were born at 42 weeks and 42+2days. Perfectly healthy.
I have no problem with not eating during labor, because I vomit profusely. It’s how my body “speeds” thing along. I vividly remember vomiting the cereal from hours prior (Captain Crunch Berries), and think I threw up about 8 times. With my second, I remember being envious of my husband, after having me set in my room, he grabbed him some breakfast. I wanted some so badly, and almost ate some. Then the vomiting set in and I was so glad I didn’t indulge.
I know I am super late on reading this but super helpful post! I will say that I am seeing a hospital based midwife and she does not bring up these things, I have to bring them up, but she is on board with the ideas, just not forthcoming which is frustrating. But I guess just strengths my resolve to be an informed mama! Thank you so much for this information and links to the research to back it up. I’m going to my 32 week appointment tomorrow armed with more questions and notes for my birth plan!
My first baby I started natural labor on my due date even though I was scheduled for an induction (I was having fluid leaking from a secondary sac not the main one but it was cause for some concern to me). I did the 4D with both kids and loved the experience, it was a private sonographer who told us how he lowers his machines so they have as much punch as ones at the doctors since the scans were for “fun not medical treatment.”
Now with my first my last Doctor sonogram was at 20 weeks. All was well. My second baby I got a scan at 36 weeks unbeknownst to me the policy had changed (my kids are only 21 months apart). So that one was normal she was headed to the 9lb mark (8.3lbs was the first one and the second ended up being 9.7lbs). I measured my normal two weeks ahead in baby and fundal height. But at 38 weeks my fundal height was 42cm. Normally, they give you a 2cm either way but at 4cm difference they consider you high risk for excessive fluid. However my doc held off another week. I developed a burst varicose vein a few days before my next appointment. My body was screaming at me. At my 39 week appointment I was 46cm. He sat me down and told me I was now medically unsafe to continue. I have to admit I was thrilled to be induced that day, my body had enough.
After induction started I was on the full dose of pitocin with absolutely no contractions. He came in and broke my water. They estimated later I had over 4 GALLONS of waters, you normally have 1ish. The contractions started and less than 2 hours later she was here and healthy, I would have NEVER been able to contract since I was soo stretched out.
My first I had an epidural because I was blacking out with sciatica labor (not even close to pleasant). I had an epidural with the second because my bp shot up again and once given it instantly came back down. So while I agree you should know you have options it doesn’t mean normal procedure isn’t good. It caught my conditions early even though I had normal pregnancies.
Plus I am one the few women who liked those drinks for glucose. Ours is naturally orange flavored glucose and that stuff was so good I licked the cup the first time I drank it (I couldn’t tolerate any sweets so it was the first sugar I had in 28 weeks), the second time I didn’t lick the cup but neither time was horrible. I believe eating real food is a better judge but if you have that option it shouldn’t be the end all to a good doctor relationship.
#10 – It’s “dire”.
Let’s be careful about pitting midwives against gynecologists. Both are professionals who are dedicated to women and their babies. Are there some uncaring weirdos? Yes – on both ‘sides’. Personally, I prefer having the expertise of a medical doctor. All 3 of our kiddos were born in the hospital (yay, no mess to clean up from our sheets), and all three births were done without pain meds and with doula support. My doctor was always supportive of me and my needs. The doctor versus midwife rants aren’t helpful.
Great post! Loved it all and I have had the same experiences as you. Midwives are great trained medical professionals and I believe they are highly undervalued. While midwife care may not be for everyone, they most certainly should be sought out by low risk women. So many uneccessary interventions in hospitals with doctors who think every woman needs to give birth the same. I’ve know too many women who just “want baby out now” that they will literally do anything to have the baby even if baby isn’t ready. We need to let women go back to laboring naturally and letting nature take its course on labor. I feel like we are breeding a generation that is full of too many interventions. If we as mothers don’t let our bodies take the natural course on labor, how are we setting up our future generations of children too? Just my thoughts.