Private vs public vs independent midwifery...

Here is an email I sent today to a friend who asked me my advice about models of prenatal care.. I thought I'd post my response here as I feel it could help others who are considering threr options.

Hi there!

I would be happy to give you advice based on my research and experience.

I chose public hospital midwifery care for Molly's birth. This meant everything was covered including all tests. The reason I chose public care was less due to cost though and more due to the MUCH lower rates of intervention and cesarean section. Midwifery care is recommended by the World Health Organisation as the gold standard of care. Obstetricians are very good at working with high risk mothers however (with the exception of a few) they treat all pregnancies as if they are high risk- that's what they are trained to do. Pregnancy is not a medical emergency and midwifery care is a much better option for a healthy mother and baby. Private hospitals have much higher cesarian rates than public hospitals. *** 

This time I am choosing to pay an independent midwife and give birth at home. I felt that being in the hospital system caused much of the drama that happened with Molly's birth. I was pregnant until 42 weeks and because of hospital policy (no clinical evidence to say either of us were not ok) I was induced and ended up with a very traumatic birth experience. No cesarean luckily but forceps and a big episiotomy and then breastfeeding dramas due to Molly being (in my opinion) unnecessarily put in the special care unit. 

So now I have a midwife (Joy) who has been working since 1973 to be with me when I give birth. She is caring and nurturing but highly experienced and I feel completely confident in her care. I have a hospital backup if I need it and Joy is trained to pick up any signs early which may indicate I need to transfer. We don't have a lot of spare money but I feel this is an expense I would go into debt for as it is so important to me to avoid the same kind of thing that happened with Molly.

Birth environment is exceptionally important when it comes to having a calm and physiological birth without the need for interventions. It is another process of elimination (like pooing! lol) and requires the same kind of safety and privacy to prevent getting "stage fright". Imagine having to do a poo in a room full of strangers with a bright light shining on your butt?? Or imagine having sex and trying to climax in this same kind of environment??!! It's the same hormones that got the baby in that will get the baby out and they can be easily disturbed. That's why there are so many more interventions in hospitals. It just doesn't always feel that safe and secure (but it CAN of course). The body knows what to do, however you can increase your chances of a really good birth by choosing your birth environment carefully. (SEE Dr. Michel Odent's work and Dr. Sarah Buckley)

There is some extremely good evidence based information here: http://www.birthready.com.au/articles/choosing-your-caregiver/ 

Hope this helps.. I am definitely biased but have done my research.

xo

Ash

** I have removed a sentence about obs making money from performing procedures as I realise I need some stats to back this up. While I am pretty confident in this statement, I am choosing to remove it as I don't have the data at this moment.