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Should You Use a Midwife?

Labor of Love

But according to mothers who extol the praises of midwives, it's in the delivery room that CNMs work their particular brand of magic. During the many fits and starts of a typical labor, midwives work to keep a woman motivated and on the move. "We walked the hospital corridors in something like a conga line -- me, my husband and my midwife," says Terez Giuliana of Lansdowne, PA. "My labor lasted 14 hours, and she was there for me the whole time -- unlike the labor nurse, who was in and out, and went off her shift before my baby was born."

This kind of constant attention and moral support is one reason women who deliver with midwives tend to need less medical intervention, says Marie Bridges, a CNM in West Columbia, SC. "One hospital procedure often leads to the next," she explains. Fetal monitoring confines a woman to bed, which would prevent her from taking advantage of some strategies that many women find helpful in reducing contraction pain, such as walking or standing in the shower. That, in turn, might make her more likely to want an epidural, which could make it more difficult for her to push. At that point, Bridges says, the possibility of a forceps delivery or a c-section increases. "Because we stay right by her side, encouraging her to shift positions and offering hot showers and massage, a woman can often avoid this whole cycle."

Midwives who work in birth centers, which are geared toward natural childbirth, have even more techniques at their disposal. Whirlpool baths, for instance, are standard at most centers, and for many women, they do make a significant difference. "The birth center was great," says Lynne Anne Baker of San Diego, who had her first baby in a center but had to have her second in the hospital because of a slight medical problem. "If more women had hydrotherapy -- just getting in a shower or bath is helpful -- they'd be able to do it without drugs."

When emergencies do arise, midwives can often resolve the problem, or at least hold down the fort until the doctor arrives. When Sandra Van Rossem's labor was cut short by a prolapsed umbilical cord -- the cord was preceding the baby down the birth canal -- her midwife quickly reached in to keep the baby's head from pressing down on his only means of life support. In this position, the two women were transported on a gurney to the operating room, where a doctor took over for a c-section. "If she hadn't been so skilled, I might have lost the baby," says Van Rossem, a mother of three in Bay Shore, NY.

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