I had midwives for both my kids' births, the first one in hospital and the second one at home. VERY VERY VERY HIGHLY RECOMMEND INDEED.
Mind, I am in Canada, so some of the administrative aspects are likely to be different from what you can get in the states. Here (in ON anyhow - not all provinces cover midwifery yet) midwives are covered by provincial health care just the same as an ob/gyn would be, woo hoo. The midwives have hospital admitting privileges and can also do homebirths; I believe in Quebec there are also midwife-run birthing centers. The midwives do operate under fairly restrictive rules in terms of the conditions under which they are required to turn over primary care to a doctor, although they still remain a part of the 'team' so to speak. Our midwife care includes all prenatal care (monthly appointments starting at 6-8 wks, more frequent in later pregnancy) plus 6 weeks of postnatal care.
It is great that you are taking the time and energy to educate yourself before getting pregnant, and thinking about what kind of care you want. If you read the literature (and I do mean the mainstream medical literature) it becomes quite clear that typical hospital/ob-gyn practices are most often NOT in accord with what research and statistics show to be "best practices". For instance, read up on EVIDENCE-BASED recommendations on the utility of routine 2d trimester ultrasounds, continuous fetal monitoring in labor, "schedules" for progress of labor, c-section rates, or effects/consequences of epidurals... and then compare to statistics of what most often HAPPENS. Scary.
Unfortunately not everybody is in a situation where they can have good care in pregnancy/labor no matter how much you educate yourself, but at the very least you can put your foot down where you CAN put your foot down, and do a lot of things to minimize the chances of getting railroaded into counterproductive interventions.
As far as my specific experiences... despite being discouraged by my family dr from using midwives (because I was 39 when the first kid was born, and 42 for the 2nd one) I saw midwives throughout both pregnancies (and for two others too that sadly ended in miscarriage). Appointments were usually 1/2 hr long and we talked about a variety of things, much better than the usual revolving-door type doctors office appointment.
The first birth, in hospital (cuz I couldn't convince DH to "allow" me to do homebirth the first time), I am positive would have been quicker and gone more smoothly had I not had to take that 40-minute car trip to the hospital in the middle of labor, but even so, it was not too bad and (the following is Ontario-specific) I did not even SEE a nurse or doctor the whole time I was in hospital except for the admitting nurse; it was just the two midwives. Really great. I went home the next morning (would have been same day except Harry was stressed from a long pushing stage of labor and I sort of chickened out about being alone with the baby at home the first night
).
The second one at home was much easier, I stood up basically the WHOLE time and thus labor was pretty short (in fact, due to my living at the opposite side of their 'catchment area' from my on-duty midwife, she only got there about an hour and a half before the birth, her student got there as the shoulders were coming out, and the [legally-required] second midwife only actually got there in time for the paperwork afterwards LOL). The midwife finally convinced me that I should stagger over to the bed for the actual delivery rather than poppin' a baby out in the ensuite lavatory
; I didn't even have to push, it was pretty neat feeling how my body just squoze the baby out all on its own
He was kind of pale and floppy at first so they gave him oxygen and rubbed his back and a minute later he was all pink and perfect, and I lay around all morning in my pj's while the midwives ate brownies and did reams and reams of paperwork <g>. It was nice that Harry could wake up in the morning and walk out to the livingroom and see his baby brother for the first time!
I did not recieve (nor ask for) any medications at all for either birth, despite pretty bad "back labor" for the first one. Yes, it does hurt QUITE A LOT (more than you can imagine) but it is *constructive* pain, and pretty much the ONLY pain you ever get in life where there is an absolutely 100% guarantee that it WILL end, probably within hours, certainly within a couple days. I can certainly imagine where if a person's labor drags on for exceptionally long, they might genuinely need pharmaceuticals or an epidural in order to relax enough to proceed, or in order to rest enough to get energy to proceed; but it seems like an awful lot of people weenie out and get drugs when they are not really NEEDED (look at what the rest of the world's women survive...) and there really ARE NEGATIVE CONSEQUENCES of epidurals and suchlike, so I really feel a person should read enough to be able to make an educated decision for themselves.
Summary: midwives, two thumbs up; resisting temptation for pharmaceuticals unless pain is seriously interfering with progress of labor, two thumbs up; homebirth when practical, two thumbs up; educating yourself beforehand so you can make intelligent decisions of your own free will, PRICELESS
JMHO, good luck and best wishes,
Pat
