There is a continuum of schools of thought regarding childbirth. On one end of the spectrum, some believe that birth is an inherently dangerous medical event. This person feels safest when the pregnancy and birth is managed by their provider with every screening, test, and intervention available to ensure the safest outcome. On an opposite end of this spectrum, some believe that birth is a natural physiological process which should have minimal or no intervention. They may wish to have a free-birth, they may forgo all testing or screening and they may deliver their babies unassisted. Along the spectrum, there are several other thoughts and beliefs about childbirth which may include choosing a hospital midwife or a homebirth midwife, and choosing to deliver in a birthing center or at home.
Before I had children of my own over 10 years ago, I often heard the sentiment among coworkers and friends going through pregnancy that you “don’t get a trophy” for having an unmedicated birth. A friend said her OB laughed at her when she asked about having an unmedicated birth. Today, I’ve noticed birthing people are seeing the value and the power in having choices, education, and support as they navigate through the transformations of pregnancy and birth. There has been somewhat of a revolution over the past 10 years where families are “taking back” childbirth into their own hands and into their own homes.
Your choice of provider is likely to be the biggest influence on your birthing options. What are some of those choices? Obstetricians (OB), Certified Nurse Midwives (CNM), and Certified Professional Midwives (CPM) are some of the providers you may choose to care for you through pregnancy, birth, and postpartum.
In a hospital birth, you may choose to see an OB, Perinatologist, or CNM for care for you during your pregnancy. They will provide all the routine testing and screening to all pregnant people and monitor and manage the pregnancy, labor, and birth as they determine to be necessary. Only some of the practices have CNM’s who you can choose to see during your care instead of the OB. CNM’s may offer a more holistic approach but still complete all routine exams, write prescriptions, and attend births instead of the OB. OB’s support all births, low and high risk, and can perform a cesarian if needed. Routine appointments with an OB will be around 15 minutes, sometimes a little longer with a CNM. The appointments focus on screening and testing for pathology during pregnancy. There are several wonderful hospitals in the area. They offer life-saving interventions and provide safe and comfortable places for birthers to come and birth their babies. This is a great option for those who have high risk situations or those who feel safer birthing in a hospital setting.
In Ohio, there are not currently any out of hospital birthing centers. There are two birthing centers in the area that are located inside of hospitals – Natural Beginnings is located at Atrium Medical Center in Middletown, and Family Beginnings located at Miami Valley Hospital located in Dayton. These facilities are both located within the hospital. They each have a few different providers who attend births at these locations. They are a mix of CNM’s and OBs. You can choose to see the midwives or the OBs if you choose care through any of those providers. The birthing centers are intended to support low risk birthers who desire to have an unmedicated birth in a hospital, but in a more home-like atmosphere. If the birth becomes deemed high risk at any point, the birther will be redirected to the typical hospital delivery floor.
Another option is a homebirth with a midwife. There are current efforts happening in Ohio to license homebirth midwives (CPM’s or Certified Professional Midwives) in Ohio. Other states have already made this move such as Kentucky. There are several midwives currently supporting homebirths in the area. You can expect routine appointments with a homebirth midwife to last 60-90 minutes and provide a holistic approach. They focus on overall health and nutrition, emotional wellbeing, and will assess any concerns or risk. These midwives support low risk birthers who desire to have an unmedicated birth in the comfort and privacy of their own home. This is a good option for those who are looking to have a family-centered physiological birth. Midwives may continuously provide risk assessment throughout the pregnancy and birth, provide interventions when needed, and recommend transfer of care when warranted.
No matter which way you go, the important part of choosing a care provider is understanding where your provider lands on the continuum and determining if you are comfortable with accepting their level of management or risk.
Stephanie is a labor/birth doula and childbirth educator located in Liberty Township, Ohio. She is a mom of four children who were born both at home and at a hospital. She has supported women all over the Cincinnati and Dayton regions in a variety of unique birth experiences and locations. If you are looking for a birth doula in or around the Cincinnati and Dayton areas to help you navigate pregnancy, labor, and learn about the differences in providers and choices they offer, contact Stephanie for a free consultation.
Happy Birthing!
-Stephanie
Liberty Doula Services | Cincinnati & Dayton Ohio Doula 