I had a traumatic homebirth that ended with a lifelong-disabled baby (it's a miracle he's alive after a severe shoulder dystocia). I also sustained injuries (but none to the extent of my son's). My midwife was a CPM (certified professional midwife), which is not really anything afterall... anybody can attain that certification if you pay for a packet and fill it out and undergo an "apprenticeship". She can decide to send in birth notes of clients to MANA (midwifery alliance of north America) that has data on all her client's births or not... so there is not much oversight and any oversight is on a volunteer basis. CPMs do not have to have any kind of insurance, so when births do go wrong there is no lawyer who would take her on in court because there is no malpractice insurance.... it often leaves families in a bind when their infants or selves have to undergo emergency surgeries/lifelong therapies/etc because there is no compensation to help pay for lifelong care even. America really is a mess of system in regards to midwifery certification and standards and even reporting, varying from state to state. Many of us homebirth trauma mamas stay quiet about our births because the community of women we surround ourselves with put a lot of pressure on us to ("not wanting to give homebirth a bad name"), we are afraid we'll lose our friends and community, our midwives pressure us to (I was told not to include our midwife's name on any hospital papers regarding our son), we don't want to feel judged by hospital staff (it's a real fear), we are already undergoing a lot of guilt (either inwardly or family heaping it on us). … It's messy. So messy... I went on to have FIVE C-SECTIONS after my homebirth. They were calm, controlled, healthy, peaceful, joyful, most beautiful (the last one was pretty rocky though) and I felt present... everything my homebirth was not. I'm so thankful to have got to experience raising 5 healthy babies because of them and the ups and downs of raising my oldest always keeps me humble and sensitive to the fallen nature of this world.
If you don't want to give homebirth a bad name or are pressured to, you should atleast be able to warn about medically untrained "midwives". Maybe they should be referred to as somewhat trained doulas to give other people an understanding about their level of knowledge. (Do nurse midwifes accompany homebirths in America or do they only work in hospitals?) How does the homebirth community react to the disability? Is it a topic at all? If the hospital asks for the midwifes name (if that includes "midwives", that aren't highly educated in the medical field) and you are pressured not to mention it, you should atleast tell the hospital the certificate level the midwife had or something like that. Hospitals should be able to educate women, who might take that route. Isn't it in everyone's interest to have safer homebirths?
Not even a mom, I just like Dr. Jones, but you deserve the encouragement for doing whatever you believe is right for your child. Love to you and your family. You sound like an amazing person.
@@MamaDoctorJones There are also issues that creep up beyond regulation of training that need overhauled, but also include: having a "board" that can oversee just like you doctors and nurses have (NARM and MANA do not revoke certifications and do not require birth records/data from each midwife), having a back up doctor close and a working relationship with them (my ex-midwife got her rhogam shots from some doctor out west who she only heard of through word of mouth but never met, same with black market oxytocin... it seems so sketchy now that I say that, but this what happens in the world of the wildwest of homebirths. There is so much emphasis on NOT having oversight that it breeds major distrust and suspicion in hospitals and doctors), a minimum number of professionals attending a birth (2 people-midwife and assistant- are not enough when both Mom and Baby are in trouble), equipment at hand, enforcement of only taking low risk patients, and so on. I really was doing what I thought was best, but statistics can be so skewed depending on a source (and not many talk about the differences between prenatal, neonatal, postnatal statistics and how different countries define things differently and that matters in the gathering of statistics) and so many books that world encourages us to read are written in the 60's and 70's when birth was handled completely different than it is in today's hospitals (it definitely throws in the scare factor for many of us- and there are a lot- who have never met an ob/gyn or been to a hospital before). I was a new farmwife and young mama and just hadn't seen enough of the world where nature fails and falters and it doesn't always matter why to understand the risk to benefit ratio on a reality-based level. I've forgiven myself, but there are definitely times when it's a choice (usually when a new issue crops up regarding my son's day to day life). Thank you for addressing these issues. I love your channel. Have a great vacation!
@@valek7700 The world of homebirthing here is kind of unique in the fact that midwives (whatever their training or lack thereof) are held in a place of honor and almost untouchable, if you want to keep your friends/community. Many midwives take on a grandmotherly role to their patients for the rest of their lives and so it'd be like someone talking "bad" about your grandma when you love your grandma so much (there is not a lot of boundaries in midwifery care here). It's a hard situation to be in because if you or your baby are suffering, you especially feel the need to be surrounded by support so you are really scared to alienate anyone around you (thus many remain silent). When I finally started to share about our homebirth, I would get shut down immediately by others if I said something about a bad judgement call made by the midwife (and there were some pretty big ones). If I talked about her other births that resulted in the more severe injuries of other babies (there were 3 very soon after my own son's), I stopped getting invited to things. *In general, the homebirth community stays pretty hush hush about injuries/deaths. When it does get brought up, it often leads to talk about what the Mom did wrong that lead to it, placing guilt and blame on her shoulders (did she not trust birth enough? did she do this or that?) and the midwife is rallied around. Because of all that, I buried so many feelings (along with the truth) and tried to shrug it off saying, "It would have happened in a hospital too." (which it would NOT have) for a couple years. I did lose a community when I started sharing what happened and the dark side of homebirthing, but I've discovered that the truth is more important than all that. I'm a very conservative person, but I do see the need for regulation and oversight in the medical world and most definitely in the homebirth world.
It's similar in the UK, you can either be a nurse and do a shorter course to become a midwife or do the full length course, the result certification is the same. The system is integrated so unless someone is an independent midwife there is always back up obstetric care and independent midwives have the same access to NHS obstetric care it's just they have to fully transfer you rather than being jointly available the whole time.
In America, to go the certified nurse midwifery route, you must have a bachelors (4yr nursing degree) or complete a year bridge program from an associates degree (has all of the nursing specific courses but none of the liberal arts of a BSN). Then you complete a 2yr masters of science in nursing degree. There is a one year requirement of working as a nurse prior to starting the clinical portion of the MSN program. After the degree has been conferred, the midwife must sit for a national certification exam, after passing they become a CNM. The issue with other types of midwives is that depending on the state, different levels of training are or are not accepted. A certified professional midwife (CPM) is a midwife who has finished a midwifery training program and say for a national exam. Many states see these midwives as legal options and in most of those states these midwives have oversight from the medical board to various degrees. Lay midwives pretty much just hang out a sign and say they are a midwife. They likely have had some level of training but haven’t taken any credentials exams. They aren’t considered legal in most states and these are more often than not the midwives that make the media when things go wrong.
Re midwife: in Denmark we don't use doctors for births. We use midwives only, unless it's a c section or high risk birth of course. Midwife here is a standalone education (bachelor degree, and can go on to masters and so forth).
Yeah and not surprisingly Denmark, AUS, UK, and Sweden all have much lower mortality rates for mothers and babies than the US. It’s atrocious that this country refuses to do anything about it. I’m trying to get presidential candidate Andrew Yang to look into midwife-led care and seeing if he can possibly research and release a policy proposal for changing the US obstetric system from medical to midwife. Until then though you won’t catch me stepping foot in a hospital to give birth unless I’m high-risk. I don’t trust it. The fact that I’m 50% more likely to die giving birth in the US than my own mother was and the mortality rates deeply validate my reasoning for this, at least I think so. 🤷🏽♀️ lol
Same in France! I'm in my 3dr trimester for my first baby in Strasbourg. They would only use a doctor in case of complication. What's the history behind this in the US, I wonder? Will have to hunt for literature.
My grandmother was a licensed midwife during the depression, 1920's-1940's. She was also pretty much the town doctor, since, being in a rural area where a real doctor was about 50 miles away. She set broken bones, and fixed minor problems. Of course, if it seemed life threatening, she had someone drive them to the hospital. BTW, of all the babies she delivered, mothers and babies all were healthy. She didn't loose one. Not many doctors, of her time could say the same. She was my hero. Loved her so much.
In germany, there has to be a midwife, when you give birth in a hospital but no doctor (when there is no risk). In fact, midwives are allowed to throw the doctor out!
My mom was a midwife in the Amish community for twelve years, and she was really good at determining when labor wasn't going smoothly and they needed to transport to a hospital.
Just to add to clarify - in the UK, our midwives qualify by taking either a three-year degree course or by first qualifying as a nurse and then later taking a supplemental 18-month post-nursing qualification. Around half of that time is spent in actual practice (so being present at births, prenatal checks etc) and the other half in learning all the theory and medical information they need to know. This is why, in the UK, midwives take the bulk of the prenatal care and deliveries, and obstetricians are generally reserved for the odd checkup or more regular care and delivery of higher risk cases etc. But there is always back up available from GPs, nurses, and hospitals. The concept of non- or under-qualified "midwives" is positively terrifying. You put your trust in that person to help ensure a safe birth for mom and baby, and the idea that they simply aren't is horrifying.
@@rosiehoy4736 To be clear - it depends entirely. There are a variety of qualifications - some (such as CPM and CNM) do multi-year courses or start off as nurses who then take a second, shorter midwifery course too. You can't (presumably) call yourself that if you're not qualified and registered to do so. But yes, the fact that in other states, you can have much less qualified people being midwives is... terrifying.
Same in Australia, I wonder if that contributes to the high rate of maternal mortality that the US has compared to other countries like UK, AUS, CAN and NZ where it is regulated.
What I find annoying though is how in the UK people are comparing independent midwives who operate outside the NHS to minimally or unqualified midwives in other countries and attempting to put them out of business. Midwife is still a protected term, so any independent midwife would have to complete the same training as any midwife on the community rota or a hospital ward. I'm not sure that if I had another child I would want to go back to an NHS hospital as the experience was pretty awful from my point of view. The whole thing where you're basically on lockdown was just frightening, I starved for 3 days because the food was so dreadful, you have fucking SALESPEOPLE barging into your bedspace. Fuck that, I'll freebirth at home before I do that again.
@@littlelaur94 I haven't done that (nor has anyone here in this comment). I'm sorry you had such an unpleasant time in hospital (and I personally agree on the fact that they allow overpriced photograph salespeople and the whole Bounty thing is pretty obnoxious - though offering decent quality and reasonably priced photos as an option for those who want them is okay). Sadly the food is very dependent upon your particular hospital. I've been an inpatient in a lot of hospitals in my life and some were horrible, while others were really good. But that's a general hospital thing I think, rather than an L&D one. It isn't great fun, the security necessary on the ward - but I'd argue that it's preferable to having someone waltz out with a random baby. But yes, this is why we have different birthing options - including homebirth (though I'd always go to the hospital, regardless of my own discomfort, if it was the best thing for the health of my child).
To me as a German it's weird that so few women in the US have a midwife. In Germany you don't have to have one for pre- and postnatal care, but most women do. The birth itself (including C-sections) has to be attended by a midwife by law, no doctor is allowed to deliver a baby or care for a woman in labour without a midwife, except for emergencies if there is no midwife available. Doctors usually leave everything to the midwife as long as there is no emergency. I guess the lack of (well trained) midwifes might be one reason (of many) for the US' high maternal and infant mortility rates.
Nikki Michaelson It actually stems heavily from racism within the US. Many midwives were originally black female slaves but when freedom was granted to the slaves many white male doctors didn’t like the fact that these black women could now achieve higher social standing by selling their services as a midwife. This launched a huge campaign to stop using midwives and start using doctors. During this racism fueled campaign horrible things were said about the black women who were practicing as midwives such as saying their hands are so dark that you can’t tell that they’re dirty. That is why, as opposed to many other countries, midwifery became an almost nonexistent career and most women chose to give birth in hospitals. Slowly but surely midwives are once again becoming a viable option for women to use during pregnancy however, because this profession is relatively new, there is a lack of consistency across all the states when regarding training, scope of practice and title. In the United States a certified nurse midwife is probably your best bet as they have to get a bachelors degree in nursing and then go back and get a masters degree in midwifery.
Doctors pushed the midwives out of business, before women even had the right to vote, because they wanted the business for themselves, and for "teaching material". CNMs were finally allowed in, primarily as "physician extenders"--but they follow OB protocols & aren't allowed to attend homebirths unless allowed by their OB. The primary reason for all this is MONEY. Healthcare is primarily a for-profit enterprise in the US.@@nikkimichaelson795
I live in California and my prenatal care requires both a midwife and OB. I mostly speak with my midwife though, and my delivery will be with her but in a hospital setting [which I prefer]. The US is quite huge and basically many countries in one. It is hard to clump it together as it is so different in other states and regions. However, I believe improvement in healthcare is always welcomed in my book.
Interestingly, in the UK, waiting 30-60 seconds to cut the cord wouldn’t be considered “delayed cord clamping”. That’s basically the standard. Delayed cord clamping here would be anything between about 3 and 15 minutes; or until it stops pulsating. When I had my third baby 4 years ago, I asked specifically for delayed clamping and I had about 5 mins (something to do with have R- blood, I can’t exactly recall now); this was very much a newer thing then, although my medical team were very much on board. With my fourth baby... well... he had VERY delayed cord clamping, because he decided to arrive rather speedily at home with no one but my husband to deliver him. 🤦🏼♀️ But delayed cord clamping made a massive difference to my post partum bleeding, and made the delivery of the placenta far easier (without it needing to be medically induced). It’s actually really interesting hearing about the differences with our healthcare system here in general. Here antenatal and postnatal care is all about midwives. You’d only see a doctor if there was some specific risk or complication. It’s crazy to me that midwives aren’t regulated over there... and kind of scary! My midwife team felt like family... especially after one had to come out to my house in the middle of the night after my cheeky born-before-arrival baby!!! 🤣
Dear Beautiful so you are saying that you had less bleeding after having a physiological (natural) third stage? I was a midwife, and tended to do managed third stage. When my sister had her kids, the Dr was open to whatever she wanted, and the midwife wanted to try physiological third stage, it seemed that my sister had more bleeding. Not immediately post delivery, but her bleeding seemed heavier than expected in the following days. It’s only one person, so you can’t really gain much from it, but I found it interesting and I like hearing other women’s experiences. The physiological third stage was the only thing we did differently in a perfect, text book natural labour and delivery, so anything different we questioned if the lack of synto at delivery might have had something to do with it. The topic of delayed cord clamping is interesting. I don’t know where people are finding the time to cut and clamp the cord in under a min. When I would deliver a baby, it would take that long just to get the baby up into Mum’s arms and get them both comfortable. Most of the times I delivered a baby the Mum was in an all fours position or side position, so it would take at least 30 seconds to just get the mum into a comfortable position. Then you are giving the baby a rub, etc. The only time I would think of cutting and clamping earlier is in an emergency, cord around the neck or if the baby is flat and floppy and needed to get onto the open care unit for resuscitation.
I'm not sure exactly where the disconnect happened, but somehow the US jumped pretty much straight from go call the other mothers straight to the OBGYN. Probably some sort of women can't be doctors thing. There is a HUGE gap in women's care in the US because of it. There's a fantastic documentary on the lack of understanding of how to handle a normal, healthy childbirth. Midwives are gaining popularity, and that's a good thing, but it's slow going.
It's not completely unregulated. It depends on the state. Some states loosely regulate midwives and some states are SUPER strict about the title and what training qualifies, which is why she talked very briefly about licensing across state lines.
Yea I think of rather delay the cutting then just allow the placenta to fall off by itself than it being forced out.. unless I'm hemorrhaging or something. I just want my birth as natural as possible. Gimme my baby. Cord attached, feed her and snuggle her. Then when the cord is no longer warm cut it off the baby but leave it attached to fall off on it's own over the next couple minutes or hour... I guess if it doesn't detach on it's own after an hour take it out. In America it's very common to make women lay on their backs and give birt and generally everything is very uncomfortable for the mother unless you have a midwife, doula, or get lucky to be able to go to a really good birthing center to advocate for you. America does a lot of things that actually cause more trauma to mom and babies body so it's good to have doulas or midwife present to advocate for mom. If she wants to change petitions to deliver let her, if she wants to keep the cord attached for 5 minutes, let her. I just believe in doing things as organically as possible. Obviously things change a bit if you are a high risk pregnancy.
Add E i have heard part of it is also to do with the idea of older midwives being witches, which is because they might have used more natural pain relief methods and tried to ignore male doctors advice. Its pretty well documented that they were called witches because they did not want or need to have men involved in their medicine. If there was a infant or maternal death, they were especially blamed, even though infant mortality was high
There’s a clear issue in the states with reproductive health in general. It’s a shame a country that proclaims to be “the greatest” fails so many of its people.
Just make sure yours is a certified nurse midwife or has been practicing for a very long time with a good reputation as a certified professional midwife.
America has actually made homebirth more dangerous in the guise of making it safer. Physicians were threatened by midwives so they sought to outlaw them, something europe did not do. Restricting access to midwives and midwifery training only makes people more likely to attempt an unassisted or unsafe birth.
Read an awful piece on not needing a degree to be a pathologists.. some guy set up shop in his basement and had did autopsies from there... (no medical degree or whatever). Im often shocked on how little papers are required for positions. Then again, because we have a healthcare system for everyone, the poseres wouldn't easily get hold as you need paperwork to get your services (midwife, pathologist whatever) refunded by insurance..
In Estonia, midwives train for 4.5 years and obtain the right to work as either a midwife or nurse (2 degrees at once!). They are highly qualified healthcare professionals with proper training and deal with women from infant to elderly, including pregnancy and delivery.
Your channel reminds me of when TLC was still The Learning Channel! As a kid, I remember watching actual surgeries on TLC and their other shows being equally as informative.
I LOVED watching surgeries and births on TLC when I was a kid! That was one of my favorite things to watch and I’m honestly sad that they no longer keep such informative shows on the channel.
Thank you so much for these videos. I am a (Swiss) comedian and I'm currently 8 months pregnant - and I'm often utterly stunned at the lack of humor people (at least in these parts of the world) are able to muster up when it comes to pregnancy. It's so refreshing to laugh out loud at all these crazy/unknown/irrational feelings and processes going on within yourself when you're building a tiny human. So again: Many thanks! And enjoy our beautiful country (I'll just consider it my gift back to you since I myself made it - not).
The question on the midwife really shocked me. In Denmark and the uk the midwife is a key part of the pregnancy and see’s you regularly for check ups, advice and to answer questions and comes for free with our universal healthcare.
That's how it should be. The US is backwards in many ways to do with healthcare and it shows in the stats. Worst maternal death rates of any developed country.
I had the same experience. My 1st delivery was with an OB and he was in such a hurry that he didn't let the local anasthetic do its job before he started stitching up my epesiotimy. Every time the needle went in I jumped. He scolded me to stay still. My midwife was lovely and calm. No rushing at all.
Hi! I think it would be really beneficial to a lot of women and young girls if you did a video on the side effects of different kinds of birth controls and statistics of more dangerous situations involving them. I've had an IUD for 3 and a half years now and I only recently found out about them getting dislodged or even lost in the uterus and my doctor never told me about those kinds of possibilities. Thank you for the great content! 💕
Yeh I agree, when I was looking into them, the information provided only specified the physical effects but not one mention of the possibility of mental side effects like mood swings or a decrease in mental health!
It's tough because there are many different types of birth control and they all have different benefits/side effects and it really depends on the person. Risks like an IUD "getting lost" is very very very rare.
I love that you want to talk to your patients through about an episiotomy!! When they did mine they never even told me that they were doing it. I only knew because I overheard them talking to the intern there about it and they told my husband about it AFTER it happened. They admit afterwards they never need to cut me but she had a scheduled c section she had to get to. She never told me the degree but after they stitched me up said it was a tiny cut and gave barely any stitches. A few days later I had bleeding on the stitches and got it checked out at the hospital where they told me it was not a tiny cut and every doctor and ob who has seen it since has seen it. A week later my episiotomy reopened and had to be reopened where they used extra stitches. There was part of the vagina lip that still had stitches intacted at the opening, it was only about an inch of the muscle that reopened and the part of the vagina lip still intacted with the stitches pulled opened because no one at the hospital wanted to even look at iit because they were too busy and it never fully closed together and it has been a year since her birth. It was a complete nightmare! Where I live in Canada they cut everyone for at least their first birth because they say it heals better than a year and is easier for them. I wish I had stood up for myself as soon as I overheard it but I was a first time mom and I trusted my doctor
In Ontario, Canada, where I am, midwives have a 4 year undergrad degree, register with the college of midwives and update some of their training on a yearly basis. Right from the beginning students are attending births. A 4th year midwifery student played a huge role in my son's home birth. This care is also free under our provincial health insurance.
This APRN appreciates to the depths of my soul how inclusive you are towards midwives and NPs. I love this video. I got halfway through the CNM program at Frontier Nursing University and then life got complicated. I’ve since finished my FNP. I know so many amazing CNMs and I’ve also seen too many bad outcomes from lay midwives or inappropriate home births. If America had a better integration of low risk home births and birth center births by CNMs, our maternal mortality rate would likely improve. But the lack of good integration complicates this for all involved. We should take notes from the UK’s system. Keep making awesome videos!!!
I don't think there is a true link between the medical world and doula's. They are just a support system for the mom and dad during birth. They don't do anything medical at all.
Vanderbilt hospital in Nashville, which is a big deal in the medical world, LOVES doulas. The OBs work with them. Some hospitals have doulas available for patients! So while they are not “medical staff” they can be a wonderful part of the birth team.
@@Ainiewainy This Doula 100% agrees with you. We are NOT medical professionals. We are a loving, supporting presence. We know what questions to ask, how to help the mom increase her comfort, keep mobile, and try to stick to intended birth plans, but we cannot and should not ever give medical advice, nor are we at all synonymous with a midwife. In a best-case scenario we are a part of the birth team, however.
30-60 seconds is not what I had in mind when they asked about delayed cord clamping. I've read that truly "delayed" cutting is waiting over 20 minutes, or at least until the cord has stopped pulsing. Thoughts?
I was thinking that is what you meant when the question was asked. I heard of at least 5 mins of a delay or until the cord stops pulsing as the person asked below!
Hi, I'm Dutch and delivered my kids in the Netherlands. My oldest was born at home with a midwife and nurse attending and placed onto my chest immediately, as he was being born the midwife lifted him up and handed him straight to me. (Initial apgar score is assesed while baby is being born and handed to the mama, only time that changes is when baby doesn't come out crying or starts crying very soon after). A good five minutes later the midwife clamped the cord and I cut it (hubby was far too squimish about blood). My youngest was born in the hospital, with a midwife and nurse attending and the same thing happened, he was handed straight to me and this time I noticed the midwife touching the cord to check for a pulse after some time - I don't remember how long after he was born that was - and then she said we could clamp and cut the cord now. Both times we indicated that I wanted to cut the cord and as there was no need at all for it to be done hastily I got to cut the cords. I really don't see why the cord would have to be clamped and cut the minute a baby is born, they're still receiving blood through the placenta and will very likely spend their first moments after being born on their mama's chest or belly anyway, no need to rush.
I had a home birth under the care of midwives (In Canada, they have a University degree and are government regulated) and it is standard of care for them to wait until the cord stops pulsing before clamping and cutting unless the mother chooses otherwise or medical circumstance dictates otherwise. This standard of care is based on current research and it's always offered as an option to the birthing parent. My daughter was born with a perfect apgar score, so she was immediately placed on my chest for direct skin to skin and we were tucked in warmly. Once the cord stopped pulsing it was clamped and cut. Her umbilical stump also fell off within 5 days, which I think may be attributable to the delayed clamping. She did have a mild case of jaundice, but we were able to treat it by laying her in front of a bright sunny window a few times a day (I still received regular checkups with my midwives at the time and her jaundice was being carefully monitored, if it had required more intervention we absolutely would have been referred to the hospital).
Delayed cord clamping is supposed to be AT LEAST 30-60 seconds on the case of an emergency but should be around five minutes. I'm not sure if that's what Dr Jones referes to because it doesn't sound like it :( it seems like she will cut the cord after 60 seconds at the very latest even if everything is alright which isn't enough. Source: americanpregnancy.org/labor-and-birth/delayed-cord-clamping-risks-benefits/
I just thought "why does everyone remind people to subscribe? Like you wouldn't do that if you like their channel?" Two seconds later I realize that I'm not subscribed, never mind 🙄
In the Netherlands we pretty much all go to midwives unless you're high risk. Midwives are trained very well here. Most people give birth with a midwive. But if you really want you can go to the OB-GYN too! Just not as usual.
I live in Australia. I had two nurse midwives and a midwifery student at my son’s birth at my midwife run birth centre. All through my pregnancy, I was carefully monitored and if my pregnancy stopped being normal I’d be transferred to the care of an OB/GYN. Things stayed normal and I had an amazing waterbirth. The real value of my midwife was in their home visits after the birth. They helped me set up breastfeeding, made sure I was recovering right and when I had issues they were able to get me a bed when I had to transfer to hospital. Also may I add I didn’t pay anything? All covered by my health system. Love my country, love the care I got.
StrickenWithFear ah, why do you act as if I didn’t know that? I pay taxes, I know it covers it. Taxes cover the health system because it’s good for society to have healthy people. It’s also there when I need it, as I have in the past and no doubt will in the future. It’s very reassuring to have my son admitted to hospital for a serious illness and NOT worry about how much it will cost!
Yeah my doctor didn’t even tell me he was going to do an episiotomy, and there was no low HR or other emergency, nor had I been in labor very long. I didn’t know until afterward. That total lack of consent and control in my own body was the primary problem for me.
This same situation happened with my first baby. I didn't really think about how awful it was until much later. To make it worse, he stitched up too much and that made sex painful for a very long time after. I wish I had been more knowledgeable at the time. I make sure to talk about it with expecting friends now.
I had a similar situation. My ob after my first push said I needed an episiotomy as she did it and I had no say. My stitches didn’t even dissolve until right before my 6 week appointment because she said she could still see some of them. My recovery and comfort took forever it felt like. Definitely would rather not have one in the future
Thank you for answering these questions! I am in my 3rd trimester with first baby. Me and my doctor appreciate all of your information/channel. It has made it easier for him to communicate and for me to understand him 😘
Wow. This why I want to give birth at home or a special birthing center. It's another concern as a black female, we are treated disproportionately worse at hospitals. Even in the 80s when my older bother was born my mother was mistreated and the doctor yanked my brother put now he has permanent nerve damage in his arm. I hope my pregnancy is healthy so I can birth at home or in a pool with a doula/or nurse midwife.
Oh my lord that is aweful. Interesting you mentionion your a women of color my husband is a black man and my beautiful son is biracial. Idk if that is what their problem was. I wasnt really looking at the situation in that way. The person who did my epidural also very rude. I am scared for my child as he gets older due to ridiculous racist people. Now looking back we may have been discrimimated upon. Its a shame really. My child is amazing and the cutest chunkiest 11 month old you ever seen lol. And i pray to god things change. Its sickening. Im sorry that happened to your brother.
@@daphnietudor2953 yea people out here are just putting so much negative energy into the wrong things. Its 2019 amd people have to worry about being mistreated in the hospital because of their ethnicity it's so ridiculous. I hope your son grows up happy and healthy and doesnt have to deal with a lot of discrimination. I think its gotten better with each generation tho amd continues to despite the outrageous things we see still happening. Just keep loving that baby no matter what and he will be ok.
@@loryndabenson2118 I have had all hospital births, the biggest thing to make a good hospital birth is be very picky about the ob you choose. I've had nurse midwives, an ob and a family practice doctor that have all been great. I have done my research before going to them, looking at community reviews for natural labors. Then I am upfront with my expectations, and judge as much by their reactions as their words on whether they would be a good fit for me. I've had great labors in the hospital, with no pushiness, and totally accepting of my wishes.
I love my midwifes. I've used them for 3 pregnancies now. I also did delayed cord clamping. My first child was obgyn driven and they forced my placenta out by pushing on it. It was horribly traumatic for a first baby. With delayed cord clamping I felt my placenta detach naturally and it was like a release not pain and it was happened during skin to skin so it was beautiful. My 3rd pregnancy was a surrogacy so It was a little weird for me. My current pregnancy will still be delayed cord clamped and delivered by my midwife :)
I had an amazing home birth almost 3 months ago with an amazing midwife ❤️ She was incredibly qualified and experienced. She knew exactly what was going on with my body and exactly what type of support I needed at that moment. I will have home births with all future babies.
I had an amazing birth with my second child with a midwife. I had told my OB that I was looking into an out of hospital birth during my first trimester, and from there he treated me like shit. At 28 weeks he told me I’d gained too much weight (20 pounds) and that I just needed to stop eating and get outside 😑. I’ve had multiple hip surgeries and he knew I was mostly sedentary due to it. Told my midwife that day and we decided to stop all my appointments with him since they were unnecessary at this point and more hurtful than helpful. After that it was a Breeze! She came at 41 weeks with no issues, 4 hours of labor, and 5 pushes in the tub. Best experience ever and very relaxing compared to the hospital where i get yelled at for everything.
@@Momof3wildbabies doctor's only recommended 10-20 lbs no matter what BMI as the BMI scale isn't an accurate measurement of health and research has shown 10-20 lbs gained during pregnancy were healthier pregnancies
Aya Jade in the US women normally gains about 20-30lbs in pregnancy. Some gain more or less, all depending on the pregnancy and woman’s size and activity level.
As a current nursing student/hopeful future CNM student, I couldn't agree more about needing regulation in the US for midwifery! The looks and questions I get when I say I am going into midwifery after my RN are astounding. So many people are under-educated about the professionalism and training that goes into what I think should be the standard for midwives (a CNM/CM). Once I explain to people that it is like being an NP, but solely focused on sexual/reproductive health, pregnancy, PP, and newborn care they begin to understand more. They also find it fascinating that I would want to work in a hospital or birthing centre located next to a hospital and am not a fan of practicing at home births. Thanks for clearing that up for so many and enjoy Switzerland!
My baby was clamped from the placenta 30min after delivery in de meantime she was lying om my chest the placenta was next to me on the bed. Hospital delivery in the Netherlands.
@@nastassjahall9358 no she meant seconds. A few people in the comments section have talked about this and she responded to them that she hasn't read any articles that point to any benefit of longer clamping. These are her words not mine.
Hi. I’m from Sweden and for me, delayed cord clamping means to wait at least 3 minutes. Or wait until the placenta is delivered, or the cord completely white. So that al blood is in baby. 60 seconds is, for me not delayed but quick cord clamping
Mama Doctor Jones. There is actually a doctor here in Sweden that have showed benefits of waiting longer. The research was what made US to recommend waiting 60 seconds. Although the study recommended more. I can give you his name if you want to. I have a very clear interview whit him we’re he talks about research results and recommendations, sadly it’s in Swedish. But, there is scientific research supporting waiting more than 60 seconds
Last I knew it was not good to wait for the placenta to be delivered because when it is it is fully detached from the mom and no more blood is being given to the baby. The cord should only be attached if the placenta is still inside the womb.
The US tends to compromise with the absolute minimum. It's stupid to put a time limit on it when it's actually about getting all the blood in the baby. And you can see when the cord is empty of blood.
Aye, our midwives are trained via full-time degree courses over many years now. The lack of regulation in the US (along with the for-profit health system) explains why there are so many people in the medical profession who dislike or are uncomfortable with the idea of midwives. It stunned me at first to see how many people were anti-midwives but the fact that in some states almost anyone can call themselves a midwife is just terrifying.
Student Midwife I know I’m currently pregnant with my second baby I couldn’t be more grateful to the midwives who brought my first into the world I think it’s a beautiful career and it’s something I would love to go into my self
Just Another Bucky Lover that’s so scary! Could you imagine putting yours and your baby’s lives in the hands of someone who isn’t really trained to help
Also, here in Italy it's a common thing, unfortunately, to do episiotomy without consent, they just do it, if you find the wrong person... This and other things started a movement called "basta tacere" (stop the silence, basically) about traumatic experiences of hospital births due to doctors and nurses being rude, mean etc...
I've had two beautiful home births with the same midwife. My first child was born in the hospital. The staff didn't really pay attention to me, the doctor didn't even make it in time for the delivery and a nurse barely caught the baby. They kept telling me not to push until the doctor arrived. Baby had other plans.
It's good to have a little more knowledge about midwives. A few of my friends have had midwives and their care was top notch. I am glad I found your channel. Have fun in Switzerland!
Thank GOODNESS to be in Canada... midwifery is a degree and is regulated. Our midwives where I am have rights at the hospital, so you can choose home birth or hospital, and transfer to hospital at any point (I had to) and still had my baby delivered by my midwife ❤️
I'm in the UK - our midwives are amazing. I only saw my OB/GYN so much because my babies were little gits and caused complications. My midwives still took control of the labour room.
My first birth was 7 hours start to finish. My second was 2 hours start to finish. I'm not gonna lie, I'm nervous to make it to the hospital (an hour away) in time. I would love if you could do some kind of video talking about fast labors and what to do if u have to have an unassisted birth. I feel like it would just help ease my mind a little and I'm sure Im not the only one who has freaky fast labor and delivery! Lol
I had an episiotomy and a vaginal tear so it was much fun. Also I'm from the UK and it's standard to see a midwife as your primary care giver during pregnancy if you're low risk.
I had three great pregnancies and deliverys with CNMs(Certified Nurse Midwife) who practiced out of my local hospital. They were fabulous and I highly reccomend a CNM!
@@gailgerard8604 I didn't know anything about how a thyroid disorder could affect pregnancy till I suffered a miscarriage 3 months into my 3rd pregnancy and a week later was diagnosed with hyperthyroidism and suffered many more miscarriages because of my uncontrolled thyroid disorder and need up having to have my thyroid removed a year after I had my 3rd child. During that pregnancy I was high risk and had to have ultrasounds every month and have my thyroid hormones checked quite often then after I had my thyroid removed I went on to have 2 more miscarriages and 2 more babies but was still considered high risk because I have no thyroid and have to be on hormone replacement medication and had to have ultrasounds every month and my hormone levels checked often. Not to mention all the effects my thyroid issues have had on my period and fertility
@@kels226 yes I am now hypothyroid since having my thyroid removed 5 years ago but even with hypo when pregnant your thyroid hormone levels have to be carefully monitored especially during the first trimester since the baby's body doesn't create it's own thyroid hormones yet your body is the one supplying it to the baby
@@nancyconnelly2011 yeah they checked it at my first appt. And it was fine but about half way through they checked it and doubled my dosage. Now I need to find out when I should go back to my normal dose but I keep forgetting to ask😂
That’s scary about midwifery in the US ! In Australia where I live we have a board that requires certain training to become registered as a nurse and/or midwife! You need to either have done a bachelors degree in midwifery (3 years) or be a registered nurse (3 year degree) and do a course which is around 18 months on midwifery! If you don’t do this then you can’t call yourself a nurse/midwife! Not sure how country’s like the US get away with this, it’s so shocking 😰😰
There’s slightly more oversight for non nurse midwives but they are not required to take the same exam (while they absolutely CAN, there’s other ways to become certified
It's one of those things that are state by state. There are sensible places with sensible regulations and... other places. I think the professional organizations like the American Medical Association should step up on this to provide and promote national standards. (I mean, I think we should also get over our states' rights fetish, but that's not happening anytime soon).
Just to be clear, in the US you must have a nursing degree to call yourself a nurse, it's a strict process comparable to that in other countries. It's just midwifery that's dumb and unregulated. Sorry if I misread, it just seemed from your comment that you thought that nursing was unregulated as well ❤
My mom had 6 c-sections. Most people look at me with huge eyeballs when they hear this. I am grateful she had this many because i am number 6 but i agree it's not common. She had many conversions with her doctor and he monitored the lining and her health after each one while he was delivering.
There was a time when if a mom had one C section, she had that procedure done for all subsequent births with no option for VBAC. As i understand it, they’d just cut through the previous scar.
I had 6 c sections, 2 miscarriages, my fallopian tubes removed and I have Polycystic ovarian syndrome. I love my OBGYN well now shes just my gynecologist, and I hope every woman can have a doctor they feel comfortable to talk with about their health.
I also wanted to say that I had 3 of my 4 babies with Certified Nurse Midwifes, and they were absolutely wonderful! They were all highly trained and delivered babies in the hospital. My last pregnancy was high risk so I saw a high risk OB in addition to my CNM and he gave the go ahead to have the CNM deliver the baby, but there was always backups and help available.
@parinazaz4044 the certified nurse midwives that delivered my babies, worked in hospitals. They were skillful care providers and worked to make the hospital environment nicer for me and my babies.
im glad you specified that is what it is like in the IS. i live in NZ, it has the best maternity system, where women have a main maternity carer, 90% of which are midwives (who have done a 3-4 year bachelor degree that is purely midwifery / obstetric focus, mother and baby). Midwifery degree also includes pharmacology, and midwives can prescribe medications for mother and baby that relate to non complicated pregnancy - we cant prescribe meds for high blood pressure, etc (high blood pressure is referral to an obstetrician, and in which case, care is then shared between the doctor and midwife; the woman will still have the midwife provide care in pregnancy, labour, postnatally) but can prescribe antibiotics, iron, treat UTIs, breast infections (mastitis), eye drops for baby etc. We can order scans, blood tests, insert IV lines, and have yearly refreshers for obstetric emergencies (hemorrhage, eclampsia, shoulder distocia, neonatal resus etc). Women can birth at home, a small midwife led birthing unit, or a main tertiary hospital. Doctors are only involved if there are complications. we care for families from early pregnancy, to 6 weeks postnatal; under the one midwife, with a back up midwife to cover when she is off call. if complications arise, we refer to obstetricians - under a legal guideline that specifies where we must offer referral, or must transfer care to the doctors. we are fully regulated, and held to account like any other health professional. our system offer women the most choice, which is what it should always be about - women centered care - her body, her choices, and our role is providing her with the information so she can make an informed choice about every aspect of her care.
@@emerald3331 its when a woman gets a tear in her perineum after a vaginal birth and the doc stitches her up but adds another for "tightness" so that the assumed husband can enjoy a "nice tight vagina"
I had that and my doc didn't call it that! She just said "one extra stitch, hubby will thank me later." This was only 13 years ago. My second did not do this.
Thank you for the clarification on Midwives! I’m currently 38 weeks pregnant and have only seen a Midwife throughout my entire pregnancy (I live in the US - North Carolina). People ALWAYS raise their eye brows when I tell them that and ask if I’m going to give birth at home 🤦🏼♀️ I feel like there needs to be more education around midwifes and people should know who they are and how they are similar / different from OBGYNs.
Fun fact when your water breaks it constantly keeps going... So you feel as if you are constantly peeing yourself. That's something no one tells you 🤣😂.
Yes, some women can have their membranes rupture early in the pregnancy and they continue to leak until the baby is born. I looked after one woman who’s membranes ruptured at 18 weeks, she didn’t deliver until she was 37 weeks. There used to be a myth of something called a ‘dry birth’. Women would be worried that if their waters broke early that it would hurt more because the baby didn’t have the ‘waters’ to help lubricate the way.
Mine kept going until I delivered. I got to the hospital and I was 2cm dialated. Then I got up to 6 and I had to have a c section. All worth it because now I have a beautiful almost two month old
In Australia, Nursing and Midwifery are separate three year undergrad degrees, however (I think this is still the case) if you want to be dual qualified its an extra 12 months to do the other side. I believe you have to have attended at least 40 live births by the end of your training. And I think Australia is really into mentoring and support for their entry level health graduates, or at least they are in speech pathology (my degree)
I had my babies in 1965 & 1967. The standard procedure was ALL ladies in labor got an enema and got shaved (“prepping “) These added a layer of discomfort to an already uncomfortable situation. For my first baby I had no prenatal classes (nobody did). I woke up at 8:15 AM, and told my husband it was time to go. After the “prep”, they gave me gas when the contractions got severe. I would awaken in the middle of a contraction, fighting it, and they would knock me out again. Fortunately, my son was born at 11:15 AM, so overall, not a bad experience. My second baby was born in 1957. At the time, my best friend was an OB nurse, and she loaned me a book: “Thank you, Dr. Lamaze.” Again, there were no prenatal classes where we were (in England, at an US Air Force station clinic, nor at the hospital, an hour away.) I read the book, and did the exercises. On Labor Day (the holiday, not my personal Labor Day!), I was having contractions about every 5 minutes, so they ambulanced me to the hospital, where they “prepped” me. I was having copious “show”, and dilated 4 cm, and completely effaced. The contractions went on for about six hours, then phased away. False labor. But since I lived so far from the hospital, and had had only a three hour labor the first time, they decided to keep me. Three weeks later, bored out of my skull, two days before my due date, they decided to induce me. So they prepped me again, and they gave me a a series of shots. Not much happened. The next day, they tried again, without success, although I was treated to another enema. (They didn’t like pooping on the delivery table, nor did they want pubic hair!). The following day, a new OB doctor came on duty. He had just finished his residency at Cornell, and taught Lamaze classes for women there. He told me that he was going to be on duty for the following three days, and he would be my Lamaze coach, and that I would have my baby while he was on duty. They prepped me again, and started a Pitocin drip, stripped my membranes, and broke my waters. 56 minutes later, after ten contractions, my daughter was born. I can honestly say that I had no pain. It was uncomfortable, but not painful. The only pain was when he was sewing up the episiotomy. (That was standard procedure then. I asked for Novocain. My first was not midline, and gave me fits for weeks, but this one was midline, and caused me no trouble.) I The main difference between my first and second, as far as the babies was that my son was groggy seeming the first few weeks: not following objects with his eyes. He was also very fussy. My daughter, on the other hand, was watching the lights as they carried her across the room to bathe her and evaluate her. She was very alert and calm. Times have changed. I had very unusually short labors, so the preparation I did with the Lamaze book brought me wonderful results, but I don’t know if I might have an epidural today. (Not likely, as I am 76, and have no uterus, nor ovaries.) I love your channel. You present solid information in a straightforward way. I wish someone like you had been available back in the dark ages when I had my babies. Congratulations on a million subscribers!
I had 2 VBACS. Both times, the nurses and doctors tried to talk me out of it. Fortunately, all went well. Please talk about why VBACS are frowned upon by the medical community.
At about 4:20 she describes one of the risks (fairly small risk if I understand right, but very real) of subsequent pregnancies after cesarean… Basically, there’s a chance things could go very very bad, very very quickly. Some doctors (or, perhaps more likely, some hospital boards of directors) don’t want to be a party to that risk. I learned while working ten years at a local nursing home, hospitals don’t like people to die on their property… it’s not good for their numbers. My daughter wanted to go for TOLAC (trial of labor after cesarean) with her second child. The local hospital wouldn’t do that, so she had to travel 40 miles to the big hospital and clinic instead. When other complications arose, she ended up choosing cesarean at the time the doctor said we need to induce today. Now. Not next week. A couple years later, when pregnant with her third, even the big hospital and clinic recommended (required ?) that she have a planned cesarean. After which, local doctor recommended tubal ligation while they were in there. She would like to try for a fourth… she will have to go back to the big hospital for a 4th cesarean if she gets pregnant again. Because local hospital is not willing to accept the risk, and perhaps might not be able to handle the worst case scenario if thinks went horribly wrong.
I love midwives! Had 3 of my 4 kids in a birth center with midwives and 2 of those were water births, which were wonderful! The room and bed were so cozy, and so many pillows. My 4th was a hospital birth only because of insurance reasons. But I am glad that I experienced both.
I’m a NP, in school I did clinical with a cnm and she was so wonderful! I always had the misconception that midwives don’t monitor you as closely but it was if anything the opposite. They monitored their patients very closely and they gave great care.
Thank you for your videos and insight! I asked for delayed clamping with my second and ended up in a cesarean after some fetal distress, to my knowledge they pulled baby boy out and cut the cord right away. This really upset me because i felt like NOTHING in my birth plan was followed per my requests and i felt defeated in many ways.
I dont know about your personal experience but at my csection the doctor did a delayed cord clamping. I didnt even have to ask she just let me know that's how it would be. It was my second and scheduled so that may make a difference.
My boyfriend and I will be visiting San Antonio this week and I can't believe you're only a few hours from there! You've taught me so much and I just love your sweet little family!
In NZ Midwifery is a bachelor degree and when you’re pregnant you choose a Lead Maternity Carer who is funded by the government. Your LMC will more than likely be a midwife. Having an OB as your LMC is quite rare.
As someone who has been so indecisive and scared about possibly having children someday, I am so glad I found your videos! Just watching you explain some of these issues and processes has made the idea of pregnancy and labor and delivery so much less frightening to consider. I am not saying they aren’t serious or anything, but it makes me feel better about the idea of it.
I wanted to give a shout-out to licensed midwives, which you don't mention in the video. Licensed midwives in California, for example, have to go through a minimum of three years of formal training and state examinations, and are licensed by the California state medical board. I gave birth at home attended by a very knowledgeable and highly experienced licensed midwife, who helped me find a supportive obstetrician and they cooperatively did my prenatal care. She was extremely prepared for the birth, brought two midwives and a host of equipment with her for support (there was even an oxygen tank and whole IV set up, just in case!), and we had several thorough conversations and a transfer plan in place to a nearby hospital in case of any complications (there were none). The other great thing was that she came to my home every few days for check-ups afterward for the first few weeks, which helped a lot. Just saying, there are some great home birth midwives out there who are very qualified, thoroughly trained, and extremely competent, who perform safe, planned deliveries every day, and I'm grateful for them!
Had a csection for my first, unmedicated vbac in hospital with second, and a homebirth with a CNM with my third. The experience was amazing! I even had to get a new midwife around 33 weeks since there was some licensing issues with my first one. My final midwife has been practicing for 14 years and served in low income clinics learning under other midwives.
In Australia if you aren’t high risk a midwife delivers your baby at the hospital. It is a 4 year university degree here. It’s amazing how it varies country to country
A properly vetted midwife can be such a gift. I had 3 natural births in the hospital and the last one with a midwife in a birthcenter. But she maintained incredibly high standards! She was only 3-5 minutes away from the closest hospital and maintained an excellent relationship with her backup. She always had nurses on call to assist with delivery. She educated me on every little thing, and we made decisions together. She was extremely cautious, and only accepted extremely low risk patients. She required documentation from my other doctors that showed that my thyroid and gallbladder issues were being taken care of properly and did not present a risk. She also caught things my OB never noticed that contributed to heavy bleeding after my other deliveries. My platelets dropped a full 100 points between 11 weeks and 28 weeks. She put me on a medicine called Immunobel and it brought my numbers up within 5 weeks. She was huge on eating right and getting enough protein. She was such a blessing! I felt so incredibly well cared for and would recommend her to anyone. Sadly she moved to another city and I literally cried . But I felt like she set the bar for midwife care in the US.
I have to say it is absolutely crazy to me (I'm from Canada) that the United States doesn't have standard midwifery certification and regulations. Canada, just like Europe, has a 4 year (3 year if you're in Quebec because of CEGEP) post-secondary degree to become a midwife, with placements.
I have a MIL who is a midwife / nurse, and she was there to deliver my son. Unfortunately it was my first birth and I had a massive DVT (blood clot) occur during labour that came close to killing me. I also had a very long labour (Wednesday water broke, Saturday he was born), and retained placenta, with cord avulsion. Whew! My midwife and her 2nd had over 600 births between them and both were nurses + extra midwifery training. Sometimes things go wrong whether you have a midwife or Obgyn. I think you need to feel comfortable with whatever you choose. Be sure your midwife feels comfortable to call in help if things start going wrong.
As someone interested in midwifery, I think it’s important to point out that CPMs are actually regulated & carry liscensure by the state in which they practice. Some states require less education than others (some don’t even recognize midwives) but to call yourself a CPM, you have to pass a nationally-regulated course (3+ yrs), an apprenticeship with a licensed CPM (which includes a threshold of attended/assisted/led births MUCH higher than just 20!), a nation-wide exam, and skills test. Then, they are licensed by the state in which they wish to practice. A lot of CPMs work with people who wish to labor and birth at home, but a lot also work in birth centers, which often also employ CNMs. Additionally, CPMs are specifically trained to understand their VERY narrow scope of care. They care for people who are within the normal range on all risk factors; as soon as someone is outside those parameters, the CPMs job is to send them to the next level of care. Of course, there a people out there who will tell you they’re a midwife with nothing to back that up, and irresponsible people in EVERY field. But I think it’s a disservice (as well as inaccurate) to entirely dismiss CPMs as uneducated, unqualified to care for and assist NORMAL pregnancies and births, and not worth looking in to.
Thank you for your comment. I was coming here to post the same. The description of non-CNM midwives in the video reflects a common ignorance about Midwifery training held by mainstream care providers in the USA. I have many colleagues who are CPMs and it is crazy the encounters they have with hospital staff who don't even realize that Midwives have been licensed to attend homebirth in our state for over 20 years. They still think they're doing it illegally!
Absolutely! The ignorance around midwifery, its scope, and its efficacy (especially from people within the MIC) is astounding - especially when you look at the data for in-hospital birth outcomes 😬
When I was having babies 10-19 yrs ago, a “Dr Jones” had a blog that was very popular and VERY negative about homebirth and midwifery. Like that was the goal of the blog was to destroy home birth. Is this the same person? (all my kids were born at home with varying levels of midwives in various states)
Talking about tearing, I’m a mum of 3 but I don’t have any medical training just my own experiences. I found that changing my birthing position helped so much with my 3rd baby, my first two I was laying on my back and tore with both births but my 3rd I had PGP so couldn’t lie back, I was on all fours and didn’t tear at all, my baby was born inside her amniotic sack and she was a healthy 7lb 8.5 oz . I was truly amazed that I didn’t need any stitches at all
Recently subscribed, an eye-opening insight to some of the myths. It's insane that some people with minimal medical training and experience can be a midwife.
I'm from Australia and we only have midwives on the labour and delivery ward. Doctors only attended if something comes up that needs to be assessed (blood pressure issues, baby's heart rate, anything that may need an emergency cesarean). You also aren't required to see a doctor unless you have a high risk birth. Midwives order all the tests and give you the results. I only saw a doctor three times in my first pregnancy, the initial visit where I got my referral, because I had a cold and because I had extreme pain in my leg (turned out to be sciatica) and I need a home doctor to come see me. My second I only saw a doctor for the initial appointment. My hospital (I live fairly outside the city so only really have one option) also offered me a home birth for my second. They handed me a pamphlet and explained that because my first birth was uncomplicated I was eligible for a home birth and they find outcomes can be better in home births because mum is more relaxed at home and that at any time if there's a change that makes your birth a tiny bit more difficult you switch to hospital birth straight away. They also have ambulance services aware that you're in labour that day so if something happens you'll be at the hospital in minutes and the midwives can bring all the painkiller options to you.
I mean...I am not who you asked to respond but I am a nurse who deals with miscarriages in peri op areas and my thought was that the placenta detached prematurely or had some other issue and that's what the bleeding was from and why the baby was still born. It didn't have blood flow in the womb prior to comming out. Then she was sick because part of the placenta was left inside. It was dramaticised and I have never seen a pregnancy that far along go bad BUT I have seen miscarriages and with the amount of blood associated with them earlier in term, I am sure it would be extremely bloody and scary and that a women back then would be lucky/unklikely to be alive from blood loss and infection complications. Not to mention infection and having part of the placenta inside can make it hard to stop uterine bleeding after birth. That was a hot mess of a situation.
Mama Doctor Jones, as someone who is currently studying to become a CNM (certified nurse midwife) I want to thank you! I dont know how many times I have had to explain what a midwife does... no it is jot all home births in a bathtub. Yes we can do epidurals. No it is not the same as a doula. Yes we have a grad level degree and certification beyond that. Thank you for helping clarify some of the difference. Even last week, after all this time my aunt called me a doula. Please don’t misunderstand. I have nothing against doulas. They can be very valuable but they are not the same thing as a CNM! Thanks again!
Great video! Have fun in Switzerland! I was wondering if you would be interested in doing a video about the number of women who are doing unassisted childbirth. To me it seems like a very troubling problem that unfortunately growing and most of these women don't do prenatal care as well. Would you be interested in doing a video about the dangers posed by this. Also I totally agree with you about the regulation of midwives.
Alex Hall home unassisted birth is not a bad thing unassisted doesn't mean that you dont have someone there many have a midwife or a nurse or their obgyn
@@annak804 unassisted means completely unassisted as in no midwife or doctor. Some women are even going as far as to be conpletely alone without even the father or a doula there as support. Homebirth can be wonderful if carefully monitored, but unassisted birth is plain dangerous.
@@annak804 I should have been more specific. The births that I am talking about are the mothers who do not have someone there that is a medical professional. I do understand that people can have unassisted births with midwives, at home births and even in hospitals with an obgyn and I am not opposed to that. However, that was not what I was referring too. Perhaps I should have said the free birth movement, but I am talking about woman who give birth on purpose without any medical professionals such as midwives, nurses or an obgyn present. And also do their own prenatal care.
None of my doctors or midwives were "weird" about cord clamping. They told me that as long as my baby was healthy and it wasn't emergent, then they didn't mind doing delayed clamping. Also, I absolutely LOVED my midwife experience. I felt it was less traumatic for me than my OB experience, but my OB experience was a high risk pregnancy and deliver. The midwife was also in the same practice as the OB. She was amazing. My family practitioner was the one who handled my first pregnancy and delivery. I never saw an OB, and I wish I had pushed for it, even though it was an amazing experience. I just feel like some of my concerns were brushed off instead of being address. Biggest issue - being told my itching was normal....and then 8 weeks after I gave birth, my gastroenterologist said that I had cholestasis....not a gall stone. I have ICP (Intrahepatic Cholestasis of Pregnancy) with my second and third....severe with my second. I am pretty sure I had it with the first, but my FP blew off my symptoms, and I had not idea about it until my second pregnancy. Even then, my nurses and many OBs kept confusing ICP with cholecystitis (gallstones). It was a fight to get a diagnosis. Do you have any advice for advocating for care for very rare complications many doctors might be unfamiliar with....like ICP (1% of pregnancies....90% recurrence in subsequent pregnancies)?
I have no idea why, but it seems cholestasis is treated and understood a lot differently in the US to the UK, but that doesn't help you advocate, sorry, I guess now you know you have a high risk of it then I'd be asking at the beginning of pregnancy when choosing an OB.
@@anneharrison1849 Where I live, there are limited options for OBs, and being military, my insurance likes to tell me where to go. It's awful. Thankfully, I am 38. I have Nexplanon, and my husband had the snipperoo after our 3rd was born. I worry mostly for my daughters when they grow up and have kids. You know?
@@AG-mt3xs yes, I understand, I don't know if your daughters would be at increased risk because you had it. Honestly with the general decreased awareness in the US I would try and do anything you can to campaign for more awareness. In the UK it's taken very seriously, 1% isn't even rare, just unusual (in my opinion, though several organisations define rare as 1 in 2000). In the UK you would be induced at 37 weeks (at least last time I checked any protocols). They don't do bloods for it routinely, but any itching or pain in the liver area and you'd get tested.
I'm pregnant with my second, and my OB who I adore, told me that after my first trimester I'd need to transfer to another provider because she's retiring (35 years of delivering babies). Yesterday, I asked her about transferring to a certified nurse midwife. What she said (after confirming I meant CNM in a hospital), " I don't generally recommend them for first babies because we're never quite sure how a woman's body will take pregnancy. You had a completely uncomplicated pregnancy last time, you delivered naturally, you're young, athletic and informed. I think you're a perfect candidate for a midwife."
The hospital i go to delayed clamping is routine. Its a certified baby friendly hospital and they do immediate skin to skin and delated clamping and bath as routine
I live in Alberta, Canada and we have have wonderfully trained and regulated midwives. We also have very safe home birth statistics (the same outcomes for low risk birth as hospitals per the McMaster University study). I had a home birth with midwives in May and absolutely loved it 🥰. My GP is from the UK and was therefore very supportive of my decision to use a midwife as it is common there.
Midwives in UK are amazing. Fully trained and can give all care pre, peri and post delivery without any doctor intervention as long as it is safe and within the scope of practice
I was with my friend last year when she delivered her son. The (nurse) midwife waited about 15 minutes to cut the cord. She waited until it finished pulsing and the cord was limp. 30-60 seconds seems like a really short amount of time. Do many people ask to wait longer than 30-60 seconds?
I graduated as a nurse and midwife in Australia. You can either do a bachelor of nursing (3years) and then do an extra course afterwards (I think it 2 years), you can do a bachelor of midwifery (3 years) or the dual degree, which I did, which is 4 years. Just for the midwifery part, you do almost 700 hours of hospital placements, on top of that you need to follow 20 women ( I think they might have lowered that number now) during their pregnancy. This involves going to at least 4-5 antenatal appointments, be on call for the birth, and then attend 2 postnatal appointments. Before graduating you have to at least 30 assisted births (vacuum, forceps, c-section), and 20 primary births, where you are the one delivering the baby. You also do 9 written exams, as well as clinical assessments. For our placements, we were paired with a registered midwife, who then had to leave feedback after every shift. We also had to have over 30 skills signed off before graduating, this was anything from looking after a woman in labour independently, to how to put up an IV drip, to things like how to deal with things if you suspect an abusive partner, or looking after a woman who speaks a different language. We also started our hospital placements very early on, I believe it was in week 2 or 3, and then once we learned certain skills we were able to use them right away in a clinical setting. Having done both nursing and midwifery, I definitely found the workload of the midwifery course much harder, and intense, but it was definitely worth. Most of the time woman in labour only see the OB maybe once or twice, the midwives usually look after the woman unless there are complications, or its a private patient. There are always OBs around in case of emergencies though.
I have 2 grown children. The first was born via midwife. It was a slow 2+day birth. My second was a 6-hour hospital birth. I would choose the 52hr midwife birth if I had to do it again. I was respected and my feelings were considered and things were allowed to happen when my body wanted them to happen. I was not strapped to a bed and was allowed to walk and soak in the tub and help my labor along. I was in control and I felt safe and supported. With the hospital birth I was made to stay in a bed where I was pumped full of medicines to take the place of what I could have accomplished on my own if I were allowed to move about. I and my baby were both in distress from the manhandling and the meds. I was bullied and insulted and all my concerns were dismissed and my requests and wishes were ignored. When I did need help, nobody would come. I had heart palpitations and hyperventilated while they forced me to have an epidural that I did not want. 25 years later I am still heartbroken and afraid of doctors because of this experience. And all because we had moved to a state where midwifes were illegal. So wrong.
I really appreciate you not totally trashing on midwives. I delivered 2 of my children with a midwife at a birthing center. The woman who ran the place was delightful, and had incredibly strict standards of care and training for her other midwives who learned with her. She also developed a great relationship with the closest hospital in the event of an emergency, or other requirement for transfer. Because of my 2nd delivery being difficult for me (and had to be transferred...lol) She would not take me as a patient again unless I got an evaluation from an OBGYN saying I was low enough risk to return as a patient. I wasn't, but she was still willing to be in contact with me for support if I needed it. I felt very confident with her, and the other women she had with her. I know this isn't the case for everyone, but you are absolutely correct in saying that it is up to us to do our research to be sure we are choosing the best possible person for our care. We do that with other medical professionals so why not do it for midwives as well?
While I can understand your hesitancy about CPMs and the lack of across the board certification, I think they do have a place. Many times CNMs cannot be at home births. And many CPMs spend 7 or more years becoming certified. And we need an option for women to safely birth at home with the right professional and equipment. Other countries have made this possible, I hope the US does in time. I so wish I had lived in the U.K. and would have become a midwife right out of high school/college. Here I would need to be in school almost as long as a doctor, after my BA. hmmmm
My first child was a horrible traumatic experience with a terrible OB. He preformed an episiotomy after I verbally told him no, and he hurt my baby delivering her with forceps (after I told him no) unnecessarily as there was no emergency that warranted forceps. He refused to delay cord clamping or even let me hold my baby. They took her away immediately, dried and weighed her then handed her to my husband. No skin to skin, I didn't even get the comfort of holding my baby after everything he did to me. I laid there in shock not understanding why my rights and my body had been violated. He also falsified her birth records. This was 5 years ago. All of my subsequent births were done with a Certified Nurse Midwife and every experience was wonderful. I had to have an OB oversee my care with my midwife this last pregnancy because I was taking blood thinners, and she was just awful. Not compassionate, no bed side manner. No sensitivity to the fact that I had just the previous year had a still birth. I'm so thankful that she wasn't anywhere near me for the birth. Every OB I've met has a god complex and no care for their patients. I really enjoyed your explanations and references to evidence in literature. You seem like you get to know your patients so you can properly care for them. Traits I wouldn't associate with an OB from my experiences.
I delayed clamping my sons cord by like 30 min to an hour and he was fine. He just hung out on me and breastfed (tried to anyway, darn inverted nipples) No jaundice and he wasn't bathed for 24 hours. He was skin to skin, his first day pretty much
In the UK. Midwives are trained for 2 years in college and then another 3 years in university doing a degree either a a BA or a BSc. For 3 years here student midwives train for 3 years straight. We start delivering in our first year and everything involving antenatal, labour & delivery incl c-sections, and postnatal care. As well as gynaecology is all included. We have to complete a lot before we get our degree in midwifery. And we don’t have to be nurses first. So just to let everyone know. We work really hard to become competent and have to continue to learn. FYI
I had a traumatic homebirth that ended with a lifelong-disabled baby (it's a miracle he's alive after a severe shoulder dystocia). I also sustained injuries (but none to the extent of my son's). My midwife was a CPM (certified professional midwife), which is not really anything afterall... anybody can attain that certification if you pay for a packet and fill it out and undergo an "apprenticeship". She can decide to send in birth notes of clients to MANA (midwifery alliance of north America) that has data on all her client's births or not... so there is not much oversight and any oversight is on a volunteer basis. CPMs do not have to have any kind of insurance, so when births do go wrong there is no lawyer who would take her on in court because there is no malpractice insurance.... it often leaves families in a bind when their infants or selves have to undergo emergency surgeries/lifelong therapies/etc because there is no compensation to help pay for lifelong care even. America really is a mess of system in regards to midwifery certification and standards and even reporting, varying from state to state. Many of us homebirth trauma mamas stay quiet about our births because the community of women we surround ourselves with put a lot of pressure on us to ("not wanting to give homebirth a bad name"), we are afraid we'll lose our friends and community, our midwives pressure us to (I was told not to include our midwife's name on any hospital papers regarding our son), we don't want to feel judged by hospital staff (it's a real fear), we are already undergoing a lot of guilt (either inwardly or family heaping it on us). … It's messy. So messy... I went on to have FIVE C-SECTIONS after my homebirth. They were calm, controlled, healthy, peaceful, joyful, most beautiful (the last one was pretty rocky though) and I felt present... everything my homebirth was not. I'm so thankful to have got to experience raising 5 healthy babies because of them and the ups and downs of raising my oldest always keeps me humble and sensitive to the fallen nature of this world.
If you don't want to give homebirth a bad name or are pressured to, you should atleast be able to warn about medically untrained "midwives". Maybe they should be referred to as somewhat trained doulas to give other people an understanding about their level of knowledge.
(Do nurse midwifes accompany homebirths in America or do they only work in hospitals?)
How does the homebirth community react to the disability? Is it a topic at all?
If the hospital asks for the midwifes name (if that includes "midwives", that aren't highly educated in the medical field) and you are pressured not to mention it, you should atleast tell the hospital the certificate level the midwife had or something like that. Hospitals should be able to educate women, who might take that route.
Isn't it in everyone's interest to have safer homebirths?
Not even a mom, I just like Dr. Jones, but you deserve the encouragement for doing whatever you believe is right for your child. Love to you and your family. You sound like an amazing person.
@@MamaDoctorJones There are also issues that creep up beyond regulation of training that need overhauled, but also include: having a "board" that can oversee just like you doctors and nurses have (NARM and MANA do not revoke certifications and do not require birth records/data from each midwife), having a back up doctor close and a working relationship with them (my ex-midwife got her rhogam shots from some doctor out west who she only heard of through word of mouth but never met, same with black market oxytocin... it seems so sketchy now that I say that, but this what happens in the world of the wildwest of homebirths. There is so much emphasis on NOT having oversight that it breeds major distrust and suspicion in hospitals and doctors), a minimum number of professionals attending a birth (2 people-midwife and assistant- are not enough when both Mom and Baby are in trouble), equipment at hand, enforcement of only taking low risk patients, and so on. I really was doing what I thought was best, but statistics can be so skewed depending on a source (and not many talk about the differences between prenatal, neonatal, postnatal statistics and how different countries define things differently and that matters in the gathering of statistics) and so many books that world encourages us to read are written in the 60's and 70's when birth was handled completely different than it is in today's hospitals (it definitely throws in the scare factor for many of us- and there are a lot- who have never met an ob/gyn or been to a hospital before). I was a new farmwife and young mama and just hadn't seen enough of the world where nature fails and falters and it doesn't always matter why to understand the risk to benefit ratio on a reality-based level. I've forgiven myself, but there are definitely times when it's a choice (usually when a new issue crops up regarding my son's day to day life). Thank you for addressing these issues. I love your channel. Have a great vacation!
@@valek7700 The world of homebirthing here is kind of unique in the fact that midwives (whatever their training or lack thereof) are held in a place of honor and almost untouchable, if you want to keep your friends/community. Many midwives take on a grandmotherly role to their patients for the rest of their lives and so it'd be like someone talking "bad" about your grandma when you love your grandma so much (there is not a lot of boundaries in midwifery care here). It's a hard situation to be in because if you or your baby are suffering, you especially feel the need to be surrounded by support so you are really scared to alienate anyone around you (thus many remain silent). When I finally started to share about our homebirth, I would get shut down immediately by others if I said something about a bad judgement call made by the midwife (and there were some pretty big ones). If I talked about her other births that resulted in the more severe injuries of other babies (there were 3 very soon after my own son's), I stopped getting invited to things. *In general, the homebirth community stays pretty hush hush about injuries/deaths. When it does get brought up, it often leads to talk about what the Mom did wrong that lead to it, placing guilt and blame on her shoulders (did she not trust birth enough? did she do this or that?) and the midwife is rallied around. Because of all that, I buried so many feelings (along with the truth) and tried to shrug it off saying, "It would have happened in a hospital too." (which it would NOT have) for a couple years. I did lose a community when I started sharing what happened and the dark side of homebirthing, but I've discovered that the truth is more important than all that. I'm a very conservative person, but I do see the need for regulation and oversight in the medical world and most definitely in the homebirth world.
Thank you for sharing your story! Don't ever be afraid to speak out, your opinion is SO valuable.
In Canada, Midwifery is an actual 4 year degree course like nursing. I would say this minimizes the risk of going to non certified midwifes.
It's similar in the UK, you can either be a nurse and do a shorter course to become a midwife or do the full length course, the result certification is the same. The system is integrated so unless someone is an independent midwife there is always back up obstetric care and independent midwives have the same access to NHS obstetric care it's just they have to fully transfer you rather than being jointly available the whole time.
@@anneharrison1849 Yes. that is the same here in Canada! After all, by books UK is still connected to Canada! Lol.
Same in Australia
Same in Germany
In America, to go the certified nurse midwifery route, you must have a bachelors (4yr nursing degree) or complete a year bridge program from an associates degree (has all of the nursing specific courses but none of the liberal arts of a BSN). Then you complete a 2yr masters of science in nursing degree. There is a one year requirement of working as a nurse prior to starting the clinical portion of the MSN program. After the degree has been conferred, the midwife must sit for a national certification exam, after passing they become a CNM.
The issue with other types of midwives is that depending on the state, different levels of training are or are not accepted. A certified professional midwife (CPM) is a midwife who has finished a midwifery training program and say for a national exam. Many states see these midwives as legal options and in most of those states these midwives have oversight from the medical board to various degrees. Lay midwives pretty much just hang out a sign and say they are a midwife. They likely have had some level of training but haven’t taken any credentials exams. They aren’t considered legal in most states and these are more often than not the midwives that make the media when things go wrong.
Re midwife: in Denmark we don't use doctors for births. We use midwives only, unless it's a c section or high risk birth of course. Midwife here is a standalone education (bachelor degree, and can go on to masters and so forth).
I wish it was like that here
Same type of thing in Australia too.
Same in the UK. Thank fuck!
Yeah and not surprisingly Denmark, AUS, UK, and Sweden all have much lower mortality rates for mothers and babies than the US. It’s atrocious that this country refuses to do anything about it. I’m trying to get presidential candidate Andrew Yang to look into midwife-led care and seeing if he can possibly research and release a policy proposal for changing the US obstetric system from medical to midwife. Until then though you won’t catch me stepping foot in a hospital to give birth unless I’m high-risk. I don’t trust it. The fact that I’m 50% more likely to die giving birth in the US than my own mother was and the mortality rates deeply validate my reasoning for this, at least I think so. 🤷🏽♀️ lol
Same in France! I'm in my 3dr trimester for my first baby in Strasbourg. They would only use a doctor in case of complication. What's the history behind this in the US, I wonder? Will have to hunt for literature.
Discussion of natural tear vs. episiotomy: Best Birth Control Ever
Discussion of Vaginal/Anal Fistula. Even better birth control.
Hahahaha. I had one of each with each of my two births an episiotomy and a tear. Neither were that bad.
@@h.r.9563 reassuring. Episiotomies always scared me.
Ps- cool name
Meredith Richardson just the word scares me and gives me the chills... lol
Tearing doesn’t hurt much. It just feels sort of sore? Hard to describe it.
My grandmother was a licensed midwife during the depression, 1920's-1940's. She was also pretty much the town doctor, since, being in a rural area where a real doctor was about 50 miles away. She set broken bones, and fixed minor problems. Of course, if it seemed life threatening, she had someone drive them to the hospital. BTW, of all the babies she delivered, mothers and babies all were healthy. She didn't loose one. Not many doctors, of her time could say the same. She was my hero. Loved her so much.
Amazing story! Your grandma was amazing!
@@kaitb07
Thank you. She passed in 1979, but still remember her sweet smile.
Your grandmother is a legend.
Amazing!
She is iconic 😌💅🏾
In germany, there has to be a midwife, when you give birth in a hospital but no doctor (when there is no risk). In fact, midwives are allowed to throw the doctor out!
Cool. I love the internet, we get to hear how it's done in other places. 😊
Yes, same in Australia. All births are attended by highly qualified midwives with bachelor degrees. Drs only show up in complex situations!
Same in New Zealand. Also, we got to choose our midwife! I now live in the uk where you are given a midwife.
Wirklich
And it's new that a midwife now has to get a university degree
My mom was a midwife in the Amish community for twelve years, and she was really good at determining when labor wasn't going smoothly and they needed to transport to a hospital.
Just to add to clarify - in the UK, our midwives qualify by taking either a three-year degree course or by first qualifying as a nurse and then later taking a supplemental 18-month post-nursing qualification. Around half of that time is spent in actual practice (so being present at births, prenatal checks etc) and the other half in learning all the theory and medical information they need to know. This is why, in the UK, midwives take the bulk of the prenatal care and deliveries, and obstetricians are generally reserved for the odd checkup or more regular care and delivery of higher risk cases etc. But there is always back up available from GPs, nurses, and hospitals. The concept of non- or under-qualified "midwives" is positively terrifying. You put your trust in that person to help ensure a safe birth for mom and baby, and the idea that they simply aren't is horrifying.
Can't believe midwives are not regulated un the USA! They think they are civilised!
@@rosiehoy4736 To be clear - it depends entirely. There are a variety of qualifications - some (such as CPM and CNM) do multi-year courses or start off as nurses who then take a second, shorter midwifery course too. You can't (presumably) call yourself that if you're not qualified and registered to do so. But yes, the fact that in other states, you can have much less qualified people being midwives is... terrifying.
Same in Australia, I wonder if that contributes to the high rate of maternal mortality that the US has compared to other countries like UK, AUS, CAN and NZ where it is regulated.
What I find annoying though is how in the UK people are comparing independent midwives who operate outside the NHS to minimally or unqualified midwives in other countries and attempting to put them out of business. Midwife is still a protected term, so any independent midwife would have to complete the same training as any midwife on the community rota or a hospital ward. I'm not sure that if I had another child I would want to go back to an NHS hospital as the experience was pretty awful from my point of view. The whole thing where you're basically on lockdown was just frightening, I starved for 3 days because the food was so dreadful, you have fucking SALESPEOPLE barging into your bedspace. Fuck that, I'll freebirth at home before I do that again.
@@littlelaur94 I haven't done that (nor has anyone here in this comment). I'm sorry you had such an unpleasant time in hospital (and I personally agree on the fact that they allow overpriced photograph salespeople and the whole Bounty thing is pretty obnoxious - though offering decent quality and reasonably priced photos as an option for those who want them is okay). Sadly the food is very dependent upon your particular hospital. I've been an inpatient in a lot of hospitals in my life and some were horrible, while others were really good. But that's a general hospital thing I think, rather than an L&D one. It isn't great fun, the security necessary on the ward - but I'd argue that it's preferable to having someone waltz out with a random baby. But yes, this is why we have different birthing options - including homebirth (though I'd always go to the hospital, regardless of my own discomfort, if it was the best thing for the health of my child).
To me as a German it's weird that so few women in the US have a midwife. In Germany you don't have to have one for pre- and postnatal care, but most women do. The birth itself (including C-sections) has to be attended by a midwife by law, no doctor is allowed to deliver a baby or care for a woman in labour without a midwife, except for emergencies if there is no midwife available. Doctors usually leave everything to the midwife as long as there is no emergency. I guess the lack of (well trained) midwifes might be one reason (of many) for the US' high maternal and infant mortility rates.
Das stimmt
Wow, I'm so curious what happened in the US historically around this situation.
Nikki Michaelson It actually stems heavily from racism within the US. Many midwives were originally black female slaves but when freedom was granted to the slaves many white male doctors didn’t like the fact that these black women could now achieve higher social standing by selling their services as a midwife. This launched a huge campaign to stop using midwives and start using doctors. During this racism fueled campaign horrible things were said about the black women who were practicing as midwives such as saying their hands are so dark that you can’t tell that they’re dirty. That is why, as opposed to many other countries, midwifery became an almost nonexistent career and most women chose to give birth in hospitals. Slowly but surely midwives are once again becoming a viable option for women to use during pregnancy however, because this profession is relatively new, there is a lack of consistency across all the states when regarding training, scope of practice and title. In the United States a certified nurse midwife is probably your best bet as they have to get a bachelors degree in nursing and then go back and get a masters degree in midwifery.
Doctors pushed the midwives out of business, before women even had the right to vote, because they wanted the business for themselves, and for "teaching material". CNMs were finally allowed in, primarily as "physician extenders"--but they follow OB protocols & aren't allowed to attend homebirths unless allowed by their OB. The primary reason for all this is MONEY. Healthcare is primarily a for-profit enterprise in the US.@@nikkimichaelson795
I live in California and my prenatal care requires both a midwife and OB. I mostly speak with my midwife though, and my delivery will be with her but in a hospital setting [which I prefer]. The US is quite huge and basically many countries in one. It is hard to clump it together as it is so different in other states and regions. However, I believe improvement in healthcare is always welcomed in my book.
Interestingly, in the UK, waiting 30-60 seconds to cut the cord wouldn’t be considered “delayed cord clamping”. That’s basically the standard. Delayed cord clamping here would be anything between about 3 and 15 minutes; or until it stops pulsating. When I had my third baby 4 years ago, I asked specifically for delayed clamping and I had about 5 mins (something to do with have R- blood, I can’t exactly recall now); this was very much a newer thing then, although my medical team were very much on board. With my fourth baby... well... he had VERY delayed cord clamping, because he decided to arrive rather speedily at home with no one but my husband to deliver him. 🤦🏼♀️
But delayed cord clamping made a massive difference to my post partum bleeding, and made the delivery of the placenta far easier (without it needing to be medically induced).
It’s actually really interesting hearing about the differences with our healthcare system here in general. Here antenatal and postnatal care is all about midwives. You’d only see a doctor if there was some specific risk or complication. It’s crazy to me that midwives aren’t regulated over there... and kind of scary! My midwife team felt like family... especially after one had to come out to my house in the middle of the night after my cheeky born-before-arrival baby!!! 🤣
Dear Beautiful so you are saying that you had less bleeding after having a physiological (natural) third stage? I was a midwife, and tended to do managed third stage. When my sister had her kids, the Dr was open to whatever she wanted, and the midwife wanted to try physiological third stage, it seemed that my sister had more bleeding. Not immediately post delivery, but her bleeding seemed heavier than expected in the following days. It’s only one person, so you can’t really gain much from it, but I found it interesting and I like hearing other women’s experiences. The physiological third stage was the only thing we did differently in a perfect, text book natural labour and delivery, so anything different we questioned if the lack of synto at delivery might have had something to do with it.
The topic of delayed cord clamping is interesting. I don’t know where people are finding the time to cut and clamp the cord in under a min. When I would deliver a baby, it would take that long just to get the baby up into Mum’s arms and get them both comfortable. Most of the times I delivered a baby the Mum was in an all fours position or side position, so it would take at least 30 seconds to just get the mum into a comfortable position. Then you are giving the baby a rub, etc. The only time I would think of cutting and clamping earlier is in an emergency, cord around the neck or if the baby is flat and floppy and needed to get onto the open care unit for resuscitation.
I'm not sure exactly where the disconnect happened, but somehow the US jumped pretty much straight from go call the other mothers straight to the OBGYN. Probably some sort of women can't be doctors thing. There is a HUGE gap in women's care in the US because of it. There's a fantastic documentary on the lack of understanding of how to handle a normal, healthy childbirth. Midwives are gaining popularity, and that's a good thing, but it's slow going.
It's not completely unregulated. It depends on the state. Some states loosely regulate midwives and some states are SUPER strict about the title and what training qualifies, which is why she talked very briefly about licensing across state lines.
Yea I think of rather delay the cutting then just allow the placenta to fall off by itself than it being forced out.. unless I'm hemorrhaging or something. I just want my birth as natural as possible. Gimme my baby. Cord attached, feed her and snuggle her. Then when the cord is no longer warm cut it off the baby but leave it attached to fall off on it's own over the next couple minutes or hour... I guess if it doesn't detach on it's own after an hour take it out. In America it's very common to make women lay on their backs and give birt and generally everything is very uncomfortable for the mother unless you have a midwife, doula, or get lucky to be able to go to a really good birthing center to advocate for you. America does a lot of things that actually cause more trauma to mom and babies body so it's good to have doulas or midwife present to advocate for mom. If she wants to change petitions to deliver let her, if she wants to keep the cord attached for 5 minutes, let her. I just believe in doing things as organically as possible. Obviously things change a bit if you are a high risk pregnancy.
Add E i have heard part of it is also to do with the idea of older midwives being witches, which is because they might have used more natural pain relief methods and tried to ignore male doctors advice.
Its pretty well documented that they were called witches because they did not want or need to have men involved in their medicine. If there was a infant or maternal death, they were especially blamed, even though infant mortality was high
I'm horrified that America doesn't require a degree to be a midwife
It varies by state. In texas you need a masters degree in nursing plus certified in midwifery
There’s a clear issue in the states with reproductive health in general. It’s a shame a country that proclaims to be “the greatest” fails so many of its people.
Just make sure yours is a certified nurse midwife or has been practicing for a very long time with a good reputation as a certified professional midwife.
America has actually made homebirth more dangerous in the guise of making it safer. Physicians were threatened by midwives so they sought to outlaw them, something europe did not do. Restricting access to midwives and midwifery training only makes people more likely to attempt an unassisted or unsafe birth.
Read an awful piece on not needing a degree to be a pathologists.. some guy set up shop in his basement and had did autopsies from there... (no medical degree or whatever). Im often shocked on how little papers are required for positions. Then again, because we have a healthcare system for everyone, the poseres wouldn't easily get hold as you need paperwork to get your services (midwife, pathologist whatever) refunded by insurance..
In Estonia, midwives train for 4.5 years and obtain the right to work as either a midwife or nurse (2 degrees at once!). They are highly qualified healthcare professionals with proper training and deal with women from infant to elderly, including pregnancy and delivery.
Same un spain except you have to be a nurse before you can be a widwife so you could work in either field!
Does Estonia have free college?
Your channel reminds me of when TLC was still The Learning Channel! As a kid, I remember watching actual surgeries on TLC and their other shows being equally as informative.
I LOVED watching surgeries and births on TLC when I was a kid! That was one of my favorite things to watch and I’m honestly sad that they no longer keep such informative shows on the channel.
Thank you so much for these videos. I am a (Swiss) comedian and I'm currently 8 months pregnant - and I'm often utterly stunned at the lack of humor people (at least in these parts of the world) are able to muster up when it comes to pregnancy. It's so refreshing to laugh out loud at all these crazy/unknown/irrational feelings and processes going on within yourself when you're building a tiny human. So again: Many thanks! And enjoy our beautiful country (I'll just consider it my gift back to you since I myself made it - not).
If you want pregnancy humour watch Ali Wong's specials 😅
Joanna Saadati I was thinking the same thing!
Miar sind halt schu kli as Büntzlivolk 😂 Do kunnt nit alles ah.
The question on the midwife really shocked me. In Denmark and the uk the midwife is a key part of the pregnancy and see’s you regularly for check ups, advice and to answer questions and comes for free with our universal healthcare.
ecuador3ful it’s truly a shame that the US doesn’t have universal healthcare. Hospitals will literally SUE patients who can’t pay their bill. 😡🤬
True, you only see an OBGYN when you have complications.
But we can only do this because we have well studied certified Nurse midwifes
Same here in Australia!! Plus is a full graduate degree not just a high school certificate.
That's how it should be. The US is backwards in many ways to do with healthcare and it shows in the stats. Worst maternal death rates of any developed country.
Personally I felt more rushed during labor and delivery with an ob, with my midwife I didnt feel so rushed and it felt more natural
I had the same experience. My 1st delivery was with an OB and he was in such a hurry that he didn't let the local anasthetic do its job before he started stitching up my epesiotimy. Every time the needle went in I jumped. He scolded me to stay still. My midwife was lovely and calm. No rushing at all.
Same. My OB snuck pitocin into my IV without telling me. Lovely experience. Not. My third baby was with a midwife. I wish I had never had OB births.
Midwives have a difference in education. They know that birth does not have to be on a clock.
YES!!
@@beccae6504 oh that makes me so mad. Sorry you went through that.
Hi! I think it would be really beneficial to a lot of women and young girls if you did a video on the side effects of different kinds of birth controls and statistics of more dangerous situations involving them.
I've had an IUD for 3 and a half years now and I only recently found out about them getting dislodged or even lost in the uterus and my doctor never told me about those kinds of possibilities.
Thank you for the great content! 💕
Yeh I agree, when I was looking into them, the information provided only specified the physical effects but not one mention of the possibility of mental side effects like mood swings or a decrease in mental health!
@@lindzdm such a good point. There really needs to be more info out there.
It's tough because there are many different types of birth control and they all have different benefits/side effects and it really depends on the person. Risks like an IUD "getting lost" is very very very rare.
Yesss
I love that you want to talk to your patients through about an episiotomy!! When they did mine they never even told me that they were doing it. I only knew because I overheard them talking to the intern there about it and they told my husband about it AFTER it happened. They admit afterwards they never need to cut me but she had a scheduled c section she had to get to. She never told me the degree but after they stitched me up said it was a tiny cut and gave barely any stitches. A few days later I had bleeding on the stitches and got it checked out at the hospital where they told me it was not a tiny cut and every doctor and ob who has seen it since has seen it. A week later my episiotomy reopened and had to be reopened where they used extra stitches. There was part of the vagina lip that still had stitches intacted at the opening, it was only about an inch of the muscle that reopened and the part of the vagina lip still intacted with the stitches pulled opened because no one at the hospital wanted to even look at iit because they were too busy and it never fully closed together and it has been a year since her birth. It was a complete nightmare! Where I live in Canada they cut everyone for at least their first birth because they say it heals better than a year and is easier for them. I wish I had stood up for myself as soon as I overheard it but I was a first time mom and I trusted my doctor
In Ontario, Canada, where I am, midwives have a 4 year undergrad degree, register with the college of midwives and update some of their training on a yearly basis. Right from the beginning students are attending births. A 4th year midwifery student played a huge role in my son's home birth. This care is also free under our provincial health insurance.
Do you get a referral to one through your family doctor or an on/gyn?
This APRN appreciates to the depths of my soul how inclusive you are towards midwives and NPs. I love this video. I got halfway through the CNM program at Frontier Nursing University and then life got complicated. I’ve since finished my FNP. I know so many amazing CNMs and I’ve also seen too many bad outcomes from lay midwives or inappropriate home births. If America had a better integration of low risk home births and birth center births by CNMs, our maternal mortality rate would likely improve. But the lack of good integration complicates this for all involved. We should take notes from the UK’s system.
Keep making awesome videos!!!
Could you talk a little about doulas? I'm curious what the medical community thinks about them.
I don't think there is a true link between the medical world and doula's. They are just a support system for the mom and dad during birth. They don't do anything medical at all.
The doulas piss allot of drs off cuz they try to run the show and give medical advice thats unwarranted or wrong
A doula is a support person. They are not medically trained and should be taken about as seriously as having a friend in the delivery suite.
Vanderbilt hospital in Nashville, which is a big deal in the medical world, LOVES doulas. The OBs work with them. Some hospitals have doulas available for patients! So while they are not “medical staff” they can be a wonderful part of the birth team.
@@Ainiewainy This Doula 100% agrees with you. We are NOT medical professionals. We are a loving, supporting presence. We know what questions to ask, how to help the mom increase her comfort, keep mobile, and try to stick to intended birth plans, but we cannot and should not ever give medical advice, nor are we at all synonymous with a midwife. In a best-case scenario we are a part of the birth team, however.
30-60 seconds is not what I had in mind when they asked about delayed cord clamping. I've read that truly "delayed" cutting is waiting over 20 minutes, or at least until the cord has stopped pulsing. Thoughts?
I was thinking that is what you meant when the question was asked. I heard of at least 5 mins of a delay or until the cord stops pulsing as the person asked below!
Hi, I'm Dutch and delivered my kids in the Netherlands. My oldest was born at home with a midwife and nurse attending and placed onto my chest immediately, as he was being born the midwife lifted him up and handed him straight to me. (Initial apgar score is assesed while baby is being born and handed to the mama, only time that changes is when baby doesn't come out crying or starts crying very soon after). A good five minutes later the midwife clamped the cord and I cut it (hubby was far too squimish about blood). My youngest was born in the hospital, with a midwife and nurse attending and the same thing happened, he was handed straight to me and this time I noticed the midwife touching the cord to check for a pulse after some time - I don't remember how long after he was born that was - and then she said we could clamp and cut the cord now. Both times we indicated that I wanted to cut the cord and as there was no need at all for it to be done hastily I got to cut the cords. I really don't see why the cord would have to be clamped and cut the minute a baby is born, they're still receiving blood through the placenta and will very likely spend their first moments after being born on their mama's chest or belly anyway, no need to rush.
I had a home birth under the care of midwives (In Canada, they have a University degree and are government regulated) and it is standard of care for them to wait until the cord stops pulsing before clamping and cutting unless the mother chooses otherwise or medical circumstance dictates otherwise. This standard of care is based on current research and it's always offered as an option to the birthing parent.
My daughter was born with a perfect apgar score, so she was immediately placed on my chest for direct skin to skin and we were tucked in warmly. Once the cord stopped pulsing it was clamped and cut. Her umbilical stump also fell off within 5 days, which I think may be attributable to the delayed clamping. She did have a mild case of jaundice, but we were able to treat it by laying her in front of a bright sunny window a few times a day (I still received regular checkups with my midwives at the time and her jaundice was being carefully monitored, if it had required more intervention we absolutely would have been referred to the hospital).
Delayed cord clamping is supposed to be AT LEAST 30-60 seconds on the case of an emergency but should be around five minutes. I'm not sure if that's what Dr Jones referes to because it doesn't sound like it :( it seems like she will cut the cord after 60 seconds at the very latest even if everything is alright which isn't enough. Source: americanpregnancy.org/labor-and-birth/delayed-cord-clamping-risks-benefits/
That's what I had thought too.
I just thought "why does everyone remind people to subscribe? Like you wouldn't do that if you like their channel?" Two seconds later I realize that I'm not subscribed, never mind 🙄
In the Netherlands we pretty much all go to midwives unless you're high risk. Midwives are trained very well here. Most people give birth with a midwive. But if you really want you can go to the OB-GYN too! Just not as usual.
Ainiewainy and you have the lowest rates of maternal mortality and morbidity
It happens that way often in America as well, the big issue is with non-trained “midwives” delivering children at home
here in America, it's almost unheard of to go to a midwife
@@brunettekoala And in that same statistics, we also have the highest home birth rate. :D
@@codename495 ...while over 98% of US births take place in hospitals...go figure
I live in Australia. I had two nurse midwives and a midwifery student at my son’s birth at my midwife run birth centre. All through my pregnancy, I was carefully monitored and if my pregnancy stopped being normal I’d be transferred to the care of an OB/GYN. Things stayed normal and I had an amazing waterbirth.
The real value of my midwife was in their home visits after the birth. They helped me set up breastfeeding, made sure I was recovering right and when I had issues they were able to get me a bed when I had to transfer to hospital.
Also may I add I didn’t pay anything? All covered by my health system. Love my country, love the care I got.
You didn't get that for free. It came out of your taxes/paycheque. Universal healthcare is great but it ain't free.
StrickenWithFear ah, why do you act as if I didn’t know that? I pay taxes, I know it covers it. Taxes cover the health system because it’s good for society to have healthy people. It’s also there when I need it, as I have in the past and no doubt will in the future.
It’s very reassuring to have my son admitted to hospital for a serious illness and NOT worry about how much it will cost!
Because you said you didn't pay anything which implies that you thought it was free. It wasn't. That's all I wanted to clarify. Have a nice day now.
Yeah my doctor didn’t even tell me he was going to do an episiotomy, and there was no low HR or other emergency, nor had I been in labor very long. I didn’t know until afterward. That total lack of consent and control in my own body was the primary problem for me.
This same situation happened with my first baby. I didn't really think about how awful it was until much later. To make it worse, he stitched up too much and that made sex painful for a very long time after. I wish I had been more knowledgeable at the time. I make sure to talk about it with expecting friends now.
I had a similar situation. My ob after my first push said I needed an episiotomy as she did it and I had no say. My stitches didn’t even dissolve until right before my 6 week appointment because she said she could still see some of them. My recovery and comfort took forever it felt like. Definitely would rather not have one in the future
That is what they call "birth rape" And not normal. Dont go with that care provider again.
That's because the doctor got more 💰 for the epesiotomy than if he had not done one. Cutting women up for extra dollars is disgusting.
Hannah I am so sorry that happened to you. I wish you healing and strength.
Thank you for answering these questions! I am in my 3rd trimester with first baby. Me and my doctor appreciate all of your information/channel. It has made it easier for him to communicate and for me to understand him 😘
I did delayed cord clamping. And the nurses acted as though me doing that was such an inconvience to them. But i didnt care at all. Oh well
Wow. This why I want to give birth at home or a special birthing center. It's another concern as a black female, we are treated disproportionately worse at hospitals. Even in the 80s when my older bother was born my mother was mistreated and the doctor yanked my brother put now he has permanent nerve damage in his arm. I hope my pregnancy is healthy so I can birth at home or in a pool with a doula/or nurse midwife.
Oh my lord that is aweful. Interesting you mentionion your a women of color my husband is a black man and my beautiful son is biracial. Idk if that is what their problem was. I wasnt really looking at the situation in that way. The person who did my epidural also very rude. I am scared for my child as he gets older due to ridiculous racist people. Now looking back we may have been discrimimated upon. Its a shame really. My child is amazing and the cutest chunkiest 11 month old you ever seen lol. And i pray to god things change. Its sickening. Im sorry that happened to your brother.
@@daphnietudor2953 yea people out here are just putting so much negative energy into the wrong things. Its 2019 amd people have to worry about being mistreated in the hospital because of their ethnicity it's so ridiculous. I hope your son grows up happy and healthy and doesnt have to deal with a lot of discrimination. I think its gotten better with each generation tho amd continues to despite the outrageous things we see still happening. Just keep loving that baby no matter what and he will be ok.
@@loryndabenson2118 I have had all hospital births, the biggest thing to make a good hospital birth is be very picky about the ob you choose. I've had nurse midwives, an ob and a family practice doctor that have all been great. I have done my research before going to them, looking at community reviews for natural labors. Then I am upfront with my expectations, and judge as much by their reactions as their words on whether they would be a good fit for me.
I've had great labors in the hospital, with no pushiness, and totally accepting of my wishes.
Wow I just had an emergency c section and they automatically did delayed cord clamping even with that.. 😳
I love my midwifes. I've used them for 3 pregnancies now. I also did delayed cord clamping. My first child was obgyn driven and they forced my placenta out by pushing on it. It was horribly traumatic for a first baby. With delayed cord clamping I felt my placenta detach naturally and it was like a release not pain and it was happened during skin to skin so it was beautiful. My 3rd pregnancy was a surrogacy so It was a little weird for me. My current pregnancy will still be delayed cord clamped and delivered by my midwife :)
Thank you for this comment. They did that with my first and it was very painful. I will be making them wait this time.
I had an amazing home birth almost 3 months ago with an amazing midwife ❤️ She was incredibly qualified and experienced. She knew exactly what was going on with my body and exactly what type of support I needed at that moment. I will have home births with all future babies.
I had an amazing birth with my second child with a midwife. I had told my OB that I was looking into an out of hospital birth during my first trimester, and from there he treated me like shit. At 28 weeks he told me I’d gained too much weight (20 pounds) and that I just needed to stop eating and get outside 😑. I’ve had multiple hip surgeries and he knew I was mostly sedentary due to it. Told my midwife that day and we decided to stop all my appointments with him since they were unnecessary at this point and more hurtful than helpful. After that it was a Breeze! She came at 41 weeks with no issues, 4 hours of labor, and 5 pushes in the tub. Best experience ever and very relaxing compared to the hospital where i get yelled at for everything.
That's because in a healthy pregnancy you're only supposed to gain 10-20 lbs.
Aya Jade wrong. Women with high BMI should only gain 10-25. Low BMI have to gain a lot more
@@Momof3wildbabies doctor's only recommended 10-20 lbs no matter what BMI as the BMI scale isn't an accurate measurement of health and research has shown 10-20 lbs gained during pregnancy were healthier pregnancies
Aya Jade in the US women normally gains about 20-30lbs in pregnancy. Some gain more or less, all depending on the pregnancy and woman’s size and activity level.
@@julianamartinez9737 again doctors recommend 20 lbs max for a healthy pregnancy any more than that it's classified as an unhealthy pregnancy
As a current nursing student/hopeful future CNM student, I couldn't agree more about needing regulation in the US for midwifery! The looks and questions I get when I say I am going into midwifery after my RN are astounding. So many people are under-educated about the professionalism and training that goes into what I think should be the standard for midwives (a CNM/CM). Once I explain to people that it is like being an NP, but solely focused on sexual/reproductive health, pregnancy, PP, and newborn care they begin to understand more. They also find it fascinating that I would want to work in a hospital or birthing centre located next to a hospital and am not a fan of practicing at home births. Thanks for clearing that up for so many and enjoy Switzerland!
Delayed cord clamping is 30 to 60 seconds? WHO says anything below 60 seconds is early and not recommended. 🤔
My baby was clamped from the placenta 30min after delivery in de meantime she was lying om my chest the placenta was next to me on the bed. Hospital delivery in the Netherlands.
That confused me as well. In germany it is more and more common to clamp the cord after the placenta stopped pulsating
@@Solina587 I love Germany's health care.
Maybe she misspoke and meant minutes
@@nastassjahall9358 no she meant seconds. A few people in the comments section have talked about this and she responded to them that she hasn't read any articles that point to any benefit of longer clamping. These are her words not mine.
Hi. I’m from Sweden and for me, delayed cord clamping means to wait at least 3 minutes. Or wait until the placenta is delivered, or the cord completely white. So that al blood is in baby. 60 seconds is, for me not delayed but quick cord clamping
Mama Doctor Jones. There is actually a doctor here in Sweden that have showed benefits of waiting longer. The research was what made US to recommend waiting 60 seconds. Although the study recommended more. I can give you his name if you want to. I have a very clear interview whit him we’re he talks about research results and recommendations, sadly it’s in Swedish. But, there is scientific research supporting waiting more than 60 seconds
Last I knew it was not good to wait for the placenta to be delivered because when it is it is fully detached from the mom and no more blood is being given to the baby. The cord should only be attached if the placenta is still inside the womb.
The US tends to compromise with the absolute minimum. It's stupid to put a time limit on it when it's actually about getting all the blood in the baby. And you can see when the cord is empty of blood.
In the uk pretty much all the prenatal and postnatal care is done threw midwives doctors are for emergencies
Aye, our midwives are trained via full-time degree courses over many years now. The lack of regulation in the US (along with the for-profit health system) explains why there are so many people in the medical profession who dislike or are uncomfortable with the idea of midwives. It stunned me at first to see how many people were anti-midwives but the fact that in some states almost anyone can call themselves a midwife is just terrifying.
I think that's the case in most countries.
Student Midwife I know I’m currently pregnant with my second baby I couldn’t be more grateful to the midwives who brought my first into the world I think it’s a beautiful career and it’s something I would love to go into my self
Just Another Bucky Lover that’s so scary! Could you imagine putting yours and your baby’s lives in the hands of someone who isn’t really trained to help
Same in Austria
Also, here in Italy it's a common thing, unfortunately, to do episiotomy without consent, they just do it, if you find the wrong person... This and other things started a movement called "basta tacere" (stop the silence, basically) about traumatic experiences of hospital births due to doctors and nurses being rude, mean etc...
I've had two beautiful home births with the same midwife. My first child was born in the hospital. The staff didn't really pay attention to me, the doctor didn't even make it in time for the delivery and a nurse barely caught the baby. They kept telling me not to push until the doctor arrived. Baby had other plans.
My friend caught her baby because the nurse let to get something and baby was ready!
It's good to have a little more knowledge about midwives. A few of my friends have had midwives and their care was top notch. I am glad I found your channel. Have fun in Switzerland!
Thank GOODNESS to be in Canada... midwifery is a degree and is regulated. Our midwives where I am have rights at the hospital, so you can choose home birth or hospital, and transfer to hospital at any point (I had to) and still had my baby delivered by my midwife ❤️
I'm in the UK - our midwives are amazing. I only saw my OB/GYN so much because my babies were little gits and caused complications. My midwives still took control of the labour room.
My first birth was 7 hours start to finish. My second was 2 hours start to finish. I'm not gonna lie, I'm nervous to make it to the hospital (an hour away) in time. I would love if you could do some kind of video talking about fast labors and what to do if u have to have an unassisted birth. I feel like it would just help ease my mind a little and I'm sure Im not the only one who has freaky fast labor and delivery! Lol
Mine was 6 hours and all my moms were 6 hours or less too😂
Just catch the baby. Odds are everything will be fine.
I had an episiotomy and a vaginal tear so it was much fun. Also I'm from the UK and it's standard to see a midwife as your primary care giver during pregnancy if you're low risk.
I had three great pregnancies and deliverys with CNMs(Certified Nurse Midwife) who practiced out of my local hospital. They were fabulous and I highly reccomend a CNM!
Mom: what did u learn today?
Me: that midwifery is a word
I learned it from Private Practice(spin off of Greys Anatomy)
I read this comment at the exact second she said it 😂
Amber Faulk same lol
I literally thought of this right after she said it and went looking in the comments 💀 didn't take long hahaha
I've heard that delayed cord clamping is 60 seconds to 5 minutes, or when the cord stops pulsating. Not 30-60 seconds
Yup.
Can you please do a video on thyroid disorders and how they affect pregnancy and reproductive health.
Yass. My pregnancy effect up my thyroid, which nobody told me that could happen.
@@gailgerard8604 I didn't know anything about how a thyroid disorder could affect pregnancy till I suffered a miscarriage 3 months into my 3rd pregnancy and a week later was diagnosed with hyperthyroidism and suffered many more miscarriages because of my uncontrolled thyroid disorder and need up having to have my thyroid removed a year after I had my 3rd child. During that pregnancy I was high risk and had to have ultrasounds every month and have my thyroid hormones checked quite often then after I had my thyroid removed I went on to have 2 more miscarriages and 2 more babies but was still considered high risk because I have no thyroid and have to be on hormone replacement medication and had to have ultrasounds every month and my hormone levels checked often. Not to mention all the effects my thyroid issues have had on my period and fertility
I have hypothyroidism but its easily controlled with medicine but during my pregnancy they had to double my dosage
@@kels226 yes I am now hypothyroid since having my thyroid removed 5 years ago but even with hypo when pregnant your thyroid hormone levels have to be carefully monitored especially during the first trimester since the baby's body doesn't create it's own thyroid hormones yet your body is the one supplying it to the baby
@@nancyconnelly2011 yeah they checked it at my first appt. And it was fine but about half way through they checked it and doubled my dosage. Now I need to find out when I should go back to my normal dose but I keep forgetting to ask😂
That’s scary about midwifery in the US !
In Australia where I live we have a board that requires certain training to become registered as a nurse and/or midwife! You need to either have done a bachelors degree in midwifery (3 years) or be a registered nurse (3 year degree) and do a course which is around 18 months on midwifery!
If you don’t do this then you can’t call yourself a nurse/midwife!
Not sure how country’s like the US get away with this, it’s so shocking 😰😰
Is delayed cord clamping indicated even with ABO incompatability and positive direct coombs?
There’s slightly more oversight for non nurse midwives but they are not required to take the same exam (while they absolutely CAN, there’s other ways to become certified
I found this link that has some really good info
www.midwife.org/acnm/files/ccLibraryFiles/FILENAME/000000006807/FINAL-ComparisonChart-Oct2017.pdf
It's one of those things that are state by state. There are sensible places with sensible regulations and... other places. I think the professional organizations like the American Medical Association should step up on this to provide and promote national standards. (I mean, I think we should also get over our states' rights fetish, but that's not happening anytime soon).
Just to be clear, in the US you must have a nursing degree to call yourself a nurse, it's a strict process comparable to that in other countries. It's just midwifery that's dumb and unregulated. Sorry if I misread, it just seemed from your comment that you thought that nursing was unregulated as well ❤
I drop this comment occasionally, but as a guy I appreciate the candidacy and information on women. I was never taught anything growing up
As an EMT we are taught not to cut the cord until it has stopped pulsating. Is that delayed cord clamping?
Cher England-Johns
Yes, I believe it is.
Yes, and I’m so glad you’re taught that
My mom had 6 c-sections. Most people look at me with huge eyeballs when they hear this. I am grateful she had this many because i am number 6 but i agree it's not common. She had many conversions with her doctor and he monitored the lining and her health after each one while he was delivering.
There was a time when if a mom had one C section, she had that procedure done for all subsequent births with no option for VBAC. As i understand it, they’d just cut through the previous scar.
My new favorite word is "midwifery"
I had 6 c sections, 2 miscarriages, my fallopian tubes removed and I have Polycystic ovarian syndrome. I love my OBGYN well now shes just my gynecologist, and I hope every woman can have a doctor they feel comfortable to talk with about their health.
I also wanted to say that I had 3 of my 4 babies with Certified Nurse Midwifes, and they were absolutely wonderful! They were all highly trained and delivered babies in the hospital. My last pregnancy was high risk so I saw a high risk OB in addition to my CNM and he gave the go ahead to have the CNM deliver the baby, but there was always backups and help available.
How do you find a certified midwife ? Isn’t fine through an ob / gyn or a family doctor?
@parinazaz4044 the certified nurse midwives that delivered my babies, worked in hospitals. They were skillful care providers and worked to make the hospital environment nicer for me and my babies.
@@heidi3963 oh ok, so you went to the hospital and asked for a CNM, or did you get a referral through your family / gyn doctor?
@@parinazaz4044 it was years ago, but I think I just looked up the names of CNMs in my area who took my health insurance.
im glad you specified that is what it is like in the IS. i live in NZ, it has the best maternity system, where women have a main maternity carer, 90% of which are midwives (who have done a 3-4 year bachelor degree that is purely midwifery / obstetric focus, mother and baby). Midwifery degree also includes pharmacology, and midwives can prescribe medications for mother and baby that relate to non complicated pregnancy - we cant prescribe meds for high blood pressure, etc (high blood pressure is referral to an obstetrician, and in which case, care is then shared between the doctor and midwife; the woman will still have the midwife provide care in pregnancy, labour, postnatally) but can prescribe antibiotics, iron, treat UTIs, breast infections (mastitis), eye drops for baby etc. We can order scans, blood tests, insert IV lines, and have yearly refreshers for obstetric emergencies (hemorrhage, eclampsia, shoulder distocia, neonatal resus etc). Women can birth at home, a small midwife led birthing unit, or a main tertiary hospital. Doctors are only involved if there are complications. we care for families from early pregnancy, to 6 weeks postnatal; under the one midwife, with a back up midwife to cover when she is off call. if complications arise, we refer to obstetricians - under a legal guideline that specifies where we must offer referral, or must transfer care to the doctors. we are fully regulated, and held to account like any other health professional. our system offer women the most choice, which is what it should always be about - women centered care - her body, her choices, and our role is providing her with the information so she can make an informed choice about every aspect of her care.
Can you talk about in a video the use/frequency of the “husband” stitch?
Ugh yes. Please bring that atrocity to light
What is that?
@@emerald3331 its when a woman gets a tear in her perineum after a vaginal birth and the doc stitches her up but adds another for "tightness" so that the assumed husband can enjoy a "nice tight vagina"
Honestly if I ever heard a dad request that I would throw placenta in his face!!
I had that and my doc didn't call it that! She just said "one extra stitch, hubby will thank me later." This was only 13 years ago. My second did not do this.
Thank you for the clarification on Midwives! I’m currently 38 weeks pregnant and have only seen a Midwife throughout my entire pregnancy (I live in the US - North Carolina). People ALWAYS raise their eye brows when I tell them that and ask if I’m going to give birth at home 🤦🏼♀️ I feel like there needs to be more education around midwifes and people should know who they are and how they are similar / different from OBGYNs.
Until about 30 years ago, most women in the U.S. had never heard of midwives, never mind used one.
Fun fact when your water breaks it constantly keeps going... So you feel as if you are constantly peeing yourself. That's something no one tells you 🤣😂.
Yes!!! I soaked thru three towels, and they had all been mult folded, so like 8 inches thick
Yes, some women can have their membranes rupture early in the pregnancy and they continue to leak until the baby is born. I looked after one woman who’s membranes ruptured at 18 weeks, she didn’t deliver until she was 37 weeks. There used to be a myth of something called a ‘dry birth’. Women would be worried that if their waters broke early that it would hurt more because the baby didn’t have the ‘waters’ to help lubricate the way.
@Liane Morran same! It was such an insane amount of fluid all at once.....definitely a sensation I'll never forget, lol
I found that it felt like it would build up a bit then gush like no tomorrow. 🤣
Mine kept going until I delivered. I got to the hospital and I was 2cm dialated. Then I got up to 6 and I had to have a c section. All worth it because now I have a beautiful almost two month old
In Australia, Nursing and Midwifery are separate three year undergrad degrees, however (I think this is still the case) if you want to be dual qualified its an extra 12 months to do the other side. I believe you have to have attended at least 40 live births by the end of your training. And I think Australia is really into mentoring and support for their entry level health graduates, or at least they are in speech pathology (my degree)
I found it terrifying when I was down under that the nurses and dentists at our school were graded on a bell curve.
It's sad how many lovely youtubers have to ask us to be kind in the comments.
I had my babies in 1965 & 1967. The standard procedure was ALL ladies in labor got an enema and got shaved (“prepping “) These added a layer of discomfort to an already uncomfortable situation.
For my first baby I had no prenatal classes (nobody did). I woke up at 8:15 AM, and told my husband it was time to go. After the “prep”, they gave me gas when the contractions got severe. I would awaken in the middle of a contraction, fighting it, and they would knock me out again. Fortunately, my son was born at 11:15 AM, so overall, not a bad experience.
My second baby was born in 1957. At the time, my best friend was an OB nurse, and she loaned me a book: “Thank you, Dr. Lamaze.” Again, there were no prenatal classes where we were (in England, at an US Air Force station clinic, nor at the hospital, an hour away.) I read the book, and did the exercises. On Labor Day (the holiday, not my personal Labor Day!), I was having contractions about every 5 minutes, so they ambulanced me to the hospital, where they “prepped” me. I was having copious “show”, and dilated 4 cm, and completely effaced. The contractions went on for about six hours, then phased away. False labor. But since I lived so far from the hospital, and had had only a three hour labor the first time, they decided to keep me. Three weeks later, bored out of my skull, two days before my due date, they decided to induce me. So they prepped me again, and they gave me a a series of shots. Not much happened. The next day, they tried again, without success, although I was treated to another enema. (They didn’t like pooping on the delivery table, nor did they want pubic hair!).
The following day, a new OB doctor came on duty. He had just finished his residency at Cornell, and taught Lamaze classes for women there. He told me that he was going to be on duty for the following three days, and he would be my Lamaze coach, and that I would have my baby while he was on duty. They prepped me again, and started a Pitocin drip, stripped my membranes, and broke my waters. 56 minutes later, after ten contractions, my daughter was born. I can honestly say that I had no pain. It was uncomfortable, but not painful. The only pain was when he was sewing up the episiotomy. (That was standard procedure then. I asked for Novocain. My first was not midline, and gave me fits for weeks, but this one was midline, and caused me no trouble.) I
The main difference between my first and second, as far as the babies was that my son was groggy seeming the first few weeks: not following objects with his eyes. He was also very fussy. My daughter, on the other hand, was watching the lights as they carried her across the room to bathe her and evaluate her. She was very alert and calm.
Times have changed. I had very unusually short labors, so the preparation I did with the Lamaze book brought me wonderful results, but I don’t know if I might have an epidural today. (Not likely, as I am 76, and have no uterus, nor ovaries.)
I love your channel. You present solid information in a straightforward way. I wish someone like you had been available back in the dark ages when I had my babies. Congratulations on a million subscribers!
I had 2 VBACS. Both times, the nurses and doctors tried to talk me out of it. Fortunately, all went well. Please talk about why VBACS are frowned upon by the medical community.
At about 4:20 she describes one of the risks (fairly small risk if I understand right, but very real) of subsequent pregnancies after cesarean…
Basically, there’s a chance things could go very very bad, very very quickly. Some doctors (or, perhaps more likely, some hospital boards of directors) don’t want to be a party to that risk.
I learned while working ten years at a local nursing home, hospitals don’t like people to die on their property… it’s not good for their numbers.
My daughter wanted to go for TOLAC (trial of labor after cesarean) with her second child. The local hospital wouldn’t do that, so she had to travel 40 miles to the big hospital and clinic instead. When other complications arose, she ended up choosing cesarean at the time the doctor said we need to induce today. Now. Not next week.
A couple years later, when pregnant with her third, even the big hospital and clinic recommended (required ?) that she have a planned cesarean. After which, local doctor recommended tubal ligation while they were in there.
She would like to try for a fourth… she will have to go back to the big hospital for a 4th cesarean if she gets pregnant again. Because local hospital is not willing to accept the risk, and perhaps might not be able to handle the worst case scenario if thinks went horribly wrong.
I used a CNM for my prenatal care and part of my delivery. The midwife at my delivery actually mentioned your videos and said she loved you!
I love midwives! Had 3 of my 4 kids in a birth center with midwives and 2 of those were water births, which were wonderful! The room and bed were so cozy, and so many pillows. My 4th was a hospital birth only because of insurance reasons. But I am glad that I experienced both.
I’m a NP, in school I did clinical with a cnm and she was so wonderful! I always had the misconception that midwives don’t monitor you as closely but it was if anything the opposite. They monitored their patients very closely and they gave great care.
Thank you for your videos and insight!
I asked for delayed clamping with my second and ended up in a cesarean after some fetal distress, to my knowledge they pulled baby boy out and cut the cord right away. This really upset me because i felt like NOTHING in my birth plan was followed per my requests and i felt defeated in many ways.
Tisha Mills if you end up having another baby make sure someone is with you the whole time who will advocate for you what you want
I dont know about your personal experience but at my csection the doctor did a delayed cord clamping. I didnt even have to ask she just let me know that's how it would be. It was my second and scheduled so that may make a difference.
My boyfriend and I will be visiting San Antonio this week and I can't believe you're only a few hours from there! You've taught me so much and I just love your sweet little family!
In NZ Midwifery is a bachelor degree and when you’re pregnant you choose a Lead Maternity Carer who is funded by the government. Your LMC will more than likely be a midwife. Having an OB as your LMC is quite rare.
As someone who has been so indecisive and scared about possibly having children someday, I am so glad I found your videos! Just watching you explain some of these issues and processes has made the idea of pregnancy and labor and delivery so much less frightening to consider. I am not saying they aren’t serious or anything, but it makes me feel better about the idea of it.
I wanted to give a shout-out to licensed midwives, which you don't mention in the video. Licensed midwives in California, for example, have to go through a minimum of three years of formal training and state examinations, and are licensed by the California state medical board. I gave birth at home attended by a very knowledgeable and highly experienced licensed midwife, who helped me find a supportive obstetrician and they cooperatively did my prenatal care. She was extremely prepared for the birth, brought two midwives and a host of equipment with her for support (there was even an oxygen tank and whole IV set up, just in case!), and we had several thorough conversations and a transfer plan in place to a nearby hospital in case of any complications (there were none). The other great thing was that she came to my home every few days for check-ups afterward for the first few weeks, which helped a lot.
Just saying, there are some great home birth midwives out there who are very qualified, thoroughly trained, and extremely competent, who perform safe, planned deliveries every day, and I'm grateful for them!
flibbertygibbette
There are also the Duggar’s daughters who hardly even were schooled calling themselves midwives after helping with a few births.
THANK YOU!!! CA midwives kick ass 💃🏼💃🏼💃🏼
Had a csection for my first, unmedicated vbac in hospital with second, and a homebirth with a CNM with my third. The experience was amazing! I even had to get a new midwife around 33 weeks since there was some licensing issues with my first one. My final midwife has been practicing for 14 years and served in low income clinics learning under other midwives.
In Australia if you aren’t high risk a midwife delivers your baby at the hospital. It is a 4 year university degree here. It’s amazing how it varies country to country
A properly vetted midwife can be such a gift. I had 3 natural births in the hospital and the last one with a midwife in a birthcenter. But she maintained incredibly high standards! She was only 3-5 minutes away from the closest hospital and maintained an excellent relationship with her backup. She always had nurses on call to assist with delivery. She educated me on every little thing, and we made decisions together. She was extremely cautious, and only accepted extremely low risk patients. She required documentation from my other doctors that showed that my thyroid and gallbladder issues were being taken care of properly and did not present a risk. She also caught things my OB never noticed that contributed to heavy bleeding after my other deliveries. My platelets dropped a full 100 points between 11 weeks and 28 weeks. She put me on a medicine called Immunobel and it brought my numbers up within 5 weeks. She was huge on eating right and getting enough protein. She was such a blessing! I felt so incredibly well cared for and would recommend her to anyone. Sadly she moved to another city and I literally cried . But I felt like she set the bar for midwife care in the US.
I have to say it is absolutely crazy to me (I'm from Canada) that the United States doesn't have standard midwifery certification and regulations. Canada, just like Europe, has a 4 year (3 year if you're in Quebec because of CEGEP) post-secondary degree to become a midwife, with placements.
I have a MIL who is a midwife / nurse, and she was there to deliver my son. Unfortunately it was my first birth and I had a massive DVT (blood clot) occur during labour that came close to killing me. I also had a very long labour (Wednesday water broke, Saturday he was born), and retained placenta, with cord avulsion. Whew! My midwife and her 2nd had over 600 births between them and both were nurses + extra midwifery training. Sometimes things go wrong whether you have a midwife or Obgyn. I think you need to feel comfortable with whatever you choose. Be sure your midwife feels comfortable to call in help if things start going wrong.
Would you consider making a video about IUDs? Good candidates, common side effects, warning signs, etc? PLEASE and THANK YOU!!!
I’m a CNM student (graduating next year woot!) and I was so happy to hear midwives weren’t bashed all together! New subscriber!
As someone interested in midwifery, I think it’s important to point out that CPMs are actually regulated & carry liscensure by the state in which they practice. Some states require less education than others (some don’t even recognize midwives) but to call yourself a CPM, you have to pass a nationally-regulated course (3+ yrs), an apprenticeship with a licensed CPM (which includes a threshold of attended/assisted/led births MUCH higher than just 20!), a nation-wide exam, and skills test. Then, they are licensed by the state in which they wish to practice. A lot of CPMs work with people who wish to labor and birth at home, but a lot also work in birth centers, which often also employ CNMs. Additionally, CPMs are specifically trained to understand their VERY narrow scope of care. They care for people who are within the normal range on all risk factors; as soon as someone is outside those parameters, the CPMs job is to send them to the next level of care.
Of course, there a people out there who will tell you they’re a midwife with nothing to back that up, and irresponsible people in EVERY field. But I think it’s a disservice (as well as inaccurate) to entirely dismiss CPMs as uneducated, unqualified to care for and assist NORMAL pregnancies and births, and not worth looking in to.
Thank you for your comment. I was coming here to post the same. The description of non-CNM midwives in the video reflects a common ignorance about Midwifery training held by mainstream care providers in the USA. I have many colleagues who are CPMs and it is crazy the encounters they have with hospital staff who don't even realize that Midwives have been licensed to attend homebirth in our state for over 20 years. They still think they're doing it illegally!
Absolutely! The ignorance around midwifery, its scope, and its efficacy (especially from people within the MIC) is astounding - especially when you look at the data for in-hospital birth outcomes 😬
When I was having babies 10-19 yrs ago, a “Dr Jones” had a blog that was very popular and VERY negative about homebirth and midwifery. Like that was the goal of the blog was to destroy home birth. Is this the same person? (all my kids were born at home with varying levels of midwives in various states)
@@Emillly3 I don't think so. I believe Mama Doctor Jones has been practicing for less than 10 yrs, so I don't see how it could be the same person.
Talking about tearing, I’m a mum of 3 but I don’t have any medical training just my own experiences. I found that changing my birthing position helped so much with my 3rd baby, my first two I was laying on my back and tore with both births but my 3rd I had PGP so couldn’t lie back, I was on all fours and didn’t tear at all, my baby was born inside her amniotic sack and she was a healthy 7lb 8.5 oz . I was truly amazed that I didn’t need any stitches at all
Recently subscribed, an eye-opening insight to some of the myths. It's insane that some people with minimal medical training and experience can be a midwife.
I'm from Australia and we only have midwives on the labour and delivery ward. Doctors only attended if something comes up that needs to be assessed (blood pressure issues, baby's heart rate, anything that may need an emergency cesarean). You also aren't required to see a doctor unless you have a high risk birth. Midwives order all the tests and give you the results. I only saw a doctor three times in my first pregnancy, the initial visit where I got my referral, because I had a cold and because I had extreme pain in my leg (turned out to be sciatica) and I need a home doctor to come see me. My second I only saw a doctor for the initial appointment.
My hospital (I live fairly outside the city so only really have one option) also offered me a home birth for my second. They handed me a pamphlet and explained that because my first birth was uncomplicated I was eligible for a home birth and they find outcomes can be better in home births because mum is more relaxed at home and that at any time if there's a change that makes your birth a tiny bit more difficult you switch to hospital birth straight away. They also have ambulance services aware that you're in labour that day so if something happens you'll be at the hospital in minutes and the midwives can bring all the painkiller options to you.
Please react to Outlander Season1 episode 20. Depicts a complicated birth in the 1760s
I mean...I am not who you asked to respond but I am a nurse who deals with miscarriages in peri op areas and my thought was that the placenta detached prematurely or had some other issue and that's what the bleeding was from and why the baby was still born. It didn't have blood flow in the womb prior to comming out. Then she was sick because part of the placenta was left inside. It was dramaticised and I have never seen a pregnancy that far along go bad BUT I have seen miscarriages and with the amount of blood associated with them earlier in term, I am sure it would be extremely bloody and scary and that a women back then would be lucky/unklikely to be alive from blood loss and infection complications. Not to mention infection and having part of the placenta inside can make it hard to stop uterine bleeding after birth. That was a hot mess of a situation.
Mama Doctor Jones, as someone who is currently studying to become a CNM (certified nurse midwife) I want to thank you! I dont know how many times I have had to explain what a midwife does... no it is jot all home births in a bathtub. Yes we can do epidurals. No it is not the same as a doula. Yes we have a grad level degree and certification beyond that. Thank you for helping clarify some of the difference. Even last week, after all this time my aunt called me a doula. Please don’t misunderstand. I have nothing against doulas. They can be very valuable but they are not the same thing as a CNM! Thanks again!
Great video! Have fun in Switzerland! I was wondering if you would be interested in doing a video about the number of women who are doing unassisted childbirth. To me it seems like a very troubling problem that unfortunately growing and most of these women don't do prenatal care as well. Would you be interested in doing a video about the dangers posed by this. Also I totally agree with you about the regulation of midwives.
Alex Hall home unassisted birth is not a bad thing unassisted doesn't mean that you dont have someone there many have a midwife or a nurse or their obgyn
@@annak804 I thought an unassisted birth was at home with no midwife?
@@MJ-vspeni it is.
@@annak804 unassisted means completely unassisted as in no midwife or doctor. Some women are even going as far as to be conpletely alone without even the father or a doula there as support. Homebirth can be wonderful if carefully monitored, but unassisted birth is plain dangerous.
@@annak804 I should have been more specific. The births that I am talking about are the mothers who do not have someone there that is a medical professional. I do understand that people can have unassisted births with midwives, at home births and even in hospitals with an obgyn and I am not opposed to that. However, that was not what I was referring too. Perhaps I should have said the free birth movement, but I am talking about woman who give birth on purpose without any medical professionals such as midwives, nurses or an obgyn present. And also do their own prenatal care.
None of my doctors or midwives were "weird" about cord clamping. They told me that as long as my baby was healthy and it wasn't emergent, then they didn't mind doing delayed clamping. Also, I absolutely LOVED my midwife experience. I felt it was less traumatic for me than my OB experience, but my OB experience was a high risk pregnancy and deliver. The midwife was also in the same practice as the OB. She was amazing. My family practitioner was the one who handled my first pregnancy and delivery. I never saw an OB, and I wish I had pushed for it, even though it was an amazing experience. I just feel like some of my concerns were brushed off instead of being address. Biggest issue - being told my itching was normal....and then 8 weeks after I gave birth, my gastroenterologist said that I had cholestasis....not a gall stone. I have ICP (Intrahepatic Cholestasis of Pregnancy) with my second and third....severe with my second. I am pretty sure I had it with the first, but my FP blew off my symptoms, and I had not idea about it until my second pregnancy. Even then, my nurses and many OBs kept confusing ICP with cholecystitis (gallstones). It was a fight to get a diagnosis. Do you have any advice for advocating for care for very rare complications many doctors might be unfamiliar with....like ICP (1% of pregnancies....90% recurrence in subsequent pregnancies)?
I have no idea why, but it seems cholestasis is treated and understood a lot differently in the US to the UK, but that doesn't help you advocate, sorry, I guess now you know you have a high risk of it then I'd be asking at the beginning of pregnancy when choosing an OB.
@@anneharrison1849 Where I live, there are limited options for OBs, and being military, my insurance likes to tell me where to go. It's awful. Thankfully, I am 38. I have Nexplanon, and my husband had the snipperoo after our 3rd was born. I worry mostly for my daughters when they grow up and have kids. You know?
@@AG-mt3xs yes, I understand, I don't know if your daughters would be at increased risk because you had it. Honestly with the general decreased awareness in the US I would try and do anything you can to campaign for more awareness. In the UK it's taken very seriously, 1% isn't even rare, just unusual (in my opinion, though several organisations define rare as 1 in 2000). In the UK you would be induced at 37 weeks (at least last time I checked any protocols). They don't do bloods for it routinely, but any itching or pain in the liver area and you'd get tested.
In the UK, all pregnant women are seen by an NHS midwife as part of their care.
The show "One Born Every Minute" points that out in every episode and is available on RUclips. I highly recommend watching it.
I'm pregnant with my second, and my OB who I adore, told me that after my first trimester I'd need to transfer to another provider because she's retiring (35 years of delivering babies). Yesterday, I asked her about transferring to a certified nurse midwife. What she said (after confirming I meant CNM in a hospital), " I don't generally recommend them for first babies because we're never quite sure how a woman's body will take pregnancy. You had a completely uncomplicated pregnancy last time, you delivered naturally, you're young, athletic and informed. I think you're a perfect candidate for a midwife."
The hospital i go to delayed clamping is routine. Its a certified baby friendly hospital and they do immediate skin to skin and delated clamping and bath as routine
Gabrielle Valentino same with mine!
I live in Alberta, Canada and we have have wonderfully trained and regulated midwives. We also have very safe home birth statistics (the same outcomes for low risk birth as hospitals per the McMaster University study). I had a home birth with midwives in May and absolutely loved it 🥰. My GP is from the UK and was therefore very supportive of my decision to use a midwife as it is common there.
Very informative. Thanks for always giving the factual information to help educate people. Have fun in Switzerland!
Midwives in UK are amazing. Fully trained and can give all care pre, peri and post delivery without any doctor intervention as long as it is safe and within the scope of practice
I can hear my aunty's friend, who is a midwife, gasping in horror that there are people who aren't qualified giving midwifery care!
Very informative video! I did not know that about midwifery certification (or lack thereof).
I was with my friend last year when she delivered her son. The (nurse) midwife waited about 15 minutes to cut the cord. She waited until it finished pulsing and the cord was limp. 30-60 seconds seems like a really short amount of time. Do many people ask to wait longer than 30-60 seconds?
I graduated as a nurse and midwife in Australia. You can either do a bachelor of nursing (3years) and then do an extra course afterwards (I think it 2 years), you can do a bachelor of midwifery (3 years) or the dual degree, which I did, which is 4 years. Just for the midwifery part, you do almost 700 hours of hospital placements, on top of that you need to follow 20 women ( I think they might have lowered that number now) during their pregnancy. This involves going to at least 4-5 antenatal appointments, be on call for the birth, and then attend 2 postnatal appointments. Before graduating you have to at least 30 assisted births (vacuum, forceps, c-section), and 20 primary births, where you are the one delivering the baby. You also do 9 written exams, as well as clinical assessments. For our placements, we were paired with a registered midwife, who then had to leave feedback after every shift. We also had to have over 30 skills signed off before graduating, this was anything from looking after a woman in labour independently, to how to put up an IV drip, to things like how to deal with things if you suspect an abusive partner, or looking after a woman who speaks a different language. We also started our hospital placements very early on, I believe it was in week 2 or 3, and then once we learned certain skills we were able to use them right away in a clinical setting. Having done both nursing and midwifery, I definitely found the workload of the midwifery course much harder, and intense, but it was definitely worth. Most of the time woman in labour only see the OB maybe once or twice, the midwives usually look after the woman unless there are complications, or its a private patient. There are always OBs around in case of emergencies though.
I have 2 grown children. The first was born via midwife. It was a slow 2+day birth. My second was a 6-hour hospital birth. I would choose the 52hr midwife birth if I had to do it again. I was respected and my feelings were considered and things were allowed to happen when my body wanted them to happen. I was not strapped to a bed and was allowed to walk and soak in the tub and help my labor along. I was in control and I felt safe and supported.
With the hospital birth I was made to stay in a bed where I was pumped full of medicines to take the place of what I could have accomplished on my own if I were allowed to move about. I and my baby were both in distress from the manhandling and the meds. I was bullied and insulted and all my concerns were dismissed and my requests and wishes were ignored. When I did need help, nobody would come. I had heart palpitations and hyperventilated while they forced me to have an epidural that I did not want. 25 years later I am still heartbroken and afraid of doctors because of this experience. And all because we had moved to a state where midwifes were illegal. So wrong.
I really appreciate you not totally trashing on midwives. I delivered 2 of my children with a midwife at a birthing center. The woman who ran the place was delightful, and had incredibly strict standards of care and training for her other midwives who learned with her. She also developed a great relationship with the closest hospital in the event of an emergency, or other requirement for transfer. Because of my 2nd delivery being difficult for me (and had to be transferred...lol) She would not take me as a patient again unless I got an evaluation from an OBGYN saying I was low enough risk to return as a patient. I wasn't, but she was still willing to be in contact with me for support if I needed it. I felt very confident with her, and the other women she had with her. I know this isn't the case for everyone, but you are absolutely correct in saying that it is up to us to do our research to be sure we are choosing the best possible person for our care. We do that with other medical professionals so why not do it for midwives as well?
While I can understand your hesitancy about CPMs and the lack of across the board certification, I think they do have a place. Many times CNMs cannot be at home births. And many CPMs spend 7 or more years becoming certified. And we need an option for women to safely birth at home with the right professional and equipment. Other countries have made this possible, I hope the US does in time. I so wish I had lived in the U.K. and would have become a midwife right out of high school/college. Here I would need to be in school almost as long as a doctor, after my BA. hmmmm
My first child was a horrible traumatic experience with a terrible OB. He preformed an episiotomy after I verbally told him no, and he hurt my baby delivering her with forceps (after I told him no) unnecessarily as there was no emergency that warranted forceps. He refused to delay cord clamping or even let me hold my baby. They took her away immediately, dried and weighed her then handed her to my husband. No skin to skin, I didn't even get the comfort of holding my baby after everything he did to me. I laid there in shock not understanding why my rights and my body had been violated. He also falsified her birth records. This was 5 years ago. All of my subsequent births were done with a Certified Nurse Midwife and every experience was wonderful. I had to have an OB oversee my care with my midwife this last pregnancy because I was taking blood thinners, and she was just awful. Not compassionate, no bed side manner. No sensitivity to the fact that I had just the previous year had a still birth. I'm so thankful that she wasn't anywhere near me for the birth. Every OB I've met has a god complex and no care for their patients. I really enjoyed your explanations and references to evidence in literature. You seem like you get to know your patients so you can properly care for them. Traits I wouldn't associate with an OB from my experiences.
I delayed clamping my sons cord by like 30 min to an hour and he was fine. He just hung out on me and breastfed (tried to anyway, darn inverted nipples) No jaundice and he wasn't bathed for 24 hours. He was skin to skin, his first day pretty much
In the UK. Midwives are trained for 2 years in college and then another 3 years in university doing a degree either a a BA or a BSc. For 3 years here student midwives train for 3 years straight. We start delivering in our first year and everything involving antenatal, labour & delivery incl c-sections, and postnatal care. As well as gynaecology is all included. We have to complete a lot before we get our degree in midwifery. And we don’t have to be nurses first. So just to let everyone know. We work really hard to become competent and have to continue to learn. FYI