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To add to the previous comment (and speaking as a midwife also working in the Portland area): midwives also employ informed choice as part of the foundation of our practice. Every step of the care we provide is explained with the purpose of educating our clients as consumers to be able to make the best choice available to them. While we are trained to recognize high risk situations, and to refer those clients for care to an obstetrician, or perinatologist, we are also trained to care for women who fall into the "complicated" category. But this care cannot be provided without full disclosure of both the potential risks and benefits of choosing to labor and birth outside of the hospital.

When a woman is pregnant with twins, or a persistent breech, or is desiring to have a VBAC, she falls into the "complicated" category. In an otherwise healthy pregnancy of the sort described above, clients are provided with written informed choice documents and are then provided with ample time to ask questions and do independent research, before making a decision as to how they choose to continue their care. The decision to birth outside of the hospital therefore lies ultimately with the client herself, and whatever her choice may be, she will be supported by her midwife.

Having also attended many prenatals and births in hospital settings, I cannot recall a time when I saw a woman or her partner allowed the time to process, research, and ask questions about the variety of procedures that will be a part of her routine care. I am worried that the majority of Americans have been so left out of the decision making process in regards to their health care. In truth we are all consumers who are being served by professionals, and we should feel free to ask questions, make choices, and seek other providers should we deem appropriate.

posted 2 years, 10 months ago
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