What is a Fertility Midwife?

I would like to create a new title for a new vocation: 'fertility midwife'. The fertility midwife would meet with couples once a month (or be in contact over the phone for couples farther away) for about six months prior to conception to work on helping the couple to improve health practices in order to achieve a state of optimum wellness---healthy "soil" and healthy "seed". I believe this is so important and so overlooked. It seems that most sub-fertile couples with whom I am in contact look at getting pregnant as the only goal. And of course, getting pregnant is a wonderful and marvelous goal! Yet as a childbirth educator, I know that having problems conceiving usually tends toward problems with the pregnancy and problems during birth and problems with breastfeeding. The wonderful way in which God designed our bodies is to protect us from these problems. If there is a chance for greater difficulties down the line, our "fearfully and wonderfully made" bodies put the brakes on at conception. Having trouble conceiving is a sign that we are out of balance. I'm not saying that infertility is the wife's fault or the husband's fault--sometimes difficulties with fertility arise because of events that occurred when we ourselves were in the womb, or in our early infancy or childhood. Yet there are many many things we can do to "tip the scales" toward fertility. These are the techniques that a fertility midwife would be trained to teach others.

When a couple comes to me for fertility counseling, we first begin with trying to understand the couple's history--the many many experiences that helped shape the people they have become. Then we work on understanding who they are today: their eating habits, exercise routines, work loads and stress levels, exposure to pollutants, and for the wife, her menstrual and ovulatory patterns, as beautifully demonstrated on her own charts---those wonderful charts on which she records the observations she herself makes of her own body. As well as, of course, understanding when exactly the couple is attempting to achieve pregnancy! All of this information is vital to making a personalized Healthy Conception Plan. This is the work a fertility midwife must do if she is to truly aid couples.

I have a dream: a dream that not only would those couples who are having trouble conceiving visit with a fertility midwife, but even "healthy" couples. To pad the fertility midwife's pockets? Nope! Because healthy children come from healthy parents. We all benefit from having someone else to keep us accountable. When am I the best hydrated? Ask my husband--it is when I know I will have my midwife checking my heart rate at my prenatal appointment!! We all have less than ideal, even downright unhealthy habits. The fertility midwife is there to be the couple's accountability--to keep the couple accountable to those healthy habits that will be the best foundation for a healthy baby. I repeat: healthy children come from healthy parents. Bring on the fertility midwives!

St. Croix Valley Mothers Need Midwives

I have just spent a fascinating few precious my-son-is-sleeping moments reviewing and comparing statistics on St. Croix Valley births. WOW! Mothers NEED midwives! I have always theoretically known this was true, but it is so fun to actually see this play out in real births. All these statistics are from births of real couples who have taken St. Croix Birth & Parenting classes. All of the women who have taken my classes have been low risk, whether they chose midwives or physicians to attend their births.

Natural Childbirths: no pain medications used during labor
85.7% of midwife-attended births were natural childbirths
20% of physician-attended births were natural childbirths

Inductions: starting labor before it starts on its own
0% of midwives induced labor
20% of physicians induced labor

Augmentations: using artificial hormones to speed labor
14.3% of midwife-attended births were augmented
40% of physician-attended births were augmented

IV's: intravenous fluids given to the mother
28.6% of midwives used IV's
60% of physicians used IV's

The only outcome for which physicians had a better track record was maternal tearing.
42.9% of mothers who had a midwife had a tear
20% of mothers with a physician had a tear

However, this outcome needs to be looked at more closely, because an additional 20% of mothers with a physician in attendance had an episiotomy performed. None of the midwives performed an episiotomy. This brings the results for any perineal trauma:
42.9% of mothers with a midwife experienced perineal trauma
40% of mothers with a physician experienced perineal trauma

Additionally, of the midwife-attended births, one-third were first degree tears (a mere split in the skin) requiring no stitches. Two-thirds were second degree tears requiring stitching. Of the physician-attended births, half of the group had an episiotomy (basically a second degree, or worse, iatrogenic--physician-caused--tear)and the other half had severe tears (3rd or 4th degree tears). In other words, even though the midwives had a slightly higher rate of perineal trauma, the actual tears were milder.

A very important observation is that in all cases of second or greater degree tears, an IV had also been used. IV's are NOT a "harmless" intervention. For those of us who believe that mothers can and should birth over an intact perineum, IV usage needs to be seriously re-evaluated.

On the plus side for all St. Croix Birth & Parenting births, we still have no cesareans, no forceps or vacuum extractor births!!! Way to go, couples!

It should be noted that actual numbers of couples are still small, but large enough now to begin to show a difference between the way midwives and physicians practice in the St. Croix Valley. I am eager to keep getting new student couples in order to continue to encourage mothers to achieve enriching, satisfying, safe births! Kudos to midwives in the St. Croix Valley, who are doing a great job meeting these goals!