Episode Transcript
Interviewer: Why should a mother to be choose care from a midwife? We'll be discussing this next, on The Scope.
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Interviewer: I'm talking today with Debra Penney. She is a certified nurse midwife from the College of Nursing. Debra, first of all, we want to establish that you are a midwife.
Debra: Yes.
Interviewer: A certified midwife. That is actually a real thing that mothers-to-be actually choose for care. Tell me some reasons why mothers, or mothers-to-be, should be choosing midwives for care.
Debra: Well, actually, there are several reasons and I can name the top few. One is we see women prenatally, just as a physician would, and we do some of the same tests, but we actually have longer visits. So, we spend that time communicating, getting to know the woman and really understanding what this birth means for her and her family.
Interviewer: So, it's a kind of a customized care.
Debra: Yes, we center in on the woman and her choices. And, we can't guarantee that she'll have all her choices. But we really want to honor those choices, respect the woman, communicate clearly with her and develop a relationship so that we know what she needs in labor and during her postpartum period. And, we try to address all those needs.
Interviewer: So, what are some of the personal choices, then, that you are talking about that she may not be able to get from a normal doctor?
Debra: Well, I think that she can get most of them, but what she may not get is the lack of unneeded intervention.
Interviewer: Got you. Okay.
Debra: We try to really manage labor according to the evidence, and try to not intervene with routine things that are known not to really help labor, to facilitate normal labor. And, also, we want to help her understand her body and what's happening physiologically through the pregnancy and birth and postpartum process. So, we do a lot of education. And, as nurses, we really like to focus in on her cultural differences, as well, and how those play in to her birth plan and her birth choices.
Interviewer: So, with that said, do you guys have the different knowledge of each culture and how they birth their babies?
Debra: Well, actually, culture is very variable, but we like to get to know the woman personally first, and then we can modify what she needs. For example, we had a lady from, I think it was southern Sudan, and it was her first time ever in a birthing hospital, here in the United States. So we took off the monitors because she was having a normal birth and used an intermittent monitor, let her move around the room freely.
Interviewer: Kind of natural?
Debra: Yes, and she could also choose her own birth position. So, I think as midwives, we can adapt more and we also, as nurses, just really key in to what this lady needs culturally as much as she can express that to us.
Interviewer: So, with doctors, I've noticed that when a woman gives birth, they kind of come in, check up on you a little bit, and then they walk out. Then they come in about, like, a half an hour later, and then, it's another, like, 30 second, "Hey, how are you doing?" I'm assuming that's different with midwives?
Debra: Yes, and since we're nurses too, our scope of practice does overlap nurses a bit. That, we're in the room, helping this lady find the best position to help her baby come down and come out. And, also we can offer a lot of different choices as far as comfort measures, acupressure, massage. We're with her the whole time in labor. Now, if she wanted an epidural, that's fine.
Interviewer: Oh, so she can get an epidural if she wants to?
Debra: Yeah, there's a common misconception that women with midwives, birthing with midwives, cannot have...
Interviewer: It's all-natural?
Debra: Yeah, and it's really not all-natural. We try to keep it as much as she's willing to keep it natural, but it's her choice to have an epidural.
Interviewer: Got you. Okay. I know that you said that you stay with the mom-to-be before she gives birth, the months leading up to it. You're kind of there holding her hand, being her best friend, and then you're there with her during labor. What's your role after labor?
Debra: So, after labor, we see them a little more frequently, perhaps, than a physician would. We like to see them at two weeks and at six weeks, and we really love if they call us. So, we're really available to them all the time that they need. And, we also do, as part of their postpartum care, we offer contraception. And, I think we have one of the highest levels of contraception with our patients.
Interviewer: Why isn't midwifery a more common thing?
Debra: I'm not really sure. I think a lot of people just naturally think that a physician is the way to go, when they don't realize they have the choice for a midwife.
Interviewer: So, the people interested in finding a midwife for their pregnancy, where can they find you?
Debra: Our practice is located here at The University of Utah, and they can find us, if their insurance covers us here. But, actually, there are midwives in every major hospital here in Salt Lake Valley.
Interviewer: See, I did not know that. That's, just, like a myth.
Debra: So, that's a really good thing. Choosing a midwife should be a more common thing, because they really save on medical dollars because of lack of interventions and they have a better outcome for a lot of the women that they serve, so less c-sections. Our c-section rate here is only 8% where it's 30% in the U.S. So, that's another good reason to have a midwife. So, midwives deliver about 10% of the births in the U.S. and that really needs to increase.
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