Certified nurse midwife Catherine Badeaux of Woman to Woman Midwifery (3615 Prytania St., 272-0681; www.womantowomanmidwifery.com) discusses natural birth and a midwife's role.
Q: What exactly does a midwife do?
A: We take care of low-risk, healthy women. Low-risk means any woman who doesn't have complications like diabetes or heart problems or illnesses that might be complicated by pregnancy. We do all prenatal care, deliver babies and we do annual exams. We can even take care of some menopausal women. We can prescribe certain medications, like birth control and prenatal vitamins.
Q: Why might a woman choose a midwife to deliver her baby instead of a doctor?
A: Women come because they know we support natural childbirth, which to me means having a baby without an epidural (anesthesia). An epidural can cause a higher incidence of C-section (caesarean section), and it slows labor down. [Our patients] want the natural experience. We do a lot of teaching in the office, and our appointments are 30 minutes as opposed to five or 10. We get to know our patients and build relationships. We don't come in at the end (of labor) and catch the baby, which is routine for a doctor.
Q: What credentials must a midwife have?
A: You have to be a registered nurse and have a master's degree in a related field like science or public health. We have to pass the board (exams) for certification through the American College of Nurse-Midwives, which works in conjunction with the American College of Obstetricians and Gynecologists.
Q: What is the process of giving birth with the assistance of a midwife? Do you do home births?
A:I have an independent practice with Esther (DeJong) and we do our deliveries at (The Family Birthing Center) at Touro Infirmary Hospital. The (birthing center) room is quiet, the lights are low, they can have family around them and a nurse will come in and out. If the father wants to help in the delivery, I have no problem with that. We come in when [our patients] are in active labor and we help them. We calm them down, encourage them, teach them to relax, have them change position. Women move around in their labor. Some squat on the side of the bed. We encourage (the patient) to move around, and when it is time to give birth, we may make a suggestion (regarding positioning), but her body is going to tell her what to do.
Q: How do women deal with the pain of natural childbirth?
A: Our biggest relief is water birth. Getting into the big tubs of water is wonderful.
Sometimes (the birthing mother) needs a little medication, like an intramuscular injection of Nubain that helps them relax and takes the edge off. Some of our patients have epidurals. If they get to a point where they ask for an epidural, I say yes. Whatever you want is fine, as long as you are safe. But the vast majority of our patients have natural childbirth.
Q: What if something goes wrong?
A. There is a safety net of being in the hospital in case there is an emergency. We have two backup physicians that we signed a collaborative practice agreement with. If there is an emergency — for example, the baby's heart rate goes down and stays down, we call them, and they come in and do a C-section. That is the beauty of being in the hospital. Our patients think it is the best of both worlds.
Q: When are inductions necessary? Can women still have a natural birth if the labor is induced?
A: Inductions are necessary when a patient is overdue by their due date. We wait until women are two weeks [past] their due date before we set up the date for induction. A lot of women have a notion that the pain will be worse (with induction) and you need an epidural, but the last three we have done, there was no epidural. The nurses were pretty amazed.
Q: How frequently are episiotomies performed and under what circumstances?
A: I have been doing this for 12 years; I think I have done six (episiotomies) in an emergency. Most of our women don't tear. We help them push slowly and nudge the baby out, and if they are in bed, we use warm compresses. However, when women do have a tear, we use a little Lidocaine and give them a few stitches. We can pretty much do everything.