The Business of Being Born Message Board

Q: I live in rural Montana (Baker, MT) and am not yet pregnant, though we’re trying. I’ve researched my little fingers off and the closest midwives I’ve found live 3-1/2 hours away. I’ve asked my OB/GYN about midwives and she’s never worked with one and has no information.

What are my options here? Do I have any?

I’m also looking at nursing schools to get an RN so I can train to be a nurse midwife. Does it matter if it’s an associates’ degree, bachelors’ degree or masters’ degree (I already have a BA and am a licensed massage therapist).

Thanks!
Anna

Dear Anna,

A: It is wonderful that you are being so proactive in your prenatal
search. How disappointing to find that you would need a 7-hour journey
for each prenatal visit. I don’t recommend using someone that far away.
You want to feel comfortable knowing that you can reach that
person/that she can reach you in a much shorter time frame.

I recommend contacting one of those “far-away” midwives. Perhaps they
know of someone not listed. If there truly is no midwife close enough,
which seems likely, I would try to find a doula who can work with you
and your doctor. Have your doula meet your doctor at a prenatal visit,
if possible, since your doctor may be new to her role.

It is important to begin to educate your doctor about the reasons you
would like a midwife and see if she is is receptive. If not, look
elsewhere now. There are certain questions to ask. Although this is not
an exhaustive list, it is a start. Explain that you have a list of
questions and would like to discuss some of the answers. It is
important not to make your doctor feel defensive, so watch your wording
and tone. Also, her willingness to answer and discuss these questions
also may influence your decision.

How do you manage pain in labor?

Do you use intermittent monitoring? In what cases do/don’t you use it?

Do you allow laboring women to walk/walk after they break their water? Eat?

What are my chances of having you deliver me versus someone who does not agree with the midwifery philosophy?

At how many weeks do you induce?

What is your c-section rate?

Do you know what a doula is? Do you know her role? Do you have any issues with a doula being present at my birth?

How often do you cut episiotomies?

Talk to friends about their birth experiences to think of other questions.

You already have a relationship with this doctor so it would be lovely
to stay with her. However, if she, or her group, is not right, look
elsewhere. Then, become a midwife so that other women in your area have
options!

As for the midwifery education, the best information you can get is
straight from the source; there is not one answer for your question
about the nursing degree.

ACNM states, “All programs accredited by the American College of Nurse-Midwives
Division of Accreditation (ACNM DOA) require a Bachelor’s degree for
entry. Many also require that applicants be a Registered Nurse,
although 22 programs currently have options for non-nurses. Many
programs require that the Bachelor’s degree be in nursing.”

Contact the programs for
information. Many programs offer a nursing to midwifery option so that
you can get it all done at one place. Go to the ACNM website (www.acnm.org) and click on “Become a Midwife”.
You will find a list of midwifery programs with contact information.

Until then, teach your husband some of your massage techniques so he can use them on you later!

Good luck, Anna.

Hilary Prager, CNM MPH