Women in Australia ask each other “Who are you going to for Prenatal Scare?” Sadly, that could be said in North America, too. Stressed practitioners unloading their personal fears on pregnant women is a common scenario all over the world.
A pregnant woman in Australia wrote to me because of these instructions from her midwives: “Lydia, your baby’s head is not engaged in the pelvis and you are close to your due date. We’re concerned that the umbilical cord might prolapse if your membranes release before your contractions are well established. If that happens, call an ambulance to get you to the hospital and get in an all-4’s position on the floor while you wait for the paramedics!”

She wrote to me in Canada to get my opinion on that advice. I told her my favorite theory about low-probability problems in birth work. I wrote: “Yes, Lydia, all that could happen, but it’s highly unlikely. Do you know that you could be walking down the street in your city and a piano could fall on your head? That’s possible, too, but none of us refuse to walk on city sidewalks because of the falling piano danger.” That explanation gave her confidence to continue with her homebirth plans. The midwives attended and everything went well.

Discussing things that are real and present is what pregnant women need from their midwives prenatally. Hallucinations of possible disasters that aren’t happening need to be silenced.
When a woman comes for a prenatal visit (or you attend at her home), she’s excited to be with her midwife and find out how her baby is doing. When a midwife is doing her best work, she will:
Be listening intently to what the client is saying.
Be organized so the client gets the message that the midwife values the client’s time.
Be writing notes of everything the parents say.
Be able to say “I don’t know the answer to that, but I will look it up and send you what I find out.”

The prenatal visits are a “dress rehearsal” for the actual birth. The family is getting an idea about how the midwife will be once the birthing time arrives. Is she punctual? Does she answer her phone promptly? Does she smell nice? Does she answer questions honestly? Do we feel comfortable, relaxed, and included when we’re with her?

I had a young couple come to an introductory appointment with me about 25 years ago. The government of British Columbia had just regulated midwifery and families wishing to have a homebirth with a midwife could get the service on their medical plan. I was not regulated and I charged $2800 to attend a homebirth. I explained that they could get a midwife “under the medical plan” and I also reminded them that I lived a 90-minute drive away from them. There were midwives working very near where they lived who would be paid by the government.
The father responded that “No, they didn’t want the local midwife and, yes, even though they didn’t have a lot of money they wanted someone like me.” He then proceeded to demonstrate what the local midwife did that he couldn’t accept. He started speaking to me while staring at a spot on the wall that was about 18 inches above my head. He didn’t connect with my eyes for the next little while. It was very weird. Then he told me “That’s what the midwife did. She never made eye contact when speaking to me.” He didn’t want long, deep stares, he just wanted a normal conversation with someone who looked him in the eye once in a while. I wondered what kind of fear state that midwife was in during the appointment.

I had a number of different physicians palpate my belly in my second pregnancy. The possibility of a homebirth had not occurred to me and my husband. We kept shopping for a doctor who would promise that 1. I wouldn’t be given an episiotomy, and 2. The baby would stay with me at all times. Those doctors were very clear that they would be in charge and I would get what they ordered and I didn’t get to tell them what to do.
Finally, we found out there were some midwives in Vancouver, BC, who would attend homebirths. We met with one of them, Elly, and for the first time in my pregnancy, someone palpated my belly with soft, warm hands and seemed to realize there was a real little human in my uterus. That experience sold me on her. Luckily, my husband was very impressed with her, too. I am forever grateful that I found the ideal midwife for me who fit with my family perfectly. Warm hands, a quiet confidence, and a willingness to meet my requests—that’s what her prenatal care encompassed.

Gloria Lemay is a childbirth activist living in British Columbia, Canada. She has a passion for VBAC, waterbirth and ending male genital mutilation. She is a blogger at Her film “Birth with Gloria Lemay” was produced in 2012 and has been viewed all over the world.

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