Episode 4

#4 Why Bree Chose a Private Midwife The Matrescence Podcast

In this episode Bree talks about her decision to hire a private midwife. We discuss what a private midwife does, how this experience differs to other models of care and whether it is worth the cost. Bree shares how she found and chose her private midwife and Kel shares some exciting news. Key themes: Private midwife, midwifery-led care, MGP, Doula, Homebirth

Transcript

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Kelly 0:11 The birth of a baby is a defining moment in a woman’s life.

Bree 0:14 But what about the birth of the mother?

Kelly

0:17 That’s right when a baby’s born, so to his mother, this transition from woman to mother have the name. It’s called metathesis. This developmental stage is as powerful and irreversible as adolescence. And yet few women have ever heard of it. So let’s talk about it. Let’s talk about it. Each episode, we will bring you honest, and thought provoking conversations, evidence based research and knowledgeable guests in order to help you emerge a more powerful and aligned version of yourself. So join

Bree

0:47 us, your hosts, Kelly, and break as we attempt to make sense of our mature essence journey, and to help you make sense of yours.

Kelly

1:04 So this is Bree and Kelly again, and today we’re going to talk about having made a birth choice. So last time, we talked about how to make a birth choice, and this time, Bree, let’s cut straight to the chase, you’ve kicked off the process you’ve made the first choice we have. Where did that start? What’s the choice you’ve made, and tell me what the process was like.

Bree

1:29 So I knew I wanted a private midwife long before I fell pregnant. The pregnancy was kind of just the final step, a very important one. But I’ve done a lot of research between my pregnancies and I had already come to the conclusion that that would be the best option for us. It is certainly not the cheapest option. So that was something I was aware of. But ultimately, we decided that it was worth it, and that we were willing to make other sacrifices to make this work. So we have found now a private midwife who we met today, and we’re very excited about working with. I originally found her on a homebirth Facebook group, she came highly recommended, which is always reassuring when you can hear of others who have had a positive experience. So we met met her today for a no cost, no obligations, meetup, she came to our home, which was lovely. And we just sat and we talked about, I guess my hopes, my dreams, my fears, any questions I had, she shared with us her history and her experience and her qualifications. And yeah, just put our minds at ease. Okay, excellent.

Kelly

2:51 So there’s two parts to this. One is what is a private midwife? First of all, because I think that’s a really important distinction of how do you even we talked briefly about birth choices, but just really the distinction? And then how do you decide which private midwife is right for you is part of the story of what happened today. So you want to just give us a quick summary about what a private midwife is and how it works? In relation to hospitals, and choices later?

Bree

3:19 Yeah. So from my understanding, the main difference is that she doesn’t work within a hospital, some private midwives do they work in a clinic, and they have, I guess, admitting rights at certain hospitals, so they will manage your birth there. So my private midwife runs her own business, and she does not have a clinic. So all of our appointments will be done at our home, which works for us and perfectly. And so she’ll follow us through the entire pregnancy. Now she can order scans and tests, she can do all the necessary checks on the baby, and she will deliver our baby at the end of it, which is really cool. Because, as she shared with us today, she doesn’t work at a hospital under an award. So she’s not bound by, like required days off or anything like that. So she’s like, if I’m on coffee or birth, I’ll be delivering your baby. Which is really, it’s it’s nice to know that because you don’t get that certainty even with a private midwife and private obstetrician. Sorry. They take holidays, they have days off. And so I love that.

Kelly

4:31 Yeah. And it’s a commitment. It’s a trust relationship between you and the private midwife. And there’s something important there that I think’s worth mentioning, because I was new to some of this terminology. So when you talk about admitting rights, I think we take for granted the process. When we turn out to have a baby and with we don’t realise how much of that is dictated by policy procedure and systems about decisions of when to do certain things and what to do. So when you talk about admitting rights You’re actually talking about the midwife. And also the right to request scans actually choosing to admit you for something or to request scans, or tests in accordance with what’s happening for you, not just what the book says. And the average graph says it’s actually about responding to your requirements and your timelines. It is Yeah,

Bree

5:23 so the most likely situation would be if during birth, I needed to transfer if there was a, an emergency of sorts. So midwives with admitting rights would then be your primary health care providers in the hospital setting. The tricky thing about that is that they’re still bound by the same hospital policies as any other midwife. So there is an advantage there, but they have limited scope that they’re working with them. So my midwife does not have admitting rights. It’s not something she wants or thinks she needs. And I’m quite comfortable with that. So if I was to transfer, she would come with me. And she would kind of step into more of a doula role she’d be supporting and advocating, which I think is just as valuable, if not more.

Kelly

6:12 Absolutely. And what I really like about this conversation, for clarity sake is, for me, it was a learning process to try and understand all of the different roles of private midwife versus midwife, midwife led care inside of a hospital versus a doula, etc. And this midwife, and we’ll get to that, in terms of what your experience was, she’s very clear about the scope where she operates best, where it really plays to her strengths. And part of our conversation is the choice to have a home birth with a private midwife is a legitimate, safe option. But there are always choices that you can make later down the track. And I love the fact that you get that comfort of being in your own home, and on your terms, which you know, has a huge impact on the psychology and psychological safety, emotions and comfort during your pregnancy for you and your family. And especially because you already have a little arm. And right now, not being able to take him with you for medical appointments would be not only logistically challenging, I mean, you want him to be involved in the process of bringing a new person into this family.

Bree

7:19 Yeah, and that’s been a, I guess, a big factor in our decision, though, granted, I think we would have made the same decision regardless. But currently in in Brisbane, most hospitals are not doing face to face antenatal appointments. So they’re still via telehealth via phone, which means that you’re not getting things like your blood pressure taken. You’re not getting your baby’s heart listened to. But I think more importantly, you’re not building that face to face, comfort and relationship. Also, when we do have face to face appointments in the current COVID climate, we would be unable to I’d be unable to bring my husband with me, my child with me, which is not only a logistical nightmare, but it’s not what I want for this experience.

Bree

8:13 I think that another challenge is you’re on their timeline. So they would set my appointments last time they did, and they were at two o’clock, and that would really conflict with my work and my husband’s work. So with the private midwife, we have all the appointments in our home, and we choose the time that suits us best. Which is such a privilege to be able to do that and to choose the time where we’re all here and present, and have our little boy running around in the backyard. That’s exactly what I envisioned for my pregnancy care.

Kelly

8:49 That’s fantastic. So tell me about the experience today. You’ve done your research you look, you saw her profile, you did some reading about the references other people’s experience, you had looked at other care providers as well that were looked, you know, equally as strong. But then what happens from there. And it’s probably worth noting, you may notice some from time to time different noises in the background. We do have a cow. So don’t worry about that if

Bree

9:15 we that is close by and occasionally there are chickens and horses, and it’s very well that it’s very

9:23

well. So yeah,

Bree

9:24 so something I wanted to touch on, I guess for your understanding. And because I think that many other people would have the same questions that I did was what is the real advantage of having a private midwife because no one wants to pay for something that they can get for free. And so early on in long before I was pregnant, I posed the question on Facebook groups, which I don’t do often but it felt like the best source of information. You know, what is the difference? And is it better to just have a doula at home hospital births, or to have a private midwife. And I think that what it comes down to is that main difference is not being bound by hospital policies. We know that currently it takes seven to 12 years for evidence to get into practice in our hospitals. And I think that’s a huge barrier.

Kelly

10:17 That is an amazing statistic on the lag of latest research to reach the ground.

Bree

10:25 Yeah, absolutely. And I think as I’ve shared before, I just did not want to have to advocate for myself, this time, I didn’t feel I would be in a state when I was in labour. And so for me, that’s the real benefit of having a private midwife. It’s the continuity, it’s knowing and trusting this person really deeply. And at the end of the day, knowing that nothing is influencing their decision making other than what they think is best. So we did, we reached out to a couple of midwives. And the one we ended up choosing got back to us really quickly, was very forthcoming with her price schedule, with her experience and her views on birth. And what it ultimately came down to was just a gut decision. It just felt right.

Kelly

11:21 But it also mean, there is an intuition element. But in some ways, I feel that there’s probably more to it than that, because there’s an alignment of values that I heard in your description so that she shared her views on birth. And it was we have an alignment, she shared her experience, it was congruent with the type of experiences that you were looking for, you know, so there’s some elements there where there is quantitative and qualitative feedback, which is aligning to your intuition and how you felt in her presence. So, because I think what’s important about that, which I know, over this period of time we’ll cover in more detail is, sometimes it’s hard to know what you want. But once you are clear about that, it’s those things become the core values, beliefs and behaviours that you want, then that becomes the core of finding your care provider, because it is different for everyone.

Bree

12:14 Yeah, absolutely. And I think that I kind of went into this meeting, I had 27 questions for her. And many of them I feel I knew the answer to from my own research. So for example, what would you do in the case of a shoulder dystocia, when the baby’s shoulder becomes stuck, because if you’ve ever seen that on shows, like one born every minute, it’s a huge emergency. Everyone comes running into the room, and it’s very dramatic. So I kind of know, within reason for my own reading what best management is in that situation. But I wanted to hear what she had to say. So I would pose that question to her. And her answer that came back to me was like, Yes, yes, that’s, that’s exactly what I thought, you know.

Kelly

13:01 I’m laughing at this question, because the average, you know, pregnant lady is not going to know to answer a question like that yet. However, it’s great that you had, that was one of your questions, which was quite specific. And, you know, I think part of it is, we don’t know what we don’t know. Yeah. So your level of understanding of what’s possible is one thing. The other part of it is, if you’re are considering knowing that there are options outside of the, I guess the public or private hospital system is one of the key factors. That is the first part of the journey. So you quite far down the track in terms of knowing the options and then wanting to really distinguish in that in the private.

Bree

13:45 Yeah. And I think what it comes back to is thinking about what your fears are, what are your fears about a home birth compared to a hospital birth? And that kind of allowed me then to pose my questions like, if I’m worried about a postpartum haemorrhage, okay. So what is your management of a postpartum haemorrhage? If the baby’s born, not breathing, how do you manage that if my baby going to be as safe at home, as it will be in hospital? Because that’s what it comes down to? We are all trying to make the safest decision. So that’s kind of how I approached my questions is there was some logistical ones like what do you sees? What does that cover? When will we see you? But then also really sitting with what am I feeling? What am I apprehensions and asking her those questions, and I found her answers to be very reassuring. And my husband and I both walked away from the conversation feeling like this was a safer option for us than a hospital birth.

Kelly

14:50 What did she ask you to understand if you were a couple that she would want to work with?

Bree

14:55 So I guess mostly just why do we want this What do we envision for our birth? And there was much more than that. I think because high birth is such a normal, safe option to her. She doesn’t need to be convinced, you know, it feels like a very valid choice to make. Yes, if that makes sense.

Kelly

15:16 Yes. The fact that you have done the research and got her to this point of the conversation is in is very much part of that journey of saying, We I know that you’re people who are committed to understanding the process thoroughly and making the right choice for you.

Bree

15:31 Yeah. And I think Currently, the statistics say that 1% of people have a home birth in Australia, it’s, it’s less than that. A planned home birth. So it’s not many. And I think that the ones that seek it out on making it lightly or flippantly, most of us have done our research. And so we are coming into this meeting armed with some knowledge and understanding of the process.

Kelly

15:56 So you’ve made the decision, you’ve each made a commitment that you’re going to now move into this model of care what happens now? And and I guess, just add lightly, how does it differ from if you were going into a traditional care model?

Bree

16:12 Yeah. So first and foremost, it differs in that I saw her this week. So I am like six weeks pregnant. In my last pregnancy, when I went through MGP in the public system, I didn’t see my midwife till about 2324 weeks. So that felt like such a long time, to me, I was so eager to meet the person that would be delivering my baby. And I was seeking reassurance and guidance. And I was getting that in bits and pieces from my GP, but the continuity was not there for me at all. So that is a major difference.

Kelly

16:51 It’s an interesting point, because it’s one of the most important things that will ever happen to you. And you’ve almost got, you know, three months of being alone with that news, and no one to bounce ideas off and talk about and what does this mean? And how are we going in all you’ve got is the internet and the books telling you, your baby’s the size of a pea

Bree

17:09 of an apple wild. And I remember feeling like, I’ve been entrusted with this responsibility to grow a human, and I had no idea how to do it. And I guess that’s innately part of it, you know, your body’s just gonna do what it’s going to do. And up until that point, if something was to go wrong, there’s not a lot of not a lot they can do to intervene anyway. So I understand why that’s a viable model of care. But I found myself, you know, asking friends and reading forums like, Is this normal? And I don’t think that that’s the best approach. So this time around, I will go get a dating skin in two weeks when I’m about eight weeks. And that was really nice, because I put that to her, like, is this something that you encouraged? And she’s like, well, how would it make you feel? And I was like, Oh, good question. And that made me realise that I was actually really seeking that reassurance. Everything is okay, the baby’s got a heartbeat, and she’s like, go do it, then, you know, if that’s what you need, I support it, go do it. And I loved that, that it was presented as an option. And a tool, I guess. And so from there, I’ll see her around nine weeks, 12 weeks, and then monthly, up until I’m about 36 weeks, and then weekly. From there, though I have my little boy at 37 weeks, so hopefully not too many weekly appointments.

Kelly

18:44 Yes, things could get exciting because you your family seemed to carry quite short. So it will be very interesting with this baby to track it and see where we end up going. And I’m very excited to now be on this journey with you, which is another thing that will be interesting, because part of choosing a midwife is also choosing who your team is, you’ve got your husband, you’ve got your family, you’ve got your midwife.

Bree

19:08 And that’s something we thought a lot about. So last time, I just had my husband and I because I felt really protective of that birth space. And I didn’t feel that I was in a place where I could manage anyone else’s feelings, someone else’s feel or concern or anything. I just felt like I needed to completely shut that off and protect ourselves. But this time round, I do feel more able to share that with other people who care about me deeply and I guess it’s finding that balance between keeping it private and sacred and also having your team there. So at this point, were thinking we will hire a birth photographer. We will have our private midwife there will potentially have my mum here. To help with my little boy, I would love to have her be a part of the birth experience and also to know that somebody is taking care of him and that I’m not on duty, I don’t need to worry. And if at any point it becomes too scary or anything like that, for him, knowing that she could take him away, will give me peace of mind. And following our conversation last week, I asked Kel if she would do me the honour of being my birth partner, and supporting me emotionally through that, which I’m really excited about.

Kelly

20:34 And I am incredibly excited about and very honoured. So thank you. And it’s been, you know, a very short and intense period for me to actually really reflect on what kind of an honour that is, but also, what does that mean for how I want to go through the process. So what’s exciting about this journey, as as you’re going on your journey, I am going to be looking to do some study around becoming a doula at the same time. So I will be able to learn more, because many of the things we’re talking about, I might have a concept over, I’ve heard over, I’ve done some light reading. But I haven’t really done a deep dive into what are the things around this. And so really, my training up until now is having two children, myself and other skills that I’ve picked out through life. So I think this will mean some really great conversations that we can help to bring to light for others, hopefully, through the journey, and with the ultimate goal of being really on in M there to support you through out your pregnancy and the birth.

Bree

21:36 And it’s really exciting, because I feel like that, that I guess passion and curiosity kind of just got ignited for you recently. And it’s not something you’ve thought long and hard about it just kind of felt right and things aligned. And it’s exciting. It is and I, you know,

Kelly

21:53 I have a corporate job. But ultimately, what I do is very much around providing emotional support and psychological safety for my team in a corporate environment. So that’s, that’s, that’s fantastic. And I love my job, and I do get joy out of it. But at the end of the day, it’s still a corporate job. And this feels like there is this bringing of something amazing into the world. And so this is really ignited, drawing on all those existing tools. And I feel like I can add so much more to that. Yeah, this learning.

Bree

22:26 And I think that in asking you to be my birth partner, my expectations, nothing beyond just being there. And I think anyone that knows Kel would know why I made that decision, because you just have a fantastic ability to read the room and intuitively know what people need to feel comfortable and to feel safe. And I have no ideas beyond that. But I’m really excited about the possibility of not just having you there for support with all these new tools, but having someone to share these conversations with and share my passion with because usually it’s me like talking to my brothers about this. I’m like, do you know the statistics on intervention? Let me tell you, and they’re like, oh, okay, like anyone who will listen. So it’s really exciting to have someone who shares that and also for you to be at the beginning of your journey and learning and asking questions, because I think that other people will naturally have those questions. And I think as you get further in your understanding of birth, I’ve got a long way to go. But I’ve done lots of reading and lots of research. And sometimes you forget those really basic beginner questions and experiences. So it’s, it’s hopefully going to be a really nice dynamic. Look,

Kelly

23:51 I think so. And I’m really excited to be able to share this journey with our listeners as well. Because this this, these parallel activities going on, there’s there’s the midwifery there’s pregnancy, there’s birth, and then there’s this learning around what is the doula? What are the options and the things that are going to unravel through this time and some of the choices that get made? And ultimately it comes back to a key? Why are we doing this? What is it that we want out of it? And we really wanted to provide options for empowerment, because the choices people make there isn’t? You know, it’s not right or wrong? It’s black, not black or white? It’s what’s right for you at that time, and that being able to understand what is my criteria to make a decision based on what are those important things? And you know, the 27 questions you had for your midwife might be completely different to the question someone else has, or there might be a small overlap.

Bree

24:41 And I think often it’s a case of not even knowing what to ask and it can be helpful just to hear other people’s experience to get to the bottom of that because I know last time I met my midwife, she asked me if I had any questions and I was like, no, nothing comes to mind. It’s kind of like in that argument when you’re in a job interview, and if you’re ill prepared like me, they asked you that question. And suddenly your mind is blank, and you can’t think of anything to ask. So I think that it can be helpful to hear other’s journeys, because you don’t know what you don’t know. And as we have talked about previously, birth is just kind of a magnifying glass of these wider issues, that we’re grappling with setting boundaries and standing up for yourself. And I think that it provides a really cool lens for talking about these wider things we grapple with us women,

Kelly

25:37 I totally agree. And I think that’s going to be an and there’ll be a number of times when, you know, might bring to the table, I was doing this, and it brought up these anxieties or fears or things that I hadn’t thought about or considered. So we’re going to peel away a lot of layers here. And it’s already been a healing process for me to reflect on the birth of my own children. Because, you know, after you do give birth, you move straight into parent mode, which is I’ve got this small creature that’s completely dependent on me. And, you know, 12 years on, I got to watch my birth video with with you. And that was an amazing healing process for me, because I, it was actually more beautiful than I remember. And that’s a terribly sad thing to say, because there’s so much intensity in the moment. And, you know, I was in a, you know, a public hospital in London, a very busy, busy Hospital, one of the ones that features on those UK shows one born every minute, yeah, there were, I think 37 babies born on the ward that night, in that one ward in that one hospital, where my first son was born. So

Bree

26:42 but so you, you have pretty much drug free birth both times with really no birth skills, you haven’t done any proper birth education, something like calmbirth or hypno birthing, where you learn these relaxation techniques, that’s amazing in itself. And perhaps, we’ll get we’ll share those stories at some point on the podcast, because who doesn’t love telling my birth story. And I know I love listening to them, and I can’t be the only one out there.

Kelly

27:13 So despite the fact that this is not specifically about birth stories, there will be things that come up. And ultimately, it’s about bringing, you know, empowerment and choice and positive aspects to going into this journey and the exciting. You know, there’s so much opportunity to explore. So big choice this week. But I can see that you really just feel really comfortable in that decision. And that will set you up now, to feel confident that you’ve got your midwife there. And you can now start to go on the rest of the journey of the pregnancy of looking after your health and well being

Bree

27:51 I think so. And when we talk about that, that wider scale, I am someone that constantly seeks feedback from other people. What do you think about this decision? Is this a good choice? I do it with clothing. I do it with travel. And it doesn’t come naturally to me. So I think that it is actually a really empowering thing to just go, No, this feels right to me. And I’m going to trust my gut and not overanalyze, and I think that’s really exciting. And I think it sets a really good foundation going forward in the pregnancy.

Kelly

28:22 It absolutely does. So today, I think we’ve covered that that very first interaction, and I’m really looking forward to speaking to you about what happens next as we get through into the next phase of the pregnancy

28:38 and of your doula training. Yes, well,

I’ll update on that when we talk next time. Very exciting. Looking forward to.

Kelly

28:49 Thanks for joining us for today’s conversation. If you want to hear more like this. Don’t forget to hit subscribe, so you don’t miss an episode. If you’d like to learn more about anything we talked about, or you heard on the podcast today, check out our website, www dot Birth of a mother.com. You can find us on Instagram at McKesson stock podcast, or send us an email to info at birth of another.com that I use. If you think others could benefit from

Bree

29:15 this podcast, take a screenshot of you listening to this episode to post on social media and tag us. Alternatively, consider leaving reviews with your favourite things about the podcast. This really helps us to increase our visibility and ensure we are reaching as many women as possible. As always, thank you for spending your time with us. We hope you will tune in next time

Kelly and Bree


kelly@birthofamother.com.au
brianna@birthofamother.com.au

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