pregnancy

Why Midwives Are Fast Becoming More Popular Than OBGYNs

Why more women are chosing midwives: Delaware Valley OBGYN blog
midwife-Brunswick-NJ

and Natalie Daher in her recent article on the Daily Beast asks why. 

Midwifery has been around for a long time, but the time for midwives to move to the forefront may have come.

Today, midwives are oftentimes sought out by highly educated, well-to-do women who seek out a more natural patient-centered experience, but that was not always the case.

Before the advent of modern obstetrics, the midwife played a central role in a woman's childbirth and reproductive experience. This was not just in mid-20th century Britain as popularized in the series "Call the Midwife," but throughout  much of human history. Given the current problems in our health care system, it may be that midwives may be able to make an even greater impact that they do now. 

There are a number of gaps in the women's healthcare in US that midwives may be able to fill:

Accessibility to pregnancy care

There is a shortage of obstetricians, particularly in underserved areas, to some extent in the inner cities and an even larger problem in rural areas. Midwives can help make up for that shortage.

Reduced Costs

Midwives provide care at less cost than OBs, with fewer invasive procedures such as cesarian sections.

Excellent Quality Care

Despite, lowering the cost and invasiveness of pregnancy-related healthcare, studies in multiple countries have shown that midwifery care leads to excellent pregnancy outcomes.

Patients Satisfaction

Women who chose midwives to deliver their child are usually very happy with their experience. Why? It could be because midwives treat childbirth as a natural experience, a family event, not a disease.

 

Want to learn more about midwifery care for your next pregnancy? Set up an appointment with one of our certified nurse midwives.

The vegan pregnancy

The Vegan Diet: Delaware Valley OBGYN blog
Is is it safe to follow a vegan or vegetarian pregnancy?

Is is safe for my baby to continue my vegan diet when pregnant?

Yes and no. It is quite possible to have a safe, healthy pregnancy while maintaining a strict vegan diet according to reputable organizations such the American College of Obstetricians and Gynecologists and the Academy of Nutrition and Dietetics. That it is of course, you plan to make up for the nutrients missing in a diet that avoids animal products. Many of our patients are vegan or vegetarian.

What kind of problems can arise if I continue my vegan diet during pregnancy?

The biggest issue is a vitamin deficiency. Vitamin B12 and iron are most likely to be an issue, and both are important for your unborn baby. It may be difficult to get enough iron with a plant based diet alone and without vitamins you will not get enough vitamin B12. Adequate vitamin supplementation is essential. Nausea and vomitting in pregnancy, and changes in your cravings may challenge your desire to avoid animal based products.

How do I plan for pregnancy if I am vegan?

See your doctor or midwife before you conceive. They can discuss the proper vitamins and supplements to maximize your chances for a healthy pregnancy.

Are there any advantages to a vegan diet in pregnancy?

While a balanced diet is advised during pregnancy, women who follow a vegan diet are less likely to excess weight gain during the pregnancy.

 

Bed rest and pregnancy

Article in Harper's Magazine questions whether bed rest is helpful in pregnancy.

Is bed rest helpful or harmful for pregnant women?

For years, obstetricians and midwives (as well as grandmothers-to-be) have recommended bed rest to treat a variety of pregnancy related problems including premature birth, preventing miscarriage, poor fetal growth (IUGR) high blood pressure and pre-eclampsia (toxemia).  Even fertility doctors have gotten in on the game, recommending bed rest to improve IVF pregnancy rates. The question that pregnancy researchers have been trying to answer and the impetus for article above, recently published in Harper's magazine: is does bed rest help?

The science behind bed rest and pregnancy

The idea that bed rest is beneficial for pregnant women certainly makes sense to most people including most womens' health care professionals recommend bed rest. Most obstetricians and midwives have been trained to use bed rest as a treatment but now in the age of evidence based medicine that therapy is being called into question.The problem is that there are few if any studies that show any benefit to bed rest during pregnancy. To be fair, there is also little evidence to suggest that it is not helpful either.

In contrast, there are are a number of studies showing the benefits of exercise for pregnant women, and moderate exercise is now encouraged in healthy pregnant women by organizations such as the American Congress of Obstetricians and Gynecologists

So, why care about bed rest in pregnant women since it is harmless?

Bed rest is not harmless. Bed rest increases the risks of a number of complications including:

  • Blood clots
  • Depression
  • Low birth weight
  • Slower recovery from childbirth
  • Loss of bone and muscle mass
  • Loss of income
  • Stress at home

In fact the more strict the bed rest, the higher the risk and severity of these side effects are.

Discussing bed rest with your OB

Making decisions about your medical care is an individualized decision a woman should have with her Obstetrician or Midwife, and bed rest is no exception. Bed rest is neither a cure all for pregnancy complications nor something to be avoided at all costs.