Why Rural Midwifery?
I was informed today that half of Texas’ midwives work in the Dallas-Fort Worth area. It’s been said many times that if you throw a rock in DFW, you have a good chance of hitting a midwife. I’m so glad DFW families have many midwives to choose from. However, once you leave the big city and its suburbs, midwives are few and far between. One seasoned home birth midwife I know won’t train a new midwife as a preceptor unless the new midwife promises to leave DFW and go work in a lesser served area.
Between Fort Worth and the Texas/New Mexico border, midwives are scarce. So if you’re reading this and planning to become a midwife, consider the families out here who need you.
Women from my hometown of Bowie, Tx have to drive at least half an hour for OB care. That’s not bad but there is one hospital there with no nurse midwives. If you want a vaginal birth after a Cesarean all the stars have to align to make it happen there. I stopped doing doula births there several years before retiring my doula hat due to the harmful practices I witnessed. This doesn’t bode well for women who want options or support for a normal, physiologic birth.
Thankfully there is a birth center in Decatur-Kueo Birth Center and they offer wonderful care. It’s common for Bowie area families to trek up to Wichita Falls for maternity care and there are more OBs to choose from an a great birth center (if I do say so myself). For these options, I’m thankful.
However there may be reasons a woman doesn’t desire to drive out of her community for maternity care such as:
Driving an hour for to wait in the waiting room for 30+ minutes for a 10 minute prenatal visit can be frustrating for some women.
The first intervention of childbirth is leaving the home. This is a relatively new concept in human maternity care-it used to be the norm to have the seasoned friend, midwife or family doctor attend birth in the home. Leaving your familiar place disrupts the labor hormones and can cause labor to stall.
Labor in the car is uncomfortable. Sure you can labor in your back seat but then you’re not able to use a seatbelt, which is not advised.
Having a baby while on the way to the hospital or birth center is not ideal, though if labor is going that smoothly and easily, it’s likely that there will not be complications.
Her community is here. Her friends, family-her tribe.
She may not want to leave her children at home and/or may want them included in her birth
It is important to me that women who identify with any of those reasons should have the option birth at home. There are challenges to this model of care and families have to accept some limitations (there’s no room for foolish risk taking when we’re many miles from a hospital that delivers babies). However, I firmly believe we can work together to minimize risks and help moms have joyous birth experiences in their own homes.