Just in time? Maybe...

On Leap Day 2008, I had the privilege of delivering the seventh child of a local couple. The woman chose me to provide her prenatal care and attend her birth because her previous ob-gyn had missed the delivery of the last two of her children. It wasn't that her labors were too fast: She labored for hours under the careful supervision of the nurses, but they didn't call for the doctor until she was almost fully dilated.This situation is actually very typical in modern labor wards, and it brings up an interesting difference between obstetricians and nurse-midwives. Generally speaking, nurse-midwives make it their business to be present during a woman's entire labor and birth. Obstetricians, by contrast, are called when the woman is ready to push. While it is true that in a hospital situation there are nurses who are watching the monitor, and will offer support if they are able, they usually have other patients to attend to besides you. So why doesn't everyone choose a midwife? Many women fear that by choosing a nurse-midwife, they will not be able to get pain medication during labor. This simply isn't the case! Patients of nurse-midwives can have IV narcotics and epidurals just as patients of ob-gyn's. However, many women who choose a midwife do so because they feel that the extra support during labor will be enough to get them through the experience without pain medication.