If you're considering giving birth with the help of a midwife instead of an obstetrician, you're not alone. Rates of out-of-hospital births have increased since 2004, and as many as 53,635 babies are born at home or in birthing centers. Women say they like the personalized attention and ability to have more control over their own births.
At the same time, you want to make sure your baby is healthy. For women with no health issues, out-of-hospital births and hospital births are considered to be equally safe.
You may be wondering how your baby's health will be monitored during your pregnancy and labor if you aren't in a doctor's office or hospital. And even if you work with a midwife who is affiliated with a hospital, you may be interested in the types of testing that may be recommended. Here's a guide to the types of testing your midwife can do and arrange for you:
- Routine health monitoring. Your midwife will always check your blood pressure, weight and the size of your abdomen to measure the baby's growth. Once it can be detected, your midwife will also use a Doppler to check the baby's heart rate.
- Blood type and Rh factor. If you have Rh-negative blood, you may need a injection of Rh immunoglobulin so that, if your baby is Rh-positive, you won't make antibodies to the Rh antigens in your baby's blood.
- STI check. You want to be sure you don't have any sexually transmitted infections like syphilis, chlamydia, HIV or hepatitis B that can be passed on to your baby or affect your pregnancy.
- Urine test. Your midwife will likely check your urine for excess sugar that could indicate gestational diabetes.
There are many additional tests that you may decide to have after discussing the options with your midwife. Generally, your midwife will not be able to do these tests at her office and will send you to a nearby clinic or hospital to have them done. These include:
- Glucose test for gestational diabetes. You drink a sugary beverage and have your blood sugar levels monitored afterward to see if your body is able to process the sugar correctly. Undiscovered gestational diabetes can result in high birth weight, which can complicate an out-of-hospital birth.
- Group B strep. This is done a few weeks before your due date to make sure you don't have any bacteria in the birth canal that can give your baby an infection. Some midwives will wait and test the baby for any problems, but there are pros and cons to this.
- Ultrasound. Some women don't care about having an ultrasound, but they can be useful for determining correct due date, checking for health issues that may impact an out-of-hospital birth and making sure there are not multiple births. Some women also like to find out the baby's gender before birth.
More specialized tests are typically not required, but some women may wish to have genetic testing done, especially if they are at higher risk of chromosomal disorders because of maternal age or family history.
Talk to any midwife you are considering working with to find out what tests are recommended for your pregnancy. Your age, weight and past history can lead a professional midwife to request additional tests that ensure you and your baby stay healthy. If your midwife can't perform any tests that you would like done, talk to an ob/gyn doctor like George L Stankevych MD.