Prenatal care

Recently I remembered the statistic that mothers who don't receive prenatal care have worse birth outcomes. I was wondering why this is.... and as luck would have it, a kinesiologist whom I interviewed questioned this and said she is not comfortable working with a pregnant woman who is not receiving prenatal care. Here is the letter I wrote her in response:

Dear _______,

I am discussing with my midwife the need for prenatal care, since I was just wondering this myself. Honestly I can't think of why it would make a difference unless it's the simple fact that a practitioner encourages good nutrition and healthy habits. The stats that you are referring to often talk about babies born in poverty, because the reason they didn't have prenatal care was because they couldn't afford it. Oftentimes these mothers are unhealthy and have unaddressed complications in their pregnancy. I think this is the reason for that statistic.

With my last pregnancy, I did all the routine visits with midwives (we had a homebirth) and we declined all testing. So it was just measurements. I have all my records and I see that my urine was always normal, I never get high blood pressure, everything was fine. Basically this tells me that the visits were unnecessary (and I was NOT taking good care of myself at the time, so now that I am, I really doubt there will be anything to be concerned about).

I believe that an informed, aware mother is going to know if she has symptoms of toxemia or anything to be concerned about. I can do my own blood pressure and listen to the fetal heart rate. I am aware of how I feel and if something seems awry. I think I can tell if I am swelling too much. I am educated on what symptoms mean and what to be looking out for.

Basically I am receving prenatal care, I am just providing it myself. I am not an uneducated mom, oblivious to my pregnancy, living in the slums.

I am discussing this with my midwife and asked if I had failed to think of some reason I need her looking at my belly every month. She is supportive of me. Maybe you are not familiar with homebirth midwifery, but most of the visits are just talking and educating the mom, and addressing concerns. They do not do all the routine testing that doctors do. This routine testing is useless and can even be harmful. As diagnostic procedures, it does not make the baby any healthier. If a mother is found to have gestational diabetes or pre-eclampsia, she is only told to rest and eat a better diet!! That is nothing that I am not doing already. If I have signs that my pregnancy would do well with technology or induction, I will see these signs and get the appropriate work done. I talk to my midwife regularly and can see her at any time to address questions in my health.

If you'd like my midwife's opinion on energy work and whether it is safe for pregnancy, I am sure I could obtain that. Is this your concern? Otherwise I don't see why my prenatal care is your business. I was only saying that I'd rather put my money toward health improvement than health assessment, as I see I am being more effective with my money this way (since I can get free answers to questions over the phone, and do my own measurements and health care).

-Annalise

And here is Lennon's (midwife) response to my question:

Yes, you are totally right. The stats are talking about very low income women who don't have access to information about even basic nutrition, dangers of smoking, drugs, alcohol, etc. There has been some recent evidence out of Europe that there is no benefit to doing frequent prenatal visits, and they have begun to have fewer routine appointments. I mean, I don't want to imply that the hands-on stuff that we do (check bp and palpate baby) is pointless, because there is a real reason we do it....but, it isn't that common for something to come up in a healthy, well-nourished women.