Should I Have a Birth Attendant or Not?

Whether you want a birth attendant or not is an individual preference. Different women react differently to having other people in the room during birth. Some women feel that the act of conceiving a baby took place in private, and giving birth to that baby should be private also. Other women don’t care, and think they want all the attendants they can get. During my first birth, I willingly handed myself over to caregivers, thinking they they would take care of everything and that would make it easier, but it did not, it only made birthing harder in my case. For my second birth, I chose to remain in control of my birth experience and did not rely on caregivers. For me, that was the right choice.


Today, women have the choice to birth with a doctor, certified nurse-midwife, direct entry midwife, doula, with their partner or other family members, or totally unassisted. To learn about unassisted birth and why that might be the right choice for you, visit my friend Laura Stanley’s Unassisted Childbirth website. She also has a book by the same name detailing her four unassisted births. Check it out!


According to MANA (Midwives Alliance of North America) the definition of a midwife is “midwife is a person who has successfully completed a midwifery education programme that is duly recognized in the country where it is located and that is based on the ICM Essential Competencies for Basic Midwifery Practice and the framework of the ICM Global Standards for Midwifery Education; who has acquired the requisite qualifications to be registered and/or legally licensed to practice midwifery and use the title ‘midwife’; and who demonstrates competency in the practice of midwifery.” However, direct entry midwives may have received training that does not fit this description which involves an apprenticeship program where they train directly under a practicing midwife. There are many avenues to training.


You must decide what your approach to birth will be. Some women feel that birth has become too medicalized. They feel that hospitals are for sick people, and pregnancy and birth are not sicknesses, so why would they want to give birth there? They feel that using a doctor or certified nurse-midwife might expose them to more medical intervention than they want, so they opt for a direct entry midwife or unassisted birth. You have to decide how much intervention you are comfortable with, and to do that you must educate yourself.


Some of the interventions you may experience with a doctor or certified nurse-midwife are:

  • Prenatal Testing
  • Use of Doppler fetal heartbeat monitoring
  • Breaking waters or stripping membranes
  • Episiotomy
  • Epidurals
  • Induction of labor
  • Internal Fetal Monitoring
  • Forceps delivery
  • Vacuum suction delivery
  • Cesarean section
  • Unwanted cervical dilation checks
  • Early cord clamping and cutting
  • Mandatory lithotomy position for birth
  • Manual removal of the placenta
  • Mandatory separation from baby after birth
  • Baby given sugar water in nursery
  • Circumcision
  • PKU test
  • Baby eye drops
  • Newborn vaccinations


After you have educated yourself, interview all the potential caregivers. Find out about their background and training. Find out how many births they have done. Get references from previous patients if possible. In my case, we interviewed both naturopathic physicians and direct entry midwives. The midwife had done 600 births, and the naturopathic physician had only done 70. So we opted to go with experience over formal training. It was the right choice for us.


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