Is it too late to change my midwife?

Photo: Getty Images
Photo: Getty Images 

Q: My wife is nine months pregnant and we are planning a home birth. Our team of two midwives came to our house to do a home visit last week, and shamed us for about 30 minutes when we let them know we would be vaccinating our baby. One of them (whom we've only met twice before) was adamant that we weren't considering the safety and health of our child. I almost kicked her out of our house, I was so angry.

Now I'm nervous my wife will be on edge about their judgment when the whole point of a home birth for us was so she'd feel more relaxed. I know it's very late in the game, but should we be looking for a new birth team?

Answer from Emily Yoffe, of Slate's 'Dear Prudence' advice column. 

I had a variation of your experience when I was pregnant (although not as far along). A test showed that I might have a serious autoimmune disease. Fortunately, it turned out to be a false positive. When I went in to talk about the results, I was seen by my obstetrician's partner, whom I'd never met before. I expressed my relief, and she said that the false positive actually meant I was at higher risk for the disease. When I asked her what I should do about that, she said, "Look, we're all going to die of something." True enough! Because it was possible that when I went into labor she might be on call, I immediately found another obstetrician and switched practices.

You don't have a long bond with these people, but you do have a short timeline. You're choosing a home birth because a comfortable environment is a high priority. I would not be comfortable if I knew that when I was at my most vulnerable, I would be subjected to a lecture whose premise is false and dangerous. I think you should fire this pair and find another team.

If it turns out all the midwives in your community believe this anti-vaccine garbage, see if there's a hospital with a birthing suite that strives to provide a more "homey" environment. You don't want to have one of the happiest times in your lives ruined by misinformed bullies.

Q: I recently found out I am pregnant. Though I am excited about the news and in a good position to have a child (stable relationship with my husband, financially prepared, 29 years old, family support), I feel a loss. It relates to the fact that I always felt that my career was the way in which I would bring more light into this world-  as in, what God put me on earth to do.

The patient population I serve has overwhelming needs, and as I prepare for a maternity leave and a scaling back of duties, I feel guilty for abandoning them. Many don't have parents who are willing or able to take care of them. I know it's not fair to my future child to feel that these people's needs are greater than his or hers, but I can't help shake the feeling. I feel like the notion I grew up with of a woman being able to do it all was naive. It seems like it was a lie, and that we as women are just biologically disadvantaged when it comes to careers, etc.

When I bring this issue up with friends they seem to look at me like I'm a bit of a monster to think that anything should be put ahead of my (future) children. I don't need any more judgment, just some advice - woman to woman.


A: Right now your baby is a fuzzy image on a sonogram, while your patients are physically here and needy. You see every day what it means for children to lack the kind of devoted parents that everyone deserves, so I'm confident you will be that kind of parent to your own child.

As important and meaningful as your work is, you alone cannot fulfill all the wants of your high-risk community. You must be able to step away and have a separate life, or you risk becoming less effective by burning out. You talk about the biological disadvantages of being a female, but I see it differently. You must admit it's pretty amazing to be able to gestate another human being. (Or, alternately, as Mel Brooks observed, "Wouldn't you be nauseous if somebody was running around inside of you?") Another thing about biology is that when they hand you this brand-new little person, you'll be overwhelmed with the kind of feelings you're now dubious about. You will also find that there's no reason your career can't continue to be deeply gratifying and even consuming; the time limits imposed by having your own family will make you more focused when you are at work. Some of my most prolific colleagues are women with three children. I don't get how they do it, but looking at them convinces me, despite the small sample size, that the reason I'm not more productive is that I had an only, instead of triplets.

I should also mention that there is a range of pregnancy-related psychological disorders that can begin before the baby is born. If you feel your thoughts are running away with you, tell your obstetrician and seek help. But I think you're just a deeply caring person who wonders if your own well of love and compassion will be deep enough for everyone in your life. I'm sure you'll find it's a renewable resource.