>>Avivah, I have a question about having the midwife stay
in the other room. Most of the midwives I’ve talked to
over the years have emphasized that *watching* the mom
labor (hopefully unobtrusively) is an important way that
they gain a sense for how the labor is progressing and
how the mom and baby are doing, without having to do a
lot of exams or monitoring. How do you feel about that?
Do you think you would be able to call the midwife in if
you felt you were having a hard time?

I’m asking, not to judge your approach, but just to
increase my own understanding.<<

It’s a good question, and you don’t sound a bit like you’re being judgemental! 

I didn’t mean to give the impression that the midwife stays out of the room the entire time – she doesn’t.  She comes in periodically and assesses how things are going, but she goes out when she sees things are fine.  If I felt I needed her at any of these times, she would stay with me.  Whenever my husband goes in and out of the room, he keeps her updated, too.  If something suddenly and drastically changed in my labor, she’s very close by, and my husband would get her.  My husband tends to be with me during a lot of labor, though he ends up sitting somewhere to the side, usually.  I like to know he’s there, but not to feel that he’s there.  🙂  That’s how he’s able to call her immediately when I say I want her to come in. 

All of my hospital births were attended by midwives (CNMs) and this is what they did, and both of my home birth midwives have done the same thing.  It really is possible to learn a lot about where a woman is holding just by watching her – I used to pretty accurately be able to guess how many centimeters the women I was providing labor support for were at by paying attention to their labor signposts.  Experienced midwives have been at a lot more births than I have and I’m sure can detect a lot more factors than that.

 I think the above is the typical approach to keeping an eye on a laboring woman, but periodic monitoring doesn’t require a constant presence, and most experienced midwives have learned the art of being unobtrusive even when they are present.

Avivah