A Good Coach is Hard to Find: In Search of Supportive Maternity Care

The two lines on the pregnancy test turned blue so quickly I’d been startled, flinging it into the bathroom mirror. It was my second semester of law school, just before exams. I was in peak training for a spring marathon when I started fading during workouts and struggling to keep my eyes open during class. Assuming I was anemic, I upped my iron intake. Then I realized I couldn’t remember the last time I’d had a period. I picked up the drug store test during a late–night study session—an afterthought in my basket of Red Bull and highlighters. The result hadn’t given me the peace of mind I’d intended.

My husband and I weren’t sure how we’d take care of a baby, but we were certain our baby would be loved. I channeled my anxiety into planning every detail of my pregnancy. I wanted to be the best mother I could be, and I wanted to start right away.

I chose to see midwives for maternity care after reading that the midwife model focused on pregnancy as the healthy, normal experience I desperately hoped it would be. As an athlete, I had learned to trust my body to do what I prepared it to do. Birth was something I could prepare for—I just needed to find the right coach. I hoped a midwife could help me perform my best.

Researching my options for birth, I read that an unmedicated labor could cut the risk of additional interventions that could complicate delivery. Honestly, the challenge appealed to me in the same way that racing marathons did. I had a high pain tolerance and a stubborn streak. But above all, my decision was a way to compensate for stumbling into motherhood unplanned. If I could do this, maybe I could be a good mother, after all.

Over the summer, I rotated through appointments with several midwives in the practice that I selected. One of them would be on call at the hospital on our big day, so I wanted to meet them all. They nodded and smiled when I told them about my plans for birth, and to my delight, each of them supported my continued efforts to run as baby and I grew. At our twenty week ultrasound, my son and I were both doing great.

But as the fall semester and my third trimester began, my prenatal visits turned adversarial. Although I’d chosen the practice specifically for its midwife care, my remaining visits were exclusively with OB/GYNs. At first, I assumed my newly–hectic schedule didn’t align with an available midwife, but I soon learned that there’d been a policy change at the practice. Midwives had been relegated to the delivery room. The OB/GYNs were not supportive of my decision to remain active during pregnancy, and their mistrust set me on edge.

“You’re measuring small,” said the first OB/GYN, rolling up her measuring tape as I lay bare–bellied on the exam table. My fundal height was apparently the same as it had been at the appointment before. “Are you still running?” she asked.

“Yeah,” I answered, “not as much as before I got pregnant.”

“How much?”

I told her. Her eyes widened. “I am putting a stop to that right away,” she said.

I explained that I’d been running competitively for over a decade. I could—and did—take cues from my body when it complained. She was not impressed.

“You’re going for an ultrasound to make sure baby is growing. If you keep running like that, you’re going to have a tiny baby and he’s going to get here before he’s ready.”

“Okay,” I said, sitting up, “But how exactly? How does exercise cause prematurity?”

“It just does,” she said, “think about it.”

The ultrasound showed that my son was an appropriate size for his gestational age, and an exam proved that although he was riding awfully low, my cervix was unbothered. I took a few days off from running...