When the usual ultrasound person walked in she had an older woman with her whom she introduced as a midwife. I immediately made the obvious crack about my unfortunate non-need for a midwife. Day three of a bad lupron induced headache was probably making me cranky. The tech clarified that the midwives sometimes did IUIs on the weekends. It soon became clear that the exam was doubling as a training session.
I don't mind being used as a teaching tool, or having a second person nudging me in the cervix with an ultrasound wand. I tried to be helpful. When the midwife was taking her turn and having trouble finding things, I informed her that my uterus was retroverted, and regular tech immediately told her to angle the wand more. The midwife also asked the tech if she could see my tubes on this. The tech said no, and I helpfully chimed in that if you wanted to see my tubes you needed to check out the pictures from my HSG. I may not mind being used as a teaching tool, but don't expect my to just lie back passively when I know the answer.
I find that I am a bit bothered by the midwife thing, though. Don't get me wrong, I think midwives are great. I'd probably even want to use one for the actual childbirth part, assuming I get that far and assuming I don't have any nasty complications. Part of it is a branding issue. Midwives do birth. Yes I know they've been branching out into the other OB/GYN areas, and that's probably a good thing, but their job title is just so closely linked to the birth part. They're also known for a low intervention approach, and IVF is about as high intervention as you can get. Now, if I ever get as far as birth I'd love to go the low-intervention road, but clearly the low intervention approach is not working for the making the baby part, so the whole midwife thing seemed out of place. The other part of what was bothering me was the midwife's attitude. She seemed a little too cheery and a tad condescending. "Is this your first IVF," she asked is a slightly false-excited tone. "No, its my third," I replied in a tone I hoped would prevent further questions along those lines. The normal tech then said something about me being a veteran. Whatever. They don't award a bronze star for repeat IVFs. You get another one-in-three shot at a baby and that's it. IVF is not a cheery and exciting thing, its what you do because that's what it takes to get around a reproductive system that is doing its very best to thwart you. I also don't need the false encouragement from someone who is clueless enough to inquire about whether you can see my tubes on an ultrasound, even one with the wand shoved up you-know-where.
I guess I am left with the impression that its probably fine if midwives do IUIs, but it would probably be better if they didn't tell the patients that they were midwives. I don't generally inquire about the qualifications of the person doing the procedures as long as they seem reasonably competant. The branding issue being what it is, seeing a person who specializes in birth when you are inferile before you are pregnant for sure just seems like a sick joke. Also, the cheery attitude might be better suited to IUI patients. If you're doing IUI you haven't given up hope that the less extreme measure might just work. Really, though, I think I want to steer clear of the midwives myself until I'm convinced that I might actually have a baby, say at around 30 weeks gestation.