By Suzanne Arms
Although the obstetrical model for birth is currently dominant in the U.S., there does exist another, time-honored and scientifically-proven model that views birth as a healthy, normal process. That model is midwifery. Midwifery is trust-based and protects normalcy by understanding the intrinsic value of caring for the mother and keeping the mother-baby pair intact.
Trained Professionals
Contrary to current misconceptions, midwives are trained professionals, skilled in their ability to assist childbearing women with the least amount of intervention, guard their privacy, protect their bodies and their babies. Midwives are trained to acknowledge, respect and treat the excessive fear that most American women now bring to birth. This fear is understandable in light of the history of modern childbirth, however it must be addressed if women are to have normal births.The hallmark of midwifery is the time they spend with a woman and the relationship of trust that forms between them. Midwives view childbirth as a psycho-sexual time and also try and care for the partner and family. Simple statistics bear this out: the average prenatal visit to a midwife lasts 30-45 minutes (and longer if the woman is planning a home birth), compared to 5-7 minutes obstetricians average with their patients.
The Role of Trust
The value of this trust and in-depth relationship cannot be over-emphasized. It provides the health professional with crucial information that can predict or prevent complications. It also plays a vital role in making women more comfortable and diminishing unwarranted anxiety of both parents-to-be, and thereby produces more normal labors.Midwives provide continuous observation in labor and are trained to know when to act and when to let nature take its course. Because a midwife does not rely on an electronic device to monitor the woman's progress in labor and the baby's well being, she is far better able to discern real problems from normal variations.
Furthermore, she is less likely to wait too long to intervene when that is called for because she has been continuously observing the process. This is why midwives attending births in all settings maintain a cesarean rate of 5% or less, even when caring for high-risk women in the hospital.
Breastfeeding Connection
Virtually all mothers cared for exclusively by midwives during pregnancy and birth breastfeed successfully. The majority of mothers who birth at home with midwives breastfeed for at least a year, which is the current recommendation of the American Academy of Pediatrics. There are a myriad of benefits from a midwifery-based system of maternity and newborn care.Accessibility
Today the U.S. has only 7,000 practicing midwives (Certified Nurse-Midwives and Direct Entry Midwives combined) attending births in all settings. In comparison there are more than 33,000 obstetricians. We will not see significant change in maternal health-care until this ratio is reversed. Obstetricians still maintain tight control over hospital obstetrics, although HMO and insurance company policies and hospital attorneys and administrators have eroded their power.Midwives who have been able to gain hospital privileges for private clients are increasingly being pushed out by obstetricians and OB residents who see their presence as direct competition for the patient dollar.
Becoming a Midwife
There are different kinds of midwives and many ways to train as one. There are two major categories of midwives:Certified or licensed practical midwives, called DPM, or sometimes LM. They usually train at a midwifery school or through an apprenticeship with an experienced midwife. For a listing of accredited midwifery schools, contact the Midwifery Education Accreditation Council, known as MEAC, at www.meacschools.org (or call 928-214-0997 ).
Certified nurse-midwives, who do a midwifery training after getting their nurses education. Contact the American College of Nurse Midwives at www.acnm.org (or call 202-728-9860) for a listing of nurse-midifery schools.
We need a midwife for every mother.