"What is a midwife?"
Eight times out of ten I get this question when someone asks me what I do. The other two times, I either get a personal birth story or something like... "Ohhh, my daughter's friend's cousin had a home birth!" Actually, midwifery has become more well known due to social media and some great studies that have come out recently validating the safety of home birth and the benefits of midwifery care. I recently had a friendly lady come up to me in the grocery store parking lot after seeing my "midwife" bumpersticker. She was all giddy and grabbed my hands saying, "My daughter had a home birth, and it was wonderful!"
So, what is a midwife? Is a midwife a witch with potions and magic? Is a midwife a nurse? Is midwifery related to husbandry? Well, yes and no... The word is derived from Old English mid "with" wif "woman." Originally meant "with-woman", the woman who is with a woman in childbirth. Of course, there have been woman attending other woman in childbirth since the rise of the human species, so midwifery is ancient. I can imagine through years of experiencing birth themselves and witnessing birth, some woman found natural remedies and methods of helping other woman during pregnancy, birth and postpartum. This was midwifery. Eventually, these "witches" became prosecuted when male dominated medicine began in Europe in the 15th and 16th centuries. In the US, by the turn of the century, medicine was male dominated and woman became nurses ruled by doctors. Midwives mostly worked within black or working class immigrant communities until the 1970's when midwives like Ina May Gaskin started promoting low intervention, natural births as opposed to the highly medicated obstetrical approach.
Now, there are mainly two types of midwives, Certified Nurse Midwives and Certified Professional Midwives. Certified Nurse Midwives, CNMs, are registered nurses with advanced degrees in midwifery. CNMs mainly practice in hospitals (although, my fierce teacher, Julia Bower, is a home birth CNM). A Certified Professional Midwife is an independent professional midwifery practitioner who has met the standards for certification set by the North American Registry of Midwives (NARM). CPMs provide midwifery services for women who want to birth their babies at home or in a birth center.
What exactly are "midwifery services"? Most midwives follow the Midwives Model of Care which is best described by MANA (Midwives Alliance North America) below:
The Midwives Model of Care™
The Midwives Model of Care™ is a fundamentally different approach to pregnancy and childbirth than contemporary obstetrics. Midwifery care is uniquely nurturing, hands-on care before, during, and after birth. Midwives are health care professionals specializing in pregnancy and childbirth who develop a trusting relationship with their clients, which results in confident, supported labor and birth. While there are different types of midwives practicing in various settings, all midwives are trained to provide comprehensive prenatal care and education, guide labor and birth, address complications, and care for newborns. The Midwives Model of Care™ is based on the fact that pregnancy and birth are normal life events. The Midwives Model of Care includes:
monitoring the physical, psychological and social well-being of the mother throughout the childbearing cycle
providing the mother with individualized education, counseling, and prenatal care, continuous hands-on assistance during labor and delivery, and postpartum support
minimizing technological interventions and
identifying and referring women who require obstetrical attention.
The application of this model has been proven to reduce to incidence of birth injury, trauma, and cesarean section.
(Midwives Model of Care definition is Copyrighted © by the Midwifery Task Force, all rights reserved)
Awesome, right? Don't you think ALL women should have access to midwives? Me, too!
So, what does it look like to have a midwife during your pregnancy, birth and postpartum period? Most midwives see women once every month until 28 weeks of pregnancy, then every two weeks until 36 weeks and weekly until the baby is born. These visits include routine lab work, diagnostic tests, physical exams, and monitoring the growth and well-being of the fetus. Lasting usually 45 minutes to one hour, prenatal visits also include lots of discussions, such as health care, emotional well-being and collaborative decision-making. All the while, a trusting relationship is being built between the midwife and the woman and her family. Midwives are trained to know what physiological normal pregnancy, birth and postpartum looks like and what to do if it's not. So, our focus during pregnancy is maintaining health and refer to other practitioners if needed. During birth, midwives monitor the laboring woman's vitals and labor progress, as well as the fetus's heart tones. Midwives carry IV fluids, oxygen and medications for managing postpartum hemorrhage. We are trained in suturing, neonatal resuscitation and CPR, but we will transport to a hospital if needed. Up to six weeks postpartum, the midwife will monitor the mother and baby's health and emotional well-being, again referring out to specialists if needed.
The result of personal, respectful and professional midwifery care is fewer interventions during pregnancy and birth resulting in a greater sense of well-being and ease of parenting in the postpartum period. Since most home birth midwives usually only have 2-4 woman due each month, each woman gets personalized care throughout pregnancy, birth and postpartum.
This type of care feels so good and natural to me. I am honored to provide midwifery care during such a special time in a woman's life.
Please comment on how a midwife has impacted your life or what midwifery care means to you and contact me for more information on how midwifery care will benefit you during your pregnancy. I offer FREE initial consultations.