Midwives delivering babies for hundreds of years

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Midwife    means “with woman.” Traditionally, women have attended and    assisted other women during labor and birth. As modern medicine    emerged in the West, birth fell into the    realm of the medical. Today the medical or technocratic model of    birth is the mainstream in America while other countries, who use    midwives as the primary care givers for natural pregnancies, use the    holistic midwifery model of care.

The    World Health Organization acknowledges that midwives should be the    primary care giver for women with natural pregnancy or low risk while    doctors should care for the high risk (which may includes twins,    breeches and other pregnancies that require the facility of a    hospital). The table below    (adapted from the book, Birth as an American Rite of Passage    by Robbie Davis-Floyd; U.C. Press, Los Angeles, 1992)shows    differences between the medical and the midwifery model of care.

Medical – Technocratic

Midwifery – Holistic

Male centered, woman is an        object/patient, male body is the norm, classifying and separating        approach to care, mind is above and separate from body, female body        is a defective machine

Female centered, woman is a client,        the female body is the norm and normal on her own terms, holistic and        integrating approach to care, mind and body are one, female body is a        healthy organism, and pregnancy and birth are inherently healthy

 

Midwives    make sure that the woman will have a natural pregnancy through    proper prenatals and responsible and conscious mothering. During the    1960s and 1970s, along with the women’s movement and renewed interest    in homebirth, the midwifery movement rekindled. It has been growing    steadily ever since.

Midwives    are becoming more and more involved with birthing families and have    been instrumental in redefining birth as a natural event in women’s    lives. They offer family and women centered birthsto    empower people with the experience of birth.

How    to Choose a Midwife

Choose    a midwife with whom you feel confident and compatible with your    beliefs about birth and your body.The    following questions may help the pregnant woman to select a midwife    who is well suited to her and her family:

  • How     did she become a midwife?

  • What     training has she had? Is she certified or licensed by any organizations?

  • What     is her basic philosophy of childbirth?

  • How     many births has she attended as the primary midwife?

  • What     is the fee for her services, how must it be paid, what does it include?

  • What     kinds of services are included in prenatal care?

  • Does     she work with other midwives or assistants at births?

  • How     do you reach the midwife; does she allow 24 hour access?

  • How     does she handle problems or complications that might develop during labor?

  • What     emergency standard equipment does she carry? What herbs or medicine     does she use? Which ones does she carry and why? Does she have any     affiliation with a physician who can answer unusual questions either     during the pregnancy or in an emergency?

  • What     is her policy for transporting to a hospital?

  • What     kind of postpartum care does she provide? (frequency of baby     check-ups; assistance with nursing)

In    addition to asking these questions, it is important to be clear    about what you expect from your midwife. Be prepared to share your    vision of your birth and discuss any fears that you may have.    Determine if the midwife’s answers to your questions agree with your    desires. Trust your instincts. You will know when you have found your midwife.

Prenatals

Prenatal    visits may take place at the midwife’s home or clinic or at the    family’s home. The latter is especially comforting for the family as    they are in their own surroundings and may be less hesitant to ask    questions and get involved. Prenatal visits are also a time for the    midwife to get to know the family and friends, neighbors, or other    children who may be present at the birth.

Prenatal    care for the pregnant woman includes discussion of nutrition,    exercise and overall physical and emotional well-being, as well as    overseeing the healthy development of the fetus.Midwives    include the family during prenatal care, inviting them to ask    questions and to listen to the baby’s heartbeat. Intimate involvement    of the family throughout the pregnancy allows for early bonding of    the newly emerging family unit.

The    midwife and family will often discuss the mechanics of birth. The    more people know about what is going to happen, the more comfortable    they will be while awaiting the birth. The midwife interviews the    pregnant woman to determine if a high risk situation exits (homebirth    may not be a viable option for everyone).

Most    homebirth midwives screen out a high risk pregnancy (those with    certain special needs or medical conditions such as diabetes or blood    disorders or carrying twins or a breech baby) to birth only in the    hospital. This process is especially important for families in rural    areas many miles from a hospital.

During    this time the midwife helps the family to prepare for the birth. The    family may want to have a birth plan. This includes a list of what    will occur during the birth: special music, food and drink, candles,    religious or cultural rituals, who will be in attendance, which room    in the home will be the birthing room, what kind of support the mom    desires, etc. These steps enable the family to create the atmosphere    they want.

Continuity    of Care

After    the baby is born, the midwife doesn’t go away. She is still    accessible for information and support. This can be of great comfort    during the postpartum period when moms have questions or problems.    The midwife will continue to check in on the mother, baby and family    for a usual time frame of six weeks, although some midwives will    continue to get calls for much longer. Some families and midwives    form lasting friendships based on the joy and trust they shared at birth.

Birth    is a well designed process, and most women can give birth easily by    trusting in themselves and in their midwives or doctors. It is my    goal that the mother would travel the path of natural birth, with its    fullness and its unknowns, with the help of midwives.

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