Dec 10, 2011

What is a midwife?

It's kind of important that I share some background to what I want to do so why not with a short primer about what a midwife is and what we do!

Midwives think of pregnancy and birth as a normal, physiological and social event that has lifelong consequences to the woman and her family. Midwives should be involved to monitor progress and guide the woman but is not there to make the decisions for her.

Midwifery-led care is a type of primary health care - a type of care that should be the first considered for women who are wanting to get pregnant, or are pregnant. Fifteen years ago, the World Health Organisation acknowledge midwives as the “most appropriate primary health care provider to be assigned to the care of normal birth” - something that applies in Australia just as much as in the developing world.

The word midwife means "with woman". It's not about being a woman or a wife and yes, there are in fact male midwives! The midwife's scope of practice is from pre-conception through pregnancy, labour, birth and the first 6 weeks of parenthood. That's about a year's worth of professional service.

Midwives provide women-centred care - the journey should have her at the centre, and information should come to her so that she can make decisions that are informed and relevant to her and her family. The woman remains in control of her care - she is aware of her options and she is in charge of her pregnancy. This is a different model from the illness, medically-supervised model many people think of with pregnancy, but is the safest model of care for women undergoing a normal part of being human.

Midwives are trained professionals, skilled in care of women and their babies, and educated in emergency skills as well. They use many tools - their hands most importantly, their observational skills and reflecting on how the woman is today compared to previous visits, as well as tools, diagnostic tests and information provided by others.

The benefits of care with a midwife through the whole journey are measurable:
* less intervention in pregnancy with similar, if not better, health outcomes for mother and baby;
* less intervention in labour and birth with similar, if not better, health outcomes for mother and baby;
* less need for pain relief such as an epidural in labour;
* higher success rates for normal birth;
* higher success rates for vaginal birth after previous caesarean section, with similar, if not better, health outcomes for mother and baby;
* higher success rates of breastfeeding.

Midwives are practitioners in their own right, with a defined scope of practice which means that they work in partnership with other practitioners - doctors, for example - and refer the woman on to other providers for care, support or treatment during the pregnancy, labour and early parenthood. This provides the necessary support to the woman, and ideally should see the woman remain under the care of the midwife still while also seeing other care providers.

Midwives are trained to provide care to newborns and infants as well, to attend births as independent professionals, to promote normal birth, to provide preventative measures for a range of situations. Midwives are able to work in many settings - hospitals, homes, the community, clinics and in lots of other places!

In the end, even if there are complexities or complications, the woman is still pregnant and still going to birth a babe and still going to be a new parent and that is why she still deserves midwifery care.

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