A Brief Overview of Midwifery Practice

A midwife is a trained professional with special expertise in supporting women to maintain a healthy pregnancy and birth, and offering expert individualized care, education, counseling and support to a woman and her newborn throughout the childbearing cycle. Midwives provide skilled, individualized, and loving care to birthing women. They monitor the physical, psychological, and social well-being of mothers throughout the childbearing cycle, providing them 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 those who require obstetric attention. They are committed to educating women and assisting them through natural, preventative, holistic, and nutritional means. They are respectful of the physiological, emotional, spiritual, sexual, and cultural aspects of labor and delivery, recognizing that birth is not an illness – it is a natural life process.

Midwives have always been part of the human experience. Midwives, like physicians, practiced without specific education, standards, or regulations until the early part of the 20th century. Although detailed statistics were lacking, the evidence available showed that midwives’ patients were less likely than physicians’ patients to die of childbed fever or puerperal infection, the most significant cause of maternal morbidity and mortality at the time. As medicine gained legitimacy and power toward the end of the nineteenth century, it called for the abolition of midwifery and home birth in favor of obstetrics in a hospital setting, a goal that it almost accomplished. Midwives were portrayed by the medical profession as dirty, illiterate, and ignorant, and women were convinced that they were safer in the hands of doctors and hospitals. By 1935, the number of births attended to by midwives had decreased to 12.5%, and shortly thereafter, they were effectively stamped out.

Despite restrictions, a small but steady number of families continued to demand alternative childbirth, and the midwives attending them began to organize to share experiences, support one another, and learn together. In 1975, the publication of Ina May Gaskin’s book Spiritual Midwifery spread the word that childbirth could be an experience of growth, empowerment, and joy. Midwifery has since experienced a resurgence. Every year, more American babies are born into the hands of midwives. The U.S. national average is 7.4%, although in some states it is as high as 20%. Still, the rate is very low compared to that in the European countries that have the best birth outcomes.

The World Health Organization’s Regional Office for Europe has declared that “nurses and midwives have key and increasingly important roles to play in society’s efforts to tackle the public health challenges of our time, as well as in ensuring the provision of high-quality, accessible, equitable, efficient and sensitive health services which ensure continuity of care and address people’s rights and changing needs.” The application of this woman-centered model of care has been proven to reduce the incidence of birth injury, trauma, and cesarean section; in countries where midwives are the primary birth attendants, the number of natural births rises significantly and the use of medical technology and cesarean section is dramatically reduced.  It has been well documented that countries in which midwives are the primary caregivers of healthy pregnant women have the best maternal and neonatal outcomes.



Copyright © 2007-2012 Raquel Lazar-Paley