This is my first post after I joined Healthy Mother in Hyderabad, India. As I am working here at Healthy Mother in this new setting from that in the US, I am realizing that the word “midwife” here means something different than it does back in the US. I thought I would take a minute to explain midwifery care as I know it. This will be a really short version and I promise I won’t go into the gruelling history – although it fascinates me immensely to look at how midwifery is practiced and viewed in different countries. But, for the sake of simplicity, here is a brief synopsis:
The word “midwife” comes from German and means “with woman” – as in a woman that gives care for another woman through her childbearing experience. Traditional midwives have been around forever and are known by different names depending on their culture – Dai in India, Comadrona in Guatemala, Sage Femme in France, Partera in Mexico etc. The way in which midwives practice varies from culture to culture.
The profession of modern midwifery started out with traditional practices of birthing techniques, herbs, nutrition, religious rites etc. While some places in the world still use mainly traditional midwives, midwifery in some countires (ie the US, most European countries, Japan,) has changed over the years to include clinical skills, evidence based practice, schooling and credentialing in addition to traditional knowledge, which is so valuable. In these countries, midwives are primary care providers and a client may not depend on a doctor for their pregnancy and birth unless there is some complication in which case, the midwife would make a referral.
Today there are many different types of midwives even within the same culture. Some midwives practice in hospitals, some at free standing birth centers (natural birth oriented facility), some do homebirths and some do all three. However, the common denominator in the Midwifery Model of Care is that pregnancy and birth are seen as a normal process of life and are cared for as such.
Midwives expect that about 85-90% of pregnancies and births will be normal and not need medical intervention. We see the mom and baby as a holistic unit. In addition to the physical care (like Blood pressure checks etc.) that is routine for other providers, we also take into consideration your psychological and emotional wellbeing as we know that these aspects are all connected to your physical well being. By educating clients about pregnancy and birth, proper nutrition, exercises and self care during the antenatal period, midwives help them to become confident and enjoy their experience of bringing a life into this world. Moms and families can expect to receive watchful and nurturing care with plenty of time for questions. When you go into labor, we are always next to you, monitoring you closely, supporting and caring for you. you are free to labor for as long as you can, provided you and your baby are well. We give you adequate space and privacy to labor on your own terms as we know that labor progresses best when uninterrupted. Similarly, after the baby is born, we encourage mother-baby bonding by keeping the two of you together and refraining from doing any unnecessary procedures.
Above all, midwives know that nature’s design is very intelligent (for one example of this see Sarah Buckley’s article) and that women are very strong (you shouldn’t need a reference for this right?). We know from recent studies that using medical interventions – such as epidurals, IVs, episiotomy, caesarean section etc – is risky and can cause more harm than good when they are used unnecessarily. It’s true that a c-section can be a life saving intervention when needed and boy am I grateful to have that resource but, we know that the majority of c-sections being done today are not necessary – they are done as a result of fear and impatience whether it’s on the doctor’s side or the parent’s side.
While it is common these days for people to think of a technological, hospital birth (a birth using technological equipment and intervention) as being safer, statistics are showing that less routine intervention results in better birth outcomes for mom and baby. The countries in the world that have the best birth outcomes for moms and babies are using midwifery care for about 70% of their population with doctor back up or primary care for the other 30%. The Netherlands, which is one of the top three countries for birth outcomes still does about 50% homebirth.
We call it the Midwifery Model of Care because it’s obviously not the just the midwife that is helping birth to be gentler and safer, it’s also the philosophy of care and the involvement and confidence of the parents. Most parents who are seeking natural birth or midwifery care are looking to be active players in their care and to take primary responsibility for the wellbeing of themselves and their baby.
I am happy to be part of the Healthy Mother team as we are integrating the best of both worlds. Every member of our team is committed to and passionate about following the Midwifery Model of Care. We have have a great team of healthcare providers including doulas (labor support people), nurses, ayas, doctors and midwives. We all work together so that each team member’s specialty compliments the others so we can provide comprehensive, individualized care to our clients.
Erinn Mandeville