1. WHAT IS MIDWIFERY?

The simplest definition of midwifery is "with woman", but truly, Midwifery means different things to different people. For many, The Midwifery Model is an attitude about women and how pregnancy and Birth occur, and view that pregnancy and birth are normal events until proven otherwise. It is an attitude of giving and sharing information, of empowerment, and of respecting the right of a woman and her family to determine their own care.

The attitude of midwifery, or the Midwifery Model can be contrasted with the Medical Model. In general, the Medical Model is an attitude that there is potential pathology in any given situation, and that medicine can assist to improve the situation. Medicine is also about teaching, informing, and prevention, but the power seems to be more with the provider rather than with the woman.

Historically, midwives have always been around to help women give birth. Before physicians, midwives were the primary healers in their communities. They were the medicine women of their own cultures, and assisted families and women throughout their lives. In the Old Testament they were described as examples of the strength and faith in God.

Midwives were once the nutritionists, herbalists, doctors, ministers, counselors all rolled into one 'profession'. Many feel they were the first holistic practitioners. Midwives were always available to help the poor, the women without medical care or the women who were the outcasts of their culture. Today, midwives take care of anyone who wishes to see them, but practice within the constraints of their medical and legal systems.

The World Health Organization (WHO) and International Confederation of Midwives (ICM)  presents us with the following definition of the midwife:

A midwife is a person who, having been regularly admitted to a midwifery educational programme, duly recognised in the country in which it is located, has successfully completed the prescribed course of studies in midwifery and has acquired the requisite qualifications to be registered and/or legally licensed to practise midwifery.

She must be able to give the necessary supervision, care and advice to women during pregnancy, labour and the postpartum period, to conduct deliveries on her own responsibility and to care for the newborn and the infant. This care includes preventative measures, the detection of abnormal conditions in mother and child, the procurement of medical assistance and the execution of emergency measures in the absence of medical help. She has an important task in health counselling and education, not only for the women, but also within the family and the community. The work should involve antenatal education and preparation for parenthood and extends to certain areas of gynaecology, family planning and child care. She may practise in hospitals, clinics, health units, domiciliary conditions or in any other service.

2. WHAT DO MIDWIVES DO?

Midwives teach, educate and empower women to take control of their own health care. In most communities, they provide prenatal care, or supervision of the pregnancy, and then assist the mother to give birth. They manage the birth, and oversee the woman and her newborn in the postpartum period.

For example, in the United States some midwives can prescribe medications, provide women's health care throughout the menopause years. Midwives worldwide attend births in the home, hospital or birthing center, depending upon their education and licensure, and the rules governing their practice.

Midwives believe it is especially important to provide time for questions, teaching, and time to listen to the concerns and needs of the women they care for.

She must be able to give the necessary supervision, care and advice to women during pregnancy, labour and the postpartum period, to conduct deliveries on her own responsibility and to care for the newborn and the infant. This care includes preventative measures, the detection of abnormal conditions in mother and child, the procurement of medical assistance and the execution of emergency measures in the absence of medical help. She has an important task in health counseling and education, not only for the woman, but also within the family and the community. The work should involve antenatal education and preparation for parenthood and extends to certain areas of gynecology, family planning and child care. She may practice in hospitals, clinics, health units, domiciliary conditions of in any other service. ( WHO, FIGO, ICM Statement).

3. HOW DO I BECOME A MIDWIFE?

There are many different paths to becoming a midwife. The path you choose will depend on many factors: where you live, what the rules and regulations are in your state or country which govern midwives, your age and education, and what sorts of experiences you have had with birthing. The most important thing is that you need to look at your reasons for wanting to become a midwife are, both short term and long term. This will help you determine which path is best for you. The resource published by Midwifery Today Getting an Education: Paths to Becoming a Midwife gives good guidance and information about the various paths to becoming a midwife. In some areas women start as childbirth educators and/or doulas to become exposed to birth and working with pregnant women.

4. WHERE DO I FIND A MIDWIFE?

5. IS MIDWIFERY CARE SAFE?

"As technical advances became more complex, care has come to be increasingly controlled by, if not carried out by, specialist obstetricians. The benefits of this trend can be seriously challenged. Direct comparisons of care given by a qualified midwife with medical backup with medical or shared care show that midwifery care was associated with a reduction in a range of adverse psychosocial outcomes in pregnancy, and with reductions in the use of acceleration of labor, regional analgesia/anesthesia, operative vaginal delivery, and episiotomy." (p 15)

BIRTH: Issues in Perinatal Care Vol:22, No 2: June 1995 summarizes this resource.