Midwives
Suzanne Arms
Although the obstetrical model for birth
is currently dominant in the U.S., there does
exist another, time-honored and scientifically-proven
model that views birth as a healthy, normal
process. That model is midwifery. Midwifery
is trust-based and protects normalcy by understanding
the intrinsic value of caring for the mother
and keeping the mother-baby pair intact.
Trained professionals
Contrary to current misconceptions, midwives
are trained professionals, skilled in their
ability to assist childbearing women with
the least amount of intervention, guard their
privacy, protect their bodies and their babies.
Midwives are trained to acknowledge, respect
and treat the excessive fear that most American
women now bring to birth. This fear is understandable
in light of the history of modern childbirth,
however it must be addressed if women are
to have normal births.
The hallmark of midwifery is the time they
spend with a woman and the relationship of
trust that forms between them. Midwives view
childbirth as a psycho-sexual time and also
try and care for the partner and family. Simple
statistics bear this out: the average prenatal
visit to a midwife lasts 30-45 minutes (and
longer if the woman is planning a home birth),
compared to 5-7 minutes obstetricians average
with their patients.
The role of trust
The value of this trust and in-depth relationship
cannot be over-emphasized. It provides the
health professional with crucial information
that can predict or prevent complications.
It also plays a vital role in making women
more comfortable and diminishing unwarranted
anxiety of both parents-to-be, and thereby
produces more normal labors.
Midwives provide continuous observation in
labor and are trained to know when to act
and when to let nature take its course. Because
a midwife does not rely on an electronic device
to monitor the woman's progress in labor and
the baby's well being, she is far better able
to discern real problems from normal variations.
Furthermore, she is less likely to wait too
long to intervene when that is called for
because she has been continuously observing
the process. This is why midwives attending
births in all settings maintain a cesarean
rate of 5% or less, even when caring for high-risk
women in the hospital.
Breastfeeding connection
Virtually all mothers cared for exclusively
by midwives during pregnancy and birth breastfeed
successfully. The majority of mothers who
birth at home with midwives breastfeed for
at least a year, which is the current recommendation
of the American Academy of Pediatrics. There
are a myriad of benefits from a midwifery-based
system of maternity and newborn care.
Accessibility
Today the U.S. has only 7,000 practicing
midwives (Certified Nurse-Midwives and Direct
Entry Midwives combined) attending births
in all settings. In comparison there are more
than 33,000 obstetricians. We will not see
significant change in maternal health-care
until this ratio is reversed. Obstetricians
still maintain tight control over hospital
obstetrics, although HMO and insurance company
policies and hospital attorneys and administrators
have eroded their power.
Midwives who have been able to gain hospital
privileges for private clients are increasingly
being pushed out by obstetricians and OB residents
who see their presence as direct competition
for the patient dollar.
Becoming A Midwife
There are different kinds of midwives and
many ways to train as one. There are two major
categories of midwives:
Certified or licensed practical midwives,
called DPM, or sometimes LM. They usually
train at a midwifery school or through an
apprenticeship with an experienced midwife.
For a listing of accredited midwifery schools,
contact the Midwifery Education Accreditation
Council, known as MEAC, at www.meacschools.org
(or call 928-214-0997 ).
Certified nurse-midwives, who do a midwifery
training after getting their nurses education.
Contact the American College of Nurse Midwives
at www.acnm.org (or call 202-728-9860) for
a listing of nurse-midifery schools.
We need a midwife for every mother.
Internationally acclaimed author, photojournalist,
visionary and activist, Suzanne Arms has been
the acknowledged leader of the natural birthing
movement and midwifery advocate in the United
States for over 25 years. Her second book
"Immaculate Deception": A New Look
at Women and Childbirth stirred a national
social change movement and became a New York
Times "Best Book of the Year" in
1975, when her daughter Molly was four years
old.
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