Midwifery

Midwives have been caring for pregnant and birth women for centuries.  Today midwifery is the optimal choice for low risk mothers. Midwives tend to have better outcomes overall, and are experts in normal healthy pregnancy and birth. Around the world, the countries where Midwifery is the standard of care have the lowest infant and maternal mortality rates.  Studies show that women receive better care with Midwives.

“Midwifery as practiced by certified nurse-midwives (CNMs®) and certified midwives (CMs®) encompasses a full range of primary health care services for women from adolescence beyond menopause. These services include primary care, gynecologic and family planning services, preconception care, care during pregnancy, childbirth and the postpartum period, care of the normal newborn during the first 28 days of life, and treatment of male partners for sexually transmitted infections.”  Read more.( American College of Nurse-Midwives)

The most important factor in choosing a care provider is finding one that you like, whom you can work with, and who respects your wishes and desires for the birth of your child.  They are after all your employee. Please keep in mind that obstetricians are highly trained surgeons, specializing in the technology and pharmacology of the problems of birth. Where as Midwives are experts in normal, natural birth. Depending upon your personal feelings and medical history, as well as present medical status, you would ideally choose a person who best fits your needs and birth philosophy.  It is as it is a very personal choice for each family.

For low risk moms the choice of a Midwife is logical. They spend more time with the pregnant woman, cost less, and offer comprehensive prenatal and obstetric care. Women who use Midwives tend to be more satisfied with their birth experience over all.   In NY State Midwifery is legal, and Midwives thoroughly trained, and licensed. A list of local Midwives is available on our  Provider Guide. You can also find more information   on choosing a midwife here:  Safety of Midwifery Care

“Numerous studies have shown that midwives provide safe and competent care for mothers and babies, with safety outcomes far superior to those of obstetricians. In 1998, Marian MacDorman and Gopal K. Singh published a study contrasting the health and survival of infants born with the assistance of certified nurse-midwives and those born under obstetric care. MacDorman and Singh reviewed birth records for every singleton child born vaginally, at 35 to 43 weeks gestation, in the U.S. in 1991. After social and medical risk factors were controlled for, when compared to physician-attended births, babies born with the assistance of midwives showed dramatically reduced mortality and higher birth weight (an important indicator of babies¹ health). Babies born with physicians in attendance were 31% more likely to die by one month of age and 19% more likely to die between one month and one year of age than babies attended by midwives. The midwife-attended babies were 31% less likely to have a low birth weight and weighed an average of 37 grams more than babies attended by physicians, likely a direct result of midwives¹ more intensive prenatal care.

The authors of this study cite several possible explanations for midwives¹ superior outcomes. These include longer prenatal visits (approximately double the time of physicians¹ prenatal visits); an emphasis on counseling and education; establishing trust; providing emotional support; empowering women to control their own birth experience; encouraging safe, non-invasive labor support measures such as walking, taking food and drink, intermittent (rather than continuous) fetal monitoring, and the presence of family and friends at the birth; and providing continuous one-on-one care during labor and birth. The authors conclude that certified nurse midwives³ provide a safe and viable alternative to maternity care in the United States, particularly for low and moderate risk women² (MacDorman & Singh, 1998).”

Alyce Adams, RN, Founding member of Rochester Birth Network.

(MacDorman, Marian F., & Singh, Gopal K. (1998). Midwifery care, social  and medical risk factors, and birth outcomes in the USA. Journal of Epidemiology and Community Health, 52 (5), 310­317.)

Since the above was written, an analysis of the Cochrane database on this subject has been conducted a number of times. All analyses (the most recent being 2016) have conclusively found that for low risk women Midwifery led care resulted in better care, and was safer for Mom’s and babies.

Additional references:

Wagner, M.; “Midwifery in the Industrialized World” Journal of the Society of Obstetricians and Gynecologist of Canada 20, #13(1998); 1225 – 34.

Wagner, M.; Born in the USA: How a Broken Maternity System must be fixed to put Women and Children First; University of California Press, Berkley, California, 2006; p.99-125.

Hatem, et al; “Midwife-led Versus other models of care for childbearing women”. Cochrane Database of Systematic Reviews 2008, Issue 4, Art. #CD004667

Sandall J, Soltani H, Gates S, Shennan A, Devane D. Midwife-led continuity models versus other models of care for childbearing women. Cochrane Database of Systematic Reviews 2016, Issue 4. Art. No.: CD004667. DOI: 10.1002/14651858.CD004667.pub5.

The Lancet Series on midwifery

You will find a list of local Midwives here: http://rabn.org/wordpress/provider-guide/midwives/

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