Of the many topics to research, and the numerous decisions to make when expecting a baby, perhaps one of the most important is whether to go with obstetric or midwife-led care.
Indeed, this decision can drastically impact how the pregnancy and birth are viewed and handled. As Sheila Stubbs of Birthing the Easy Way writes, “The midwife considers the miracle of childbirth as normal, and leaves it alone unless there’s trouble. The obstetrician normally sees childbirth as trouble; if he leaves it alone, it’s a miracle.”
Those are two very different mentalities.
Midwifery is as old as childbirth. Throughout history, it’s been typical for women to accompany women in childbirth, often the mother or another female relative. There are prehistoric figures and ancient Egyptian drawings that show women giving birth in the sitting or squatting position – something a midwife would typically be open to trying over an obstetrician – and birthing stools and midwives are mentioned in the Old Testament.
Obstetrics, on the other hand, wasn’t recognized as an established medical discipline in Europe and the United States until the 19th century. According to “The start of life: a history of obstetrics”, obstetricians originally came into play only when it became apparent a cesarean delivery might be required. It wasn’t until the 1900s that obstetrics began to include antenatal care as well.
Obstetricians weren’t originally meant to replace midwife care, and the countries with the lowest infant and maternal mortality rates continue to use midwives for the majority of births to this day.
Yet in the United States, for example, just eight percent of births were attended by midwives in 2014 according to The National Center for Health Statistics (the most recent year with final birth data) – compare that to more than half of all births in England.
There are a number of potential reasons for this, including the big business behind the medical industry; if midwifery were used for 75 percent of births in the United States, the annual health care savings would be $8.5 billion.
That’s great for patients, not so great if you’re trying to run a business.
Dispelling the myths of midwife-led care
Additionally, somewhere along the line several myths became associated with midwives. Take a look at some of these common myths below, and then read on to learn about the numerous benefits to midwife-led care.
Myth: Midwives only deliver at home
While many midwives will attend home births, some practices will only oversee births in a hospital or birth center environment.
Myth: Midwives don’t have formal training
This may have been the case centuries ago, when a midwife’s knowledge came in the form of giving birth herself and/or through attending other births, but midwives now have to pass a certification exam and are subject to state regulations. It’s also not uncommon for midwives to have a nursing degree and experience in the nursing field.
Myth: Midwives can’t manage high-risk pregnancies or treat complications
Midwives are trained to recognize and treat complications and usually work in conjunction with a physician who’s on-call to assist when needed.
Myth: Midwives can’t provide medication during labor
They can provide the same kinds of medication as doctors and are skilled in pain management, but they don’t jump to using them; they work with the laboring mother and her preferences. With medical-led care, medication and interventions are often routine.
Midwives not only focus on the survival of mom and baby but the emotional, physical and mental well-being of the woman.
Some of the benefits of midwife-led care, according to traditionalmidwife.org include:
- birth freedom
- feminine dignity
- informed choice
- a respected birth plan
- individualized care
- a holistic environment
- minimal intervention
- familiar caregivers
- chosen attendants
- sacred space
- honest education
- realistic expectations
- nurtured spirit
- confidence in the mother’s ability
- supported birth choice
- spirit renewal
- honored birthright
And since midwifery views pregnancy and childbirth as a normal life event, not something to fear, that often makes all the difference in how the experience is handled.