What Is a Midwife?
"Midwife" is a word that comes from the old English words mit wif, literally "with woman."
A New York State licensed midwife is a health care provider who may care for the health needs of pre-adolescent, adolescent, and adult women throughout their life span. Licensed midwives provide primary well woman health care including: gynecologic care, and care during pregnancy and childbirth, as well as care of the newborn following birth.
Licensed Midwives are legal in NY. We can prescribe medications, order diagnostic tests, and collaborate with medical professionals. Midwives work in homes, birth centers and hospitals.
The Midwives Model of Care is based on the fact that pregnancy and birth are normal life processes.
The Midwives Model of Care includes:
- Monitoring the physical, psychological, and social well-being of the mother throughout the childbearing cycle
- Providing the mother with individualized education, counseling, and prenatal care, continuous hands-on assistance during labor and delivery, and postpartum support
- Minimizing technological interventions
- Identifying and referring women who require obstetrical attention
The application of this woman-centered model of care has been proven to reduce the incidence of birth injury, trauma, and cesarean section.
With protection from interference and good support, childbearing women and their fetuses/newborns experience effective innate, hormonally-driven processes that have developed over the course of evolution. These processes begin at the onset of labor, continuing through the birth of the baby, delivery of the placenta, and then through the establishment of breastfeeding and mother-baby attachment.
Midwives practice in diverse settings—including homes, hospitals, and birthing clinics—and provide many of the same services as physicians, including prescribing medication and ordering tests. The care that midwives provide is based on the philosophy of not intervening unless there is a current or potential health problem. That approach has several benefits, according to a 2009 review of 11 studies involving more than 12,000 women. Women who used midwives were more likely to be cared for in delivery by their primary provider (rather than whoever was on call) and were more likely to have a spontaneous vaginal birth without the need for an epidural, forceps, or vacuum extraction. They are also more likely to report feeling in control during their birth experience and to initiate breast-feeding. Consumer Reports
We, the midwives of the American College of Nurse-Midwives, affirm the
power and strength of women and the importance of their health in the well-being of families, communities and nations. We believe in the basic human rights of all persons, recognizing that women often incur an undue burden of risk when these rights are violated.
We believe every person has a right to:
- Equitable, ethical, accessible quality health care that promotes healing and health
- Health care that respects human dignity, individuality and diversity among groups
- Complete and accurate information to make informed health care decisions
- Self-determination and active participation in health care decisions
- Involvement of a woman's designated family members, to the extent desired, in all health care experiences
Midwife led care delivers best outcomes, Cochrane review 2013
Women whose maternity care is provided primarily by midwives appear to have better outcomes than those who receive their care primarily from doctors or from doctors collaborating with midwives, a Cochrane review has found.1
In the review, Jane Sandall, of the Division of Women’s Health at King’s College London, London, United Kingdom, and colleagues, examined 13 studies involving 16 242 women comparing outcomes of care delivered by a midwife led continuity model of care with that delivered by a doctor led or a shared model of care in which both doctors and midwives provide care.
They found that women who were randomised to care delivered under a midwife led model were less likely to undergo spinal or epidural regional analgesia (average risk ratio 0.83, 95% confidence interval 0.76 to 0.90, 13 trials, n = 15 982, Tau2 = 0.01, I2 = 48%), to have vaginal birth with instrumentation with forceps or vacuum (average risk ratio 0.88, 95% 0.81 to 0.96, 12 trials, n = 15 809), or to give birth prematurely (average risk ratio 0.77, 95% 0.62 to 0.94, seven trials, n = 11 546, Tau2 = 0.03, I2 = 42%).
Women who had been randomised to the midwife led model of care were also more likely to experience a spontaneous vaginal
birth (average risk ratio 1.05, 95% 1.03 to 1.08, 11 trials, n = 14 995).
The researchers found that there were no statistically significant differences between the groups for caesarean birth (average risk ratio 0.93, 95% 0.84 to 1.02, 13 trials, n = 15 982), overall fetal loss, or neonatal death (average risk ratio 0.84, 95% 0.71 to 1.00, 12 trials, n = 15 869).
“Overall, we did not find any increased likelihood for any adverse outcome for women or their infants associated with having been randomised to a midwife led continuity model of care,” the researchers wrote.
They concluded, “Most women should be offered midwife led continuity models of care and women should be encouraged to ask for this option, although caution should be exercised in applying this advice to women with substantial medical or obstetric complications.”
1 Sandall J, Soltani H, Gates S, Shennan A, Devane D. Midwife-led continuity models versus other models of care for childbearing women. Cochrane Database Syst Rev 2013;8:CD004667, doi:10.1002/14651858.CD004667.pub3.
Cite this as: BMJ 2013;347:f5321 © BMJ Publishing Group Ltd 2013
Why be a midwife?
"There is the privilege of sitting vigil as a woman's sweet agony is transformed into overwhelming surrender, then into a warrior's grace and finally into a mother's love." quote from Michelle Doyle-midwife