Midwives are the new Haute Choice

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the middlewife as status symbol

The New York Times published an article about midwives being a new trend amongst celebrity moms and models. The article suggested that the rich have taken the more natural route to deliver their babies, but it didn’t really get into what a midwife does, and the benefits to having one for those who don’t know. It’s great that we are getting a lot of love in the maternity movement right now, but let’s help folks understand why a midwife might be a good choice for their birth.

More than 98 percent of births in the United Sates take place in hospitals.  Pregnancy, delivery, and newborn care were the second and third most expensive “conditions” treated in U.S. hospitals in 2005. Hospital charges for pregnancy/delivery increased 75 percent between 1997 and 2005.  It cost an average of $7,000 for an uncomplicated hospital birth in 2005.  The cost of giving birth in a free standing birth center was about 75% less. Hello, do the math, why would you spend more?

When I delivered my son we chose a birth center and midwives and not only did our insurance cover it without question, it was really cheap since I was 23 and in robust health. My midwife Stacy Rees was at Elizabeth Seton Childbearing center- which was the only freestanding birth center in NYC. She now operates Clementine Midwifery.

So, what exactly does a midwife do anyway?

A professional midwife is a licensed, formally trained maternity care provider who works collaboratively with physicians and other maternity care professionals. Midwives can care for women in or outside of the hospital.  In all industrialized countries in the world except the United States professional midwives attend the majority of births. In those countries maternal and infant health outcomes are much better. The national health service of countries like Great Britain, Ireland, Canada, and the Netherlands support home birth.

Midwifery care is the best model of care for the majority of healthy pregnant women. The model of care provided by midwives is based on the concept that pregnancy and childbirth are normal life events that should be carefully monitored but not interfered with unless necessary. Midwifery care has been proven to reduce the rate of medical interventions in labor and birth, such as inductions of labor, electronic fetal  monitoring, and episiotomy that may cause harm when used routinely. Midwifery care also reduces the need for a cesarean section. Midwives look to maximize health outcomes using a minimum number of medical interventions. They also address the emotional, psychological, and cultural concerns of women in their childbearing year.

Midwives support the process of healthy birth

The philosophical foundation of midwifery care is based on protecting, supporting, and enhancing the normal process of birth. In contrast, the foundation of the technocratic birth model of care is that birth is inherently dangerous and the female body can not complete the birthing process unassisted by drugs and instruments. The focus is on the “abnormal” or pathological aspects of childbearing and birth. The technocratic and biomedical model of care, obstetrics being one specialty, is risk-focused and tends to view all normal pregnancies and births as potentially becoming “abnormal” and “risky” and all women needing medical interventions.

Current evidence shows that the woman-centered, hands-on, low-tech midwifery model of care for low-risk women has produced excellent health outcomes.

What the research shows

Research published by The Coalition for Improving Maternity Services (CIMS) in the Journal of Perinatal Education (Winter 2007)  shows that compared to a similar group of low-risk births in hospitals, planned homebirths with a qualified provider, and births in freestanding birth centers have equally good or better outcomes and lower rates of interventions.  Based on a review of 28 high-quality studies, the  CIMS Expert Work Group found in comparison to care provided by physicians for similar populations, care provided by professional midwives resulted in the same or better maternal and perinatal health benefits and no worse outcomes. These are a few of their findings.

Women cared for by professional midwives have:
•    Fewer hospital admissions during the antepartum period.
•    A lower incidence of hypertension during pregnancy and labor.
•    Fewer episodes of abnormal heart rate in labor.
•    Less need for pain medication in labor, including epidural analgesia.
•    A lower incidence of shoulder dystocia, in comparison to similar women cared for by physicians.
•    A lower rate of instrumental deliveries (use of forceps or vacuum extractors).
•    A lower incidence of retained placenta, and fewer or equivalent postpartum hemorrhages.
•    Fewer perineal injuries and fewer 3rd and 4th degree lacerations.
•    Fewer cesareans and more vaginal births after cesarean section (VBACs).

So what does this all mean? Well we should examine the way we view birth. How you are born is so important and normalizing the birth process means empowering women and I am all for that. For help navigating your options visit- www.ChoicesinChildbirth.org

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