Choices in Childbirth

 

CHOOSING YOUR MEDICAL CAREGIVER

 

Obstetrics has become a specialized and lucrative field for many physicians.  However, many women may not realize that they don't need a specialist for their birth if they are having a normal, low-risk pregnancy and are anticipating the same for their birth.

According to the World Health Organization, midwives should be the preferred medical caregiver for low-risk pregnant women, reserving OB-GYN's for high-risk pregnancies for emergency birth complications only.

 

"The most appropriate person to care for pregnant women is someone with midwifery skills who lives close to   the community. People trained in midwifery are qualified to provide preventive care to pregnant women, detect abnormal conditions in mothers and infants, assist women through labor and delivery and prescribe essential drugs. When delivery complications arise, those providing midwifery care ­ especially at the community level ­ need to be able to carry out emergency measures if medical help is absent, and get medical assistance or refer women to an appropriate health facility."  

WHO/FIGO/International Confederation of Midwives, "Definition of the Midwife", 1992.

 

The California Association of Midwives once detailed a lovely and comprehensive description of the Midwifery Model of Care: "In the midwifery model of care, the woman maintains power and authority over herself. Responsibility is in the hands of the woman, shared with her partner and midwife. The goal is to assist the woman toward self-care as a healthy person in a state of normalcy. The mother and baby are a unit whose medical and emotional needs are complimentary; what meets the needs of one meets the needs of both. The woman's body is a well-functioning home for herself and her baby. Its needs and workings are best known by the woman herself. The emphasis is on pregnancy and birth as times of physical, psychological and emotional growth for the mother and fetus. Childbirth is seen as an activity that the healthy woman engages in. The midwife guides and educates the woman during her experience. Childbirth is seen as an event in the lives of the woman and her family. The woman's active birth-giving is enhanced by education, support, and skilled care." (reprinted with permission)

 

The Midwives Model of Care definition was created by midwives and consumers as a tool for advocating midwifery. The definition was created jointly by the Midwives Alliance of North America (MANA), the North American Registry of Midwives (NARM), the Midwifery Education Accreditation Council (MEAC) and Citizens for Midwifery (CfM) in 1996, and is copyrighted by the Midwifery Task Force. 

Citizens for Midwifery (CfM),  is a non- profit, volunteer, grassroots organization.  Founded by several mothers in 1996, it is the only national consumer-based group promoting the Midwives Model of Care.    

 

 

THE MIDWIVES MODEL OF CARE

The Midwives Model of Care is based on the fact that pregnancy and birth are normal life processes. 

 

• 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.

*Copyright (c) Midwifery Task Force, Inc. Reprinted with permission. All rights reserved.

 

 

SUGGESTIONS FOR CHOOSING YOUR MEDICAL CAREGIVER

 

Interview your potential medical caregiver carefully before choosing them for your pregnancy and birth. Ask pointed questions regarding their cesarean rate, how they handle various aspects of pregnancy, labor and birth, and their personal as well as professional philosophy regarding labor and birth.  

 

Women that don't ask pointed questions before choosing their medical caregiver may receive a different type of care than they anticipated.  Invariably, these women find themselves asking these types questions when they are much further along in their pregnancy and may not be happy with the answers they receive.  While you always have the option of changing medical caregivers if you become unhappy with the care you are receiving, many women are intimidated having to do so when they are towards the end of their pregnancy.

 

Since most women are reluctant to change medical caregivers late in pregnancy, try not to put yourself in this situation. Make certain you do your homework before you pick your medical caregiver, and find someone that you feel will be compatible with your ideas for your labor and birth experience.  Ask for and check out references from previous clients.

 

Citizens for Midwifery (CfM) has developed an excellent brochure about the Midwives Model of Care©. You may order a sample copy or packets of the brochure here.  

 

The Coalition for Improving Maternity Services (CIMS) offers a free brochure “Having a Baby? Ten Questions to Ask" that you may download online.

 

Read my "SAMPLE LIST OF QUESTIONS TO ASK YOUR MEDICAL CAREGIVER" hand-out in the link below.

 

"You are constructing your own reality with the choices you make...or don't make. If you really want a healthy pregnancy and joyful birth, and you truly understand that you are the one in control, then you must examine what you have or haven't done so far to create the outcome you want."

Kim Wildner, Mother's Intention: How Belief Shapes Birth