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Q&A with SPB: Midwifery Care

Posted on May 5, 2015 at 7:49 PM
Happy International Day of the Midwife to the midwives of the world.

Facebook image - source: KNOW YOUR MIDWIFE

We are so blessed with so many amazing midwives in our birth community.  Here is a little more about why Sweet Pea Births advocates for midwifery care to be an available option to all birthing families:










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Here is a little more about the different ways a health practioner can certify to become a midwife - excerpt from THIS article:

There are two types of midwife in the United States:
**Nurse-midwives are educated and licensed as nurses first, and then complete additional education in midwifery. They are known as Certified Nurse-Midwives (CNMs). CNMs are licensed to practice in all 50 states. They are usually licensed in individual states as Nurse Practitioners (NPs).
**Direct-entry midwives are educated or trained as midwives without having to become nurses first. They may be Certified Professional Midwives (CPMs) or Certified Midwives (CMs). The legal status and requirements for direct-entry (non-nurse) midwives vary from state. They are usually licensed in individual states as Licensed Midwives (LMs) or Registered Midwives (RMs). The Midwives Alliance of North America tracks the laws and regulations in each state for direct-entry midwives.

For a good explanation of the way a midwife is different from a doula read this excerpt from the bump:
"A midwife is…a health care provider and a doula is more of a childbirth coach. You might choose to have a midwife instead of an OB for prenatal care and to deliver your baby — midwives can deliver babies in hospitals, birthing centers or even in your home. A doula, on the other hand, doesn’t replace your healthcare practitioner but rather can add extra services, such as helping you with techniques to manage pain during labor and even providing support and help during baby’s early days." 

A midwife's main scope of practice is the health and well-being of the Mother and the Baby.  She is doing "watchful waiting" through the pregnancy and birth, ensuring that everything is proceeding and staying healthy and low-risk.  If things start to vary or complications develop, depending on the midwife and whether they are home- or hospital-based, they may encourage the family to seek co-care or transfer care to an obstetrician who is trained to manage pregnancy that is moving away from low-risk.  

In the Phoenix, Arizona area, home birth families have the choice of doing co-care with Certified Nurse Midwives in the hospital setting, and still maintaining the midwifery model of care.  This allows for families to continue with "watchful waiting" and preserve their autonomy as consumers of healthcare.

Why hire a midwife?
The first study to compare birth outcomes between midwifery and obstetrical care was published in 1998.  Here are the conclusions:

"After controlling for a wide variety of social and medical risk factors, the risk of experiencing an infant death was 19 percent lower for births attended by certified nurse midwives than for births attended by physicians. The risk of neonatal mortality (an infant death occurring in the first 28 days of life) was 33 percent lower, and the risk of delivering a low birthweight infant was 31 percent lower. Mean birthweight was 37 grams heavier for the certified nurse midwife attended than for the physician attended births. Low birthweight is a major predictor of infant mortality, subsequent disease, or developmental disabilities.

Certified nurse midwives attended a greater proportion of women who are at higher risk for poor birth outcome: African Americans, American Indians, teenagers, unmarried women, and those with less than a high school education. Physicians attended a slightly higher proportion of births with medical complications. However, birth outcomes for certified nurse midwives were better even after sociodemographic and medical risk factors were controlled for in statistical analyses."

Excerpt from http://www.cdc.gov/nchs/pressroom/98news/midwife.htm

For the study abstract, click HERE
To read the study, click HERE

Is homebirth safe?
There are several studies that have been conducted around the world that show midwifery is safe - find a reference list HERE.  The big question remained: would outcomes be comparable in the US, where we do not practice socialized medicine?

The MANA study found that:
"Among 16,924 women who planned home births at the onset of labor, 89.1% gave birth at home. The majority of intrapartum transfers were for failure to progress, and only 4.5% of the total sample required oxytocin augmentation and/or epidural analgesia. The rates of spontaneous vaginal birth, assisted vaginal birth, and cesarean were 93.6%, 1.2%, and 5.2%, respectively. Of the 1054 women who attempted a vaginal birth after cesarean, 87% were successful. Low Apgar scores (< 7) occurred in 1.5% of newborns. Postpartum maternal (1.5%) and neonatal (0.9%) transfers were infrequent. The majority (86%) of newborns were exclusively breastfeeding at 6 weeks of age. Excluding lethal anomalies, the intrapartum, early neonatal, and late neonatal mortality rates were 1.30, 0.41, and 0.35 per 1000, respectively."
~Excerpt from THIS article




Are you curious about midwifery care??
Here are some posts where we share our birth journey with midwives:

Midwives Make a House Call - Third Trimester

Preparing for our Homebirth - Third Trimester







Link List
1998 Midwifery Study
http://www.cdc.gov/nchs/pressroom/98news/midwife.htm
http://jech.bmj.com/content/52/5/310.abstract?sid=52c15f2a-a71c-45d5-a827-c403cb953fa1
http://jech.bmj.com/content/52/5/310.full.pdf+html?sid=52c15f2a-a71c-45d5-a827-c403cb953fa1

MANA Homebirth Study
http://mana.org/blog/home-birth-safety-outcomes

Homebirth Studies Reference Page
http://mana.org/research/section-a-best-available-studies-grouped-by-design-level-of-evidence

Bradley Method® natural childbirth classes offered in Arizona: convenient to Chandler, Tempe, Ahwatukee, Gilbert, Mesa, Scottsdale, PaysonDisclaimer: 
The material included in this blog and video is for informational purposes only. It is not intended nor implied to be a substitute for professional medical advice. The viewer should always consult her or his healthcare provider to determine the appropriateness of the information for their own situation.  Krystyna and Bruss Bowman and Bowman House, LLC accept no liability for the content of this site, or for the consequences of any actions taken on the basis of the information provided.  This blog and video contain information about our classes available in Chandler, AZ and Payson, AZ and is not the official website of The Bradley Method®. The views contained in this video and on our blog do not necessarily reflect those of The Bradley Method® or the American Academy of Husband-Coached Childbirth®.
 


Categories: Birth, Birth center, Homebirth, Hospital Birth, Midwife, Midwifery Care, Midwifery Scope of Practice Committee

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