What Do Midwives Do?
The following is an outline of typical midwifery care that I provide. Keep in mind that the care I provide will be personalized for each individual woman.
Care During Pregnancy:
Free consultation (Initial Interview) where the mother and family get to know the midwife.
Provide clients with disclosure of education, training, years of experience, statistics for the practice and emergency back up plan.
Support Families and their decisions.
Screen for complications and consult and refer to another health care provider when indicated.
Remain available to the family via phone, pager or mobile phone throughout pregnancy.
One hour prenatal visits, every three weeks until 28 weeks, then every 2 weeks until 36 weeks, then weekly until birth, or more often as needed.
During Labor and Birth:
Monitor physical well-being of mother & baby.
Keep Mother well fed and hydrated.
Let labor progress on Mother's timetable.
Give encouragement and suggestions as needed.
Immediate skin to skin contact for Mother & Baby.
Continue to monitor Mother and Baby's well-being.
Newborn examination within two hours of birth.
Stay as long as needed, at least two hours after Mother and Baby are both stable.
Revisit home for a 1 day, 3 day, 7 day and 3 week postpartum home-visit.
Help mother and baby establish a successful breastfeeding relationship.
The final visit is at 6 weeks postpartum.
What Midwives Do Not Do:
Prescribe drugs or administer narcotics.
Interfere with normal labor and birth.
Attend high risk births.
Use continuous electronic fetal monitoring (EFM). Monitoring often leads to partial or total restriction of movement which can domino into more pain due to lack of freedom to assume a better position and/or trouble with the baby descending properly, which is often aided by movement. Use of continuous EFM during labor has not been shown to improve outcomes when compared with intermittent fetal monitoring with fetoscope or hand held Doppler.
Offer drugs for pain relief like Epidurals, which can lower the mother's blood pressure too much, decreasing the amount of oxygen for the baby, and increasing the risk of fetal distress.
Routinely offer internal exams late in pregnancy.
Routinely cut episiotomies. Episiotomies increase the risk of major tears and usually require many more stitches than a natural tear. Episiotomies have a higher rate of infection and a higher rate of serious complications.
Tell a Mother where, how and in what position she must push.
Make Mom lie flat on her back during labor or pushing. This is physically bad for baby because it restricts blood flow to the pelvic region, reducing or cutting off the baby's oxygen supply and has been shown to be associated with fetal distress.
Use forceps or vacuum extractors.
Withhold food and drink.