Midwives focus on promoting the health and well-being of their clients through respectful, compassionate, and evidence-based care that acknowledges the inherent power and wisdom in their bodies. Midwives are trained to recognize abnormal situations in pregnancy, childbirth, and gynecological care, and provide for consultation, collaborative management, and referral as needed. Midwives believe that all people have a right to quality health care that respects their dignity and individuality, accurate information that allows active participation in decision-making, and family involvement as desired.
The normalcy of reproductive and gynecological events is acknowledged by a “high touch, low tech” model of care that emphasizes the therapeutic use of human connection and communication, while appropriately utilizing interventions and technology only when necessary. Midwives provide health care to their clients throughout the life-cycle: preconception counseling, prenatal care, labor and birth, postpartum care, newborn care, well-person exams, family planning, menopause, and health counseling.
PHYSIOLOGIC MODEL OF CARE
The Physiologic Model of Care is founded on a deep respect for the normalcy of birth and for the uniqueness of each childbearing person and their family. This approach to care promotes health and helps prevent complications. Midwives who practice this model of care have excellent outcomes while providing safe individualized care. The application of this client-centered model of care has been proven to reduce the incidence of birth injury, trauma, and cesarean birth (May 1996, Midwifery Task Force).
KEY ELEMENTS OF THE PHYSIOLOGIC MODEL
- Monitoring the physical and psychological well-being of the client throughout the childbearing cycle.
- Attending to the emotional, social, and spiritual aspects of childbearing.
- Providing the client with individualized education, counseling, and prenatal care, continuous hands-on assistance during labor and delivery, and postpartum support.
- Minimizing technological interventions, and only using them when necessary and indicated.
- Identifying and referring clients who require obstetrical attention.
TYPES OF MIDWIVES
In the U.S. there are two kinds of midwives. The difference is in how they are trained and where they ultimately end up offering care.
Certified Nurse Midwives (CNMs) are nurses before completing midwifery training. Certified nurse midwifery training programs are masters or doctorate level programs, usually at accredited universities. Most CNMs work in hospitals as part of large OBGYN practices, although there are some working in birth centers or independently as homebirth midwives (like me!) CNMs do well-person care, reproductive health care, and full-spectrum maternity care, and are licensed to practice in all 50 states. They are often licensed in individual states as Nurse Practitioners (NPs) or Licensed Midwives (LMs).
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). Most direct entry midwives work in birth centers or do homebirth. 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).