What is Midwifery? Role and Types of Midwives

The Tradition and Roll of Caring for Mother and Child

Every year men and women across the country follow the calling to become nurses, to care for those who need care, to be of assistance to those who heal, and to be of service in the health and well-being practice to millions of people around the world. Midwifery, the practice of providing health and care to women who want to have children, who are expecting, through to the after-care of newborn and mother.

In midwifery, the practitioner is called a midwife. The history of midwifery goes bacj thousands of years, as far back as ancient Egypt. An ancient papyrus known as the Ebers papyrus, dating back from 1900 to 1500 BCE, includes details about obstetrics and gynecology and birth. Centuries ago the midwife was a well learned woman of the village who knew how to take care of the other women. Midwives were the healers, herbalists, counselors and first holistic practitioners of the past. They believed in the care of women of any status in the area and, to some, were mystical and grounded in a relationship between the Earth and woman kind. Fast forward to today and things are much different. Today's midwives are advanced practice nurses, nurse practitioners, and women who are trained and certified in low-risk pregnancy, childbirth and the postpartum health, and certain birth situations including breech births and posterior position births.

The Role: What Exactly Do Midwives Do?

What midwives do depends on what kind of midwife training she has and what she is licensed or certified to do. Simply put, a midwife is there to help women. Midwives are in tune with a woman's natural rhythms, often helping women conceive without fertility drugs by helping her through family planning and nutritional counseling. Some midwives will help women with basic physical examinations, and may even do pap smears. Education is a big part of a midwife's responsibility as well. They will often help women understand the dangers of sexually transmitted diseases, educate young women about menstruation and guide older women through menopause and beyond. As experts in the birth process, midwives are usually found at home births as well as home births as a support and guide for the woman in labor. They will also spend time helping to educate the father to be and the family about what to expect and how they can be of assistance and be more involved in the natural process of child birth.

If there are issues that are beyond the training of the midwife, the patient is usually referred to an obstetrician.

The Different Kinds of Midwives

There are two kinds of midwives in North America, the nurse-midwife and direct-entry midwives.

Nurse-midwives

The practice of the nurse-midwife began in 1925, with the beginning of the Frontier Nursing Service (FNS). This practice brought help to the women and families living in Kentucky, and proved successful with a lower maternal and infant mortality rate. The Frontier Graduate School of Midwifery was then opened in 1939, and in 1989 the school began distance education programs for women through the Frontier School of Midwifery and Family Nursing. The American College of Nurse-midwives now accredits nurse-midwifery education programs and is the national professional society for all certified nurse-midwives and midwives. National certification exams are provided by the American Midwifery Certification Board.

Direct-entry Midwives

A direct-entry midwife is not a registered nurse, but is someone who studies through apprenticing, going to midwifery school, or other training such as self-study. They are also trained in the care and health of women, from preconception through out the entire childbearing cycle.

Certified Professional Midwife (CPM)

A CPM is someone who has been certified by the North American Registry of Midwives (NARM). (http://www.narm.org ) To be certified as a CPM, the individual must be trained and understand out-of-hospital-setting care of women, expecting women, and beyond. There are only about 900 CPMS in the United States.

Licensed Midwife

A licensed midwife is a midwife who has a license to practice in their state.

Lay Midwife

Not all midwives are actually certified. Lay midwives have learned the details and practices of midwifery through informal measures such as self-study or apprenticeship.

It's important to note that the American College of Nurse-Midwives (ACNM) also accredits midwife programs for non-nurses, and colleges for nurse-midwives. Unfortunately, the Certified Midwife credential is recognized in only three states. Certified Midwives write the same exam by the American Midwifery Certification Board for CNMs.

The Role of Midwives Around The World

Midwifery is still important around the world. In fact, many countries rely on the midwives for a lot of essential health services. Take, for example, the Panjshir province of central Afghanistan. This out of the way region has almost 600,000 residents with roads that are often washed out by floods and avalanches, making it impossible to access. The women of these areas will walk for days to reach a clinic. The reality is that there are an estimated 1,000 maternal deaths in every 100,000 live births because there of the poor care these women receive and the lack of midwives in the area. In fact, most areas like this have less than six doctors, seven nurses, and four midwives per 100,000 women. UNICEF is working hard create a midwife training program in the country to help these women.

In China, as reported by Mavis Chen in Midwifery Today, most midwives hold a lower social status and do not have any kind of support organization to turn to. The fact that China's cesarean section rate is quite high in some areas and the use of anesthesia to stop birth pain is promoted so much may be due to the fact that there is a lack of midwifery to help with natural birthing techniques.

Because of the need for both internal and external support for midwives, a group of dedicated midwives in Europe formed the International Confederation of Midwives in 1919. Today the ICM has over 90 member association members from 80 countries in Africa, Asia Pacific, Europe and the Americas. The ICM is the organization that defined the approved "Essential Competencies for Basic Midwifery Practice", which is used by the American College of Nurse-Midwives.

The Great Debate – Are Midwifes Safe?

Midwifery, as we said, has been around for centuries. Some women are a little nervous about using a midwife instead of relying solely on her obstetrician or gynecologist for specific female needs. With more education more and more women are understanding that relying on her sisters for support is not only natural, it's a beautiful way to reaffirm the connection between women and the natural process of her body from pre-conception to conception, from conception to birth, and beyond.

Article © MyNursingUniforms.com / Young Lion Incorporated