Benefits of Midwifery
In countries with the best childbirth outcomes, all people have access to maternity care, midwives are the lead caregivers, and the cost of care is much lower. Evidence supports the benefits of a model of care that focuses on wellness rather than illness.
Pregnancy and birth are essentially healthy experiences for the majority of childbearing people. However, most birthing people in the U.S. now experience numerous interventions during labor and birth that have been shown to be neither beneficial nor benign. Experts agree that although we use more interventions and spend more money than any other country, outcomes for our birthing parents and babies are not better.
Continuity & Trust
When pregnant individuals and their families are able to get to know their maternity care provider over the course of months and many conversations throughout their pregnancy, a trusting and caring relationship can be built. At SHM, individualized prenatal visits allow for a relaxed setting in which we discuss in depth our client’s wellbeing, questions, hopes, and concerns, and any testing and treatment options relevant to their pregnancy. Building this relationship can be grounding for families during a time of transition and growth.
Support & Shared Decision Making
Midwives believe that birth usually happens best with minimal intervention, and when laboring people and families feel safe and well supported. While giving birth in a hospital environment can feel like the hospital “rules” trump the wishes and desires of the birthing family, community midwifery care emphasizes a model of informed choice. In this model, midwives offer research-based evidence, personal experience, and sometimes recommendations, and clients decide what works best for them, taking into account this information together with their own values and preferences.
During labor, midwives encourage movement, eating, and drinking hydrating fluids. We prioritize the comfort of the laboring person and trust their intuition along with our own. We catch babies in many different positions and spaces, and work around laboring people to get the information we need to keep our clients and their babies safe, including vital signs, fetal heart rates, and exams. If a medical complication arises, we may take on a more directive role, and even during these times we still prioritize the experience of the family by maintaining a calm, respectful, and supportive environment.
Fewer Medical Interventions
As compared to care with an obstetrician in a hospital, those in midwifery care experience fewer medical interventions during pregnancy, labor, and birth (including ultrasound, lab testing, vacuum/forceps delivery, episiotomy, medications, anesthesia, and cesarean delivery). Meanwhile, maternal and newborn outcomes for low-risk pregnancies remain similar across settings (hospital vs. birth center vs. home) and provider types (obstetrician vs. midwife).
This decrease in unnecessary interventions may be due to an overall different outlook on pregnancy; obstetricians are trained to manage complications and illness in pregnancy and birth, whereas midwives view pregnancy and birth as most often normal, physiological processes that childbearing bodies know how to do. That said, midwives screen for illness consistently throughout pregnancy, from a client’s initial acceptance into care through their labor and birth and into the postpartum period. This continuous screening and risk assessment is what makes midwifery care safe.
Continuous Labor Support
Studies show that one-to-one labor support improves birth outcomes and lowers the rates of unnecessary interventions for birthing people and babies. In hospitals, despite the hard work and best wishes of nurses, nurse-midwives, and obstetricians, this model fo care is rarely available due to staffing and time constraints.
Midwives outside the hospital setting provide one-to-one labor support that begins at the onset of active labor, until a few hours after the birth of the baby, or until everyone is healthy and stable and ready for a nap. This support includes clinical care, physical support, suggestions to improve the laboring person’s comfort or encourage labor to be more efficient, and clear and respectful communication in response to client questions and concerns. If the need or desire arises to move to the hospital during labor, the midwives accompany clients in order to facilitate the transfer of care to a hospital-based team.
Some clients may also wish to hire a doula, who is able to provide support during early labor as well as active labor and birth. Because they do not have any clinical responsibilities, they are entirely focused on the laboring person (and partner’s) physical and emotional wellbeing. Midwives love working with doulas!
During labor and birth, midwives work to create a calm, intimate, supportive, and minimally intrusive environment. Clients are encouraged to adjust the lighting, temperature, smells, and sounds to their comfort. Midwives encourage frequent position changes, laboring and/or birthing in water, and eating and drinking fluids to stay energized and hydrated. We work around laboring people and bonding families in order to continue to monitor safety.
Midwives recognize that it is not just a baby, but also a new family that is being born! At SHM, we believe that including family members so they feel informed and engaged (where desired and appropriate) can serve to strengthen these foundational relationships. We encourage partners and other support people to attend visits and have their questions answered. We also love to involve siblings in clinic appointments, and even at the birth (under supervision) when this is desired by clients.