BENEFITS OF THE MIDWIFERY MODEL OF CARE
This article is dedicated to International Midwifery Day, May 5, 1997.
The Midwifery Model of Care respects pregnancy and birth as normal events. This model focuses on all aspects of the childbearing woman, whereas the medical model emphasizes only the physiological aspects. The midwifery model of care monitors the physical, psychological and social well-being of the mother throughout the childbearing cycle. The midwifery model of care provides the mother with individualized education, counseling and prenatal care, continuous hands-on assistance during labor and delivery, and postpartum support. The midwifery model of care minimizes technological interventions and identifies and refers women who require obstetrical attention.
The Midwifery Model of Care is health-promoting and prevention oriented. Because education and preventive care are very important components to the midwifery model of care, midwives devote a great deal of time with their clients in prenatal care. Midwives promote the overall health of their clients and encourage healthy lifestyle practices, such as proper nutrition, breastfeeding, and avoidance of drugs, including tobacco and alcohol. The result is full-term, full-weight babies, thus reducing the enormous risks and costs associated with low birth weight.
While midwives do not hesitate to consult and refer for the judicious use of medical technology, the midwifery model of care avoids costly standard procedures and their risks. These procedures are not necessary or appropriate for most women. Costs of unnecessary interventions and their subsequent complications are avoided. The midwifery model of care has been shown to decrease morbidity and mortality, and to decrease the incidence of cesarean births. Cesarean section normally doubles the costs of the birth and puts baby and mother at risk for further complications and infections. Other benefits to midwifery care include decreased exposure of mother and baby to infections, which may be antibiotic-resistant; minimized disruption of the birth process, typically caused by moving the mother, strangers, and loss of autonomy; improved bonding, due to eliminating mother/baby separation and mother/father separation; in depth breastfeeding support; and reduced morbidity associated with technological interventions.
The midwifery model of care is family friendly and encourages family participation and bonding. This model of care greatly reduces major barriers to seeking health care, such as dissatisfaction with a fragmented system of care. The midwife who provides prenatal care is lmost always the midwife attending the birth. Unless there is a need for medical intervention, the midwife provides all prenatal, labor and delivery, postnatal and well-woman care. Thus improving continuity of care. Compliance is improved under the Midwifery Model of Care because of the decreased social distance between midwives and their clients and because midwives foster trusting relationships.
Insurance companies recognize that the midwifery model of care is associated with favorable liability statistics and are beginning to provide liability coverage to licensed midwives. One reason attributed to the favorable liability statistics is improved informed consent. Because of the emphasis on education that is part of the midwifery model of care, clients of midwives are in a much better position to give informed consent. Another benefit is that the midwifery model of care is centered around the woman, not the needs and requirements of an institution. Lastly, I want to mention the psychological benefits of the midwifery model of care. The natural childbirth movement has been criticized for being overly concerned with the emotional needs of women while disregarding safety issues. Nothing could be further from the truth! Birth is a miraculous and empowering event. The midwifery model of care gives birth back to mothers.
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