Midwives
From Encyclopedia of Sex and Sexuality
The midwife is an expert in normal pregnancy and childbirth. The care she gives revolves around supporting birth as a normal physiological process. Midwives offer social, emotional, psychological, and nutritional support during the childbearing year, as well as monitoring physical changes and fetal growth. Midwives guide laboring mothers through the birthing process, and have been defined as “women who help other women empower themselves in birth.” In fact, the word midwife means “with women.”
While the majority of births in America are attended by physicians, throughout the world the overwhelming majority of births are midwife-attended. This is true in both developed and developing nations. In the United States, approximately 4 percent of births are attended by midwives (1992), as compared to Europe, where more than 75 percent of babies are born into midwives’ hands. Nurse-midwives are registered nurses who have completed additional course work in midwifery. Most training occurs within medical institutions, although community-based nurse-midwifery programs are now being offered. Nurse-midwives define themselves as members of the “obstetric team,” usually working in conjunction with an obstetrician. The vast majority of nurse-midwives attend births in a hospital setting, while the rest work in birthing centers or attend home births. Nurse-midwives are legally permitted to practice in all fifty states, although regulations and scope of practice vary on a state level.
Direct-entry midwives are not nurses but come from a variety of educational backgrounds: Some are trained in midwifery schools in the United States and abroad, while others have learned through apprenticeship. Most have home birth-based practices, with a small number working in birthing centers. Direct-entry midwives are less likely to work directly with an obstetrician, although physicians and hospitals are used for referral. The legal status of direct-entry midwifery varies from state to state. Eleven states have active licensing certification or registration, and direct-entry midwifery is legal in an additional nineteen states.
