5. Is Midwifery Care Safe?
Description
This article is from the Midwifery FAQ, by cnmpat@aol.com (Pat Sonnenstuhl) with numerous contributions by others.
5. Is Midwifery Care Safe?
As mentioned before, midwifery is probably the oldest profession known
to humankind. Certain mammals (whales for example) have been seen
assisting their sisters births, and helping new whales reach the surface
of the water, and are called midwives. The more the scientific method is
used to analyze birth and the use of technology, the more the midwifery
model stands out at a model for normal pregnancy and birth. Two recently
published works support non-intervention and midwifery care as being
safe and cost effective.
"A Guide to Effective Care in Pregnancy and Childbirth" is a
collaborative effort to prepare, maintain and disseminate reviews of
randomized trials of health care using the Cochrane Database. This is an
international effort, and a very readable resource.
The Database is based on a decade-long study of controlled trials in
obstetric care concerning different aspects of care and treatment. It
also describes the approaches and decisions that have been demonstrated
effective and those for which the evidence in inconclusive or negative.
"As technical advances became more complex, care has come to be
increasingly controlled by, if not carried out by, specialist
obstetricians. The benefits of this trend can be seriously challenged.
Direct comparisons of care given by a qualified midwife with medical
backup with medical or shared care show that midwifery care was
associated with a reduction in a range of adverse psychosocial outcomes
in pregnancy, and with reductions in the use of acceleration of labor,
regional analgesia/anesthesia, operative vaginal delivery, and
episiotomy." (p 15)
BIRTH: Issues in Perinatal Care Vol:22, No 2: June 1995 summarizes this
resource.
A second excellent resource is "Obstetric Myths Versus Research
Realities". This lists many recent abstracts from medical research in an
organized and systematic fashion.
It would be impossible to quote them, and one needs to review this text
to appreciate its value.
Women seeking assistance for her pregnancy and birth will find providers
at all points along the spectrum: physicians that are highly
interventive, physicians that behave similarly to midwives that are non-
interventive, trusting herbs and other modalities, and midwives that
practice like physicians. The onus is on the woman and her family to
question the available providers and find the match that best suits her
individual needs.
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