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The Midwives Model of Care: An Individualized, Holistic, and Healthy Birth Alternative Hollie S. Moyer Midwives College of Utah

Running Head: MIDWIVES MODEL OF CARE The Midwives Model of Care: An Individualized, Holistic, and Healthy Birth Alternative Midwives model of care offers a unique approach to care during the childbearing cycle that is individualized, holistic, and may result in better outcomes for mothers and babies. This model is marked by the attention to maternal well-being, individualized and continuous care,

minimal use of technological interventions, and appropriate identification and referral of women in need of obstetrical attention. For women with low-risk pregnancies, the midwives model of care provides an empowering entrance into motherhood. Monitoring Maternal Well-Being The midwives model of care involves monitoring the physical, psychological, and social well-being of the mother throughout the childbearing cycle. This is possible as a result of the midwives view of birth as a normal life event. One mother writes, To my midwife, I was a normal, laboring mother. My baby was assumed to be healthy unless evidence showed otherwise (Shive, 2008, p. 13). Midwives are also attentive to the fact that birth is a significant life event. They are sensitive to the fact that it will change each woman and family forever and therefore seek the well-being of the mother. Physical Well-Being. Midwives emphasize the importance of good nutrition by helping their clients develop personalized diets. In addition to nutrition, this model incorporates discussions of proper exercise, hydration, and rest to maintain a vibrant pregnancy and prepare for a healthy birth. Psychological Well-Being. A distinctive characteristic of midwifery care is the time that midwives spend with their clients. Midwives monitor and nurture the psychological well-being of their clients by taking the

Running Head: MIDWIVES MODEL OF CARE time to listen to women express their thoughts and experiences and to face their fears. In their study of mothers experiences regarding fear of childbirth Lyberg and Severinsson (2010) write, Through their relationship with the midwife, the women developed the ability to cope with difficulties in everyday life, become more prepared and mature, were able to set boundaries related to demands and maintained self-esteem (p. 388). By listening to and validating the feelings of their clients, midwives promote healing. They are also a source of positive affirmation encouraging mothers that their bodies are strong, can grow and nourish a healthy child, and that they will learn to be a wonderful mother by trusting their instincts. Midwives respect the intrinsic power of birth and trust the strength of mothers. Social Well-Being. The midwives model of care is unique it the importance it gives to the social impact of the childbearing cycle. In their true capacity, Davis (1997) writes, midwives are concerned with womens well-being in a whole life context. Clearly, the transition of childbirth is more

than having a baby; it is a pivotal even in a womans personal development (Davis, 1997, p. 6). Birth is a life-altering event. It changes the woman, the family, and the community. Midwives respect the spiritual nature of birth, and care holistically for not only the mother, but also the baby, and the whole family (David, 2010). Providing Continuous, Individualized Care The midwives model of care provides the mother with individualized education, counseling, and prenatal care, as well as continuous hands-on assistance during labor and delivery, and postpartum support.

Running Head: MIDWIVES MODEL OF CARE Individualized Care. Midwives provide individualized care through education, counseling, and extended

prenatal visits. As Smith (2005) explains, Midwifery is unlike any other health profession in that the people within it have an inordinate thirst for all evidence-based knowledge and information that helps improve the care they provide (p. 748). Midwives are not motivated by popular medicine, but rather by what scientific evidence, and real-life experience have proven to be effective. This model emphasizes evidence-based research so that midwives can provide accurate educational materials for their clients, as well as the best care possible. By providing women with educational materials about pregnancy, birth, and parenting, midwives empower women to take control of their health. By allotting time for extended prenatal visits midwives gain understanding of their clients history, personality, lifestyle, and personal desires (Croft, 2011), thus enabling the mother and midwife to troubleshoot unique situations through shared decision-making. For example, one midwife helped to ensure maternal-newborn bonding for a blind mother when eye contact was not possible (Enning, 2010/2011). Continuous Care. Unique to the midwives model of care is continuous hands-on assistance during labor and delivery. Lyberg and Severinsson (2010) cite one mother who said, I stopped worrying about the birth andtrusted the midwife fully. She was there all the time during labor, even when the birth took a long time she was there with me. She guided me, she listened to me and I could concentrate on giving birth (p. 387). Under the midwives model of care, women are not left alone but are continuously supported. This support extends into the postpartum period with frequent postpartum visits that seem almost like family reunions due to the intimacy that has grown between the midwife and mother.

Running Head: MIDWIVES MODEL OF CARE Minimizing Technological Interventions Midwives prefer to focus on prevention rather than intervention because interventions used in the childbearing cycle can enlarge problems or lead to new complications (Croft, 2011). Prevention begins during prenatal care with proper nutrition, exercise, hydration, and rest enabling midwives to correct potential problems early by advising the woman on labor position, providing her with food or water, encouraging rest or activity, or using other noninvasive methods. Midwives couple analytic knowledge with experiential intuition. Thompson and Dowding (quoted in Levy, 2005) explain this approach: Intuitive judgment distinguishes the expert from the novice; with the expert no longer relying on analytic principles to connect their understanding of the situation to appropriate action (p. 31). Midwives value and trust a womans innate ability to give birth (Levy, 2005) freeing them to enter into what Davis-Floyd and Davis have called a dance (quoted in Levy, 2005, p. 32) where the mothers and midwives mirror one another providing strength and courage. Identifying and Referring for Obstetrical Attention The midwives model of care identifies and refers women who require obstetrical attention. Midwives are referred to as guardians of normal birth. Not only are they are knowledgeable about healthy pregnancy and birth, but because they are closely connected to their clients they know what is normal for each individual mother and baby. As a result, midwives can very quickly identify and treat abnormalities if they arise. Mothers with high risk pregnancies will be helped to find the best care by referral to a trusted birth care provider suited to her needs. In the event that a woman begins labor with a midwife outside of the hospital and

requires transfer for obstetrical attention, the midwife will maintain continuity of care throughout the birth experience. As Davis (1997) writes, Every birth has some potential for complications,

Running Head: MIDWIVES MODEL OF CARE but with continuity of care, the midwifes competence in handling these is facilitated both by foreknowledge of the mothers condition and by the mothers trust in her abilities (p. 5). Midwives know and are committed to women and babies. Conclusion This paper has shown that the midwives model of care is individualized, holistic, and therefore offers better outcomes for mothers and babies. Care is personal, fitting the desires of each mother. Shared-decision making empowers women to take control of their birth and wellness beyond. The midwives model of care emphasizes the whole woman, recognizing that pregnancy and birth are significant, life-altering events. Part of this holistic approach is the continuity of care provided by midwives, which serves as a source of stability for the woman, family and community. For women with low-risk births, the midwives model of care offers better outcomes for mothers and babies by avoiding unnecessary interventions and promoting well-being of mother and baby and offers a healthy alternative for pregnancy and birth.

Running Head: MIDWIVES MODEL OF CARE References Croft, N. (2011). Introduction to midwifery. Salt Lake City: Midwives College of Utah. David, S. (2010, Spring). From fear to peace: Jeremys birth story. Midwifery Today, 32-34. Davis, E. (1997). Heart and hands: A midwifes guide to pregnancy and birth. Berkeley, California: Celestial Arts. Enning, C. (2010/2011, Winter). Waterbirth with a blind mother. Midwifery Today, 17. Levy, M. (2005, Summer). Intuition, women and birth. Midwifery Today, 30-32. Lyberg, A. and E. Severinsson. (2010). Fear of childbirth: Mothers experiences of teammidwifery care a follow-up study. Journal of Nursing Management, 18, 383-390. Shive, L.T. (2008, Winter). A midwifes gift: Olivias birth story. Midwifery Today, 12-13. Smith, N. (2005, December). Individualized care will help promote social inclusion. British Journal of Midwifery, 13(12), 748.