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There are two basic models of care in obstetrics today.  Understanding their fundamental differences is part
of making an educated choice about where you birth.

The Midwifery Model of Care*

1.        The Midwives Model of Care is based on the fact that pregnancy and birth are normal life
processes.
As a pregnant woman you feel special and unique, but if someone ever approached you and said, "You are
at risk in your pregnancy and I don't believe you can be successfully pregnant without my direction and
these procedures" you would think they were nuts!  Just as with your pregnancy, when you strive to
understand and educate yourself about your growing baby, doing the same for your labor and delivery
(your
birthing) is the natural conclusion to this healthy, educated process.  If someone approached you and
said, "Gee you are looking so healthy and pregnant,  I'm here if you need me and I have a wealth of
resources and knowledge at your disposal"--your confidence and pride as a mother
would be boosted and
you would likely really appreciate it!  

The Midwives Model of Care includes:

  • Monitoring the physical, psychological, and social well-being of the mother throughout the
    childbearing cycle
    Your care will include prenatal visits which include options for all of the same testing procedures
    available to you with the care of an OB.  This includes ultrasound if you would like one or if the
    midwife would like one.  Nothing will be done to you or for you without your full understanding of that
    procedure or test and consent to it.  This means you will spend time with your midwife learning about
    your own care and being the active leader of the care for your body and your baby, and she will be
    your guide and interpreter.
  • Providing the mother with individualized education, counseling, and prenatal care,
    continuous hands-on assistance during labor and delivery, and postpartum support
    Your care will include a lot of education.  The midwife believes mothers are naturally interested in
    their own care, and that they are capable thinking women who can and should make decisions for
    themselves based on information and research they have read and discussed.  Much of the prenatal
    care is devoted to this cause.  Women and their partners are encouraged to take responsibility for
    their bodies and babies and the midwife helps provide the tools to make this possible.  
  • Minimizing technological interventions
    The Midwife uses her hands and mind, her heart and knowledge to observe and draw conclusions
    about the health of a pregnancy or birth.  She is acutely aware of the points in pregnancy and birthing
    that may or do require more than she has on her person.  While she uses her tools such as a feto-
    scope or Doppler, blood pressure monitoring, and blood work, she will use additional technology only
    as necessary to maintain the health and safety of the mother and baby, and not superfluously.  The
    Midwife is aware of the woman and baby as a whole being who require a holistic approach to their
    health care.  She will work with you and never do to you.  Yet she easily asks for help and refers
    mothers and babies who need special care to Physicians and others in the medical community she
    has created relationships with and whom she trusts.   
  • Identifying and referring women who require obstetrical attention
    As stated above, the midwife asks for help and refers her mothers who need it to a specialist.  
    Obstetricians play a valued and critical role in Midwifery care in Seattle.  Relationships between
    Midwives and Doctors vary greatly from person to person and when interviewing Midwives, this is an
    important question to ask.  The State of Washington has rules about who a Midwife can and can not
    care for, and your Midwife will refer you out to an Obstetrician if she can not provide care for your
    high risk pregnancy.  If this happens, ask for a provider who can deliver you at Group Health Capitol
    Hill or Highline Hospital in Burien.  Both hospitals are full of nurses who understand a mother who
    wants to participate in her birthing experience and make it her own.  

Click Here to see examples of this model of care vs. standard obstetrical model of care


    The application of this woman-centered model of care has been proven to reduce the
    incidence of birth injury, trauma, and cesarean section.
And what more could a mother ask for?!

The (U.S.) National Birth Center Study  of nearly 12,000 women receiving care in 84 out-of-hospital birth
centers, is the largest and most complete source of information about this type of care. As with many smaller
studies, the national study found that the birth center group experienced low rates of invasive procedures
and restrictions, when compared to similar women in hospitals. One woman in six transferred to hospital
care after beginning labor, but just one woman in 42 transferred to hospital care under emergency
circumstances. No mothers died. When compared with large studies of low-risk women in hospitals, the birth
center group:
--
was half as likely to have a cesarean section
--had a similar rate of death of babies after 20 weeks of pregnancy or in the first four weeks after birth.
Non-hospital birth center care compared to hospital-sponsored birth center care.
(Rooks and colleagues 1989, 1992a, 1992b, 1992c; Fullerton and Severino 1992)
*This definition (the parts of this page in bold) of the Midwives Model of Care comes from the Citizens for Midwifery Website.  The explanation (parts of the page
not in bold) was written by Jodilyn Owen.  Permission to reprint with this explanation and links to both the CFM site and
SeattleBirthNet included is granted.  
c.2005