Midwifery scope midwifery model of care

2. Midwifery is
Mdwifery is a
woman centered,
primary
health care
discipline
founded on the
relationships
between
women and their
midwives

3. Midwife

4. The midwife understands,
promotes and
facilitates the physiological
processes of
pregnancy and childbirth

5. • Midwifery Care takes place in partnership
with women
• Midwifery is holistic by nature combining an
understanding of the social, emotional,
cultural, spiritual, psychological and physical
ramifications of women's
reproductive health experience, actively
promoting and protecting women's
wellness;

6. collaborative with other health professionals.
•Midwifery is a profession concerned with the
promotion of women's health. It is
centered upon sexuality and reproduction and an
understanding of women as healthy individuals
progressing through the life cycle.
•Midwifery care is given in a manner that is flexible,
creative, empowering and supportive
•The key components of the Midwifery Model of care
are:
•Choice
•Continuity
•Control

7. Settings

9. Midwives are....
recognized by the World Health
Organization as the most appropriate and cost
effective type of health care provider
to be assigned to the care of normal
pregnancy and normal birth, including risk
assessment and the recognition of
complications

10. ICM and WHO has one model of maternity care in mind and
that is;
a) every pregnant woman and her family is attended by a
midwife they know, close to her home and with easy and
supportive referral access to tertiary services as required!!
b) Every woman and her baby has a skilled midwife with her at
birth. ( most of the worlds women who do not have access
to any midwifery care or any skilled attendant what so ever at
their birth)
c) Finally the availability of excellent skilled obstetricians,
midwives and anesthetists etc who are skilled in the
abnormal/pathology of childbirth and can provide
immediately responsive emergency services to women and
babies

11. Midwifery Care, The Evidence....
• Women with normal pregnancies cared for by
midwives :
• Are better supported
• More satisfied with their care
• Have lower rates of labour augmentation
• Required fewer epidurals and episiotomies
• Had less major surgery for birth
• Had less underweight babies, neonatal resuscitation
and admission to NICU

12. Improvements over last 18 years of Midwifery
Independence and Autonomy…
• Continuity for 94% of women
• Women's info & satisfaction levels
• Smoking rates in pregnancy & post partum
• Screening in pregnancy
• Episiotomy rates and birth canal trauma
• Pain management in labour (32% use
water)
• Instrumental birth rates

13. Neonatal admissions of newborn
• Perinatal mortality rates
• Low birth weight rate in newborn
• Home birth rate
• Exclusive breastfeeding rates
• Numbers of home visits
• Premature and LBW rate
• Immunization rates at 6 weeks (94%)

14. Stabilized the rates of……
• Normal births
• Caesarean section
• Induction
• Epidural
All against a tide of global medicalization
and hugely increasing birth rates

16. The Way Forward
The midwifery model of care works
We must repost midwifery as a
primary provider to normal birthing
The new goal is getting place of birth
right

17. Research studies on home birth (Olsen, 1997)
and free-standing birth centres (Walsh and
Downe, 2004) and integrated birth cetres
(Hodnett, et al. 2006) all conclude that less
pharmacological analgesia is used in these
settings Research into continuity of care
(Walderstrom and Turnball, 1998) come to
the same conclusion whether it be team
midwifery or caseload midwifery.

19. Institutionalized births
When a midwife’s time and
focus is taken up with
monitoring and recording, she
is less able to be “with
woman” the original meaning
of the word midwife – as
guardian of normal birth.
A focus on technology, a focus on task and record keeping, an
institutionalized and bureaucratic milieu, absence of privacy and of known
birth companions, and rigid polices and protocols all conspire to make large
maternity units toxic for normal birth (Walsh, p.47)hospitals

33. • M