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Midwifery
Midwifery is a blanket term used to describe a number of different types of
medical practitioners, other than doctors, who provide prenatal care to
expecting mothers, attend the birth of the infant and provide postnatal care
to the mother and infant. Nurse-midwives also provide gynecological care to
women of all ages. Practitioners of midwifery are known as midwives, but are
not necessarily women (the term means "with the woman"). Most work under the
supervision of a physician and deal with normal births only. If something
abnormal is discovered during prenatal care, the patient is sent to an
obstetrician. Other midwives will deal with abnormal births, including
breech births.
Midwifery in the U.S.
There are two main divisions of modern midwifery in the United States, nurse
midwives and non-nurse midwives.
Nurse Midwives In the United States, nurse midwives are registered nurses
with a bachelors degree in nursing who return to college for two additional
years to specialize in midwifery and gynecological care of normal women.
Most nurse midwives also have a masters Degree in nursing. Nurse midwives
practice in hospitals and medical clinics, and may also deliver babies in
birth centers and assist with home births. They are able to prescribe
medications and provide care to women from puberty through menopause, not
only during childbearing. Nurse-midwives work closely with an obstetrician,
who provides consultation and assistance to patients who develop
complications. Often, women with high risk pregnancies can receive the
benefits of midwifery care from a nurse midwife in collaboration with a
physician. Currently 2% of nurse midwives are men.
Direct Entry Midwives Direct entry midwives vary greatly in their training,
certification and methods. Some are graduates of colleges or schools of
midwifery which offer degree and certification programs of different
lengths. Others choose to become Certified Professional Midwives through the
North American Registry of Midwives. The American College of Nurse-Midwives
(ACNM) certification council also provides accreditation to non-nurse
midwife programs as well as colleges which graduate nurse midwives. All
midwives certified by ACNM must pass the same certifying exam. Other
midwives follow the time-honored path of the traditional birth attendant,
learning the trade through apprenticeship and hands-on experience rather
than a more formal course of study.
Midwives catch babies in any number of settings. While the majority of nurse
midwives work in hospitals, some nurse midwives and many non-nurse midwives
often catch home deliveries. In many states midwives form birthing centers
where a group of midwives work together. Laws regarding who can practice
midwifery and in what circumstances vary from state to state, and some
midwives practice outside of the law.
Someone needs to write about the history of midwifery, the competition
between mostly rural & female midwives and mostly urban & all male early
medical doctors in the 18th and 19th centurys, and modern midwifery in
countries other than the US
In the United Kingdom midwives are practitioners in their own right, and
take responsibility for the antenatal,intrapartum and postnatal care of
women. One may become a registered midwife by completing an eighteen month
course (leading to a degree qualification) following completion of nurse
training, or by undertaking a 3 year degree in midwifery. All practising
midwives must be registered with the UKCC and the ENB and are subject to the
local supervising authority. Most midwives work within the National Health
Service providing both hospital and community care, but a significant
proportion work independently, providing total care for their clients within
a community setting. To be a midwife is to be responsible for the woman for
whom you are caring at all times, to know when to refer complications to
medical staff, but also to act as the woman's advocate, to ensure that she
retains some choice and control over her childbirth experience. Many
midwives are opposed to the so-called 'medicalisation' of childbirth,
preferring a more normal and natural option, to ensure a more satisfactory
outcome for mother and baby.
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