Midwives

The midwife is a professional in obstetrics. The term is used in reference to both women and men, although most midwives are female. In addition to providing care to women during pregnancy and birth, some midwives may also provide primary care related to reproductive health, including annual gynecological exams, family planning, and menopausal care. Many developing countries are investing money and training for midwives and other community health workers so that they can provide well-woman primary care services that are currently lacking. Midwives are specialists in childbirth, postpartum, and well-woman health care. They are educated and trained to recognize the variations of normal progress of labor and deal with deviations from normal to discern and intervene in high risk situations. In many developing countries, where it is available midwifery is the front-line of maternal health services and provides necessary care in a safe and cost effective manner. In the United States, more women utilize obstetricians rather than midwives, Obstetricians are medical doctors who can provide care not only in healthy pregnancies, but surgical and instrumental deliveries in situations which require them as well. Midwives refer women to specialists such as obstetricians or perinatologists in complications related to pregnancy and birth when a pregnant woman requires care beyond the midwives’ scope of practice. In many parts of the world, these professions work in tandem to provide care to childbearing women. In others, only the midwife is available to provide care. Midwives are trained to handle certain more difficult deliveries, including breech births, twin births and births where the baby is in a posterior position, using non-invasive techniques. A 2013 Cochrane review concluded that “most women should be offered midwife-led continuity models of care and women should be encouraged to ask for this option although caution should be exercised in applying this advice to women with substantial medical or obstetric complications.” The review found that midwife-led care was associated with a reduction in the use of epidurals, with fewer episiotomies or instrumental births, and a decreased risk of losing the baby before 24 weeks’ gestation

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