Midwifery in the Industrialized World

Abstract

Because of the successful attempt at the beginning of this century to dismantle midwifery in Canada and the United States, there is much ignorance and misunderstanding among the public and health professionals about the essential role of midwives in modern maternity services. With the renaissance of midwifery in North America, health administrators, health providers and the public need information about modern midwifery.Midwifery is primary health care for women with a focus on reproductive health. Key elements of the midwifery model of care are normality, facilitation of natural processes with the minimal amount of evidenced-based intervention, and die empowerment of the woman and the family.Scientific evidence proves that: midwives are as safe or safer than doctors for primary maternity care; using midwives greatly reduces the rates of unnecessary obstetrical interventions; midwifery services lead to considerable cost savings; midwives have more success in reaching socially disadvantaged groups; women have more satisfaction with midwife-managed care.In nearly every industrialized country outside North America, midwives provide primary maternity care, and obstetricians, generally, are hospital-based specialists providing tertiary maternity care. In Scandinavia, the Netherlands, New Zealand and other countries, all prenatal, intrapartum and post-partum care for at least 70 percent of women is provided solely by midwives. These countries have much lower obstetrical intervention rates than Canada, and have maternal and perinatal mortality rates equal to and, in some cases, better than Canada.An autonomous midwifery profession in equal standing with the medical profession is a key component of an optimal modern maternity care system.