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Care Provider

What is Mother-Friendly Care?

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Mother-Friendly is short for the Mother-Friendly Childbirth Initiative (MFCI).  There are 10 steps, which an institution or care provider must take in order to be considered “mother-friendly”.  .  They are very specific and some steps are harder to achieve than others.  Do not just assume that your care provider is Mother-Friendly.  Ask them.  These steps are based on evidence and what produces the best outcomes in birth.

A Mother-Friendly Care Provider, Hospital, Birth Center, or Home Birth Practice: Read more

Rules for Talking to a Laboring Woman

Preparing for birth is a unique time in a woman’s life. Many women spend their lives looking outward, seeking to serve others. But in labor and birth a woman has the opportunity to be at the center for a brief moment, and to have those around her serve her, listen to her, and help her in any way they can.

Occasionally, however, those close to a birthing woman use it as an opportunity to fill their own needs or express their own fears to the mother or those closest to her. While it may seem obvious to most, dumping our own emotional baggage on a pregnant or birthing woman is actually inappropriate. Sadly, there are many who have missed the boat on this particular subject.

How many birthing women are surrounded by people (including family) at their birth that they didn’t even want present? How many pregnant women must listen to the horror stories of others simply because they have a round belly and are, obviously, expecting? Birth, however, is not about making those that surround a woman happy and comfortable. A great birth team seeks to make the mother and her closest loved ones happy and supported so that they and the baby can have the best experience possible both physically and emotionally.

The Goldman and Silk “Ring Theory,” as discussed in this LA Times article, explains the idea that during times of extreme stress (such as turmoil or illness) the person most affected or at the “center” has the privilege of receiving emotional support, and the ability to “dump” outward. That is, the person at the center can ask for help, and the people outside can offer.

The idea that “support goes in, needs expressed go out” doesn’t just apply to illness; it works beautifully in labor, too.

When a woman is in labor she should be at the center of the circle, the center of attention, and the person who is focused on. She can request anything from those around her. Support should always flow towards the center from the outer circles, and requests should flow outward. For example, random strangers should not act as though the birth is theirs or that their needs are more important than those of the laboring mother. The mother should not have to support her partner, doula, or family. When the focus
of support stays on the mother, the entire labor goes better and she feels safe and secure.

Remember this simple rule of birth etiquette when attending a birth. Remember, also, that very soon that laboring woman will be a mother and all of her attention will be focused outward on her precious child. We can focus our love and support on her for a few hours to help ensure that both mom and baby receive the best start possible.

Choosing a provider: Understanding the medical and midwifery models of care

What is the difference between the midwifery and the medical model of care?

One of the first decisions that a woman makes, after her discovery of pregnancy, is her choice of care provider. In most countries, there are two basic care providers available- the obstetrician and the midwife. There are many factors that contribute to which provider will work best for your birth. A basic understanding of the common differences in their approach can help you make the best decision for your family.

Midwifery model of care-

Most midwives, whether working out of a hospital or attending home births, practice what is known as the “midwifery model of care.” The basic midwifery approach to birth and the pregnant woman tends to be more holistic. This means that they look at all factors which may contribute to the health and safety of the woman and her birth. Emotions, living situations, nutrition, and education should all be addressed by someone providing the midwifery model of care.

At the time of birth, this care provider will be aware of and trained to spot things that may go wrong, but will, overall, consider childbirth a natural process that frequently proceeds normally and safely.

Those trained in the midwifery model of care routinely refer out to an obstetrician when they observe that the pregnant woman needs to be cared for by someone with a deeper knowledge of pathology.

The Citizens for Midwifery note that,

“The application of this woman-centered model of care has been proven to reduce the incidence

of birth injury, trauma, and cesarean section.”

Medical model of care-

A practitioner using the medical model of care, as is common among western medical doctors, tends to approach the patient from a problem solving approach, searching for the defect or dysfunction and trying to fix it. Unlike the midwifery model of care that seeks to understand the whole person and prevent unnecessary intervention or surgery, things are viewed from a pathological model searching for the problem and a solution.

Obstetricians, who provide the bulk of medical care for birthing women in the United States of

America, frequently approach their patients and their pregnancy and birth from this angle.

Which is right for me?

When choosing your care provider, there are many factors to consider. One would be your own philosophy towards birth. Do you view birth as a normal life event or as a pathology or disease?

Assessing your own beliefs will help you choose a care provider that best matches your own needs.

Another thing to consider is your own health and wellbeing. If you or your pregnancy are high risk, for some reason, then choosing an obstetrician who approaches birth from the medical model of care and who is versed in your risk factors in particular may be the choice that works best for you and your family.

It is also important to realize that not all midwives use the midwifery model of care and not all obstetricians use the medical model of care. You may be able to find an OB who views birth as a normal, healthy life event and approaches it with minimal interventions. You will also find midwives who have come to view birth as dangerous and pathologic and who have high intervention and cesarean section rates in their practices. Interviewing your individual care provider and asking for experiences from other mothers, doulas, and your childbirth educator will help give you some idea of their practice and philosophy.

Take your time and research your care provider. Your birth and your baby are worth the effort!

References:

Citizens for Midwifery- “Midwives Model of Care” brochure

http://cfmidwifery.org/mmoc/brochure_text.aspx

CIMS- Coalition for Improving Maternity Services

http://www.motherfriendly.org/MFCI/

How to have a Natural Birth

Many families are beginning to realize how important a natural birth can be to both them and their babies. But the idea of having a natural birth can be overwhelming and when you first begin pursuing it. Here are a few tips on getting the natural birth you are looking for.

1) Take a natural birth class: 1000 years ago everybody had a natural birth, it was just “natural”. But today most people deliver in hospitals and there is much to learn if you desire a birth slightly different than the norm. A good class with an experienced teacher can help you learn how to make this happen.

2) Carefully choose your birth place: All hospitals are not the same. Some offer a good NICU, others fantastic surgeons. If you are particularly looking for a natural birth, you will want to find a hospital that has policies that help with that desire, rather than hinder it. Your birth teacher will be able to teach you what to look for.

3) Carefully choose your care provider: From OB to midwife, there are lots of options in both skills, personality, and experience. Interview, discuss, and find out what birth professionals in your area recommend in your local care providers. It will be worth your time and effort.

A natural birth is possible, but it takes preparation and passion.

Using a Midwife (Types of Midwives)

Many women desire the benefits of midwifery care for their pregnancy but become overwhelmed when they start to look into it and find that there are many different types of midwives to choose from.

While options, certifications, and even legality vary from one state to another and from one country to the next, here are a few basic tips for deciding what type of midwife you want.  There isn’t necessarily a right answer, just different choices for different situations.

The Certified Nurse Midwife (CNM)- For women who want to be attended by a midwife in a hospital setting, the CNM is a great option.  A CNM is someone who has trained as a registered nurse and then attended further training (often a master’s program) to specialize in midwifery.  A CNM has some medical background and can function in various different settings.  Many work within a hospital, some work in or own birth centers outside of the hospital, and some even attend home births (though the legality of this varies from state to state).

The Certified Professional Midwife (CPM)- For women who desire to birth at home, a CPM is often what she will choose.  A Certified Professional Midwife is usually certified through the North American Registry of Midwives (NARM) and has completed their testing and requirements.

A CPM is not required to have the medical background that a CNM has but has completed reading, apprenticing, and testing in order to specialize in normal birth and has also studied variations and emergency situations that can occur in a birth setting.

Some states also have their own state licensing and will have licensed midwives (or LM) who have passed their state licensing.  States vary in their requirements.

There are also, in some states, Direct Entry Midwives (DEM) who have studied midwifery and apprenticed but have not necessarily licensed through an organization or school.  A DEM will work in a home or birth center setting but not within the hospital.

Knowing your options and the different types of midwives is a wonderful start to making informed birth choices for you and your baby.

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