The Midwives Model of Care

The Midwives Model of Care is based on the fact that pregnancy and birth are normal life processes.

The Midwives Model of Care includes:

Monitoring the physical, psychological, and social well-being of the mother throughout the childbearing cycle
Providing the mother with individualized education, counseling, and prenatal care, continuous hands-on assistance during labor and delivery, and postpartum support
Minimizing technological interventions
Identifying and referring women who require obstetrical attention
The application of this woman-centered model of care has been proven to reduce the incidence of birth injury, trauma, and cesarean section.

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Text of the Midwives Model of Care brochure.

Congratulations!
You are about to experience the birth of your baby!

Women in the United States are learning that pregnancy and childbirth are normal, healthy processes, not diseases. And they are finding out that they and their families can benefit from the care of a midwife.

The Midwives Model of Care includes prenatal visits and "hands-on" care throughout labor, birth and right after. It results in less chance of complications, fewer interventions, and a healthier birth for you and your baby.

Women are discovering that the hospital is not the only option for safe birth. Women are most likely to labor best in a place where they feel free, safe and private, with attendants whom they know and trust.

Many women find that they feel most comfortable at home or in a birth center, with the ongoing attention and nurturing care of a midwife or doctor trained in gentle, natural, safe childbirth - someone who is an expert in normal birth and provides the Midwives Model of Care.

Pregnancy and childbirth involve every part of you. Your feelings, hopes, fears, physical and practical needs, and spiritual or religious beliefs can all affect your pregnancy and birth. A midwife providing the Midwives Model of Care addresses all of these aspects to help you give birth naturally, safely and confidently. In addition, women who experience the Midwives Model of Care report feelings of great satisfaction and empowerment!

Compared to standard medical management, the Midwives Model of Care is a fundamentally different approach to pregnancy and childbirth.

This pamphlet explains what to expect with the Midwives Model of Care, and how this kind of care can help make your childbirth experience a joyous life event.

What to Expect
from a Caregiver Who Provides the Midwifery Model of Care:

Respectful Treatment
Gentle, nurturing care that respects you, your family and your beliefs.
Respect for your informed decisions about medical tests, recommendations and interventions.
Willingness to support your birth plan, including any family members and friends you may want present at the birth.
Freedom to move, eat, bathe - to do what helps you during labor and birth; your midwife doesn't "prohibit" or "allow," but patiently supports and guides you as needed.
Respect for the birth process as it unfolds uniquely each time. Although amazing, being pregnant and giving birth are actually normal life processes for which a woman's body is well-designed. Each woman's experience is unique.
Respectful care regardless of setting, although at present this kind of care is most readily found in homes and birth centers.
Personal Attention
Prenatal visits that allow plenty of time for questions and answers - 30 to 60 minutes for each prenatal appointment is common.
Meaningful discussions to explore and help resolve fears and concerns you or your family may have.
Caring attention to develop a trusting and nurturing relationship with you and your family that can help you to labor and give birth naturally and safely.
Plenty of Information
Plenty of information about pregnancy, birth and the newborn, and about breastfeeding and newborn care.
Suggestions about ways you can take good care of yourself and your baby.
Encouragement and practical suggestions for you to have good nutrition and make healthy lifestyle choices.
Full information about any recommended tests, procedures or treatments so you can make informed choices about your care.
Appropriate Monitoring
Regular and thorough check-ups for you and your baby throughout your pregnancy, during labor, and after the birth, to make sure both of you are healthy and doing well.
Recommendations for diagnostic technology when appropriate.
Planning with you for the unexpected and for the rare emergency.
Referrals to other health care specialists or to a different birth setting if needed.
Expertise in normal, natural childbirth. Because they are experts in normal pregnancy and birth, midwives are experienced in the variations of normal birth and recognize the early signs of conditions that are not "normal," including as medical conditions or complications that may occasionally arise during pregnancy or the birth process.
Confidence in Your Body
Help with discovering your own body's ability to give birth, in its own way and in its own time.
No routine treatments or arbitrary timetables that can interfere with your body's healthy process of laboring and giving birth.
Truly individualized care, privacy and natural childbirth.
Support for doing the work of giving birth. Rather than someone else "delivering" the baby, you are empowered to give birth to your own baby yourself!
Natural Techniques for Comfort
Help you cope with the discomfort of labor. Midwives have found that encouragement, massage, relaxation, laboring in water, changing positions and other approaches are often very effective.
Encourage the progress of labor and help you give birth to your baby gently and lovingly.
Help you avoid risks (to yourself and to your baby) that are associated with many standard medical techniques and hospital protocols.
A Care Provider Who Will Stay with You
Attentive, sensitive care and emotional support in tune with your needs, throughout labor. Research has shown that having a "sympathetic female companion" with you all through labor and delivery reduces the chance of complications and the likelihood of an unnecessary cesarean section. The Midwives Model of Care means that your midwife stays with you and mothers the mother.
Post-partum care and help with breastfeeding. After your baby is born, the midwife will stay with you until breastfeeding is established and both you and your baby are resting comfortably. She will arrange a visit after the birth to check you and your baby and to answer any questions.
Will you receive the Midwives Model of Care from your midwife or doctor? Use this information to ask detailed questions when choosing your caregiver and deciding where you want to give birth. It's also a good idea to question others who have used the caregiver. At present, this degree of individualized and supportive care is most typically provided by midwives in homes and birth centers. Someday, this kind of care will be available in all settings.

The Midwives Model of Care™

The Midwives Model of Care is based on the fact that pregnancy and birth are normal life processes.

The Midwives Model of Care includes:

monitoring the physical, psychological and social well-being of the mother throughout the childbearing cycle;
providing the mother with individualized education, counseling, and prenatal care, continuous hands-on assistance during labor and delivery, and postpartum support;
minimizing technological interventions; and
identifying and referring women who require obstetrical attention.
The application of this woman-centered model of care has been proven to reduce the incidence of birth injury, trauma, and cesarean section.

Background about the Midwives Model of Care : About the Definition

During May 1996, representatives of the Midwives Alliance of North America (MANA), the North American Registry of Midwives (NARM), the Midwifery Education Accreditation Council (MEAC) and Citizens for Midwifery (CfM) worked together to write a"definition" of what we called the "midwives model of care" that all the groups could use consistently in communicating with health care decision makers.

As we worked, we realized that we needed a definition that would address the primary concerns of health care decision-makers about midwifery, a definition that they would be likely to read. We started from the assumption that such decision-makers are mainstream and probably do not think in terms of mothers being capable decision-makers, and that the idea of partnership between mother and caregiver is either foreign or insignificant to their way of thinking. We felt that they would be concerned about whether or not mothers and babies would at least get the basic"medical" care that our culture feels is essential for adequate "safe"maternity care. The definition addresses those concerns.

Our hope and expectation was that once these decision-makers read/hear what THEY NEED to read/hear, they might begin to accept, that midwifery itself is not "dangerous" and that the Midwives Model of Care and the midwives who provide it should be included in general health care.

Note that the definition says the Midwives Model of Care INCLUDES the points in the definition; it does not say that these define the whole of midwifery care. Obviously, the definition is "barebones;" the Midwives Model of Care includes much more that is not overtly expressed in the short definition. (That is why Citizens for Midwifery subsequently developed the Midwives Model of Care brochure.)

Of importance to Citizens for Midwifery as a consumer organization is that the definition emphasizes the kind of care, rather than a particular type of provider. We all know that there are a few rare doctors out there who practice this model, and also some midwives who, for a variety of reasons, do not really provide this kind of care.

By focusing on the model of care, we can avoid divisiveness over credentials and which categories of care-givers do or don't practice "real" midwifery. The issue becomes the kind of care -- the evidence that supports its value, how to remove obstacles to its availability, how to make it available to as many women as possible, regardless of who is providing the care. The Midwives Model of Care then becomes a standard or ideal that all maternity care providers can attempt to meet.

In May 2001, the four organizations agreed to change the title to the "Midwives Model of Care." The definition is copyrighted and the logo trademarked by the Midwifery Task Force, a non-profit organization. The definition (not the logo) may be used in full with complete attribution. For information about licensed use of the logo, contact Citizens for Midwifery.

Citizens for Midwifery
1-888-236-4880
www.citizensformidwifery.org