Benefits Of Independent Midwives

My very good friend and colleague Rose wrote this article which has been printed into a leaflet for distribution in South Australia. She is clearly well qualified being both an independent midwife and a home birth woman. I’m impressed with it’s simplicity and comprehensive understanding, with as ever well reference findings. Thanks Rose for letting me put it on my site.
By Rose Pride Independent midwife

Continuity of Care/Carer

Continuity of care/r is a well researched area which shows that women value not only continuity but also their place of birth and the right of control over their own bodies [1]. Women do not want fragmented care from multiple care givers who provide conflicting and inconsistent information [2]. Research shows that women who have this type of care have far greater outcomes, including a decreased need for pain relief (including epidurals), lower episiotomy rate, less interventions and a smoother transition to motherhood [3].

The most appropriate care giver to provide continuity of care/r in the healthy woman is a midwife. Midwives are the only health professional specifically educated to provide total maternity care for well women and their babies. Women with sole Midwifery care (compared to any shared-care type) can expect more normal births, less caesareans, less forceps and vacuum extractions of their babies as well as the highest breastfeeding rates at six weeks and the lowest perinatal mortality rate [4].

Greater Control

It has been suggested that women in labour do not always feel equal and relinquish their personal autonomy and control [5]. However being fully informed and involved in decision making helps women retain a sense of autonomy, identity, confidence and control [3]. Having choice and control in childbirth can also have a significant effect on children’s healthy development [13].

When you have an Independent Midwife as your carer, you have the ultimate control over all decision making. As there are no hospital policies to ‘limit’ your choices, you and your partner are the only people who have the final say in your care. Midwives’ role is to present all of the evidence-based research to you, and then it is your decision as to what test, scans, procedures etc you choose for you and your baby, if any.

Ability for a Homebirth

Homebirth should be offered to women at low risk of complications as it offers considerable benefits to women and their families [6]. There is ample evidence showing that women who labour at home increase their likelihood of a birth that is both safe and satisfying [7-9]. Women planning homebirths have less intervention rates, more satisfaction, experience less pain and use less pharmacological pain relief, have fewer interventions and more autonomy. This reduction in interventions includes induction and augmentation of labour, perineal trauma and episiotomy, instrumental delivery and caesarean. Importantly, women describe their homebirth experience as empowering and increased their sense of control and self esteem leading women to have an overwhelming preference to homebirth compared to hospital births [7,9-12].

Midwives working Independently, compared to hospital employed do so because it allows them to be flexible about the care they provide to women; working in partnership, directed by the wishes of women and their families. This means they are not restricted by hospital protocols, and on the day of the birth, your Midwife stays with you through the whole labour-no shift changes which require the midwife to leave, as happens with hospital based care.

Having a homebirth with an Independent Midwife allows you to have home visits during your pregnancy, which allows for greater family and partner involvement. Independent Midwives recognise how special the first weeks of becoming a family are, so your midwife will visit your home regularly to assist all of your needs including breastfeeding support and helping you to grow and feel confident in caring for your new baby now and beyond.

Some private health insurance companies will cover part of the cost of an Independent Midwife.

References:

1. DOH (Department of Helath), 1992, Health Committee Second Report, Sessions 1991-1992, Maternity Services. London
2. Natioanl Health Committee, 1999, Review of Maternity Services in New Zealand, Wellington
3. Flint,C, Poulengeris,P & Grant, A. 1987, The Know Your Midwife Scheme: A Randomised trial of continuity of care by a team of midwives. Midiwfery 5:p11-16
4. Guilliland, K, 1998, Midwives and Midwifery-Leaders in safe Maternity care. New Zealand College of Midwives Newsletter. p1-3
5. Kirke, P. (1980), Mothers’ view of obstetric care, Br Journal Obstetrics and Gynaecology. 87: p1029-1033
6. Royal College of Obstetricians and Gynaecologists (2007), RCOG and Royal College of Midwives Joint Statement No.2.; cited [www.rcog.org.uk/index.asp?PageID=2023]
7. Wiegers,T, KierseM, Van der Zee,G. (1996)Outcome of planned homebirth and planne dhospital births in low risk pregnancies: prospective study in midwifery practices in the Netherlands. BMJ 1996;313: p1309-13
8. Olsen, O. (1997) Meta-analysis of the safety of the homebirth. Birth 1997;24:4-13
9. Ogden, J, Shaw, A, Zander, L, (1997). Deciding on a homebirth:help and hinderences. British Journal Midwifery, 1997:5;212-15
10. Davies, J. (1997). The midwife in the Northern Regions Home Birth Study. Br Journal Midwifery 1007;5: p219-24
11. Munday, R. (2004). Women’s experience of the postnatal period following a planne dhomebirth; a phenomenological study. MIDIRS Midwifery Digest 2004;13: p371-5
12. O’Brien, M, 1978. Home and Hospital: a comparison of the experience of mother’s having home and hospital confinements. J R Coll Gen Pract 1978;28: p460-6
13. Department of Health. (2004), The National Services Framework for Children and Young People. Maternity Services. Standard 11. London: Department of Health; 2004. Cited [
www.dh.gov.uk/assettRoot/04/09/05/23/04090523.PDF]