Midwifery: Alternative Care for Pregnancy and Childbirth

Abby Able, who is pregnant, decides to have her baby at home. She receives prenatal care from a certified nurse-midwife, (CNM), and after months of preparation and planning, she delivers a healthy baby at home. A physician calls this an example of maternal trauma and child abuse. Bonnie Baker, also pregnant, does as many women do and visits her obstetriciadgynecologist. She and the physician afso plan and prepare, but Bonnie’s baby is delivered in a hospital. Bonnie later complains about the cold, sterile environment of the hospital, of being treated by strangers, of having no friends or family present at the birth, and of being treated like someone with a chronic disease. These two cases are hypotheticrrf. They reflect the attitudes described by Rose Weitz and Deborah A. Sullivan, Department of Sociology, Arizona State University, Tempe, in a discussion of the politics of childbirth. 1 They focus atiention on midwifery-a field of health care that is often both controversial and tnismtderstood. The word “midwife” comes from the Middle English words mid, meaning “with,” and wi~,meaning “woman,” and it denotes a person who assists women in childbirth. As we shall see, the scope of a midwife’s work has come to include much more than simple assistance in deliveries. Indeed, the profession of midwifery has grown. Midwives are caring for women in hospital-based maternity programs and in alternative settings such as freestanding birthing centers, and they are providing a wide range of services, including family planning and well-woman gynecology. This essay will attempt to define midwifery, find out what makes it unique, look at some of the problems, and characterize the literature and status of relevant research.