What is a Midwife?

A midwife is a specialist in normal pregnancy and birth. Viewing birth as a safe and normal passage in a woman's life, midwives foster confidence in women; consequently women are less likely to experience interventions during pregnancy and birth. A midwife provides "continuity of caregiver," which means she provides all the care from early pregnancy, through the birth and into the postpartum period. Primary midwives work with a back-up midwife who arrives later the in labour process.

Alberta's midwives are professionals who provide primary care to expectant mothers in northern Alberta. They are registered by the Alberta government and meet the government's training and experience requirements. They are members of the Alberta Association of Midwives (AAM).

Midwives are trained to focus on the normalcy of pregnancy and birth, to view these processes as safe and natural, having many normal variations. They disagree with the idea of a textbook labour, respecting instead that each woman needs to labour and give birth as her body indicates. Each woman and birth are considered unique, calling for an individual, non-routine response.

Midwives not only attend to the physical processes of pregnancy and birth, but also offer women important emotional, spiritual and psychological support throughout the transition of becoming a parent. Many consumers of midwifery care cite this as a major difference between midwifery and medical care.

Some of the care and services a midwife provides include: prenatal visits, prenatal classes, home visits, labour support for the duration of the labour and birth, as well as continuous postpartum care for as long as necessary. A midwife fulfills the role of many other professionals a pregnant woman would otherwise see -- doctor, prenatal instructor, case room nurse, public health nurse, and lactation consultant. Consequently, midwives and their clients establish close relationships. This is comforting to a pregnant woman and it is also beneficial to the midwife, who, having become very familiar with her client, is quickly alert to changes in the woman's state. If a midwife does detect an abnormal or questionable condition in the mother or child, she can supply some assistance, or procure medical support, or in the absence of medical help, execute emergency measures.

In Alberta midwives may practice as primary caregivers in the home setting, at a birth centre, or in hospitals where regional health authorities have granted midwives hospital admitting privileges. Otherwise, midwives may act as birth support in a hospital, providing continuous care to the woman and family through the labour and delivery.

In the last few decades, over two thousand babies have been born in northern Alberta with the help of a midwife. Most of these have been born at home. It is a myth that hospital births are safer than homebirths. Studies show conclusively that homebirth is as safe as or safer than hospital birth (see "The Issue of Safety").

Midwives come to a birth with a kit which includes supplies such as oxygen, resuscitation equipment, blood pressure cuff, suturing equipment, stethoscope, drugs to treat shock and hemorrhage, suction equipment, and fetoscope. Midwives are trained to perform resuscitation on a newborn, to administer oxygen, to start an IV, and to repair tears. They also bring a scale to weigh the newborn, forms for Alberta Vital Statistics and Alberta Health Care, and vitamin K and eye drops for those families who choose to have these administered to their newborn. A planned midwife-attended homebirth is a safe alternative to a hospital birth.

If you choose to birth in your own home, you must have a midwife as your caregiver. Physicians are not allowed to attend homebirths in Alberta.

Once you have established who you will have as your caregiver, take your support people (husband, family, friends) to meet the caregiver. Everyone will be more comfortable at the birth if they have met beforehand. If at any time you become uncomfortable with your caregiver, feel free to change. It is never too late. You may feel that changing would be disloyal, but you must not compromise your health or the health of your baby. Even if health and safety are not at risk, you have the right to a satisfying birth experience. If you thought the mechanic working on your car was compromising your personal safety or simply not listening to your concerns, you wouldn't hesitate to find a different mechanic!

If you would like to meet with a midwife, contact the ASAC or Birth Unlimited office for a list of practising midwives or check the yellow pages under "Midwifery" or simply look on the inside cover of this magazine.

This article was taken from ASAC's Birth Issues Winter 2000. Please visit www.asac.ab.ca.