The issue of whether to have a midwife delivery is one of deep conflict for many people. It is made more complex since the term midwife could mean several things. A certified nurse midwife has a certain degree of medical training that a lay midwife lacks, for instance. Moreover midwife delivery doesn’t have to mean delivering at home, though that’s what some women want. It might be easy to conclude that women should simply go with their feelings on this issue, but there’s a little more to it than that, and the matter ought to be carefully considered, particularly if a home birth is planned.
Some of the reasons people choose midwife delivery is because they want a more natural approach to birth. It is argued that throughout the world, few women give birth in hospitals and under most circumstances things go very well. Furthermore, there is resistance to the increasing “medicalization” of birth in hospitals, with increased use of induction of labor, c-sections, and epidurals. Some women want to avoid these things and view birthing at home or at birthing center with a midwife in charge a much more natural event.
In contrast, people are often afraid of midwife delivery because many midwives don’t have standardized medical education, though many are well educated. Still, a midwife is not a doctor and can only do so much if an emergency arises before or after birth. How would a midwife handle hemorrhaging on the part of the mother or the need to perform a caesarian section? What happens if a child is born with a life threatening medical condition, like transposition of the great arteries? These are real concerns and anyone considering birth outside of a hospital should ask midwives how emergencies are identified and handled.
Another confusing aspect of this is that more and more, nurse midwives are part of medical teams that include obstetricians. This helps to do away with some of the concerns people feel about potential complications during a birth. Should these arise, the nurse midwife has a way to contact an obstetrician immediately. Additionally, many midwives do not deliver at home but work in hospitals, so having a midwife delivery doesn’t necessarily imply a home birth, although it can.
Perhaps the best advice that can be offered to women is to interview midwives and obstetricians and to do some research on the safety and benefits of midwife and doctor delivery. Those considering birthing at home should also look at statistical information on safety of home births. Understanding background of midwives is equally valuable since some may have different levels of training, and what it takes to get a license to practice can vary by region.
Under any circumstances, giving birth is a perilous passage for mother and child. How parents want a birth to go is important information, but childbirth isn’t predictable and seldom conforms to any form of birth plan. Women should have competent leaders by their sides that are able to change the plan when needed, and these leaders could be either midwives or doctors. Who to choose to “steer the ship” remains a personal decision that requires much thought.
