Midwifery Model of Care and Support
May 17, 2015
The text below comes from the assignment to write a one page paper describing the entitlement all women have for healthcare that subscribes to the midwifery model as outlined by MANA.
From the very first tenet the Midwife’s Model of Care supports all women and their right to respectful treatment that addresses their individual needs when seeking healthcare. When midwives care for women they do so in a manner that serves to acknowledge the distinct needs of an individual. Women are as individually unique as is each birth experience for a mother. Survivors of childhood sexual abuse are especially vulnerable and within the Midwives Model of Care a framework is provided to support these women in particular. It is not just this population of women who will benefit from working with a midwife but all women and in fact society as a whole who will be the beneficiaries as the future generation learn that the dignity of self determination can be a reality when working with healthcare providers.
Providing the mother with individualized care provides opportunities to re-emphasize that birth is meant to happen simply and without distress or danger. Without the patriarchal culture and institutionalized power struggle women can again feel powerful and can understand better that she is truly the only direct care provider for herself and her unborn baby. Women are not expected to submit to the patient role and tolerate physical exams that may be painful emotionally and physically without complaint. Most midwives provide continuity of care during labor and many midwives personally provide one-on-one care to their clients at every visit. With this individualized care and the shared decision paradigm midwives form strong relationships where women are free to share their history of trauma if known. For those who have no cognitive memories of abuse or who choose not to share their history a caring midwife’s tenderness, respect and patience can avoid adding another layer of mistreatment to the woman’s pain.
The underpinning philosophy of the midwives model of care is the natural ability of women to experience birth without routine interventions. When women are protected from unnecessary intervention, such as being placed on her back to “deliver,” they begin to find inherit power in the strength of their unique nature. This is especially important for survivors of childhood sexual abuse. She can again learn to trust in her own perceptions, exercise her own power and establish personal physical boundaries that have long been violated. A woman who feels the power of natural childbirth begins to again sense her own value and the true meaning of love.
To summarize, the midwives model of care is offered in partnership with women and that the woman herself is the one who makes decisions as to all choices, procedures and permissions given during her care. It provides for a familiarity where crucial conversations can occur after a baseline of trust has been established and it removes the technological interventions to help the mother feel more empowered in her own care. This is especially important to survivors of childhood sexual trauma but quite frankly all women deserve this care and we, as a society, will be the beneficiaries.
Providing the mother with individualized care provides opportunities to re-emphasize that birth is meant to happen simply and without distress or danger. Without the patriarchal culture and institutionalized power struggle women can again feel powerful and can understand better that she is truly the only direct care provider for herself and her unborn baby. Women are not expected to submit to the patient role and tolerate physical exams that may be painful emotionally and physically without complaint. Most midwives provide continuity of care during labor and many midwives personally provide one-on-one care to their clients at every visit. With this individualized care and the shared decision paradigm midwives form strong relationships where women are free to share their history of trauma if known. For those who have no cognitive memories of abuse or who choose not to share their history a caring midwife’s tenderness, respect and patience can avoid adding another layer of mistreatment to the woman’s pain.
The underpinning philosophy of the midwives model of care is the natural ability of women to experience birth without routine interventions. When women are protected from unnecessary intervention, such as being placed on her back to “deliver,” they begin to find inherit power in the strength of their unique nature. This is especially important for survivors of childhood sexual abuse. She can again learn to trust in her own perceptions, exercise her own power and establish personal physical boundaries that have long been violated. A woman who feels the power of natural childbirth begins to again sense her own value and the true meaning of love.
To summarize, the midwives model of care is offered in partnership with women and that the woman herself is the one who makes decisions as to all choices, procedures and permissions given during her care. It provides for a familiarity where crucial conversations can occur after a baseline of trust has been established and it removes the technological interventions to help the mother feel more empowered in her own care. This is especially important to survivors of childhood sexual trauma but quite frankly all women deserve this care and we, as a society, will be the beneficiaries.
References
Davis-Floyd, R. (2001). The technocratic, humanistic, and holistic paradigms of childbirth. International Journal of Gynecology and Obstetrics, 75, S5-S23.
Enkin, M., Keirse, M. J. N. C., Neilson, J., Crowther, C., Duley, L., Hodnett, E., & Hofmeyr, J. (2000) A guide to effective care in pregnancy and childbirth. New York, NY. Oxford University Press.
Midwives Alliance of North America (n.d.). Midwifery Model. Retrieved from http://www.mana.org/about-midwives/midwifery-model
Romano, A. M. and Lothian, J. A. (2008), Promoting, Protecting, and Supporting Normal Birth: A Look at the Evidence. Journal of Obstetric, Gynecologic, & Neonatal Nursing, 37: 94–105. doi: 10.1111/j.1552-6909.2007.00210.x
Simkin, P. & Klaus, P. (2004). When Survivors Give Birth: Understanding and Healing the Effects of Early Sexual Abuse on Childbearing Women. Seattle, WA. Classic Day Publishing.
Sandall J, Soltani H, Gates S, Shennan A, Devane D. Midwife-led continuity models versus other models of care for childbearing women. Cochrane Database of Systematic Reviews 2013, Issue 8. Art. No.: CD004667. DOI: 10.1002/14651858.CD004667.pub3.
World Health Organization. Care in Normal Birth: A Practical Guide. (WHO reference number: WHO/FRH/MSM/96.24) World Health Organization; 1996. Retreived from http://whqlibdoc.who.int/hq/1996/WHO_FRH_MSM_96.24.pdf
Davis-Floyd, R. (2001). The technocratic, humanistic, and holistic paradigms of childbirth. International Journal of Gynecology and Obstetrics, 75, S5-S23.
Enkin, M., Keirse, M. J. N. C., Neilson, J., Crowther, C., Duley, L., Hodnett, E., & Hofmeyr, J. (2000) A guide to effective care in pregnancy and childbirth. New York, NY. Oxford University Press.
Midwives Alliance of North America (n.d.). Midwifery Model. Retrieved from http://www.mana.org/about-midwives/midwifery-model
Romano, A. M. and Lothian, J. A. (2008), Promoting, Protecting, and Supporting Normal Birth: A Look at the Evidence. Journal of Obstetric, Gynecologic, & Neonatal Nursing, 37: 94–105. doi: 10.1111/j.1552-6909.2007.00210.x
Simkin, P. & Klaus, P. (2004). When Survivors Give Birth: Understanding and Healing the Effects of Early Sexual Abuse on Childbearing Women. Seattle, WA. Classic Day Publishing.
Sandall J, Soltani H, Gates S, Shennan A, Devane D. Midwife-led continuity models versus other models of care for childbearing women. Cochrane Database of Systematic Reviews 2013, Issue 8. Art. No.: CD004667. DOI: 10.1002/14651858.CD004667.pub3.
World Health Organization. Care in Normal Birth: A Practical Guide. (WHO reference number: WHO/FRH/MSM/96.24) World Health Organization; 1996. Retreived from http://whqlibdoc.who.int/hq/1996/WHO_FRH_MSM_96.24.pdf
Reflection
I was honored when my instructor Mary Burgess asked if she could post a copy of my paper for other students to read and reflect on. I am very passionate about upholding the midwifery model of care. I was a bit irritated when a colleague from the medical community was offended by the division of thoughts into a medical model and a midwifery model. While yes the ultimate model of care is one that evidenced based practice is esteemed the midwifery model is the only model of care whose central purpose is for women to be afforded the respect to be presented with evidenced based practice options and recognized as the only true authority to choose which of the options (for there are more than one) she would like to use. I am currently reading a masterful book by author Anne Radioman, The Spirit Catches You and You Fall Down: A Hmong Child, Her American Doctors, and the Collision of Two Cultures. Even among the most homogenized segments of society we must learn to treat individuals and not medical conditions. The very core of my practice, if nothing else, will be about honoring women and respecting this important dynamic. I am in fact serving women, they are the masters of their own lives, and each has come from a place of incredible experience to share with me the lessons of life. Reflecting back on my thoughts above I feel that the biggest accomplishment in the assignment was articulating this passion.
Document
As a bonus this class also required a very unique document to be created, a client handout of Self Care ideas for pregnancy. I have also written a reflection for students in my musings. You can find it here: Self Care. The document below was the one I created for my assignment.
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