In this article I will explain what a midwife is and what her functions are.
What is a midwife or midwife?
The midwife is the ideal professional and specialist in physiology, in normality, in everything related to the sexual, reproductive and maternal health of women, and provides comprehensive care in prevention, health promotion, care and health recovery.
As for maternity, the midwife offers care to the mother in the diagnosis, monitoring of pregnancy, accompaniment of the birth and normal postpartum period, as well as care for the healthy baby during the first 28 days of life, as well as being the specialist in breastfeeding by autonomy.
What education does a midwife have?
In order to practise, she must have successfully completed a training programme in midwifery recognised by the Ministry of Health, must be registered and licensed to practise in the country where she works, and must demonstrate competence in the practice of midwifery.
The midwife must be responsible for her scientific attitude, keeping her training and knowledge of clinical and technological means and procedures up to date.
It must maintain a salutogenic approach, from which it can offer varied, contrasted information based on scientific evidence, so that women can freely decide what the best options are for them and their families.
The midwife is the great advocate for mother and baby, staunchly defending their informed decisions.
What does a midwife do during maternity?
As a specialist in physiology, the midwife's approach to pregnancy, childbirth and the postpartum period is one of total normality. To this end, care focuses on providing continuity of care and support, taking into account the complexity of the woman's physical, psychological, spiritual, family and social reality.
The midwife's work consists of providing information, counselling, promoting self-knowledge and intuition, and offering totally individualised and personalised care, which allows situations with possible complications to be addressed early, suggesting changes to improve the health of the woman and the baby.
Midwife = better outcomes
Low-risk childbearing processes, accompanied by this type of continuous care exclusively by midwives, have been shown to have better maternal and perinatal outcomes, as well as higher levels of maternal and family satisfaction.
Women feel more capable and confident, with a greater sense of control and freedom of decision.
Fewer medical interventions
Women accompanied exclusively by midwives tend to require fewer medical interventions, are less likely to request epidural analgesia, less likely to have an instrumental delivery and an episiotomy. They are also more likely to have a spontaneous vaginal birth and a successful initiation of breastfeeding.
The midwife should keep technological interventions to a minimum, and should know how to refer to other professionals when the situation deviates from normality, thus recognising the limits of her competence for the safety and well-being of mother and baby.
When a woman has a risky pregnancy, childbirth or postpartum, the midwife remains the reference professional who coordinates care among all health professionals involved in the family's care.
What does a midwife do on the first visit?
As the midwife is the most appropriate professional to care for women during pregnancy, childbirth and the postpartum period, she should be the first contact and the referral professional for all women when planning a pregnancy or becoming pregnant.
In all pregnancy visits, the midwife allows the woman to express herself freely:
The midwife listens to the woman and offers information and tools or treatments to ensure her physical and emotional well-being and sense of security.
If the woman leaves a midwife's office with more fear, insecurity or nervousness than before entering, something has gone wrong; we can say that the midwife has not done her job well.
In addition, in this first visit, the midwife asks about the family medical history, the woman's own medical and obstetric history, her nutritional habits, her work, physical activity, dental health, emotional and mental health, sexual health, family situation with its relationships and ties, how the births and breastfeeding of other women in the family have been, etc.
Thus the midwife begins to get to know the woman in order to better accompany her, taking into account her cultural and social individuality, her unique reality, taking into account her specific needs, because all of this will shape and mould this unique and unrepeatable experience of motherhood.
How does the work of a gynaecologist differ from that of a midwife?
An obstetrician-gynecologist is trained to detect and resolve pathological situations and diseases related to the sexual and reproductive life of women.
His training and outlook is that of pathology.
A midwife has been trained, and should be a specialist, in the physiology of a woman's sexual and reproductive life.
Their training and their vision is that of normality, knowing how to detect when something is no longer normal in order to refer it to the appropriate professionals in each case, but avoiding unnecessary interventions in a process that, in a very high %, occurs spontaneously without complications.
Therefore, it is only essential that you have the care of an obstetrician-gynecologist when you have a health problem.
Remember, pregnancy, childbirth and the postpartum period are normal, physiological processes that are rarely complicated if we let them follow their own unique rhythm.
You decide who you want and need to accompany you.
What is the difference between a doula and a midwife?
A doula is a woman, with or without a health background, who offers only emotional support and logistical support to women and their families.
A midwife is a health professional who should always offer emotional and logistical support to the woman and her family, in addition to clinical, physical and emotional care, ideally with a holistic and salutagenic approach.
Therefore, you would need a doula, in case you feel you cannot find a midwife to give you emotional and logistical support, and to make you feel safe and confident.
You decide who you want and need to accompany you.