From the 18th century, a conflict between surgeons and midwives arose, as medical

men began to assert that their modern scientific techniques were better for mothers
and infants than the folk medicine practiced by midwives.[32][33] As doctors and
medical associations pushed for a legal monopoly on obstetrical care, midwifery
became outlawed or heavily regulated throughout the United States and
Canada.[34][35]. In Northern Europe and Russia the situation was a little easier - in
Imperial Russia at the Duchy of Estonia, Professor Christian Friedrich Deutsch
established a midwifery school for women at the University of Dorpat in 1811, which
existed until World War I. It was the predecessor for the Tartu Health Care College.
Training lasted for 7 months and in the end a certificate for practice was issued to
the female students. Despite accusations that midwives were "incompetent and
ignorant",[36] some argued that poorly trained surgeons were far more of a danger to
pregnant women.[37] In 1846, the physician Ignaz Semmelweiss observed that more
women died in maternity wards staffed by male surgeons than by female midwives,
and traced these outbreaks of puerperal feverback to male medical students not
washing their hands properly after dissecting cadavers, but his sanitary
recommendations were ignored until acceptance of germ theorybecame
widespread.[38][39] The argument that surgeons were more dangerous than midwives
lasted until the study of bacteriology became popular in the early 1900s and hospital
hygiene was improved. Women began to feel safer in the setting of the hospitals with
the amount of aid and the ease of birth that they experienced with doctors.[citation
needed] “Physicians trained in the new century found a great contrast between their
hospital and obstetrics practice in women’s homes where they could not maintain
sterile conditions or have trained help.”[40] German social scientists Gunnar
Heinsohn and Otto Steiger theorize that midwifery became a target of persecution
and repression by public authorities because midwives possessed highly specialized
knowledge and skills regarding not only assisting birth, but also contraception and
abortion.[41]
ContemporaryEdit
At late 20th century, midwives were already recognized as highly trained and
specialized professionals in obstetrics. However, at the beginning of the 21st
century, the medical perception of pregnancy and childbirth as potentially
pathological and dangerous still dominates Western culture. Midwives who work in
hospital settings also have been influenced by this view, although by and large they
are trained to view birth as a normal and healthy process. While midwives play a
much larger role in the care of pregnant mothers in Europe than in America, the
medicalized model of birth still has influence in those countries, even though the
World Health Organization recommends a natural, normal and humanized birth.[42]
The midwifery model of pregnancy and childbirth as a normal and healthy process
plays a much larger role in Sweden and the Netherlands than the rest of Europe,
however. Swedish midwives stand out, since they administer 80 percent of prenatal
care and more than 80 percent of family planning services in Sweden. Midwives in
Sweden attend all normal births in public hospitals and Swedish women tend to have
fewer interventions in hospitals than American women. The Dutch infant mortality
rate in 1992 was the tenth-lowest rate in the world, at 6.3 deaths per thousand births,
while the United States ranked twenty-second. Midwives in the Netherlands and
Sweden owe a great deal of their success to supportive government policies
2
Whatever option you choose - whether it is with a midwife at a birthing centre or a doctor at a
maternity hospital (or even a doula at a home birth) - it is your choice and you should always do
what you feel comfortable with, rather than worrying what other people will think.
The main difference between doctors and midwives is that, while midwives are trained to deal
with women who are having normal, uncomplicated, low-risk pregnancies, doctors are trained to
handle any complications. If there are any complications with your pregnancy, or if any develop
while you are pregnant and under the care of a midwife, you will be referred to an obstetrician.
Typically, midwives believe in allowing women to make informed decisions regarding their
pregnancies and they tend to incorporate modern medical knowledge with traditional methods of
dealing with pregnancies and birth.
Midwives do not feel that births have to take place in a hospital but can provide you with
information about the potential risks of choosing other options.
Some midwives choose to work privately, rather than be employed by hospitals and other
institutions, in the belief that it ensures that the care offered will be in partnership, directed
primarily by the wishes of the women and their families.
Private practitioner midwives are able to provide continuity of care to the families who choose to
use their services. During the pregnancy, the woman and her family develop a friendly supportive
relationship with their midwife (in some cases e.g. homebirth, the care is shared by two
midwives). On the day the baby arrives the midwife remains with the woman throughout the
entire labour. There are no shift changes that require the midwife to leave. During the first week
of the baby's life the same midwife visits daily until the baby has settled into a feeding pattern
and the parents feel confident in caring for their new baby.
Some midwives in private practice choose to work in specific areas. For example, some may
offer post natal care, or advice with difficult breast feeding problems (Lactation Consultants). In
addition, some midwives are skilled and have qualifications in complementary areas such as;
Maternal and child health, counseling, naturopathy, reiki, kinesiology, massage and homeopathy.
Many people associate midwives with a less sterile approach to pregnancy and birthing and
believe that they generally give more attention to their patients than doctors. This is not because
doctors don't want to spend time with their patients but is usually because the workload of a
doctor in a hospital ward is very busy. If you have chosen to engage a private midwife to support
you throughout your pregnancy and a home birth experience than you will have had the
opportunity to form a strong bond with her and can be assured of her undivided attention to you.
Difference Between Midwife & Nurse
Nurses and midwives provide important medical care for their patients, but they may focus on
different types of medical needs and have different training requirements. This article compares
the professions in greater detail.

Midwives and nurses work in the medical field and provide care to patients, but midwives are
nurses who have additional specialized training. They focus on treating the medical needs of
women and they deliver babies. Nurses can assist with the medical care of patients of any
age, and they typically follow the orders of a doctor or nurse practitioner.
How to Become a Midwife

Midwives provide primary health care to women during pregnancy and beyond. Some
types of midwives, notably certified nurse midwives (CNMs) and certified midwives
(CMs), provide gynecological care for women throughout their lives. Other types of
midwives, such as certified professional midwives (CPMs) deal primarily with
pregnancy. All types of midwives guide women through prenatal care, labor and
delivery, and postpartum care.

Midwives may work in private practices, hospitals, or birthing centers. Some specialize
in attending to home births

What kind of training is required to become a midwife?

The type of education required of midwives depends on what type of certification one
is seeking.

Certified nurse midwives have master’s degrees in nurse midwifery, and to enter a
nurse midwifery program, one must typically have a bachelor’s degree in nursing and
some experience working as a registered nurse. Some programs accept registered
nurses with associate degrees, however.

Prospective nurse midwives should select a program that is accredited by

Accreditation Commission for Midwifery Education. Students in these programs
study health assessment, normal pregnancy care, high risk pregnancy care, well
woman care, management of complications, nursing research, and pharmacology.
Students also complete clinical rotations in different areas of midwifery practice.

While nurse midwives must first be registered nurses, certified midwives can enter a
master’s degree program in midwifery with a non-nursing bachelor’s degree.
Certified midwife programs are also accredited by the Accreditation Commission for
Midwifery Education and offer a curriculum similar to a nurse midwifery curriculum,
including coursework and clinical rotations. Because students in CM programs are
not coming from a nursing background, however, they may have to take
supplemental courses in health skills and medical sciences.

Prospective midwives who want to follow the certified professional midwife path
should seek a midwifery program accredited by the Midwifery Education
Accreditation Council. MEAC-accredited midwifery programs may lead to associate,
bachelor’s, or master’s degrees. Students take courses in anatomy and physiology,
pharmacology, prenatal care, pregnancy care, postpartum care, and newborn care.
Students are also paired with a certified nurse midwife or certified professional
midwife in an apprenticeship. Through their apprenticeship, students will observe
and assist with a minimum number of prenatal exams, births, postpartum exams,
and prenatal exams.

Are there any certification or licensure requirements?

Each midwifery path results in certification through a certifying agency. CNMs and
CMs are certified by the American Midwifery Certification Board, and CPMs are
certified through the North American Registry of Midwives. Both certifying
organizations are accredited by the National Commission for Certifying Agencies. To
earn a certification, CNMs and CMs must graduate from an accredited nurse
midwifery or midwifery program. CPMs can earn certification by completing an
accredited program, but they may also earn certification by passing a portfolio
evaluation process.

In addition to certification, most states require midwives to have a license to practice,

but the licensure requirements for midwives vary by state. All states license certified
nurse midwives, but only roughly half recognize certified professional midwives, and
five recognize certified midwives.

To become licensed, CNMs must have a current registered nursing license,

complete an accredited nurse midwifery program, and pass a national board
licensing exam given by the American Midwifery Certification Board.

Three states license CMs: New Jersey, New York, and Rhode Island. CMs in these
states must also complete an accredited program and pass a national board exam.

Recognition and licensing of CPMs varies by state. Some states require CPMs to
obtain a license to practice, while in other states licensure is voluntary.

How long does it take to become a midwife?

It can take at least eight years to become a CNM: four years for a bachelor’s degree,
one year of nursing experience, and three years in a nurse midwifery program. Some
CNMs may take less or more time to gain certification and licensure. Becoming a CM
may take slightly less time, as nursing experience is not required.

The amount of time it takes to become a CPM depends on one’s program. A CPM
program can take one to five years to complete after high school graduation.

What does a midwife earn?

The median yearly pay for CNMs in the United States was $89,600 in 2012. The
Bureau of Labor Statistics does not keep data for CPMs, but the Midwifery Education
Accreditation Council reports that CPMs charge $2000 to $4000 per birth, depending
on location and experience, and that a busy solo practice can expect to can attend to
two to four births per month.
A midwife is a trained health professional who helps healthy women during labor, delivery, and
after the birth of their babies. Midwivesmay deliver babies at birthing centers or at home, but
most can also deliver babies at a hospital. Women who choose them have had no complications
during their pregnancy.17 Okt 2018