Friday, April 25, 2008

Differences

After some thought I have decided to keep going with these posts. I know we all have different opinions and some very strong feelings but this is why it needs to be said. There needs to at the very least be a discussion in this country to what we all really want in our lives. No woman can make a real informed decision if they do not know there are many options out there. What do you even pray about if you do not know all of your choices. Most women think of a midwife as a lady who wants you to have our baby in a barn or only in your home. This is not always the case. There are people out there who are only making things worse because they are antagonistic towards anything other than what they think you should do. This is NOT what I am about. I only want women to have the option. To know what they are getting into when they choose to have there babies wherever they choose to have there baby. So this post is the different options for a caregiver during our pregnancy and birth.


Midwife's And OBYN's   * These quotes come from MANA (Midwives Alliance of North America)

*A midwife is a person who, having been regularly admitted to a midwifery educational programme, duly recognised in the country in which it is located, has successfully completed the prescribed course of studies in midwifery and has acquired the requisite qualifications to be registered and/or legally licensed to practice midwifery.

The midwife is recognised as a responsible and accountable professional who works in partnership with women to give the necessary support, care and advice during pregnancy, labour and the postpartum period, to conduct births on the midwife’s own responsibility and to provide care for the newborn and the infant. This care includes preventive measures, the promotion of normal birth, the detection of complications in mother and child, the accessing of medical or other appropriate assistance and the carrying out of emergency measures.

The midwife has an important task in health counselling and education, not only for the woman, but also within the family and community. This work should involve antenatal education and preparation for parenthood and may extend to women’s health, sexual or reproductive health and childcare.

A midwife may practice in any setting including in the home, the community, hospitals, clinics or health units.*

Did you know there are four different types of midwives. Lay, Direct entry,Certified Professional Midwife, and Certified nurse Midwife, I would love to dredge through the confusion and let you all know the difference. 


Lay Midwife: *This is a term used to designate an uncertified or unlicensed midwife who has been educated through informal routes such as self study or apprenticeship.* 


These types of midwives are outlawed in most states in the U.S. However, there are many who practice under the eyes of the law. They are not licenced to suture, resuscitate, write prescriptions, or even to transport to the hospital. They have to disappear if something goes wrong because they can (and in my opinion probably should) be prosecuted. a lot of the moms who choose these types do not realize how little medical training they have. Although some are well trained in low risk birth I am weary because they would maybe push moms no to see a dr. or be tested for many things that would decrease there ability to birth away form a medical facility.


Direct entry midwife: *She is an independent practitioner educated in midwifery through self study, apprenticeship, a midwifery school, or a collage- or university- based program distinct from the nursing program. She works in and out of hospital setting.*


- again this lady though probably well trained to handle a low risk birth still, has no medical training. Many states licence these types of midwives, however there is a push for outlaw going on in this country as well. They have the same limitations as far as suturing and resuscitation as lay midwives.


Certified Professional Midwife (CPM) 

*A Certified Professional Midwife is a knowledgeable, skilled and professional independent midwifery practitioner who has met the standards for certification set by the North American Registry of Midwives (NARM) and is qualified to provide the midwifery model of care. The CPM is the only international credential that requires knowledge about and experience in out-of-hospital settings. *


- These women have more medical training but not enough to be able to prescribe medication. They practice at home births.


Certified Nurse-Midwife (CNM) 
Certified Nurse-Midwife (CNM) is an individual educated in the two disciplines of nursing and midwifery, who possesses evidence of certification according to the requirements of the American College of Nurse-Midwives.*


-These are my pick These women have an advanced medical degree the same as a nurse practitioner. They can resuscitate both baby and mom. They bring with them pitocin in case of hemorrhage, they very often work with OBGYN's to transfer a woman who becomes high risk. If they develop complications, or if mom needs to be transported. They monitor for these things very closely. And in no case would they deliver a women who (even if they begged) should not deliver out of the hospital. Many of the time these women deliver at homes because in this country most birth centers close within a few yeas of opening. Due to a lack of support from insurance companies.


In all other developed countries (for example: Great Britain, Sweden, Japan, Norway...) CNM's often practice alongside OBGYN's the Midwifes work with the 70-80% of low risk and the OBGY's take care of the other high risk women. 


OB/GYN: A commonly used abbreviation. OB is short for obstetrics or for an obstetrician, a physician who delivers babies. GYN is short for gynecology or for a gynecologist, a physician who specializes in treating diseases of the female reproductive organs. The word "gynecology" comes from the Greek gyno, gynaikos meaning woman + logia meaning study, so gynecology literally is the study of women. These days gynecology is focused largely on disorders of the female reproductive organs. An obstetrician/gynecologist (OB/GYN) is therefore a physician who both delivers babies and treats diseases of the female reproductive organs.  ( this definition comes form Medicinenet.com)


-A OBGYN is a medically trained surgeon When in medical school if you specialize in Birth you have a surgical rotation. These professionals are very good at what they do. They are trained to save women who need them. Unfortunately they also look for pathology where it may not be. Many of them have never seen a truly natural intervention free birth. 


If we as Americans want to bring our Mortality rates during birth back to where they should be Doctors and midwives have got to work together. There has to be a link between these two worlds. We have got to come together to help the women in this country. We have to quit fighting and work together to get informed. We have got to get better results, we claim to be the most developed country and we have more women and babes dying every day, than morst third world countries. We have got to come together Our babies deserve that. 

8 comments:

Marianne said...

After having Clara with an OBGYN and Collin with a midwife, I'm all about midwifes. I had such a better experience, even though I still had an epidural and delivered in the hospital. The all around care was so much better. I had a great relationship with my midwife that I never had with my OBGYN. When I told my mom I was using a midwife she was very upset and thought I was reverting back to pioneer days. I don't think she understood that we can still take advantage of modern medicine and have a midwife at the same time.

Alison Wonderland said...

You make a really good point here. Sure midwives can be great but get one who can catch, and save your life too. I know that 99% of women could be dropped on a deserted island somewhere and pop a baby out with no complications, I happen to be one of those women, but I just wouldn't risk having a baby with someone who wasn't up on all the latest theories, procedures and whatever else.
I work in a hospital, in an operating room, with anesthesiologists and when I had #3 natural I had a few who thought I was crazy and a few who seemed to take it personally. It was right for me and I don't regret a minute of it, I'd do it again. But There was and is real comfort in knowing that it was available should it become necessary.

1stdaughter said...

The situation I hoped for was similar to marianne's. I opted for a CNM and had many friends in the area recommend her. Unfortuantely it didn't work out and had it not been for my mom's (chronicler's) urging and me balling like a baby in the CNM's office I probably would still be pregnant (or dead).

Thanks for the post. I think it is something that needs to be dicussed because I do believe in being informed and making the best choice for you and your baby.

PS-No hard feelings about the last post. I completely understand where you are coming from now. Thanks.

Alison Wonderland said...

There's another option. My doc is an OB General Practitioner. He does my prenatal care, delivers my babies and does my follow-up. but he's family practice so he's also the kids' pediatrician and my husband's doc. He knows me , my kids, my whole family. He was happy to let me give birth without drugs and he even does perineal massage to avoid too much tearing (he's not an episiotomy kind of guy). I love love love him.

chronicler said...

pea, I sent an email to the known email address for you and it got returned. You won part of the drawing. Email me your address!

Tiffany said...

I love the info! You are wonderful and I miss you. I'm so glad that you post good info because I would have no idea and next time I'll definitely do things differently!

Tiffany said...

Please call me! I can't find your number anywhere!

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