What is the difference between the Medical & the Midwife model of care and does it matter?

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There is a very real possibility that you have never really thought much about what kind of birth you would like or even what choices are available. One hundred years ago, this wouldn’t have mattered. But in the context of the 21st century the choices are endless, even though nothing about childbirth itself has changed at all!

Babies are still born today in the same way that that they have been born for generations but the primary difference between the two models of care is determined by who you choose to be the primary responsible person for your pregnancy and birth. A midwife is well suited to support healthy pregnancy and delivery and treat pregnancy as a normal, natural physiological process.

Midwives view the mother and baby as a single unit and utilize natural care remedies, focusing primarily on preventive diet, social support and exercise to provide a holistic approach. Midwives view birth as a social/life event and have a women/family centered approach. You can have a home or a hospital birth with a midwife and she will be your primary care giver throughout your pregnancy and after the birth. Most midwives work together with a back up doctor to refer for any complications or events out of their scope of practice. If you choose to have a midwife as your primary care provider you will spend about 10 hours with him/her in an average 40 week pregnancy excluding health education, time spent with you during labor and home visits after your birth.

Midwife Philosophy and Practice

  • See birth as a holistic process.
  • Shared decision-making between caregivers and birthing woman.
  • Shared decision-making between caregivers and birthing woman.
  • Equal relationship.
  • No class distinction between birthing women and caregivers.
  • Information shared with an attitude of personal caring.
  • Longer, more in-depth prenatal visits.
  • Often strong emotional support
  • Familiar language and imagery used.
  • Awareness of spiritual significance of birth.
  • Believes in integrity of birth, uses technology if appropriate and proven.

Medical philosophy and practice

In the medical model, the doctor or obstetrician is of primary responsibility. Doctors are trained in pathophysiology. “Patho” relates to disease/dysfunction and abnormality and they depend largely on testing, pharmaceutical drugs, and preemptive technological interventions to prevent or treat pathophysiology. Their parameters of care do not usually include social support or intense counselling about nutrition, exercise and birth preparation. Birth is viewed as a potentially pathological process managed by doctors, nurses, midwives and other experts. You are seen as the patient and not an active participant. If you choose to have a Doctor as your primary care provider you will spend about 10 hours with him/her in an average 40 week pregnancy.

  • Trained to focus on the medical aspects of birth.
  • Often a class distinction between obstetrician and patients.
  • Dominant-subordinate relationship.
  • Information about health, disease and degree of risk not shared with the patient adequately.
  • Brief, depersonalized care.
  • Little emotional support.
  • Use of medical language.
  • Spiritual aspects of birth are ignored or treated as embarrassing.
  • Values technology, often without proof that it improves birth outcome.
  • Hospital, unfamiliar territory to the woman.
  • Bureaucratic, hierarchical system of care.

Remember that babies can be born anywhere and every day babies are born safely in hospitals, homes, fields, cars and rice paddies, around the world. You need to find what is right for you as well as being informed about what is available in the country where you will be giving birth. 

If you are uncertain of your options then let’s have a chat. No sales talk, no pitches, just an opportunity to explore what is available and what you want. By the end of this call you will have a clear idea of what kind of birth you would like, who you would like to have with you and how you will go about getting that.

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