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Midwife Versus Medical

Comparing Models of Care

Choosing where to have your baby will help you decide what kind of practitioner you would like to have attend your birth. Beliefs and perceptions about the birth process are influenced by cultural practices. These may or may not be evidence based.

We hope that you are asking many questions about what will happen and why during your birth. This chart may help you to evaluate your beliefs about the birth process.  Theses are the two extremes and are a tool for comparison.

Parents must ask many questions to determine how a midwife will be able to support a physiological or natural birth within a hospital setting.  BirthLink also offers birth options consultations that give you lists of questions to ask as well as background on midwifery practices in the Chicagoland area. It is possible to have a positive birth experience with hospital based midwives keeping in mind that they do have to work within their facilities rules. The rules and flexibility in the rules can vary a great deal from facility to facility and practice to practice.

 

The Midwife Model of Care	The Medical Model of Care
Definition of Birth
Birth is a social event, a normal part of a woman's life. Birth is the work of the woman and her family. The woman is a person experiencing a life-transforming event.	Childbirth is a potentially pathological process. Birth is the work of doctors, nurses, midwives and other experts. The woman is a patient.
Birthing Environment
Home or other familiar surroundings. Informal system of care.	Hospital, unfamiliar territory to the woman. Bureaucratic, hierarchical system of care.
Philosophy and Practice
See birth as a holistic process. Shared decision-making between caregivers and birthing woman. No class distinction between birthing women and caregivers. Equal relationship. 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.	Trained to focus on the medical aspects of birth. "Professional" care that is authoritarian. 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.

Special thanks to the Morning Star Women's Health and Birth Center, Menomonie, Wisconsin, for sharing this information with us.