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 midwife birth and medical birth comparison chart may help you to evaluate your beliefs about the birth process. Theses are the two extremes and are a tool for comparison.
Always interview any practitioner before choosing to work with them. Interviewing will help you choose a midwife, or group practice, and will reveal to you if she is a good match for you. Call and ask for an interview in person appointment. They may call it a consultation. Some charge and some do not. Remember midwives can work in hospitals, alternative birth centers in hospital, free standing birth centers and at your home.
How they practice is often dictated by rules of the facility. However, you may be able to find a practice that has a great deal of autonomy within that framework. Many hospitals call the labor and delivery ward a family birthing center. This is marketing and you need to be able to understand their practices and procedures to know if they will truly be able and willing to support a mother/baby led birth.
Midwife 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.
Medical Definition of Birth
- Childbirth is a potentially pathological process.
- Birth is the work of doctors, nurses, midwives and other experts.
- The woman is a patient.
Midwife Birthing Environment
- Home or other familiar surroundings.
- Informal system of care.
Medical Birthing Environment
- Hospital, unfamiliar territory to the woman.
- Bureaucratic, hierarchical system of care.
Midwife 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.
Medical Philosophy and Practice
- 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.