| |
|
Historical Perspective
Historically, midwifery has been one of the few medical practices dominated by female practitioners. From Agnodice in ancient Greece to the 18th century in Europe, the care of mothers and delivery of infants has been regarded, both by patients and by the medical profession, as appropriately carried out by women. In the 18th century, a division between surgeons and midwives arose as medical men began to assert that their modern scientific processes were better for mothers and infants than the folk-medical midwives. At the outset of the 18th century in England, most babies were delivered by midwife. By the onset of the 19th century, the majority of those babies born to persons of means had a surgeon involved. A number of excellent full length studies of this historical shift have been written.
There are two main divisions of modern midwifery in the United States, nurse midwives and non-nurse midwives.
Midwives catch babies in any number of settings. While the majority of nurse midwives work in hospitals, some nurse midwives and many non-nurse midwives often catch home deliveries. In many states midwives form birthing centers where a group of midwives work together. Laws regarding who can practice midwifery and in what circumstances vary from state to state, and some midwives practice outside of the law.Midwifery in the U.S.
Nurse Midwives
In the United States, nurse midwives are registered nurses with a bachelors degree in nursing who return to college for two additional years to specialize in midwifery and gynecological care of normal women. Most nurse midwives also have a masters Degree in nursing. Nurse midwives practice in hospitals and medical clinics, and may also deliver babies in birth centers and assist with home births. They are able to prescribe medications and provide care to women from puberty through menopause, not only during childbearing. Nurse-midwives work closely with an obstetrician, who provides consultation and assistance to patients who develop complications. Often, women with high risk pregnancies can receive the benefits of midwifery care from a nurse midwife in collaboration with a physician. Currently 2% of nurse midwives are men. Direct Entry Midwives
Direct entry midwives vary greatly in their training, certification and methods. Some are graduates of colleges or schools of midwifery which offer degree and certification programs of different lengths. Others choose to become Certified Professional Midwives through the North American Registry of Midwives. The American College of Nurse-Midwives (ACNM) certification council also provides accreditation to non-nurse midwife programs as well as colleges which graduate nurse midwives. All midwives certified by ACNM must pass the same certifying exam. Other midwives follow the time-honored path of the traditional birth attendant, learning the trade through apprenticeship and hands-on experience rather than a more formal course of study.