The Art of Midwifery

By Jennie Joseph

Midwifery is a finely tuned balancing act, an ability to provide a helpful human service, practice a medical profession, meet emotional and spiritual needs for all involved and all the while appear as a humble, yet significant partner in this amazing journey to life. The Art of Midwifery is in and of itself practically indescribable.

There are certain universal tenants that hold true no matter what; they are that every pregnancy will eventually come to an end and generally speaking the baby will indeed come out. Now add the fact that in 95% of the cases things will happen so smoothly and straightforwardly that even a five year old could handle it and ultimately all would still be well! (Within the last year or two you have probably heard of such a story in your local news).

So given that the human female is already supremely designed and equipped to carry out this spectacular feat, why do we need midwives? Well for the same reasons that we need obstetricians. Although rare, complications can and do occur during the course of pregnancy, labor or postpartum. There are women who are already suffering from poor health when they conceive; they are at risk during a pregnancy and need obstetrical care. Others develop unusual or abnormal situations that can only be safely managed by OB specialists. On the other hand there are women who start off well and will remain perfectly healthy throughout if they receive the correct information, support and/or treatment along the way. This latter case, usually the majority of childbearing women, is where the art of midwifery really comes into its own.

When a human system works so well that it needs little, if any, intervention, it seems foolish to think that we can improve on it with science alone. Midwives/women have attended other women in childbirth since time began. Centuries of skills have been handed down through generations and to this day, worldwide, women still want and need the same support during their birthing experiences as they have always had. A midwife’s attributes, therefore, are many and her role is to enhance this already near-perfect experience by empowering and educating the expectant woman and family. She can lend that support because she understands the impact of these factors and their effect on the final outcome for the women in her charge. In which other medical discipline would you be able to see marked improvement in physiological functioning of, say, uterine muscle tissue, just by removing a negative friend or family member from the room or by speaking encouraging words to an exhausted laboring mother? Midwives know that to pay attention to factors such as these, contributes greatly to the normalcy and efficacy of the birthing process. In other words, perhaps the art of midwifery is in acknowledging and accepting the intangible and unexplainable aspects of pregnancy, labor and delivery and serving as a guardian for a normal childbearing experience. Does this mean that obstetricians do not have these skills? Not at all. Sadly, however, in today’s busy OB/GYN practices, large clinics and hospitals there is no longer time, space or perhaps energy for individualized care. Rather, the OB physician is typically forced to manage an enormous case-load of generally healthy women, handle high-risk and crisis cases, provide surgical intervention at the drop of hat and all the while maintain and protect their own tremendous investment in time, education and money! But, if this type of care is provided to the masses in as “ efficient” and in as safe a manner as possible then why are we seeing such awful statistics and experiencing such miserable outcomes? Why are cesarean and intervention rates so high? Ask any recently delivered mother who used the “conventional” system and the chances are that she will not relate an especially happy or satisfying experience. Yes, or course she is thrilled with her healthy baby and there may even have been some highlights along the way, but for the most part women are left with a nagging sense of disenchantment with their overall experience. (http://www.maternitywise.org/listeningtomothers/index.html)

Worldwide midwives are seen as the primary caregiver for normal healthy women. In underdeveloped countries, in many cases, midwives are the only caregivers available. It seems that other countries have figured out that birth is not an illness and that absent any risk factors, women and babies are safer if they are watched expectantly, provided guidance, support and education but left to negotiate their childbearing experience their own way. Midwives have always understood the importance of the actual journey to delivery. A woman does not suddenly just find herself at term one day. She must navigate all three trimesters and the different obstacles, trials and feelings that each brings. The majority of a pregnancy is spent in an expectant mother’s head, not her uterus! Universally women report similar emotions and experiences, a sense of “oneness” with all pregnant women prevails. Midwives know and encourage the camaraderie of being with other women and recognize the impact on self- realization and empowerment that derives from these interactions. Midwives, often mothers themselves, offer the reassurance and “mothering” that all women need when preparing for the birth of their own child.

It would appear then that the art of midwifery is best described in the translation of the word itself. Midwife – derived from Middle English means “with woman”. Simply put, the art of midwifery is the art of being totally able to BE with women in childbirth.

Jennie Joseph
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