Midwifery in Brief

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The Midwifery Coalition of Nova Scotia, a grassroots consumer organization composed of citizens and health professionals in all regions of the province, was formed to promote the practice of midwifery and its legalization and integration into the health care system.

The MCNS adopts the World Health Organization’s definition of midwifery , i.e.,
“A midwife is a person who having been regularly admitted to a midwifery education program fully recognized by the country in which it is located, has successfully completed the prescribed course of studies in midwifery and has acquired the requisite qualifications to be registered and/or legally licenced to practice midwifery.”

and it’s (the WHO’s) definition of midwifery’s sphere of practice:
“The midwife must be able to give the necessary supervision, care and advice to women during their pregnancy, labour and post-partum periods, to conduct deliveries on her own responsibility and to care for the newborn and the infant. This care includes preventive measures, the detection of abnormal conditions in mother and child, the procurement of medical and non-medical assistance and the execution of emergency measures in the absence of medical help.”

We believe that a direct-entry, autonomous model for the profession is the only appropriate choice, if the needs and wishes of the childbearing population of this province are to be fully addressed. ‘Direct-entry’ refers to midwifery training; it means that it is not necessary to have had any prior medical or nursing education in order to train as a midwifery practitioner. Autonomy would to some extent flow from this education model; midwives would be colleagues of other health professionals, and would consult with them rather than be under the supervision of another group.

With the current state of our health care system, and the province’s commitment to changes as outlined it its document, Health Strategies for the Nineties: Managing Better Health (Nov 1990), it is timely to promote the midwifery model. It very clearly ties in with the Royal Commission’s five principles to which the government is committed:

#1. Health promotion and disease prevention is embodied in midwifery’s holistic approach, which stresses prenatal and preconceptual health.

#2. Improved management of financial and human resources would be furthered by the midwifery model. Midwifery care could be provided on bases other than fee for service. Studies have shown that women undergo a lower Caesarian section rate, lower rate of operative procedures (e.g. episiotomy), and generally ‘lower tech’ treatment with midwives, which is less costly. Hospitalization periods are also generally shorter.

#3, #4, #5. Increased public involvement, regional planning and improving community access to health care all point to the government’s commitment to improving the fit between health needs and services, and we believe that midwifery, with its tradition of being community-based and operating in a variety of settings, would best serve childbearing women’s needs.

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