Who is a 'midwife'? Is she someone who helps with childbirth? Let's talk!

Hello! Today we are going to talk about a topic that may be important to many people. You may have heard of someone called a 'midwife'. But who exactly is this 'midwife'? What do they do? This is an attempt to simply understand what kind of service you receive from these people, especially as a mother.

Who exactly is a 'midwife'?

Simply put, a midwife is a health worker who has received special training in women's reproductive health, that is, childbirth and related matters. Imagine, if you are hoping to become a mother, these people can help you with all the advice and care you need during pregnancy, help during childbirth, and the care you and your baby need after having the baby. But most of the time, their services are for low-risk pregnancies, without major complications .

In addition, some midwives provide advice on family planning methods, i.e., birth control, and other health issues specific to women, such as menopause. They often work in conjunction with doctors. However, in some countries, they are also allowed to work independently, depending on the legal framework.

Are there different types of midwives?

Yes, there are actually different levels of training and qualifications for 'midwives'. Not everyone is the same. Let's see how that works. In some countries, these classifications are clearly defined. For example, in a country like America, they are classified according to their education and certifications. In Sri Lanka, the service of our 'Family Health Midwives' is a little different from the concept of 'midwife'. Our PHMs contribute more to community health, home care for pregnant women and young children, and vaccinations. But the 'midwife' we are talking about today is someone who plays a more direct role in childbirth, sometimes holding the main responsibility.

In general, the main training levels are as follows:

• Those with advanced medical training and a degree: These are people who usually have a degree in nursing and then a specialized degree in midwifery. They can provide a wide range of services. This means they can provide care during pregnancy, assist with childbirth, provide care after childbirth, and treat some gynecological problems. They work in hospitals, birth centers, clinics, and, when appropriate, home births. In some countries, they are called Certified Nurse Midwives (CNMs) or Certified Midwives (CMs).

• Those who have completed specialized midwifery training programs: These may not necessarily have a university degree, but they do have to complete a specialized training course (about three to four years) and pass an exam to become a midwife. They focus mainly on helping mothers with low-risk pregnancies give birth in birth centers or at home. However, unlike the previous types, they are not usually allowed to prescribe medications, work in complex cases in hospitals, or treat gynecological problems in non-pregnant women. In some countries, they are called ``Certified Professional Midwives - CPMs''.

• Traditional or customary midwives: These midwives may not have received formal training or certification. They may have learned the trade on their own, worked as an apprentice under an experienced midwife, or learned it through tradition. They are also known as 'Lay Midwives' or 'Traditional Midwives'. In some countries, they are also allowed to work under a legal framework, but most often only for home births.

The most important thing is that if you are considering seeking services from a midwife, you should thoroughly research that person's training, qualifications, and experience.

In what situations do you seek the services of a midwife?

Now you might be thinking, 'So who would choose a 'midwife'? Wouldn't it be better to see a doctor?' True, most of the time, when we think of childbirth, we think of an obstetrician and gynecologist (OB-GYN). But some people prefer to seek the services of a 'midwife'. There may be several reasons for this.

Perhaps it's because they feel that their personal preferences, that is, the way a midwife provides services, that philosophy, aligns well with their expectations. Midwives often view childbirth as a natural process. Therefore, they try to minimize unnecessary medical interventions and provide a more personalized level of care.

But there is something you should definitely remember here. The services of a midwife are only suitable for mothers who are in good health and who are not likely to have major complications during pregnancy or childbirth (i.e., 'low-risk').

Then, there are those who are not particularly suitable for the services of a midwife. That is, those with pregnancies that fall into the ``high-risk`` category. Here are a few examples:

• If you have high blood pressure.
• If you are suffering from Diabetes Mellitus.
• If you have any heart disease.
• If you are carrying twins or more (multiples).
• If the baby is not positioned correctly, that is, if the baby is turned towards the buttocks and is in a ``Breech position``.
• If you have previously given birth to a baby by cesarean section (C-section) (this can also be a risk factor in some cases).

In cases like this, it is safest to give birth in a hospital with the necessary facilities, under the supervision of an obstetrician-gynecologist (OB-GYN).

Let's learn a little more about getting services from a 'midwife'

There is one more thing you should be aware of. In many countries, especially in countries like the United States, pediatricians and OB-GYNs recommend that the safest and most appropriate places to give birth are hospitals or accredited birth centers . This is because they have the facilities to provide immediate medical care in the event of an unexpected emergency.

It is also believed that the best pregnancy care and childbirth support is provided when doctors and qualified midwives work together as a team . This means that the midwife can take care of normal, uncomplicated cases, but can refer you to a doctor if a problem arises. This provides maximum safety for both mother and baby.

But one thing must be said. There are some countries in the world, where due to reasons such as culture, history or easy access to health services, the service of a 'midwife' is very common and even important. That is, 'midwives' take the lead in childbirth. Although our system in Sri Lanka is a little different, I think it will be useful for you to know about this service called 'midwife'.

Things to remember in summary

Okay, so from what we've discussed, I hope you have a good idea of ​​who a 'midwife' is and what their services are like. Finally, here are some important things to remember:

• A 'midwife' is a health worker who specializes in women's reproductive health, especially pregnancy, childbirth, and postpartum care.
• Their services are often suitable for low-risk, uncomplicated pregnancies.
• The training and qualifications of midwives vary, so it is important to research carefully before hiring a midwife.
• If you have high-risk conditions such as high blood pressure, diabetes mellitus, or heart disease, medical supervision is essential.
• In many cases, doctors and qualified midwives working together as a team can provide better protection and care for both mother and baby.
• Although the role of our 'Family Health Midwives' in Sri Lanka is somewhat different from the role of 'Midwives' who lead childbirth in some countries, as described in this article, it is important to be aware of this.

If you have any further questions about this, don't forget to talk to your doctor or Family Health Manager (PHM). They can give you the best advice.

` Midwife, Childbirth, Pregnancy Care, Women's Health, Low-Risk Pregnancy, Postpartum Care