Most women who seek the care of a midwife are experiencing healthy, low risk pregnancies. A midwife’s scope of practice includes caring for healthy women in healthy pregnancies. I have often heard midwives referred to as “guardians of the normal” meaning that midwives work very hard to help their mothers experience healthy, uncomplicated pregnancies. A very important part of being a good midwife, however, includes recognizing when a pregnancy is beginning to veer from “healthy and normal” toward “variations of normal” and possibly into disease (such as uncontrolled gestational diabetes or BP, heart defects or other fetal anomalies, etc)
When these situations happen, it is important for midwives to have a system of collaborative care set up with local health care providers.
Here is a list of just some of the individuals or groups with whom midwives may collaborate:
- Labs– for lab work to ensure that mother’s are, and remain in the “low risk” category.
- Ultrasound centers– the verify accurate due dates if needed, and for the mid-pregnancy u/s to ensure healthy growth and anatomy in the developing baby.
- Physicians– for consulting when a mother or babe in utero’s health begin to veer off the course of “normal, healthy, and low risk.
- Hospitals– for those times when it becomes unwise or unsafe for a woman to deliver outside of the hospital setting (this may be due to a complication that requires the need of interventive care that is not possible in the out of hospital setting, or the own mother’s desires for pain medication, among other reasons)
- Chiropractors– for any number of complaints, or complications that can truly be helped by the care of an excellent chiropractor.
- Lactation consultants– for those instances where breastfeeding moms experience complications that require further assistance than that offered by midwives.
Throughout the years, I have had the opportunity to experience collaborative care at it’s finest, and I have witnessed “collaborative care” break down in ways that can only cause harm to the mother’s, babies, and reputation of both the local hospital, and the midwives involved.
There is a reason that we, at Labors of Love Midwifery strive to maintain professional relationships in the medical community. Hospitals and physicians are NOT the enemy, they are the next step up in care for those who NEED interventions not offered or available in the out of hospital setting.
Just as a cardiologist is not an enemy, of the Family practice physician, so Maternal Fetal Medicine and OB/GYN are not the enemy of midwives.
Just as the hospital is not the enemy of a physician office, so the hospital is not the enemy of the birth center or home setting.
Or, lets look at it this way. A fall that requires 6 stitches does not require an inpatient hospitalization. A heart attack does. Just so, in pregnancy, women and babes should have the healthcare provider and the location that fits the needs of their pregnancy, labor and birth. Not ALL babies should be born out of hospital.
It is truly SUCH a blessing to have relationships with not one, but two local hospitals who welcome the mothers who risk out of their desired birth and location, and treat them with respect and dignity. It is incumbent upon us as midwives to continue to develop and strengthen our relationships in the medical community to help to ensure that the women of the Upstate are well served, and have access to the care that they desire, AND the care that they need in each individual situation.