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03/22/2012

Reflection On Partnerships Between Women And Midwives


Reflection on Partnerships between Women and Midwives

 

Topic Statement: The fundamental starting point for partnership is the recognition that women and midwives both have expertise that will contribute to an optimal experience for each woman and her family. The way in which both a midwife and a woman will contribute to the relationship needs to be individually negotiated. Each will bring different expectations and skills (Leap & Pairman, in Pairman et al. 2006, p. 261).

Midwives Experience in the Progress of the Pregnant Women

Midwives are the main providers of care in pregnant women. Midwives, as a model of care, prove their effectiveness in promoting the childbearing stages (Williams, Lainchbury, and Eagar, 2005, p. 4; NHS, 2007, p. 6). The antenatal care led by the midwives has no detrimental effects on prenatal or postnatal outcomes. An antenatal check-up or screening is any contact with a midwife or doctor to check the progress of a pregnancy and includes checking the woman’s blood pressure and urine. Midwives use the antenatal or prenatal screening not only to ensure the health of the mother but also to determine the existing abnormalities on new-born child (Stout, 1997, p. 170; Peckham and Marshall, 2009, p. 4; Philips, et al., 2007, p. 25). Many women had been recorded to have a great risk for delivering the babies; therefore the support of the midwives is highly expected.

A good antenatal care includes the access to education about the parenting and preparation for birth (NHS, 2007, p. 7).  The continuity of care by midwives has demonstrated benefits for women and babies, including a lower risk of antenatal hospital admission, less use of relief drugs in labor, fewer episiotomies and less need for neonatal resuscitation (NHS, 2007, p. 6; Williams, Lainchbury, and Eagar, 2005, p. 5). The finding is that women, cared for by midwives, had less need for pain relief was consistent with earlier researches on the experience of midwives in caring for pregnant women.

During labor of the women, one midwife is staying with her to look after her and support her needs. Her presence, skill, and knowledge are always available to support and assist the woman in developing a strong and capable mother (Kirkham, 2000, p. 20; Green, 2009, p. 28). And if there is some serious problem, the midwives are open for collaboration with the hospital staff because the only focus of a midwife is to support the women with all her knowledge, trust, and confidence (Malavisi and Mansfield, 2006, p. 16; Kirkham, 2000, p. 23).  

 After the birth, all newborn babies are examined to check if there are any problems within the first week of their life, or before they are discharged from hospital. Then, the postnatal check-up is given to the women who gave birth approximately four to six months after the labor. This is to ensure that there is an early identification and management of new mother’s health, which is very important because health problems may lead to ongoing pain, disability, and depression (NHS, 2007, p. 8; UNFPA, 2006, p. 26). The outcome measures the safety in antenatal, intrapartum, and postpartum, including the baby’s safety –whether the baby is needed to be admitted to the special care nursery, postpartum complications and referral or readmission of baby or mother. Other important outcomes include the breastfeeding and mothers’ evaluations on their own care and adjustment to motherhood (Williams, Lainchbury, and Eagar, 2005, p. 5). In this area of care, the counseling, and education are given such emphasis (USAID, 2002).

Reflection

The concept of maternity care is addressed or measured in the safety and satisfaction of the women. This might involve the emotional and physical well being of the mother and the baby. As women they value good communication, consistent information, friendliness and interest especially in child-bearing (Williams, Lainchbury, and Eagar, 2005, p. 4; Hatem, et al., 2008, p. 11; Davis, 2004, p. 8; Peckham and Marshall, 2009, p. 5).

Midwives are the leading models of care and they aim to provide continuity of care by ensuring that child-bearing women to receive their ante, intra, and postnatal care from midwife.  There are controls in the antenatal care led by midwives had comparable results to that led by obstetricians. The experiences of the midwife in caring for pregnant women suggest that they are better able than unfamiliar staff to provide appropriate support in child-bearing.

The duty of a maternal caregiver or midwife needs a lot of dignity and with their compliance in fulfilling their responsibilities; the role of the midwives in the new generation is very much appreciated. The role they create and caring expertise leaves a great impact in the motherhood stage of the woman. The everyday duty that a midwife performs to assist and support the woman needs proper focus and attention especially in the situations where there is a matter of life-and-death. And as a contributor to health and wellness, a solid ground of knowledge and a caring heart is all a midwife’s needs to survive in the healthcare industry.

Most midwives are women; this is probably why the woman and the midwife make it easier to trust in each other. In addition, their strong relationship and connection in each other enables the midwife deliver the needed support and action of the pregnant women. In the view of a midwife, the monitoring of the pregnant may sound boring to others because it will spent 9 months, accompanied with the swinging attitudes and behaviors of the woman, but it is considered as the most caring field in medicine. It is because of the fact that in the hands of the midwife, together with her care and attention, she is helping the woman to carry and bring out the joy of the woman’s knowing that they are both strangers for each other.

The woman who is under the care of a midwife will experience a special kind of treatment that is suit to her needs. Mostly, the aim of a midwife is to safeguard the woman in the stages of antenatal, intrapartum, and postnatal of childbearing. This kind of attention and attention is important especially to those women who have a high risk in carrying or delivering a baby, such the “teen-mothers”.  With the proper care and support of the midwife, there is an assurance that the woman will feel safe and can build her confidence in the new chapter of her life.

The information provided by the midwives serves as guidance in all women on how to take care of the babies after birth. Other than that, the woman can communicate freely to their midwives even if they already delivered the baby and went back home. The relationship of the woman and the midwife is special because both of them are focused on the baby, and definitely, the woman will receive the help and advice from the professionals in child care not only on the midwives but also pediatricians who specializes the caring environment for the child. Midwives, on the other hand, will continue to deliver the work in the community and provide assistance to the childbearing woman, whenever they were asked to.

Discussion

The Philosophy of Care

Care may come in different nature or in different situations. Mostly, the providers of care are women because of the natural heart they give to their patients, especially when the people are close on them. Care is often shared by family doctors, obstetricians, through midwives (Hatem, et al., 2008, p. 4). There is a great impact on the physical and psychological health of the mother, emotional adjustment for the partners, especially when they are first-time parents, and the social relationships within the family (Malavisi and Mansfield, 2006, p. 20). Through this fact, there is a transition of different roles and responsibilities that obliged the people involved to support the parents in taking care of the baby. 

In this sense, the mother is expected to take proper measures of care not only on herself but also to the unborn child resting in her womb. When the issue of care involves, the role of the midwife was given an emphasis. Their main duty is to focus on the women throughout their pregnancy. Under the model women, midwives have responsibilities in guiding the women for the pregnancy phase which includes the labor, birth and early parenting days (Malavisi and Mansfield, 2006, p. 24).

Midwives: The Role

Part of midwives’ role is to introduce to the pregnant woman the importance of care in the antenatal (during pregnancy), intrapartum (during labor and birth), and postnatal (after birth) stages (Vedova, Tomasoni, and Imbasciati, 2006 p. 11). They educate the women and the entire community with regards to gynecology, family planning, and child care (Malavisi and Mansfield, 2006, p. 20; UNFPA, 2006, p. 57).  And for over the years, the existences of midwives were appreciated as the relationship and partnership of the midwife and the mother in raising the child is getting stronger.

Midwife and Woman Relationship

Through the built relationship, women can have an access to different pregnancy health care which can be cost-saving medical intervention and still delivering the needed efficiency (Malavisi and Mansfield, 2006, pp. 21-22). Aside from the midwives, there are other care providers that aim for healthy pregnant women. It is the midwives who only provide total care throughout the pregnancy and the existence of midwifery and its practice is also respected (Weaver, 2005, p. 5). Midwives are accounted as wise partners of women (UNFPA, 2006, p. 16). Some accounts said that there is women are naturally connected to the midwifery because most midwives are women and frequently acts in humanitarian assistance but, there is a little recognition on the opportunity (UNFPA, 2006, p. 17). And the relationship of the midwife and the pregnant should be linked as the mother-and-daughter relationship (Mens-Verhulst, 1995, p. 10).

The Modern Medicine

In many parts of the world, it is important that there is a low mortality ratio and this gives much respect to the profession. But in some instances, midwifery has been treated as the other medical profession such as nurses or multi-tasked health workers. Although there are many recognized programs to increase the competencies in midwifery, still the midwives do not have sufficient exposure to the nature of their practice.

The lack on hands-on training contributes to the incompetent management of normal births. It also lessens the core values of the workers even if they are skilled or have potential in attending the pregnancy needs and the diminishing the understanding and appreciation of the normal processes in the stages of pregnancy and childbirth. As a result, the women cannot have much capacity to work and trust in a partnership to midwifery (UNFPA, 2006, pp. 16-17).  In the generation where technology is a great influence, the hospitals has given the standards in measuring the care through the detection of abnormal conditions of the mother or the child, procurement of the medical assistance and the execution of the emergency measures in the absence of specific medical help (Malavisi and Mansfield, 2006, p. 20; UNFPA, 2006, p. 18; Stout, 2007 p. 170).

Conclusion

In summary, midwives nowadays do many things, but first and the most important – midwives’ assists the women in pregnancy and they don’t stop there. They also attend the labor and provide education for the pregnant women as well as their families. The midwife assists and supports the pregnant woman, guiding her and introducing her to world of motherhood. This type of relationship is unique because in the phase of pregnancy, two different people as more likely as strange to each other are bound together to bring one little hope alive.

            The philosophy of care is in the blood of the medicinal world. Medical professionals understand the different difficulty that their patients endure and all they have to do is to focus in their job and provide security for their patients. Midwives, again as a model of care, provide the proper attention that all pregnant women should receive. The role of the midwife is different from the role of the nurses and other medical practitioners, although there is confusion between the roles of the nurses, obstetricians, and midwives. Still, midwives can provide the care and attention suitable for the mothers. In this event, a great relationship between the mother and the midwife is founded. The trust they have for each is unique and incomparable.

Sometimes, the woman and midwife argue about the possibility and confusion of pregnancy because of the changing hormones of the women. In this case, the midwife takes her professionalism into action. As a midwife, her purpose is to support and care the pregnant woman and not to build a war against her. Despite of the differences between the woman and the midwife, the latter deeply understands the woman’s situation, she still gives enough patience in sustaining their relationship – all for the wellness of her patients who are the mother and the child under her care. And in return, the mother will learn more about her pregnancy and can have a great understanding on keeping their relationship strong.

References:

Davis, E., 2004. Hearts and Hands: A Midwife’s Guide to Pregnancy and Birth, Ed. 4, Celestial Arts. [Online] Available at: http://www.elizabethdavis.com/books.html. [Accessed 08 Jan 2010].

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Mens-Verhulst, J., 1995. Reinventing the Mother-daughter Relationship. American Journal of Psychotherapy, Vol. 49 No. 4. [Online] Available at: www.questia.com. [Accessed 08 Jan 2010].

NHS, 2007. Women’s Experiences of Maternity care in the NHS in England, Key Findings from a Survey of NHS Trusts Carried Out in 2007. [Online] Available at: http://www.cqc.org.uk/_db/_documents/Maternity_services_survey_report.pdf. [Accessed 13 Jan 2010].

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Philips, D., et al., 2007. Factors That Influence Women’s Disclosures of Substance Use during Pregnancy: A Qualitative Study of Ten Midwives and Ten Pregnant Women. Journal of Drug Issues, Vol. 37, No. 2. [Online] Available at: www.questia.com. [Accessed 08 Jan 2010]. 

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UNFPA, 2006. “Maternal Mortality Update” Expectation and Delivery: Investing in Midwives and Others with Midwifery Skills. United Nations Population Fund. [Online] Available at: http://www.unfpa.org/upload/lib_pub_file/718_filename_mmu_06_en.pdf. [Accessed 08 Jan 2010].

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Vedova, A., Tomasoni, V., & Imbasciati, A., 2006. Mother-fetus Communicative Relationship: A Longitudinal Study on 58 Primiparae and Their Children during the First Eighteen Months. Journal of Prenatal and Prenatal Psychology & Health, Vol. 20, [Online] Available at: www.questia.com. [Accessed 08 Jan 2010]. 

Weaver, K., 2005. The King’s Midwives: The 1764 Midwifery Expedition to Saint Domingue and Why It Failed. Nursing History Review, Vol. 13, p. 5. [Online] Available at: www.questia.com. [Accessed 08 Jan 2010].

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