A group of three medical students from the University of Alberta examine the issues of “woman-centered care” and the various birthing options available for low-risk obstetrics.
The issue of decision-making with regard to one’s birthing experience has been a hot topic for some time now and one that has been responsible for significant changes in Alberta. Until recently, the only birthing options available to Alberta families were an obstetrician/physician-assisted birth in the hospital, or an unassisted birth in their home. Obstetricians are physicians who are reproductive health specialists, have advanced training in complex obstetric cases and are trained surgeons. These specialists are vital for handling high-risk pregnancies and emergency birthing situations. However, many obstetricians are finding, along with much of our medicare system, that they are spread too thin among their patients to be able to provide the individualized care and time they would like [reference 1].
While physician-assisted birthing is responsible for saving the lives of many neonates after high-risk pregnancies [reference 2], research evidence indicates that planning a home birth is just as safe as a hospital birth among low-risk women, provided the maternity care system facilitates this choice through the availability of well-trained midwives [reference 3]. Natural birth
A midwife is a specialist in normal pregnancy and birth whose scope of practice includes providing primary care to low risk women and their newborns through pregnancy, birth and 6 weeks postpartum. Registered midwives have complete access to laboratories and diagnostic services; are able to prescribe and carry select medications, and consult or refer to other specialists when needed [reference 4]. Midwives work within the philosophy that pregnancy and birth are normal and natural life events so are present to enhance those experiences promoting wellness in women, babies and families [reference 5]. Complementing the work of midwives, Doulas are experienced in childbirth and provide continuous physical, emotional, and informational support to the mother before, during and just after childbirth [reference 6]. Inter-professional cooperation between midwives and physicians can help ensure that our families have adequate and safe birthing options to choose from. The utilization of doulas, nurses and other birth attendants can help make the birthing experience more satisfying.
Consistent with the scientific evidence and the reality of an overstretched medical system, and following extensive public pressure, the Alberta government announced in 2009 that it would cover the costs for expectant mothers who choose to deliver their babies with a midwife [reference 7]. With this announcement, Alberta has officially welcomed registered midwives as an addition to our current birthing specialists. Being a very new addition to the list of mainstream medical services, midwives are often misunderstood, or missed altogether as a potential option for Alberta families. Three medical students at the University of Alberta recognized this knowledge gap in their program and worked to start educating their peers by putting together a film titled “A Mother is Born”. The potential role for doulas within the birthing team is also discussed in this film. We are pleased to have the opportunity to share this film with anyone who is interested.
The documentary “A Mother is Born” will be shown on 19 January at 4pm at Able Body Health Clinic. Admission is free, but we do request an RSVP to bbtfilmlethbridge@gmail.com so that we can provide adequate seating and refreshments.
For additional information about the documentary, see ‘Birthing Babies Together’ – A University of Alberta Medical Student Initiative where you can also watch the documentary trailer!
References
1) The Society of Obstetricians and Gynaecologists of Canada. http://sogc.org/wp-content/uploads/2012/09/BirthingStrategyVersioncJan2008.pdf
2) Centers for Disease Control and Prevention. Pregnancy Complications. http://www.cdc.gov/reproductivehealth/maternalinfanthealth/pregcomplications.htm
3) de Jonge A, van der Goes BY, Ravelli AC. et al. Perinatal mortality and morbidity in a nationwide cohort of 529,688 low-risk planned home and hospital births. BJOG 2009;116(9):1177-84.
4) Alberta Association of Midwives. What is a midwife? http://www.alberta-midwives.com/aam/what-is-a-midwife/
5) Alberta Association of Midwives. Midwifery philosophy. http://www.alberta-midwives.com/aam/what-is-a-midwife/midwifery-philosophy/
6) Association for Safe Alternatives in Childbirth. Doulas online in Alberta. http://www.asac.ab.ca/alberta_doulas
7) Alberta Health. Benefits and Services. http://www.health.alberta.ca/services/midwifery.html
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