Talk:Midwifery
From Academic Kids
The entry reads:
- Midwives provide care and support to expecting mothers. They deal with normal births, and are trained only to recognize what is abnormal. If something abnormal is discovered, the patient is sent to an OB/GYN, as midwives are not trained surgeons. They do receive medical training as they are RN's.
What does OB/GYN and RN mean? and is midwifery the proper heading for this entry? --css
- OB/GYN=obstetrics/gynecology / obstetrician / gynecologist
Seems to describe modern midwifery in the U.S. It needs to be expanded to historic and worldwide. --rmhermen
Whats a "non-MD"? I know, you mean someone other than a medical doctor / physician--so why not just say "other than doctors"? "MD" is rather obscure, and is an Americianism. (Australian doctors don't have an MD, they generally have an MBBS). -- SJK
This is not NPOV. This is propaganda:
- All midwives believe that birth is a natural process. In general, midwives perform births without painkillers, epidurals, or labor-inducing drugs. While some do use drugs in emergency situations to stop hemorrhaging, others use herbs and massage in place of all drugs. Midwives were early adopters of the water birth method and birthing chairs. In general, midwives cut down on postnatal complications by letting births proceed naturally, so jaundice commonly caused by labor-inducing drugs (needed because epidurals inhibit contractions), and requiring additional hospital stays is much less common with midwife assisted births than births done with an obstetrician. Postnatal infections are also much less common in mid-wife assisted home births than in hospital births. In hospital births with nurse midwives, statistics show bigger and healthier babies, less use of pain medications, less complications.
-- SJK
It's mostly true. Hospital-Acquired Infections (http://www.aims.org.uk/Journal/Vol12No3/infection.htm) are very real and very serious. The home may contain many more germs, but they are mostly uninteresting germs. You can catch some pretty exotic stuff at the hospital. Hospitals rush things for many reasons, with little concern for injury because a surgeon can "fix" things up afterward. For my first child, the birth was rushed because the doctor's home was flooding and because an 8 PM cut-off point (for insurance purposes) was being approached. The doctor even yanked on the umbilical cord, causing lots of blood loss. I have a friend who got a truly horrible episiotomy so that the doctor wouldn't miss his golf game tee time slot. Hospitals are rather quick to suggest drugs of all sorts, even to mothers that aren't requesting them. If labor stops when at home, the midwife will just come back some other day. A hospital would typically force the labor to continue or just operate; they can't stand to have a woman show up 5 times without producing anything. Epidurals do inhibit contractions; even the hospitals admit this. It would be surprising if statistics didn't show bigger and healthier babies, because babies grow more (duh) if you don't start labor early or surgically remove the baby before the birth would naturally happen. Hospitals also estimate age wrongly; for example the large babies in my family throw off the hospital estimates by 2 or 3 weeks. A midwife would generally not decide to force an early birth based on such estimates, while a hospital would. AlbertCahalan 00:41, 26 May 2005 (UTC)
I almost agree. Most of it is propaganda, but I don't see anything objectionable about this part:
- In general, midwives perform births without painkillers, epidurals, or labor-inducing drugs. While some do use drugs in emergency situations to stop hemorrhaging, others use herbs and massage in place of all drugs.
Untrue. My wife is a midwife. Midwives perform most births in the UK and they most certainly make use of drugs, epidurals, callipers, etc. Derek
Well, it does say "in general" and "some"; I'm not professing to be an expert on midwifery. What I meant was that those bits above don't push an apparent agenda as much as the rest of what SJK removed. And, BTW, "some" in terms of logic means nothing more than "at least one." :-) --KQ
Fair enough, KQ, but for everyday English usage rather than logical usage, "in general" and "some", get the emphasis completely wrong. If the text had said
- A minority of midwives perform births without painkillers, epidurals, or labor-inducing drugs. While most do use drugs in emergency situations to stop hemorrhaging, a very few use herbs and massage in place of all drugs.
it would have been closer to the mark (for the UK anyway). Derek
Well, as I said, I'm no expert. Do you know about the trends worldwide? Because I imagine--and I have no evidence to back this up, mind you--that in fact "most" (in the typical sense) midwives would not use drugs, once you factor in all the midwives in third-world countries. --KQ
You could well be right. I can only claim to know a little about the UK situation. Of course once you start talking about the global situation, you then have to decide whether to count all women who are carrying out midwife functions, or just those who are, in some way, accredited midwives. Getting indisputable information could prove tricky. -- Derek
Would it be fair to say that nurse-midwives or midwives working closely with a physician are more likely to use painkillers and other drugs, whereas those not working with physicians often don't? Also, I think that midwives that specialize in home deliveries for "normal" pregnancies would be less likely to use drugs. Also midwives in Third World countries are probably less likely to use drugs, simply because of availability. There is at least a subset of midwives in the United States that does avoid drugs, and that does promote the deleted propaganda. Wesley
Being picky I'd say that a very tiny percentage of midwives use painkillers while delivering babies... it's the pregnant woman that uses them! ;) Well that said the number of stress headaches my fiancee has... But anyway most situations have the woman not wanting drugs but succumbing at some point. As for third-world countries I don't think they're really midwives as they haven't gained the qualification, though they perform the role of a midwife. violet/riga 10:40, 14 Aug 2004 (UTC)
- Those people in 3rd world countries (and also in parts of the USA and elsewhere) are properly called direct-entry midwives (DEM) or lay midwives. They fit the international definition too. See here (http://www.mana.org/definitions.html). AlbertCahalan 05:29, 27 May 2005 (UTC)
