The Midwives Model of Care
The Midwives Model of Care™ treats birth as an essentially healthy process and a significant life event. This model is woman-centered and empowers women to make their own choices about the care they receive. (Midwives Model of Care, 1996).
The Midwives Model of Care™ holds true that the majority of women are perfectly equipped to safely deliver at home, close to their loved ones, with the care of a professional midwife, and without unnecessary interventions or the use of invasive electronic equipment. If the mother is in control and is empowered with an enabling environment, the birth process develops successfully and mother and baby are safe. Within the Midwives Model of Care, the professional midwife is also well-prepared to respond to the eventuality of time-pressed emergencies, to recognize when higher-level medical care is required, and to facilitate the transition to that care.
The Midwives Model of Care™ is based on the fact that pregnancy and birth are normal life events. It includes: Midwife Certification
- Monitoring the physical, psychological and social well-being of the mother throughout the childbearing cycle; Midwife Certification
- Providing the mother with individualized education, counseling, and prenatal care, continuous hands-on assistance during labor and delivery, and postpartum support; \
- Minimizing technological interventions; Midwife Certification
- And identifying and referring women who require obstetrical attention. Midwife Certification
The application of this model has been proven to reduce to incidence of birth injury, trauma, and cesarean section. To lower the maternal mortality rates, we must improve the safety of homebirth (see below for more on homebirth). The safety of mother and child rests on the accessibility of a well-trained midwife, as well as emergency care. It is the right of women and families to make informed choices about how and where they want to give birth. Midwife Certification
Source: Citizens for Midwifery Midwife Certification
Certified Professional Midwives (CPMs)
A Certified Professional Midwife (CPM) is a knowledgeable, skilled and professional independent midwifery practitioner who has met the standards for midwife certification set by the North American Registry of Midwives (NARM) and is qualified to provide the Midwives Model of Care. The CPM is the only midwifery credential that requires knowledge about and experience in out-of-hospital settings.
Most CPMs own or work in private home or birth center based practices throughout the United States, Canada, and Mexico. Providing continuous care for women throughout their childbearing cycle, CPMs generally carry a relatively low client load (averaging 3-6 births per month) which allows for more personalized and comprehensive care than typical obstetrical practices. The scope of practice of the CPM is derived from the NARM Job Analysis, state laws and regulations, and individual practice guidelines developed by each midwife according to her skills and knowledge. Midwife Certification
Based on the MANA Core Competencies, the guiding principles of the practice of CPMs are to work with women to promote a healthy pregnancy, and provide education to help her make informed decisions about her own care. In partnership with their clients they carefully monitor the progress of the pregnancy, labor, birth, and postpartum period and recommend appropriate management if complications arise, collaborating with other healthcare providers when necessary. The key elements of this education, monitoring, and decision making process are based on Evidenced-Based Practice and Informed Consent.
Learn more about how our programs serve NARM certification through the PEP Process.
In most cultures throughout history, women have given birth at home. The majority of women worldwide continue to birth their babies in non-hospital settings today. In many cultures birth is viewed as an integral part of family life. The advent of obstetrics in this century had a tremendous effect on childbirth customs in the United States. The birthing process became segregated from mainstream family life. Many were led to believe that the only safe birth was a hospital birth. Though doctors and hospitals took credit for statistics that indicated that birth was more successful than in previous centuries, in reality better nutrition, hygiene and disease control improved outcomes. Even today US statistics don’t support the premise that the only safe birth is a hospital birth. The US ranks 28th among industrialized nations for healthy births, at 7.0 infant deaths per 1000 births. (These data are based on 2002 statistics from the Maternal and Child Health Bureau: US Department of Health and Human Services.)
By the 1950s, most births in the US were taking place in hospitals. Cesareans, epidurals and heavy doses of pain medication became the norm. Women were denied feeling and experiencing birth through their bodies, and the drugs were having adverse effects on mothers and babies.
In the 1960s and ’70s, women began to question and challenge the way obstetricians were treating them—as though childbirth were a sickness. Women began to reclaim their power, and the homebirth movement was born.
The 1990s became a time of maternity awareness. People were concerned with making all of pregnancy and birth a family experience. Today – through midwife certification and utilization – a carefully monitored homebirth has been proven to be very safe and successful for women who have been helped to stay low-risk through nutrition and good prenatal care. (See Johnson,K.C., and B.A. Daviss. 2005. Outcomes of planned home births with certified professional midwives: large prospective study in North America. BMJ 330: 1416)
For more information on why homebirth works, go to Jill Cohen’s article in Midwifery Today, The Homebirth Choice.
FAQ about Midwifery
Q: Is it Safer to Give Birth in a Hospital or at Home?
A: If a woman or child has health issues, or is more susceptible to high-risk complications, it is important she be in or has immediate access to a hospital. For a healthy mother and child, however, studies have shown that out-of-hospital births are as safe, or safer, than hospital births. Midwife Certification
Q: What is the difference between a direct-entry midwife and a Certified-Nurse midwife?
A: A direct-entry midwife specializes in birth outside the hospital, whereas, a Certified Nurse-Midwife typically functions within a hospital. See our blog post, “CPM vs. CNM: What’s the Difference?” for a more detailed explanation.
Q: In the United States, which states legally recognize direct-entry midwives?
A: States vary in their recognition of direct-entry midwives. Contact Citizens for Midwifery (1-888-CfM-4880) to find out the policies of the state in which you’d like to practice. Midwife Certificaiton
Q: What is the NARM test?
A: The North American Registry of Midwives (NARM) is a certifying organization for direct-entry midwives. Many licensing boards use this test as a means to legally recognize a practicing midwife. Midwife Certification
Answering the Call for Midwives
The world needs more midwives. Our Global Midwife Training Advanced Internships, Midwifery Intensives and 3-Year Midwifery School provide a challenging learning environment intended to train midwives who will be equipped to provide high-quality maternity care in a variety of settings. But we do more than just train midwives. Our service learning model is designed to influence the way student midwives see themselves and their role in the communities they serve, and to develop the skills necessary to become the future leaders of positive change in maternity care. Apply Now.
Take a look at our unique approach to midwifery education and international clinical experience. Find out how we integrate service learning into our methodology. Learn more about midwife certification and the Midwives Model of Care, or how our programs can help you to become a Certified Professional Midwife (CPM) through NARM. Read inspiring stories about how to become a midwife on our weekly blog. Learn about the state of maternal health worldwide. Share the UNFPA “Call to Action” with your network.