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From the German words for "with wife," the midwife has served an important function for hundreds of years. Until about the last 60 years, a vast majority of births took place at home, with the help of neighbors and friends. As childbirth has become more 'medicalized,' it has become for the most part, the domain of doctors and hospitals. Many expectant couples do not know that midwives still exist and are available in many areas of the U.S. They can manage prenatal care, birth and postpartum, and follow-up care including birth control.

There are two types of midwives: the 'lay-midwife' who has learned mostly on the job and typically does home births, and the 'certified nurse-midwife' who has received a great deal of academic training and generally works with physicians doing hospital deliveries, though some do home births.

The philosophy of midwives is that labor and birth are normal processes that require few, if any, interventions such as IVs, episiotomies, continuous fetal monitoring, or food restrictions. Midwives encourage birth plans and feel that prenatal education is extremely important for a woman to have the best birth possible. If complications arise, physician backup is available, however, most births can be handled completely by the midwife.

Midwives often like to be present throughout the labor (as opposed to physicians who generally rely on the labor & delivery nurses to inform them when a woman is far along enough for the physician to arrive in time for the birth), and act as support for the woman and her coach. The midwife will stress breathing, relaxation, visualization and massage techniques in order to decrease or eliminate the need for medication. Movement is encouraged, and laboring in a variety of positions can help to speed labor and increase the mother's comfort. Showers and tubs are great ways to decrease the discomfort of contractions; many women don't want to leave the tub once they have been talked into getting in!

While midwives have been around for a long time, it has only been in the past 25 years that they have been gaining renewed acceptance in the U.S. Most hospitals and many physicians' groups now have midwives in practice, though not all insurance companies will currently reimburse for a midwife's services. In the future it is likely that many more women will decide to have a midwife for their birth attendant, and will benefit from truly personalized care.


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