Friday, October 23, 2009

Midwifery Model in New Zealand

Beautiful country...beautiful babies!

Baby Ewan

In 2007-2008 I had the gift of being able to practice midwifery on the South Island of New Zealand in a rural town on the edge of Fiordland National Park, Tuatapere. The town has a "medical centre" which houses "Tuatapere Maternity", a small rural "birthing unit" (similar to our freestanding birth centers in the US). I just returned from 3 weeks "holiday" there and caught up with many of the families I was privileged to serve during my time there. Great fun to see how these sweet babies have grown.

Midwifery is alive and well in this island nation! It is a country and culture where midwives are the primary obstetric care providers. (If you want to see a physician, you must get a "referral" from your midwife!!) They practice in various settings and promote the "naturalness" of pregnancy and birth. All facilities where birth takes place have been mandated by the government to be certified as "Baby Friendly". Quite a statement about breastfeeding!! Women in New Zealand can have their babies in whatever setting they choose: home, birthing unit or hospital and it is totally supported (and paid for) by the government. Midwives are also responsible for care of the newborn for the first 6 weeks. The government mandates weekly postpartum HOME visits by the midwife. There is only one category of "midwife", unlike the US where we have multiple initials that connote a variety of paths to midwifery (see our BWHC website for a description of major categories). They are governed by a Midwifery Council that describes the practice of midwifery:

"The midwife works in partnership with women, on her own professional responsibility, to give women the necessary support, care and advice during pregnancy, labour and the postpartum period up to six weeks, to facilitate births and to provide care for the newborn.

The midwife understands, promotes and facilitates the physiological processes of pregnancy and childbirth, identifies complications that may arise in mother and baby, accesses appropriate medical assistance, and implements emergency measures as necessary. When women require referral midwives provide midwifery care in collaboration with other health professionals.

Midwives have an important role in health and wellness promotion and education for the woman, her family and the community. Midwifery practice involves informing and preparing the woman and her family for pregnancy, birth, breastfeeding and parenthood and includes certain aspects of women’s health, family planning and infant well-being.

The midwife may practise in any setting, including the home, the community, hospitals, or in any other maternity service. In all settings, the midwife remains responsible and accountable for the care she provides."

If only our government would see the value of midwifery care and breastfeeding...we could be a critical piece in health care reform. (Midwives have been "reforming" healthcare for a very long time!) We could benefit so much from implementing strategies countries the world over have embraced to decrease the maternal -infant morbidity/mortality rates, improve breastfeeding success rates and increase women's satisfaction with their pregnancy and birth experiences.

1 comment:

  1. I look forward to the day the US medical model and insurance companies develop the same attitude toward midwifery & doula care.