The Midwife: a woman’s lifelong companion

 The Midwife before

She was the one who had the trust of pregnant women, and the one who delivered their babies when the time came. Midwives didn’t use to have any formal education; her knowledge was passed on from other midwives and from her own experience.

The Midwife today

Today Midwives receive former education in Midwifery. In some countries a Midwife must receive first a degree in nursing before receiving a degree in midwifery, she also needs to receive practical training and pass certain tests before being able to practice Midwifery. The role of a Midwife is also different from one country to another, depending on how different health care laws are.

In some countries, the Midwife can provide prenatal, and postanal care and can deliver babies, only through hospitals. While in other countries she can practice independently in her clinic where she can receive patients, she can also assist in home births.

Midwives' Role in Women’s Care

Midwife means “Next to the wife” meaning she is the one who is next to the woman at every stage of her life.

Supporting young girls through puberty

It is noteworthy that a midwife’s role isn’t just in prenatal and postnatal care and delivery. In fact, her role starts when a young girl reaches puberty, midwives provide an educational role to teenage girls, to educate them about the menstrual cycle, even before puberty, to ease the surprise for them. A midwife also teaches girls about ovulation, and how to calculate their cycle, in addition to raising awareness in sexual and reproductive health.

Pre-pregnancy care

During the pre-pregnancy stage, the midwife guides the lady trying to conceive and helps her prepare for the upcoming experience, by providing educational support and by suggesting the appropriate supplements for this stage.

Prenatal care

Midwives can provide prenatal care for women with low-risk and normal pregnancies. During the first trimester when the pregnant woman feels the early symptoms of pregnancy, which can be uncomfortable like nausea and vomiting, and moderate pain, the Midwife’s role is to guide the pregnant woman and help her ease these symptoms. In addition to telling the expecting mother about the needed checkups and tests to oversee her health and the health of her unborn baby.

During Labor

A Midwife can also be a doula, as she can be on the expecting mom’s side from the early onset of labor until the baby is born. An experienced Midwife can tell the lady going through labor, when is the best time to head to the hospital and when she can wait and make her aware of any emergencies that might require immediate medical assistance.

Before being on the woman’s side during delivery, Midwives need to study her medical file. This will help her learn the medical history of the patient, and what she has gone through before the day of the delivery. If a woman has gone through several miscarriages before this pregnancy, she will need special care and attention, as she will be under great stress, unlike a first-time mom, or one who already has four children.

Knowledge is power

I believe that knowledge can provide us the power to overcome anything, therefore I am keen to educate and provide women with the knowledge they need during labor. I tell the expecting mother all the details on different stages of labor, and what to expect during each one of them. I also make her aware of the available pain management options, like the epidural, and I tell her about all its side effects. I explain to her the role of the monitors she has on her belly and how we use them to monitor the baby through the delivery process. I tell her what are the normal as well as the worrying readings that might require a c-section. I walk the woman through the pushing stage and tell her how to push properly, especially if she is under the epidural which would require more guidance. As a Midwife, I am present next to the mother to ease her delivery and help her avoid any vaginal tearing.

Postnatal care

The Midwife is there when the baby comes out, she will put the baby in the mother’s arms so that they both benefit from the golden minute, which is the few moments after birth when the baby receives the skin-to-skin contact that eases breastfeeding. Midwives are there beside the woman at every stage to help, guide, and ease the transition to the next stage.

Breastfeeding

It has been proven that skin-to-skin contact immediately after birth, eases latching, which makes breastfeeding a lot easier. This is why it is imperative that the Midwife is there to advise the new mom and to help her during the first few hours post-birth. The Midwife will assist the mother with breastfeeding so that she benefits as well as her baby from this great gift. Studies have shown that breastfeeding reduces the chances of postpartum bleeding and postpartum depression.

Mental health

My role as a Midwife is not to only provide medical care, I also to provide awareness and education about women’s mental health. I support women trying to conceive, by providing information about this stage. In particular, I raise women’s awareness about stress and its role in delaying pregnancy sometimes.

Pressure and anxiety can be reasons for the severity of pregnancy symptoms. During pregnancy, a woman would need a companion to share her feelings with, to ease the stress and the annoying symptoms.

Postpartum, Midwives play a great educational role in mental health. I talk to my patients about postpartum depression, its symptoms and causes, and the support she needs to overcome it. Postpartum depression, or baby blues which is a less severe condition, happens due to the sudden change in hormones, due to the void the mother feels in her belly that has been filled with her baby for nine months, and due to many other reasons. My role is also to detect any signs of possible depression, educate the mother about this condition and refer her to a specialist if needed. I also help the mother connect and bond with her newborn, in addition to helping her overcome any breastfeeding issues and make this experience as stress-free as possible.

Babycare

In some countries, Midwives are allowed to do home visits after the mom and the baby leave the hospital. These visits aim to help the mom with breastfeeding, baby bathing, and other baby care aspects where she might require assistance.

Share awareness about contraception

A Midwife can provide advice about different contraceptive methods. In addition to educating mothers on the importance of taking time between one pregnancy and the next, until she fully recovers. This role is different depending on the permissions given to midwives by the health authority in each country.

Menopause

Women face many unprecedented symptoms during menopause; therefore, they will need the support and guidance of a midwife. We offer advice on how to control the symptoms and the uncomfortable hot flashes, in addition to performing routine breast exams to check for breast cancer, and Pap smears to check for cervical cancer, and refer to specialists if needed.

Differences between a Midwife and an OBGYN

I must remind you that a Midwife’s role during pregnancy and labor is possible only with low-risk pregnancies, and complications-free deliveries. Midwives can not be primary care providers in the following cases:

- If the pregnant woman suffers from gestational diabetes, gestational hypertension, or pre-eclampsia.

- If a lady gives birth naturally after previously having a c-section.

- If the baby is in a breech or transverse position (although in some countries midwives are allowed to reposition the baby).

In all these cases as well as in many other critical cases, the OBGYN must be present, to oversee the case and intervene when needed. But these severe cases do not exclude the midwife, she still can assist by supporting and guiding throughout the pregnancy and birth, under the supervision of a specialist doctor.

Another difference between midwives and doctors is the nature of the midwife’s work allows her more time to be beside the woman throughout her labor, while the doctor must oversee several patients, and perform many surgeries, so she can be there only during fragments of time. So, when an expecting mother chooses a stress-free delivery method such as water birth, hypnobirthing, or even uses a birthing ball, it is the midwife who is next to her during this whole experience.

The main characteristic of a Midwife

Passion and compassion are essential characteristics of midwives. A midwife spends a lot more time with a pregnant woman and a woman giving birth. So she builds a strong bond with her, this bond is essential to a woman during her motherhood journey, which makes the midwife the faithful companion in this journey.