Midwifery: Care for the whole person
What is a midwife?
Midwives are the traditional care providers for mothers and infants. Midwives are trained professionals with expertise and skills in supporting women to maintain healthy pregnancies and have optimal births and recoveries during the postpartum period. Midwives provide women with individualized care uniquely suited to their physical, mental, emotional, spiritual and cultural needs. Midwifery is a woman-centered empowering model of maternity care that is utilized in all of the countries of the world with the best maternal and infant outcomes such as The Netherlands, United Kingdom and Canada.
**The language on this page has been drawn from official documents used by the Midwifery Alliance of North America and cannot be altered. AIMM recognizes that not every pregnant person is a woman or a mother, and promotes inclusion of all pregnant people of all genders. **
The Midwives Model of Care
The Midwives Model of Care™ is based on the fact that pregnancy and birth are normal life events. The Midwives Model of Care includes:
- Monitoring the physical, psychological and social well-being of a person throughout the childbearing cycle
- Providing a pregnant person with individualized education, counseling, and prenatal care, continuous hands-on assistance during labor and delivery, and postpartum support
- Minimizing technological interventions and;
- Identifying and referring people who require obstetrical attention
- The application of this model has been proven to reduce to incidence of birth injury, trauma, and cesarean section.
MANA Statement of Values & Ethics
Since what we value infuses and informs our ethical decisions and actions, the Midwives Alliance of North America affirms:
I. Woman As a Unique Individual:
A. We value each woman as a strong, creative, unique individual with life-giving powers.
B. We value each woman’s right to a supportive caregiver appropriate to her needs and respectful of her belief system.
C. We value a woman’s right to access resources in order to achieve health, happiness and personal growth according to her needs, perceptions and goals.
D. We value a woman as autonomous and competent to make decisions regarding all aspects of her life.
E. We value the empowerment of a woman during the processes of pregnancy, birth, breastfeeding, mother–infant attachment and parenting.
II. Mother and Baby as Whole:
A. We value the mother and her baby as an inseparable and interdependent whole and acknowledge that each woman and baby have parameters of well-being unique to themselves.
B. We value the physical, psychosocial and spiritual health, well-being and safety of every mother and baby.
C. We value the mother as the direct care provider for her unborn child.
D. We value the process of labor and birth as a rite of passage with mother and baby as equal participants.
E. We value the sentient and sensitive nature of the newborn and affirm every baby’s right to a caring and loving birth without separation from mother and family.
F. We value breastfeeding as the ideal way to nourish and nurture the newborn.
III. The Nature of Birth:
A. We value the essential mystery of birth.
B. We value pregnancy and birth as natural, physiologic and holistic processes that technology will never supplant.
C. We value the integrity of a woman’s body, the inherent rhythm of each woman’s labor and the right of each mother and baby to be supported in their efforts to achieve a natural, spontaneous vaginal birth.
D. We value birth as a personal, intimate, internal, sexual and social experience to be shared in the environment and with the attendants a woman chooses.
E. We value the right of a woman and her partner to determine the most healing course of action when difficult situations arise.
F. We value the art of letting go and acknowledge death and loss as possible outcomes of pregnancy and birth.
IV. The Art of Midwifery:
A. We value our right to practice the art of midwifery, an ancient vocation of women.
B. We value multiple routes of midwifery education and the essential importance of apprenticeship training.
C. We value the wisdom of midwifery, an expertise that incorporates theoretical and embodied knowledge, clinical skills, deep listening, intuitive judgment, spiritual awareness and personal experience.
D. We value the art of nurturing the inherent normalcy of pregnancy and birth as expressions of wellness in a healthy woman.
E. We value continuity of care throughout the childbearing year.
F. We value birth with a midwife in any setting that a woman chooses.
G. We value homebirth with a midwife as a wise and safe choice for healthy families.
H. We value caring for a woman to the best of our ability without prejudice with regards to age, race, ethnicity, religion, education, culture, sexual orientation, gender identification, physical abilities or socioeconomic background.
I. We value the art of empowering women, supporting each to birth unhindered and confident in her natural abilities.
J. We value the acquisition and use of skills that identify and guide a complicated pregnancy or birth to move toward greater well-being and be brought to the most healing conclusion possible.
K. We value standing up for what we believe in the face of social pressure and political oppression.
V. Woman as Mother:
A. We value a mother’s intuitive knowledge and innate ability to nurture herself, her unborn baby and her newborn baby.
B. We value the power and beauty of a woman’s body as it grows in pregnancy and a woman’s strength in labor and birth.
C. We value pregnancy and birth as processes that have lifelong impact on a woman’s self-esteem, her health, her ability to nurture and her personal growth.
D. We value the capacity of partners, family and community to support a woman in all aspects of pregnancy, birth and mothering and to provide a safe environment for mother and baby.
VI. The Nature of Relationship:
A. We value an egalitarian relationship between a woman and her midwife.
B. We value the quality, integrity and uniqueness of our interactions, which inform our choices and decisions.
C. We value mutual trust, honesty and respect.
D. We value a woman’s right to privacy, and we honor the confidentiality of all personal interactions and health records.
E. We value direct access to information that is readily understood by all.
F. We value personal responsibility and the right of a woman to make decisions regarding what she deems best for herself, her baby and her family, using both informed consent and informed refusal.
G. We value our relationship to a process that is larger than ourselves, recognizing that birth is something we can seek to learn from and to know, but cannot control.
H. We value humility and the recognition of our own limitations.
I. We value sharing information and understanding about birth experiences, skills and knowledge.
J. We value a supportive midwifery community as an essential place of learning.
K. We value diversity among midwives that broadens our collective resources and challenges us to work toward greater understanding.
L. We value collaboration between a midwife and other health-care practitioners as essential to providing a family with resources to make responsible and informed choices.
M. We value the right and responsibility of both a midwife and a woman to discontinue care when insurmountable obstacles develop that compromise communication, mutual trust or joint decision making.
N. We value the responsibility of a midwife to consult with other health-care practitioners when appropriate and refer or transfer care when necessary.
VII. Cultural Sensitivity, Competency and Humility
A. We value cultural sensitivity, competency and humility as critical skills for the midwife to master in an increasingly multicultural society.
B. We value cultural sensitivity—a midwife’s awareness of and ability to honor differences between people and the cultural values of the women she serves.
C. We value the importance of cultural competency in addressing the social and economic barriers to access to care for vulnerable, underserved and marginalized women, thereby improving maternal and infant health and the well-being of families.
D. We value cultural humility as a lifelong process of self-reflection and self-critique in order to develop a respectful partnership with each woman.*
*Section VII is derived from Melanie Tervalon and Jann Murray-Garcia, “Cultural Humility versus Cultural Competency: A Critical Distinction in Defining Physician Training Outcomes in Multicultural Education,” Journal of Health Care for the Poor and Underserved 9 (May 1998): 117–25.