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Considering Midwives

Congratulations, you're pregnant! Let the decision-making begin. Choosing a health care provider to care for you and your baby during your pregnancy is one of the biggest decisions you'll make.

In the United States, women's choices have traditionally been limited to an obstetrician or a knowledgeable family doctor. But for some women with low-risk, uncomplicated pregnancies, midwives offer an excellent alternative.

In Europe, midwives assist at more than 70% of normal vaginal births. Though midwives delivered only 7% of American babies in 1997, that percentage has been increasing since 1975. But most Americans aren't sure what they do, how they're trained, or if they're even available. Is a midwife a viable option for you?

The History of Midwives
The word "midwife" comes from Old English and means "with woman." Midwives have helped women deliver babies since the beginning of history. References to midwives are found in ancient Hindu records, in Greek and Roman manuscripts, and even in the Bible.

As early as 1560, Parisian midwives had to pass a licensing examination and abide by regulations to practice. Not all midwives had this level of education, however. English midwives received little formal training and weren't licensed until 1902. America inherited the English model of midwifery.

Early American midwives usually learned their craft through apprenticeship and tradition. They remained ignorant of scientific advances in fighting infection through hygiene and drugs such as penicillin. By the early 20th century, women and their babies were more likely to die under the care of midwives than under the care of doctors.

Around this time, American medical doctors began a campaign against midwifery in the press, the courts, and Congress. They cited the poor outcomes for mothers and babies under the care of midwives. Today's research into the first few decades of the 20th century suggests that doctors may also have wanted a greater market share of the maternity business and, therefore, didn't welcome competition from midwives.

Whatever the doctors' motivations, the rate of midwife-attended births dropped during and after the campaign. But the widespread criticism from the medical establishment prompted the foundation of the first certified American nurse-midwifery school in 1933. It aimed to incorporate the necessary medical training into midwifery's traditional approach to pregnancy and labor.
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