all midwives should be nurses first

Midwives Vis-à-Vis Nurses

MIDWIVES VIS-À-VIS NURSES

Name:

Grade Course:

Tutor’s Name:

(10, August, 2010)



Introduction

A midwife is a trained proficient which has unique expertise of offering support to

pregnant women to maintain a health measures, counselling, prenatal education, offering

personal care expertise and generally assisting the mother throughout her pregnancy and after

with the childbearing cycle as echoed by Abernathy and Donna (1989). The midwife assists the

mother and her newborn to identify the uniqueness of their physical, emotional and social

requirements. However, in cases where the case becomes out of bound of the midwife expertise

capability, then the mother is referred to a specialized health care provider for further diagnosis

and care (Courter, 1992; Edwards & Waldorf, 1984). This assignment shall outline the fact

outlaid by the debate should midwives be nurses first or should they just be midwives without

first being nurses (Hart Et al, 2001; Gordon, 2001).

History of midwifery

Traditionally these were the only qualified personnel who would oversee child delivery

and offer prenatal care and counselling, they only comprised of elderly ladies who had expertise

in handling this procedures (Albers & Vern, 1993; Gillow, 2001). According to Bergen and

Garvey (1994) this tradition was passed on from generation to generation, and only certain

family who had perfected this profession was allowed to practice within the society. The history

of midwifery in Australia dates back to 1801, but the recorded literary articulate that this practice

was recognized and accepted after Callaghan, Emma Jane (1884-1979), who was an aboriginal

nurse and midwife was imprisoned and later released from allegation of witchcraft. She was the

first ever recorded midwife in Australia. This practice was then formalized in education in the

year 1866 after doctor Thomas discovered there were midwifery examiners in Royal college of

2


Surgeon in England and carried this work to Australia. He offered his services of midwifery and

also taught other this art. Presently majority of the university offers three year bachelor of

midwifery and this was initiated in the year 2002 by five universities in two states. This was the

auspice of Australian College of midwives (ACMI) and from this juncture was renamed National

education Standard Taskforce (ANEST) (Edwards & Waldorf, 1984; Varney, 1987).

Types of midwives

Generally there are two types of midwives, nurse-midwives this are the ones who have

special training on health care provision in both sector of nursing and midwifery, and direct entry

midwives, this are also trained to be midwives but are not as qualified nurses (Durand, 1992).

Lefeber-Mans and Yvonne (1994) articulates that the most credited midwife is a Certified

Professional Midwife (CPM) this are trained professional who offer midwifery services and they

undergo training of nursing of three years.

Direct-Entry Midwives (including Licensed Midwives)

Direct Entry Midwives: this are midwifes that have initiated in the midwifery profession

as an apprentice in the field of midwife without attending any formal learning concerning this

profession (Youngkin & Davis, 1995).

Direct entry midwifery education has been notched up in Australia and is escalating to

the tertiary (university) level in majority of the states. Usually this course is offered for one year

in the hospital; however the new initiative requires at least a university outreach program which

offers some courses in direct entry midwifery. Most of the university which offers these

programs offers a package of graduate diploma which duration is one to two years (Kitzinger,

1991; WHO, 1990).

3


Advantages of direct entry midwives

Offer solace to the mother

Allows the mother to make most of the decisive decision through counselling

Usually lessen the chances of infection in cases of home birth

Allows mother to be with her family even the delivery period

Minimizes the cases of infant mortality

Minimizes the cases of premature birth

Offer services at low prices

Lessens chances of caesarean section delivery (Dean & Mountford, 1990; Ulrich, 1993)

Disadvantages of direct entry midwives

Lack of expertise in time of complication

Usually increase infection to the baby after birth

Not equipped to handle an emergency be it high risk or low risk deliveries

Direct entry midwives cannot administer prescriptions in the cases of infections or labor

pains (Renfrew and Neilson, 1995).

Certified Nurse Midwives (CNMs) /(CPM)

Nurse Midwife this are midwives who have undergone the formal training of nursing and

midwifery in Australia they are certified by the Australian College of Midwives (ACMI) located

in Melbourne Victoria, they also license on behalf of the Nurses Registration Boards. Bachelors

Degree is mandatory at the end of the training period (Edwards & Waldorf, 1984; Gillow, 2001).

Nurse midwives education is required to have three years of nursing course in university

education; this is usually a degree course which encompasses all aspects of nursing and health.

After graduation the nurse midwives can practice in different division concerned with prenatal

4


care delivery like the postnatal areas, midwifery units and NICU (Bergen & Garvey, 1994;

Varney, 1987).

Advantages of Nurse Midwives

Nurse midwives have competencies in lessening infant and maternal mortality

Nurse midwives usually lessens the chances low birth weight rates

Nurse midwives prenatal care is of higher quality equivalent to that of care provided by

doctors

Nurse midwives are more adept than direct entry midwives when providing prenatal care

as they converse with the mother for latest development and preventive actions (Dean &

Mountford, 1990).

The quality of care offered by nurse midwives is equivalent to doctor’s care within their

line of competence (Holloway & Wheeler, 2002).

They don not have to answer to anyone directly

Disadvantages of Nurses Midwives

Their prices are relatively higher than those of direct entry midwives

Not fully equipped to do operations or caesarean section delivery

Midwives usually have little time for themselves as they always engrossed in prenatal

caring and supporting the expectant mother (Bergen & Garvey, 1994)

Conclusion

Midwives and nurse midwives are two very distinct overlapping medical field of practice

which centralizes on provision of postpartum and prenatal care to an expectant mother and

5


delivery. Because of numerous complication that usually arises in the course child bearing cycle

there is need to have some formal nursing training to the midwives (Castro, 2000). Nurse

midwives have the capacity to facilitate any form of normalities that may arise during pregnancy.

Midwives without nursing education will have problem mitigating some complication that may

arise during pregnancies. However, it may also be necessary that if it not formal education then

they have close association with doctors (Conrad & Kern, 1996).

References

Abernathy, T., & Donna, M. (1989). Planned and Unplanned Home Births and Hospital Births.

Public Health Reports. 104, 4. 373-377.

Albers, L., & Vern, L. (1993). Birth Setting for Low-Risk Pregnancies, an Analysis of the

Current Literature. Journal of Nurse-Midwifery 36, 4. 215-220.

Bergen, D. & Garvey, J. (1994). Obstetric Myths Versus Research Realities. London: The

Feminist Press.

Burst, H. (1987). Women's Health: Pregnancy and Childbirth. Issues and Concerns of Healthy

Pregnant Women. Public Health Reports Supplement. 19. 57-61.

Castro, M. (2000). Homeopathy for Pregnancy, Birth, and Your Baby's First Year. New York:

St. Martin's Press.

Cochran, S. (2008). Home Birthing Discussion. Retrieved on August 10 2010 from

http://www.youtube.com/watch?v=Lv-7B43iPWg&feature=player_embedded

Conrad, P. & Kern, R. (1996). The Sociology of Health and Illness: Critical Perspectives. New

York: St. Martin's Press.

Courter, G. (1992). The Midwife's Advice. New York: Penguin.

6


Dean, J. & Mountford, B. (1990). Innovation in the assessment of nursing theory and its

evaluation: a team approach. Journal of Advanced Nursing. 28, 2. 409-418.

Durand, M. (1992). The Safety of Home Birth: The Farm Study. Journal of the American Public

Health Association. 82. 450-452.

Edwards, M., & Waldorf, M. (1984). Reclaiming Birth: History and Heroines of American

Childbirth Reform. New Jersey: The Crossing Press.

Gillow, K. (2001). Organizing the nursing workforce: a review of the literature. Toronto:

University of Toronto.

Gordon, L. (2001). Woman's Body, Woman's Right: A Social History of Birth Control in

America. New York: Grossman.

Hart, A., Lockey, R., Henwood, F. & Sommerville, F. (2001). Evaluation of the effectiveness of

midwifery education in preparing midwives to meet the needs of women from

disadvantaged groups. London: Palgrave.

Holloway, I. & Wheeler, S. (2002). Qualitative research in nursing. Oxford: Blackwell

publishing.

Kitzinger, S. (1991). The Midwife Challenge Pandora. Journal of Social Research. 39. 652-78.

Lefeber-Mans, B. & Yvonne H. (1994). Midwives without Training: Practices, and beliefs of

traditional birth attendants in Africa, Asia and Latin America. Netherland: Van Gorcum

& Comp.

Renfrew, M. & Neilson, J. (1995). A Guide to Effective Care in Pregnancy and Childbirth.

Oxford: Oxford University Press.

Ulrich, L. (1993). A Midwife's Tales. New York: Vintage Books.

Varney, H. (1987). Nurse Midwifery. Oxford: Blackwell Scientific Publications.

7


World Health Organization. (1999). Standards for midwifery practice for safe motherhood.

Delhi: Regional Publication.

Youngkin, M. & Davis, T. (1995). Woman's Health, a Primary Care Guide. Connecticut:

Appleton and Lange Press.

8

all midwives should be nurses first

Healthcare