Midwives vs. Physician Care

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Introduction
The birth of a child is an event of both tremendous joy and stress. In this day and age, there are several options in regards to childbirth that include the before and after care of a newborn. But which method would provide future parents the greatest success in the delivery room? The two main options I will be discussing will be midwives or physicians. Many physicians agree that “"the safest setting for labour, delivery and the immediate post-partum period is in a hospital or a birthing center within a hospital."(Kluger, 2009). However, midwives seem to disagree by saying “home births attended by trained nurse-midwives are no less safe than hospital births...providing the midwives are affiliated with a nearby hospital to which the mothers can be brought in case of complications.”(Kluger, 2009). Although both methods are healthy, is seems as though women are more comfortable with midwives than doctors “a good midwife.....has to be caring and they need to give the patient emotional supports as well as physical support” (Reiger & Lane, 2009). Midwifery care, associated with low risk pregnancies, provides a comfortable and caring environment that is a personal experience for both the mother and the baby, as well as provides are more comfortable form of before and after care in comparison to physicians.

Annotations
Galotti, K.M., Pierce, B., Reimer, R.L., & Luckner, A.E. (2000). Midwife or doctor: A study of pregnant women making delivery decisions. Journal of Midwifery & Women’s Health, 45(4). This first study used pregnant women to find out their preference of either a midwife or doctor. They used eighty-eight pregnant women in the study and used interviews to ask them questions. The main questions targeted in the interviews were choice of prenatal genetic tests, choice of birth attendant, and choice of comfort/pain relief measure for delivery. The results of this test showed that women who considered a midwife were more likely to feel that they had a choice over delivery location, more confident about pregnancy choices, more knowledgeable about birth attendant, in more control over delivery decisions, in control and satisfied with pain medication decisions, and had more approval from spouse/significant others or friends. Overall, there was a more positive outcome from midwife deliveries. One negative of this article is that there is a possibility that the questions could have had a bias in favour of midwifery. When it comes to physician-assisted births, matters such as location of birth, and choice of birth attendant are handled within the hospital administration. Therefore, those that chose a midwife-assisted birth would naturally present themselves as having more choice and control over their child’s birth than physician assisted births. This study supports the fact that midwives produce a more positive and more personal birthing outcome compared to doctors. They take the time to make ensure the women is comfortable with her decisions and that she is making the right choices and feel that she has the options to do what applies to her preferences such as hospital location and pain medication use.

Janssen, P.A., Saxell, L., Page, L.A., Klein, M.C, Liston, R.M., & Lee, S.K. (2009). Outcomes of planned home birth with registered midwife versus planned hospital birth with midwife or physician. CMAJ, 181(6-7), 377-383. This study is focused on comparing the outcomes of home births with the attendance of a midwife to planned hospital births with the attendance of a midwife or a physician. Before the study began the researchers analyzed the groups to determine if there were any trends associated with certain types of women and types of birthing methods. The primary outcome measured was perinatal mortality. The secondary outcomes measured were obstetric interventions and adverse maternal and neonatal outcomes. It was noted that perinatal death per 1000 births was lowest during planned home births...
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