I interviewed yesterday by phone for an hour with Mike Flowers, nurse recruiter for the Tsehootsooi Medical Center. I learned from Mr. Flowers that not only are all tribal healthcare facilities moving towards Baby-Friendly designation, but they also have adopted the Midwifery Model of Care. 100% of native women are seen exclusively by nurse-midwives. CNMs practice with a great degree of autonomy in these facilities and are truly primary care providers. Obstetricians are brought in only for the rare cesarean section. TMC boasts a 6% c-section rate, whereas the national average is 34%!!! They are obviously doing something very right.
What is the Midwifery Model of Care?
The Journal of Nurse-Midwifery defines it this way:
The midwifery and medical models for the care of pregnant women are based on particular perspectives on pregnancy and birth. The approaches resulting from these perspectives are complementary and, as a result of midwives and physicians working together, there has been significant merging of the models. Instead of two mutually exclusive ways of managing birth, there is wide variation. Nevertheless, there are important differences between the two models, including differences in philosophy and focus, in the relationship between the care provider and the pregnant woman, in the main focus of prenatal care, in use of obstetric interventions and other aspects of care during labor, and in the goals and objectives of care. The midwifery model has advantages for many women because it avoids unnecessary interventions during labor, thus helping the process remain normal, and because it addresses needs that are often not adequately met by the medical management model.
J Nurse Midwifery 1999;44:370–4 © 1999 by the American College of Nurse-Midwives.
MARIE BERG is a senior lecturer in the Institute of Nursing, Faculty of Health Caring Sciences at Sahlgrenska Academy, Göteborg University, Sweden. She is also a senior lecturer at the Department of Obstetrics and Gynaecology, Sahlgrenska University Hospital, Göteborg, Sweden. She wrote an excellent article entitled, "A Midwifery Model of Care for Childbearing Women at High Risk: Genuine Caring in Caring for the Genuine" that can be found at the link below.
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1595225/
The organization Midwives of North American (MANA) defines it this way:
The Midwives Model of Care™ is based on the fact that pregnancy and birth are normal life events.
Definitions of common terms associated with the practice of midwifery:
J Nurse Midwifery 1999;44:370–4 © 1999 by the American College of Nurse-Midwives.
MARIE BERG is a senior lecturer in the Institute of Nursing, Faculty of Health Caring Sciences at Sahlgrenska Academy, Göteborg University, Sweden. She is also a senior lecturer at the Department of Obstetrics and Gynaecology, Sahlgrenska University Hospital, Göteborg, Sweden. She wrote an excellent article entitled, "A Midwifery Model of Care for Childbearing Women at High Risk: Genuine Caring in Caring for the Genuine" that can be found at the link below.
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1595225/
The organization Midwives of North American (MANA) defines it this way:
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 the mother throughout the childbearing cycle
- providing the mother 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 women who require obstetrical attention
The application of this model has been proven to reduce to incidence of birth injury, trauma, and cesarean section.
The Midwives Model of Care definition above is Copyright © 1996-2001, Midwifery Task Force, All Rights Reserved.
I feel very blessed that I will be working in a system that honors the traditional role of the midwife as the primary care provider for childbearing women. This is in keeping with a major precept amongst the Navajo, the Dine', that being líná ba chánáh hasin or, when translated, Honoring Life.
Definitions of common terms associated with the practice of midwifery:
 | American College of Nurse-Midwives (ACNM) | |
| | <><> American Midwifery Certification Board (AMCB), formerly ACC | |
| | <><> Certified Midwife (CM) | |
| <><> Certified Nurse-Midwife(CNM) | |
| | <><> Certified Professional Midwife (CPM) | |
| | <><> Citizens for Midwifery (CfM) | |
| | <><> Direct-Entry Midwife (DEM) | |
| | <><> International Confederation of Midwives (ICM) | |
| | <><> International Definition of a Midwife | |
| | <><> Lay Midwife | |
| | <><> Licensed Midwife (LM) | |
| | <><> Midwifery Education Accreditation Council (MEAC) | |
| | <><> Midwives Model of Care (TM) | |
| | <><> North American Registry of Midwives (NARM) | |
| | <><> Preceptor |