Midwifery

Principles and Historical Development

Transcript

• Siddiqua Hussaini is here on a life-saving mission. The young midwife is checking up on Sabra[?] and her baby girl whom she helped deliver.
• simple advice but still desperately needed. In Afghanistan’s remote Bamiyan province, maternal and child mortality are amongst the highest in the world. Cut-off by the rugged terrain, pregnant women have almost no access to clinics or health workers.
• I used to think that I would die or the baby would die; that I wouldn’t be able to give birth, I would bleed too much.
• Every family in this province has lost women and babies during childbirth. Siddiqua herself could only watch as her aunt’s child died a few years ago.
• When the baby was being born I didn’t know what to do because I wasn’t trained as a midwife. The umbilical cord was wrapped round the baby’s neck; it only lived for two, three minutes.
• It was at this moment that she decided to enroll in an 18-month midwifery training program funded by the US government. Here at the provincial hospital, students are taught how to treat birthing complications and post-natal bleeding, the leading causes of death. The aim is to send them back to their own villages to support pregnant women, who far too often only have their relatives to help them deliver.
• Women are helping each other but this is also not safe because they don’t have this knowledge; they don’t have enough practice. They don’t know.
• Almost 600 women like Siddiqua have graduated as midwives since 2006. The impact they’ve had is believed to be enormous. A current study on infant and maternal mortality is expected to show a sharp decline in deaths – a small ray of hope for women in Afghanistan.

Midwifery care is founded on the principles of women-centeredness, acknowledging and supporting [Page 952]natural maternal processes, intervening only when necessary, and advocating for women and their families. Midwifery philosophy includes a valuing of the mind/body connection and “women's ways of knowing,” including birthing women's ability to attune to the rhythm of childbirth and knowing what they need better than anyone else. Midwives view birth as a normal physiological process, not a medical event.

In the modern Western culture, midwives have fought to gain primary care provider status; the ability to deliver babies where the mother wishes, be that home or hospital setting; and to offer care, control, and choice to women. In North America, aboriginal midwives have reclaimed their ability to provide culturally safe and community-centered maternity care that is informed by elders and guided by aboriginal protocols.

Egyptian papyrus records dated as early as 1900 B.C.E. depict midwives engaged in delivering babies and caring for mothers during pregnancy. Midwifery is an ancient practice that offers contemporary women a shift from modern medicine and technology that often regards pregnancy as an illness to be treated medically, and the birthing process as a surgical procedure. Having a baby is an important social event in human life. Midwives focus on the birthing mother, her desires and designs for the actual birth, as well as making space for the mother's social community.

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