Saturday, November 17, 2007

CfM Vision + Ideals vs. Reality

CfM has a Vision: The Midwives Model of Care is universally recognized as the optimal kind of care for pregnancy and birth, and is available to all childbearing women and their families. To achieve this vision, CfM promotes the Midwives Model of Care by providing public education about midwifery, the Midwives Model of Care and related childbirth issues, and by encouraging and supporting effective grassroots action.

The World Health Organization (WHO) and the Coalition for Improving Maternity Services (CIMS) both recognize midwives as the appropriate birth attendant for normal births. WHO recommends out-of-hospital birth as preferred and CIMS recommends the location for birth that is preferred by the mother. Based on 2004 data, the ideal is much different than the reality for most women in the United States where less than 8% of births are attended by midwives and 99% of births take place in hospitals. WHO and CIMS also recommend that electronic fetal monitoring (EFM) *not* be used routinely, though when last accounted for 85% of women experienced EFM during their labors. The organizations also recommends against the routine use of pain relief medications during labor and 80% of women in the US used pain medications in labor. The suggested induction rate is 10% or less when in reality it is at least twice that percentage (48% according to the 2005 Listening to Mothers II report). The WHO states that the systematic use of episiotomy is not justified, but the US women still have a 23% chance of having one. Finally, the cesarean rate recommended by the WHO and suggested by CIMS is 10-15%, where is has reached 32% in the United States as a whole (and is much higher in some areas and hospitals).

Many women feel their experiences and the interventions involved with their births were unique to them, when they actually experienced what Naomi Wolf terms a "stereotypical bad birth."

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