10 Things That Midwives Should Do (And 10 Things Only A Doctor Should Do)

In the Western world, moms are lucky to have medical facilities that support them during pregnancy and childbirth. Some women feel reassured and comforted by a midwife and enjoy her support during the pregnancy, birth and afterward according to Midwife. Others feel more reassured by a doctor who has more technical knowledge and experience of how to manage high-risk situations.

Many women will see both types of professionals until and after the birth, and find that both midwives and doctors have experience and knowledge that can be beneficial. A midwife will be a valuable source of support once the baby is born, after which time she may not see the doctor again.

Midwives were traditionally other mothers who assisted in deliveries, and as they are often moms themselves, other moms feel empathy and a connection with them that makes them feel very secure. This is an important part of childbirth, as women who are emotionally supported tend to have a more relaxed experience.

Undeniably, both professionals offer their own source of expertise and offer different levels of service. There are, however, some things that midwives will do that the OG-GYN will not and vice versa. Doctors have trained long and hard for their professions, but midwives will have spent lots of time with pregnant and laboring women. Both can be invaluable to expectant and new moms.

20 Midwives Should: Spend Time Talking

A midwife is often a friend, a counsellor and a support network, as well as a professional. They have the time to spend and reassure women prenatally, during the birth and postnatally. Women don’t feel they are wasting a midwife’s time as much as with a doctor according to Web MD.

Midwives are often women, and many have had children themselves, so they have a level of empathy that a doctor might not have. This forms a commonality between midwife and patient that can be a very special bond. The midwife can be as much of a support emotionally to a mother as she can physically.

19 Doctors Should: Deliver Multiple Births

If you are expecting more than one baby, you will receive more monitoring during your pregnancy to ensure that both babies are thriving, and the mother is coping well. When it comes to delivery, if a V-birth is recommended, there will be more staff present at the birth than with a single baby.

For instance, you will have one nurse or midwife per baby and one doctor per baby, according to the NHS. There will be double the amount of fetal monitoring and more intense monitoring because there are more things that can go wrong with multiple births. There is also careful monitoring of the babies post delivery to ensure that both are healthy.

18 Midwives Should: Offer Advice About Nutrition

A midwife will offer much more of a holistic service than a doctor will. They will offer advice on lifestyle and answer questions that women may have about their pregnancy or the baby reveals NCBI. They will ask questions about what the mom is eating or drinking and gently suggest things.

A doctor might pass valuable advice and give a mom a leaflet, but they are trained in childbirth and complications and not really there for general lifestyle chit chat. A midwife will suggest more practical things that you can do as if from a friend as well as from a professional.

17 Doctors Should: Give an Epidural

To administer an epidural, a skilled anesthetist is required. It is a risky procedure that can, in some cases, cause permanent back pain or paralysis, so a qualified professional is the only person who should ever perform one.

An epidural is the injection of painkillers into the small of the back that numbs the lower half of the body, thus making labor pain free, according to American Pregnancy. You can only get an epidural performed if you are in an obstetrician-led maternity ward. It cannot be administered during a home birth or if the mom is having a water birth.

16 Midwives Should: Check Blood Pressure

A major part of prenatal screening is testing blood pressure. As women are likely to have many more routine midwife appointments than doctor appointments, the blood pressure will be taken at every visit. In fact, blood pressure will be checked at every prenatal appointment, regardless of the professional conducting it.

Raised blood pressure can be an early sign of preeclampsia, which, if it develops into eclampsia, can have a poor outcome for mother and baby, points out Practising Midwife. If blood pressure is monitored regularly, it gives professionals a good idea of how well the mother is and they can address any issues that might be arising.

15 Doctors Should: Diagnose Newborns

Once the baby is born, the doctor will conduct a number of checks on the baby to ensure that all is well. If the baby is very small, very cold or dealing with jaundice, the doctor can take action to help the baby thrive.

If there are more serious complications, and the baby needs special care, the pediatrician can liaise with the neonatal doctor and see what can be done to quickly improve the condition of the newborn. If the baby needs immediate surgery, the pediatrician may be the one to perform that, or at least assist. Whatever the complication, he can quickly diagnose and act suggests WHO.

14 Midwives Should: Check Unborn Baby’s Heartbeat

Once the pregnancy is advanced enough, the midwife will check the fetal heart rate at each appointment using a doppler. This will project a sound on a speaker that the mom to be can hear, thus reassuring her that the baby is alive and well.

The rate of fetal heart rate is important as it can indicate how well the baby is doing. The fetal heart rate will raise as the pregnancy advances and give the midwife an indication of how the fetus is faring. If the rate falls below 90 beats per minute, the fetus is likely to be unviable. During the first trimester, it rises to 110 and then up to 170 as the pregnancy progresses. The optimum level is between 110 to 160 bpm according to Livestrong.

13 Doctors Should: Use Forceps

A forceps delivery is necessary if the baby gets stuck during a prolonged labor and the doctor needs to get the baby out quickly. The device is inserted inside the cervix and goes either side of the baby’s head, so it can be pulled out as the uterus contracts.

It is a risky procedure, albeit routine, and a doctor needs to be trained to perform a forceps delivery. It requires a great deal of knowledge and precision to ensure a successful delivery. If all other options have been exhausted and a forceps delivery has not been successful, the doctor may make the call for a C-section according to Mayo Clinic.

12 Midwives Should: Attend A Natural V-Delivery

If you choose to have a home birth, a midwife will attend the delivery rather than a doctor, according to Easy Baby Life. Midwives are fully trained to deliver babies, and only need to involve a doctor if there are complications. Midwife-led births tend to be very successful for low-risk mothers.

Mothers report feeling very reassured and calm during a midwife-led birth, especially if it is the home birth that the mother wanted. The midwife may suggest walking, water and massage as ways of staying calm and coping with pain, and the feel-good hormones that this strategy induces can counteract the adrenaline that causes muscles to contract and hurt more.

11 Doctors Should: Perform C-Sections

A cesarean section is a major abdominal operation and a trained surgeon needs to perform it. He will be supported by a number of nursing staff, possibly including midwives and also an anesthetist reveals Tommys. Although it is a birth, it is also a surgical procedure and all precautions need to be taken.

Your cesarean might be an emergency operation, so skill needs to be employed to ensure a happy outcome for mother and baby. If it is planned, you may find that the experience is more tolerable, but it still involves opening up your abdomen and uterus and checking that pain relief is sufficient, so trained medical staff need to be involved.

10 Midwives Should: Keep the Mom Relaxed

As a rule, a midwife is more likely to talk to a mother in a natural, friendly way, joking and distracting the mother as labor progresses. She will keep her voice calm and provide a stable presence that many women find very helpful during labor advises RCM.

Maybe this is because the midwife is a woman and treats the mom as an equal, maybe it is because when there is only a midwife present, the mom knows that intervention is unlikely. Whatever the magic formula that midwives impart, they seem to have a knack from experience, of providing a relaxing atmosphere around the mom.

9 Doctors Should: Use A Ventouse

If labor is not progressing as it should, and the doctor decides that assistance is needed, he or she may opt for a vacuum suction or ventouse delivery points out RCOG. This involves a suction cup being attached to the top of the baby’s head so that the doctor can gently pull the baby out as the mother has a contraction.

It is very important to have expert knowledge before using a ventouse. It will only be used for three contractions before being abandoned, and a forceps or cesarean birth may be the only other options, especially if the baby is in distress.

8 Midwives Should: Try To Keep Discomfort Away As Naturally as Possible

Most midwives will advocate natural pain relief and try and use the body’s natural resources to offset labor pain. The midwife will know that if endorphins are released in the mom’s body, this is natural pain relief,  and if the mom panics and adrenaline is produced, then her body will feel more pain.

Midwives will encourage different positions, movement, water, and massage, as first ports of call, and then possibly move on to alternate methods, if the pain is not bearable or the labor prolonged. Midwives know the signs and stages of labor and report that women who struggle are often those who are very nervous/scared, or don’t have good emotional support, according to My Expert Midwife.

7 Doctors Should: Treat Certain Medical Conditions

If a woman is high-risk before or while she is pregnant, the doctor will take careful note of this and offer strategies on how to cope with pregnancy in the safest way. Moms may have diabetes, lupus or heart problems, and all of these can affect how she copes with the changes to her body that pregnancy brings about.

If the condition she has poses a risk to the baby, strategies can be suggested for managing the pregnancy and keep mom and baby healthy. Moms who have had multiple losses, for example, may seek guidance as to how to cope with pregnancy and mitigate risk according to UCSF Health.

6 Midwives Should: Encourage Movement During Labor

Midwives know how the body reacts to the trials of labor and that if a mom keeps moving, it is likely to move labor along more quickly and to encourage the baby to descend into the birth canal more readily than if she is lying flat.

There are even Active Birth Classes that moms can take before they face labor and this encourages yoga-type positions and rocking movements that ease pain and relax the mind, reports Home Birth. It will help the pelvis to open and facilitate the turning of the baby’s head that is necessary for labor. Of course, this will happen naturally whatever position the mom is in, but it will be quicker if she is moving.

5 Doctors Should: Deal with Certain Pregnancies and Births

A high-risk pregnancy does not necessarily mean that you will have a difficult pregnancy or birth, just that you need to be monitored closely during both to ensure that underlying conditions do not cause complications according to Kids Health.

OB-GYNs are specialized at knowing what to look for and how to keep the mom and baby safe during the pregnancy and throughout the delivery. They can advise on any changes that might need to be made in routine medication and how to keep yourself and the baby healthy during the pregnancy. A doctor can also advise parents who are predisposed to certain genetic defects and offer to counsel on screening and outcomes.

4 Midwives Should: Accompany Mom at Home Birth

Many moms favor a home birth, with comforts around her and without the sterility and bright lights of a hospital. In fact, most women go into labor at night and this is because it is the optimum condition for a baby to be born and a mom to relax reveals Midwifery Today. Having bright hospital lights can intimidate and startle the mom, and doesn’t make for the best environment.

A midwife will be there to reassure the mom and the rest of the family. She may let the mom labor on her own and leave her to it, but once she is called upon, she will be there with advice and support and deliver the baby into the world.

3 Doctors Should: Be Super Qualified

It takes years of training to qualify as a doctor according to Work.Chron. Firstly, they need to study to become a doctor at a recognized institution. After they have chosen their special field of interest, they have to complete a postgraduate residency to be eligible to take the American Board of Pediatrics Exam.

They have to pass the licensing tests for the state in which they intend to practice and once they have passed the exam, they are allowed to practice as a doctor. This whole process takes many years and a great deal of dedication. You can be assured that your doctor has trained well to be able to look after you.

2 Midwives Should: Support Prenatally, at Delivery and Postpartum

A midwife is trained in all elements of pregnancy and baby care. Therefore, she can advise and support mom and baby from the start of the pregnancy through the delivery and afterward suggests Baby Centre. She can advise on breastfeeding, recovery from labor and coping strategies for dealing with a newborn.

If you are lucky enough to see the same midwife throughout your pregnancy and afterward, she will have built up an idea of who you are and what you need. It is a supportive relationship that goes beyond patient and professional. The midwife has been with you for the most important time in your life and seen bits of you that even you haven’t seen!

1 Doctors Should: Treat Women with Medical Conditions During Delivery

If a mom-to-be is assessed as having a high-risk delivery, an OB-GYN will be on hand to support and possibly call on a neonatal specialist to attend as well. This may be the case with a very premature baby, or if a mom has preeclampsia or toxemia.

They will also be on hand if a mom has placenta previa, which means that the placenta is blocking the birth canal, or with a placental abruption, where part of the placenta has come away and the mom has a chance of bleeding, reveals Mama Natural. While a breech position is not a barrier to a V-delivery, an experienced doctor is usually on hand to assist with these births.

Sources: Yourchildbirthguide, Familyeducation, Fitpregnancy, Thenest, Livestrong