Is the Midwifery Model of Care Right For Your Facility?
The midwifery model of care (MMoC) is a person-centered approach to women’s health, pregnancy, childbirth, and postnatal care provision. In hospital settings, midwives focus on empowering and supporting women through the natural birthing process. While they seek to protect healthy processes by reducing unnecessary interventions, they also collaborate with OB/GYN providers, especially if complications arise.
The midwifery model is gaining momentum in hospital settings as a response to patient requests for alternatives to the medical model of care for childbirth. A growing number of hospitals are transitioning to midwifery models of care by integrating the philosophy into existing clinical pathways. This shift is supported by the World Health Organization (WHO) and other healthcare authorities.
Because of this trend, you may be wondering if it’s right for your facility. In this guide, we’ll take a closer look at the approach and how it can be used alongside standard medical care. We’ll also discuss its advantages and disadvantages. Though the MMoC has many research-backed benefits, it’s not the right primary model to use in all scenarios.
What Is the Midwifery Model of Care? Definition and Overview
Midwife-led care refers to an approach to women’s health that is individualized, empowering and supportive. Within this model, birth is viewed as a natural life event. Care tends to be holistic in nature, with an emphasis on allowing the patient to make informed choices about their care.
The History of Midwife-Led Care
Midwifery has a long history that dates back to ancient times. Midwives were informally trained through experience and apprenticeship. In the 1800s, the medical model grew more prominent. Physicians trained in obstetrics distanced themselves from midwives and warned patients against midwife-assisted births.
Despite the popularity of the medical model, the first nurse-midwifery agency was founded in Kentucky In the early 1900s. In 1929 the American Association of Nurse-Midwives was formed. The feminist movement in the 1970s added to the momentum, supporting alternative birthing options within the healthcare system.
More recently, rising maternal health disparities have prompted investigations into possible ways to improve health outcomes for women and children. Both national and international healthcare policy initiatives advocate for more integration of midwife-led care in women’s health.
Midwifery Model of Care vs Medical Model of Care
In broad strokes, there are some fundamental differences between these two philosophies in the context of labor and delivery. Here’s a breakdown of the major distinctions.
| Emphasizes that pregnancy is not a disease, and encourages trust in the physiological process of labor | May treat the labor as a process that can be improved upon through intervention (i.e. by induction or acceleration of labor) |
| Promotes minimal-intervention care plans and the use of intervention only when necessary | Integrates interventions (such as surgery) as needed |
| Providers are trained to observe and support the birth process (“watchful expectancy“) | Providers are trained to engage in active management of the birth process |
| Therapies include positioning, emotional support, and providing information | Therapies include administration of medications, using technology to monitor physiological markers, and surgery |
Advantages of the Midwifery Led Model of Care
Research shows that midwife-led care models are associated with the following outcomes, in comparison to other care models:
- Higher rates of spontaneous vaginal birth
- Higher rates of births without analgesia/anesthesia
- Longer average duration of labor
- Reduced episiotomy rates
- Reduced rates of pre-term birth (less than 37 weeks)
- Reduced rates of fetal loss and neonatal death
- A more positive experience for women who are giving birth
Disadvantages of the Midwifery Led Model of Care
The MMoC has limitations, which is why it is often offered alongside the medical model of care. In midwifery-led practice areas, for example, steps may be taken to ensure patients also have access to surgical services if certain complications arise. Here are some disadvantages to consider:
- Midwives are not trained to perform surgery. If surgery becomes necessary, care is transferred.
- Midwives specialize in low-risk pregnancies. The model is not ideal for women with complex medical conditions.
- The model is resource intensive. Due to the focus on therapeutic relationship-building and the provision of emotional support, midwives typically spend more time with their patients than doctors do.
Integration of Care Models
In modern healthcare facilities, midwifery and standard medical care are not in opposition. Many facilities offer a combination of approaches to parents. Certified nurse midwives and physicians can work together to strive for the best outcomes. The midwifery model integrates components of the medical model, and vice versa, and care providers collaborate to offer complimentary or synergistic services.
Is MMoC Right For Your Facility?
Whether this model will serve your facility or not depends on the resources available to you as well as your pain points and objectives. Integrating the model involves employing trained, qualified midwives (such as certified nurse midwives with advanced practice registered nurse licensure) who can spend ample time with patients before, during, and after childbirth, typically with 24/7 coverage. If poor maternal health outcomes are a pain point for your organization, integrating MMoC into current pathways may help you achieve your objectives.
Discover More Ways to Improve Patient Satisfaction
Through integration of the midwifery model of care, nursing leaders have provided patients with more options and the possibility of a better birthing experience. Looking for more ways to elevate patient care? Our streamlined healthcare resources highlight the ideas and innovations that will make your facility stand out.