What is a Midwife?
The first topic to explore is the meaning of the word “midwife.” What does it mean to be called to midwifery?
We could take the internationally accepted definition from the International Confederation of Midwives:
A midwife is a person who, having been regularly admitted to a midwifery educationalprogramme, duly recognised in the country in which it is located, has successfullycompleted the prescribed course of studies in midwifery and has acquired the requisitequalifications to be registered and/or legally licensed to practise midwifery.The midwife is recognised as a responsible and accountable professional who works inpartnership with women to give the necessary support, care and advice during pregnancy,labour and the postpartum period, to conduct births on the midwife’s own responsibility andto provide care for the newborn and the infant. This care includes preventative measures,the promotion of normal birth, the detection of complications in mother and child, theaccessing of medical care or other appropriate assistance and the carrying out ofemergency measures.The midwife has an important task in health counselling and education, not only for thewoman, but also within the family and the community. This work should involve antenataleducation and preparation for parenthood and may extend to women’s health, sexual orreproductive health and child care.A midwife may practise in any setting including the home, community, hospitals, clinics orhealth units.
This is a very thorough definition that includes all the things a midwife may do, but I am not sure any midwife actually does all the tasks listed.
Logistically speaking, creating a universal definition is a tricky thing. What if midwives in one country are given more responsibility than midwives in another? Or what if the roles are simply different? Did you pick out the requirement that the midwife complete a program that is recognized in the country in which it is located? I am sure this was an important factor because the definition could not negate any laws that require specific training for midwives. But this does leave us with some issues. For example, what if the program of study completed by a midwife is not recognized by another country when she crosses borders?
This gets even tricker here in the United States where I live because each state has it’s own Midwifery Practice Act. This means a person who is legally able to practice as a midwife in one state may not be considered qualified to practice in another. Sometimes it is not a question of training, but instead a difference in scope of practice. What does that mean? Well, all states allow Certified Nurse Midwives (CNMs) to practice. But not all states allow the CNM to practice independently for example, in some places she must have a written practice agreement with a physician.
What this means to you
So here you are, hoping to someday become a midwife and not really knowing where to start. One place to start is to determine what laws regulate midwifery where you live. This will help you understand what type of training you will need, and in what capacity you will be able to serve families when you officially offer services as a midwife. Citizens for Midwifery keeps a great listing of the current laws for the United States. For other countries check with your midwifery council to learn about laws. Some links are available within their respective countries in the Natural Childbirth Directory.
Once you know about the laws where you live you need to consider how your ability to practice will be affected if you move to another state or want to do midwifery in another country. Every circumstance is different, only you know what your future is likely to hold for you and the probability that international midwifery is your calling.