A midwife is a healthcare provider who has specialized training in obstetrics. Some midwives have their own practice, but most work within a hospital or doctor’s office. In order to become a midwife he or she can either go through an apprenticeship or through a community-based program that does not involve nursing. A certified nurse midwife, however, are registered nurses with midwife training and certification.
There are many OBGYNs who have at least one midwife in their practice in order to care for more pregnant mothers and manage more deliveries. It can be a surprise to many patients when they go into labor and instead of the doctor, a midwife appears. This could be a part of the expectant mother’s delivery plan, however most expect the OBGYN to be present.
The duties of a midwife depends on the practice and can include:
- Disease prevention,
- Oversight of general care for mothers before and after they have given birth,
- Family planning,
- Gynecological examinations,
- Prenatal care, and
- Providing support during labor and delivery.
A midwife should generally not provide principal care for complicated deliveries. This is because of the increased risk of injury to the baby, and potential for medical malpractice. Complications include cephalohematoma from a labor complication, Erb’s palsy, or cerebral palsy due to prolonged hypoxia. If there is fetal distress the knowledge and experience of the OBGYN could be necessary to avoid permanent injury to the baby.
Midwife malpractice often results from:
- Patient criteria – it is important that midwives screen their patients carefully because not all women are candidates for home births or to be assisted by a midwife during labor. These woman may be considered to have a high risk pregnancy and may need a doctor during delivery.
- Informed consent – it is necessary for the midwife to disclose significant risks of a midwife assisted delivery clearly and openly.
- Negligent credentials – there are midwives who do not meet the minimum standards or licensing requirements of the state where they practice.
- Failing to properly assess the condition of the baby – a midwife may ignore the warning signs during pregnancy or delivery in order to provide a mother and child with a natural birth.
- Midwives may also fail to have adequate policies or procedures in place regarding cases where an emergency delivery is needed.
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