I am a direct-entry midwife practising in England. I cannot understand the attitude of those in the U.S. who have decreed it a felony to be one! I presume there are many OBGYN doctors who do not want to lose the financial benefit.
Here in England direct-entry midwives are beginning to outnumber those who have trained as nurses. After 3 (or sometimes 4) years of training we gain either a diploma or degree status depending on the course chosen at university.
Following qualification I have now been in practice in a large teaching hospital for 18 months. I look after women during normal labour and delivery and providing things are proceeding well, also am the sole person attending the delivery. Only if things do not go according to plan do I need to ask the assistance of the medical team. Even then I could still be the only person at the delivery if there is no need for instrumental or c-section birth. Similarly I will work with the docs when caring for women with problems. If the birth itself is predicted to proceed to a normal vaginal delivery I will be the person there.
There are other aspects to my job where I also practice autonomously, but that is the situation as far as delivery in hospital is concerned.
The powers that be in the U.S. could do well to look at the practice of midwifery in other countries; they will see that despite some problems it works well to the benefit of women. However, until the U.S. healthcare system is no longer dominated by men and money, I think it will be a long struggle for the midwives there to change things. You all have my wholehearted support and best wishes.
-Coreen
Reprinted from Midwifery Today E-News (Vol 2 Issue 5, Feb 4, 2000)
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