Janine Gard of Bellies to Babies discusses role of midwives

Midwives play an essential role in childbirth.

Janine Gard is a diploma qualified birth educator and founder of Bellies to Babies. She has taught more than 2900 parents to feel confident, informed, supported and prepared. This week she talks about midwives.

Four babies are born each second of every day. By the time you finish reading this sentence, eight babies will have been born. Now, just stop for a second and read that again. Eight babies will have been born somewhere in the world (well, maybe 12 now). Child birth is among the most common, constant and natural of human experiences - Yay!

Over the past 100 years, birth in much of the world has moved from the home to the healthcare system. This has had both positive and negative effects. On the one hand, the increase in births taking place with skilled attendants in health facilities has helped to significantly reduce maternal mortality. On the other, it has also led to the medicalisation of labour and delivery. Increasingly, health providers are treating labour and birth as a "medical event" and are often performing unnecessary interventions. This may lead to severe infections, haemorrhaging and organ damage.

So how do we continue to support people giving birth in health facilities, where providers are able to respond to potential complications, while also recognising that the vast majority of births are normal, non-medical events? Midwives, a vastly underutilised and often overworked (and underpaid, but don't get me started on that) segment of the health workforce, are an important part of the solution.

Midwives have supported people during labour and birth since ancient Egyptian times, and today, in many parts of the world, they are providing a unique set of lifesaving services for mothers and babies.

Midwives are trained with a focus on supporting natural births and thus are distinctively positioned to provide respectful, high-quality care that places women and newborns at the centre. Research has shown that women who have access to a midwife experience fewer preterm births, fewer interventions during labour and shorter hospital stays. Midwifery is also one of the earliest opportunities to invest in a child's wellbeing. International reviews have demonstrated that midwifery contributes to the short, medium and long-term outcomes of mothers and babies. The outcomes include long-term health benefits but also contribute to social and economic wellbeing.

Yet, there are major gaps in maternal and newborn health outcomes across the world. Annually, approximately 287,000 women die from preventable causes related to pregnancy and childbirth. Further, 2.7 million babies die every year in their first month of life and a similar number are stillborn. An estimated 56 per cent of these deaths could be prevented through strong partnerships with midwives.

In New Zealand, midwives work in partnership with the woman and her family, providing or supporting continuity of midwifery care throughout the woman's maternity experience. This partnership is based on a relationship of trust, shared decision making and responsibility, negotiation and shared understanding.

The word midwife means "with woman" and is reflective of the midwife's role in accompanying the woman on her journey through pregnancy and childbirth into motherhood. The midwife has a responsibility to share all the available information with the woman and to respect her values and beliefs. The midwife also acknowledges the woman's autonomy in her own life and respects the decisions she makes for her childbearing experience.

Being a midwife is a unique profession. While they work alongside other medical professionals like GPs and obstetricians, a midwife alone provides a very particular kind of care that these professionals don't. A midwife provides 24-hour on-call cover to every woman in her care throughout pregnancy, the birth and for six weeks beyond that - pretty amazing!

To understand their role a little clearer, there are several kinds of specialised demands, during the pregnancy, a midwife is responsible for including organising all scans and tests to check the baby's growth. A midwife also screens any pre-existing conditions or risk factors that might affect the labour and birth process. They then use this information, their knowledge and experience and include the woman and her family in all conversations to ensure that the birth will happen in the safest circumstances possible.

Then, when it comes to labour and birth, there's a bit more to it than hand holding and telling Mum to "push" when the time comes. This is where the "life or death" factor comes in. It's the midwife who has to know if other medical professionals are needed.

Also, you may have noticed that babies have a funny habit of entering the world at the most antisocial times. Midwives get called out at all hours of the day and night to be at the side of birthing mums. And, where some labours can stretch over days, others are a matter of hours. And their job doesn't stop there. Your midwife will provide you with the care that you and your baby need immediately after the birth and for four to six weeks after the baby is born, called the postnatal period.

Midwives will assess mum and baby's general wellbeing, answer any questions and address any concerns that may be present. They may also suggest other service providers or support organisations that are in the community.

Throughout the world midwives stand by women when they may be at their most vulnerable. They fight daily to defend a person's human right to go through pregnancy, labour and birth safely, even as they themselves often face discrimination and harassment. To celebrate the amazing job that our midwives do, we celebrate International Day of the Midwife. This has been observed globally on May 5 every year since 1992. This day is celebrated to recognise the work of midwives and raise awareness about the status of midwives for the essential care they provide to mothers and their newborn.

Welcome to all the new babies that were born during the time it took you to read this. Next time you see your midwife, or you have the opportunity to speak with one, remember to thank them for the amazing job they do.

■ Hawke's Bay Baby Massage Classes, Bellies to Babies Antenatal & Postnatal Classes

2087 Pakowhai Rd, Hawke's Bay, 022 637 0624, https://www.hbantenatal-classes.co.nz/postnatalclasses

Medical disclaimer: This page is for educational and informational purposes only and may not be construed as medical advice. The information is not intended to replace medical advice offered by physicians.