Midwifery versus Medical Model of Care 1
Midwifery Model of Care versus Medical Model of Care
Ashley Musil
Module I, Introduction to Midwifery
November 4, 2011
Midwifery Model of Care versus Medical Model of Care
In order to compare two concepts, one must first define each concept as accurately as possible. In this case, the two concepts are the Midwifery Model of Care and the Medical Model of Care.Citizens for Midwifery (CfM) defines “The Midwives Model of Care” as follows:
The Midwives Model of Care is based on the fact that pregnancy and birth are normal life processes. The Midwives Model of Care includes:
- Monitoring the physical, psychological, and social well-being of the mother through the childbearing cycle.
- Providing the mother with individualized education, counseling, and prenatal care, continuous hands-on assistance during labor and delivery, and postpartum support.
- Minimizing technological interventions.
- Identifying and referring women who require obstetrical attention.
CfM also states that “the application of this woman-centered model of care has been proven to reduce the incidence of birth injury, trauma, and cesarean section” (emphasis mine). According to the CfM website, this definition was developed through collaborationbetween the Midwives Alliance of North America (MANA), the North American Registry of Midwives (NARM), the Midwifery Education Accreditation Council (MEAC) and Citizens for Midwifery.
In contrast, the Medical Model of Care considers childbirth as a potentially pathological process. According to Our Bodies,Ourselves, “a strict medical model of care focuses on preventing, diagnosing, and treating the complications that can occur during pregnancy, labor, and birth.” It goes on to say,“Training in the medical model does not typically focus on developing skills to support the natural progression of an uncomplicated birth. In addition, under the medical model, care generally follows a certain routine.” (Pregnancy & Birth: Models of Maternity Care). This routine-based care reduces individualized care, creating a sort of assembly line atmosphere. The medical model sees the woman as a patient who needs a doctor, although the doctor does not adequately share information about health, disease and degree of risk with the patient. A practitioner of the medical model of care is trained to focus on the medical aspects of birth, offers little emotional support, uses medical language, ignores spiritual aspects of birth, and values technology. In addition, there is often a class distinction between care provider and patient, creating a dominant-subordinate relationship.
Although there is great contrast between the midwifery model and medical model of care, they are complementary models. They adhere to different philosophies, with overlapping purposes and bodies of knowledge. Physicians who practice the medical model of care are experts in pathology. They should have primary care for women who have recognized disease or serious complications. Practitioners who follow the midwifery model of care, however, are experts in normal pregnancy and birth and in meeting the other needs of pregnant women – needs that are unrelated to pathology. They view birth as a normal, albeit life-changing event. As such, they offer support, protection, and enhancement of the normal physiology of labor, delivery, and breastfeeding.
It is fortunate that birth technology has made such advancements in the past century, as physicians have been able to save countless lives. Women who were previously unable to bear children are now able to through the use of technology. Although most pregnancies would proceed healthfully without any medical intervention, serious complications and diseases can still arise and are potentially fatal to the woman or her fetus. The downside to this technology is that practitioners have narrowed the range of what is considered “normal” in pregnancy. They point to slight deviations from normal as solid reasons for medical intervention, turning a normal pregnancy or birth into a pathological problem which quickly becomes a snowball of medical interference.
Birth is still a natural process that must be protected when there are no apparent contraindications to normal birth. The spiritual, emotional, and psychological effects of birth are far reaching. Their impact on a woman’s ability to bond with her child, her success in breastfeeding, and her confidence in parenting often last a lifetime. Women who are pushed aside - discouraged from being an active participant in their own healthcare - often feel abused, neglected, and self-conscious. On the contrary, women who are encouraged to take responsibility for their own health and the health of their unborn child feel empowered by the experience of pregnancy and childbirth. They become confident in their own abilities and learn to trust their instincts. The impact of a normal, intimate birth can give a woman the positive thrust she needs to chart the unknown territory of parenthood with confidence. It can also strengthen the bond between the woman and her partner as they enter a new phase of their lives together.
This author has experienced firsthand both the medical model of care and the midwifery model of care. Though each birth was assisted by a midwife, they clearly did not practice the same model of care. One was over-medicalized, induced for unclear reasons, and interfered with at every turn. Though the mother and baby were healthy, the experience was traumatizing for both. The next two births, also attended by midwives, were empowering experiences, with practitioners who trusted the mother’s instincts and self-assessments. It was a delicate dance in which the mother took the lead and her attendants provided the support she needed as labor took its natural course. Although the “medical” outcome was the same for each birth – healthy mother, healthy baby – the spiritual and emotional impact varied greatly.
The goal of the midwifery model of care is to provide support and education to help a family make an important transition, while the goal of the medical model of care is to save the lives of babies and their mothers. Normal, low-risk pregnancies should always be attended by a practitioner of the midwifery model of care to obtain the best possible outcome. Truly high-risk pregnancies are best left to physicians of the medical model of care, who can provide the interventions and technology necessary to save lives. In a perfect world, these two models would work together to ensure each and every mother receives the best possible care for her individual situation. Perhaps someday that goal will be realized as women become more and more insistent on receiving the best care available.
Reference List
Midwife model vs. medical model of care. Morning Star Women’s Health and Birth Center. Retrieved from
Midwife-led versus other models of care for childbearing women.The Cochrane Collaboration. Retrieved from
Pregnancy & birth: The midwifery model of care. Our Bodies, Ourselves. Retrieved from
Pregnancy & birth: Models of Maternity Care. Our Bodies, Ourselves. Retrieved from
The midwives model of care. Citizens for Midwifery. Retrieved from