What happened to the Midwifery Model of Care?

The Midwifery Model, compared to the Medical Model, focuses on the normalcy of pregnancy and birth while maintaining an ever watchful eye for evidence of problems. The Midwifery Model is client-centered rather than disease centered. The Midwifery Model results in better outcomes, lower costs, and increased client satisfaction. Who doesn’t want those outcomes increased? When you juxtapose that with the US rankings for maternal and neonatal death compared to other industrialized countries, outcomes that are associated with the general state of health for a nation, it begs the question even louder. What happened to the Midwifery Model?

Just the other day I was talking with a friend who is in CNM school and who also works as a doula. She was interviewing me for a paper she was writing and we started talking about the Midwifery Model of care and why it hasn’t seemed to have taken hold here in south Florida. I realized what a great question that is! The Midwifery Model of care for pregnancy and childbirth has been shown over and over again to be the best model in terms of outcomes for at least the last 20 years! However, very few, if any, hospitals and medical systems have embraced it. The question that begs to be answered is simply, “Why is this so?”

Hospital/Insurance/Pharmaceutical/Industrial Complex

I propose that the primary responsibility for the lack of enthusiasm for the Midwifery Model and the reason for stubbornly clinging to an archaic and sometimes cruel model of care lies in the hospital/insurance/pharmaceutical industrial complex. We have a for-profit mega industry driving the decisions that are made in healthcare. It’s bad enough when dealing with an actual disease such as cancer. Then it’s made infinitely more heinous because childbirth is mostly a physiological event that just needs to be supported to happen naturally and achieve the best outcomes.

The fear of birth, distrust of women’s bodies and babies ability to survive the birth process

The next biggest reason that we merely pay lip service to the Midwifery Model (at best, at worst we don’t have Midwives involved at all) is that most of the people involved in the institutions that provide childbirth services are scared to death of birth! Including the midwives! From the moment labor begins, until the baby is on the outside, the woman’s body is seen as a hostile environment for the baby who could expire at any second during this dangerous journey. Interventions are passed out left and right in an effort to speed up this dangerous process and get it over with. Once the baby starts to emerge, every effort is made to just get the baby out as quickly as possible. Sometimes at the cost of damage to the baby from forceps, a vacuum, or just an impatient providers’ gloved hands. In addition, there is no trust in the baby either. She is not allowed to transition to breathing air without intervention – roughly drying her skin, suctioning her breathing passages, and immediately cutting off the placental transfusion that happens when the cord is left intact for some period of time.

All of the usually unnecessary interventions that are (often) forced upon the birthing couplet happen to increase the bottom line for the hospital and pharmaceutical companies. Yet we do not protest. We file into the OB offices and through the revolving Labor and Delivery wards like sheep offering our bodies and those of our most precious babies up for sacrifice. We do not educate ourselves. Instead, we suffer from postpartum depression and PTSD from our traumatic experiences.

The Solution lies with every birthing woman, person, and family…

When will we learn that we are powerful beyond measure? The ability to bring forth life into this world is the birthright for those with a womb – do not squander your gifts. Educate yourself! Read a book or two by women who trust birth and women’s bodies to do their naturally designed work. Pay attention to the food you eat! You are making a new person, so make sure your nutrition is top notch. And remember that the baby is experiencing life through your thoughts and emotions; try to keep a good vibration as you move through your life.


I have included some of my favorite resources to help you on your journey to a better birth! Each resource is linked for your convenience.


Birthworks International


Birth Monopoly/ Birth Allowed Radio

Evidence Based Birth/ EBB Podcast

Circle of Birth Podcast

The Birth Hour

Real Food For Pregnancy

Ina May Gaskin

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