Community Midwife Situation This Is a Personal Essay

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Community Midwife Situation

This is a personal account based on my experience during a postnatal visit to a home where a new mother had given birth, in the town where I live. My own visit was because I was accompanying a midwife and observing the steps that the midwife takes. But while I was in the house I witnessed a situation with a young mother and a midwife that caused me considerable concern. This is a reflective account of that situation, and what should have been done, what could have been done, what are the correct steps a midwife should take to care for a primagravidae mother who is having problems getting her newborn girl to breastfeed -- all of those issues will be discussed and critiqued in this paper.

Home Births, Breastfeeding, Paperwork, and Priorities

Home Births: It is not a unique idea to give birth at home. I have always applauded women who preferred to have their babies in the comfort and shelter of their own homes. In fact I have done the research for this paper and according to the Centers for Disease Control and Prevention (CDC) website, the number of home births increased by 29% from the year 2004 to 2009 (MacDorman, et al., 2012). In 2009, there were 29,650 home births in the United States, and although that only represented 0.72% of all births in the U.S., and the great majority of home births are attended by midwives (just 5% of home births were attended by doctors (MacDorman, p. 3).

Why do many women prefer home births? I asked this question of the midwife I was with that day and she didn't have an answer other than to say that some women want to stay home and others want to be in a hospital in case there are complications with the birth. The CDC article points out that the percentage of home births that were "preterm" (early) was 6% and the percentage of births that were preterm in hospitals was 12% (MacDorman, p. 5). And the percentage of home births that had low birthweight was 4% compared with 8% for hospital births.

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My point here is there is a lower risk profile for home births, and so it is a wise decision for the pregnant woman to create a comfort zone for the delivery of her baby in her own home. I studied the statistics and the literature on home births and on breastfeeding prior to my visit.

Breastfeeding Problems: No sooner had we entered the home of the primagravidae mother than it was very obvious that this young, 22-year-old mother was struggling, trying to get her baby to breastfeed. She was in anguish. She was worn out because she said she had been up all night trying to get the infant to latch on to her breast. It wasn't working for her. I was empathetic to the point that I actually experienced her torment. This was all new to her and clearly she did not have the tutoring / mentoring that she needed up to that point. She was knowledgeable enough to realize her baby might be dehydrated.

Rather than immediately attend to the breastfeeding crisis for this young, first-time mother, the midwife offered a few words of advice and then changed the subject. The mother should have been attended at the very moment the midwife realized the struggle she was going through. It is no secret that a mother's stress and tension is automatically passed on to her baby. I knew that, and I was nervous and anxious myself, as a witness to this scenario in a private home. On top of the stress that the mother was experiencing, her breasts were engorged (swollen) to the point of being painful. She was in serious discomfort.

In the Medline Plus publication (produced by the U.S. National Library of Medicine and the National Institutes of Health) it explains that a mother has several steps she can take to reduce the discomfort of engorged breasts. "Learning to relax and finding a….....

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