Reducing epidurals: While I believe that doulas are a wonderful addition
to the birthing scene, and fully acknowledge their documented
contributions to birthing families, I think that birthing families would
be even better served by encouraging and promoting midwifery care.  Why?
The philosophy of midwifery is "with woman care". Midwifery approaches
birth as a normal process, focuses on keeping birth normal, focuses on
education, and empowerment of women and families, focuses on encouraging
women to assume responsibility for caring for themselves, to participate
in decision making, to act as partners in their care.  Midwives are much
more likely to stay with their clients and offer emotional support in
labor as well as physical care, and to do whatever is possible to keep
moms and babies together.

 The fragmentation of the caring part of being with women (offering
emotional support, physical support, comfort, etc) and the clinical part
of care is really bothersome to me.  I am not suggesting that one care
provider can be all things to all women, just that it is the fundamental
lack of the midwifery approach, and lack of continuity of care in the
childbearing process that contributes to so many problems we see.

C. Ione Sims, CNM, IBCLC