Regardless of political, personal, or moral/ religious beliefs, this is a question I still hear a lot. What (if any) is the midwife’s role in preventing conception and/or termination?
This depends on three things.
First, what type of midwife is your provider? Is she a Traditional Midwife, Direct Entry, Certified Professional, or Certified Nurse-Midwife? Nurse-Midwives (CNM) and Certified Professional Midwives (CPM) tend to have a larger scope of practice, meaning they can offer more in terms of care than other midwives. The American College of Nurse-Midwives position statement and the International Confederation of Midwives both affirm midwives as abortion providers.
In order to evaluate if midwives actually make sense as abortion providers, a 2018 study was conducted called Abortion-related care and the role of the midwife: a global perspective. The study concluded that midwives are in fact a common-sense option for families seeking contraceptive services. Furthermore, the Midwifery Education and Accreditation Council (MEAC) consider abortion-related services to be essential in the training of midwives.
The second factor to consider is the state you live in. Each state has its own rules and regulations regarding midwifery care and birth control/ abortion. States like Montana and Maine have physician-only abortion laws. These laws may be wholly unnecessary and may also be placing an undue burden on the pregnant person. Virginia overturned their physician-only law because of exactly that. If you want to know how your state scores check out the images in this article.
Currently, Oregon sits at the top of the list for reproduction access and South Dakota is resting at the bottom. Yet even in Oregon, the certification requirements to provide reproductive health services is 12 pages long and never once mentions midwives or midwifery. In California, the safety of Midwives providing these services is widely acknowledged in the medical industry and in the state’s legislation.
The last consideration is the demand for these services (along with the midwife’s personal beliefs). According to a 2013 study published in the Journal of Women’s Health, the national demand for women's health care is predicted to grow by 6% by 2020. This rate will require an increase in the need for physicians or nonphysician clinicians [ i.e. Midwives], which is clinically equivalent to 2,090 full-time OB-GYNs. The Center for Reproductive Rights see that involving midwives in reproductive health also has the potential to bridge some of the disparities in accessibility, affordability, and racially congruent care. As for contraception use, an estimated 99% of women who have had sex have used contraception at least once. For more information on the use of contraception in the US review this fact sheet by the Guttmacher Institute. All of this adds up to a need within our health care system that’s simply not being met with physician-only sexual health care.
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