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The Gap Between Knowledge and Practice
If the facts on the health benefits
and cost savings of midwifery care were common knowledge in North America, individual choice would bring midwifery into the mainstream. But
this information is not widely available. It is found in the biomedical
research literature, but is not distributed through the mainstream healthcare
system in any widespread coordinated way. There is a major disconnect between what scientific evidence tells us about safe and cost effective childbirth and what is practiced in the obstetric ward of the typical North American hospital.
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Many people do not consider midwifery care as a childbirth option because they have not learned of its benefits or have heard
misleading information.
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Those who want to consider using midwifery care often don't know where
to find information on this choice, including research on its safety, where
to locate a midwife, and insurance options.
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Families that prefer midwifery care are often blocked from using it because there is no midwife available in their area, because their state or locality does not allow the practice of midwifery, or because their insurance carrier will not cover midwifery.
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Aspiring and practicing midwives must overcome many hurdles. The challenges
they face preclude many from following this career. This reduces the total
number of available midwives. Barriers faced by midwives include: the scarcity of accredited
midwifery education programs; the high cost of midwifery education; difficulty
in establishing consulting relationships with doctors; the high cost of
malpractice insurance; the unavailability of insurance coverage for midwifery
care for many potential clients; difficulty in obtaining hospital
privileges, and the high cost of starting a practice.
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Many of the barriers described above also relate to doula care.
Go to next page:
A HISTORY OF PROGRESS: Overcoming Barriers to Informed Choice in Childbirth
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