midwife midwife a midwife is a health professional who cares for mothers and newborns around childbirth, a specialization known as midwifery. midwifea pregnant woman receives an ultrasound examination from a midwife sonographeroccupationnamesmidwifeoccupation typeprofessionalactivity sectorsmidwifery, obstetrics, newborn care, women's health, reproductive healthdescriptioncompetenciesknowledge, professional behaviour and specific skills in family planning, pregnancy, labour, birth, postpartum period, newborn care, women's health, reproductive health, and social, epidemiologic and cultural context of midwiferyeducation required bachelor of midwifery master of midwifery fields ofemploymenthospitals, clinics, health units, maternity units, birth centers, private practices, home births, community, etc.related jobsobstetrician, gynecologist, pediatrician the education and training for a midwife concentrates extensively on the care of women throughout their lifespan; concentrating on being experts in what is normal and identifying conditions that need further evaluation. in most countries, midwives are recognized as skilled healthcare providers. midwives are trained to recognize variations from the normal progress of labor and understand how to deal with deviations from normal. they may intervene in high risk situations such as breech births, twin births, and births where the baby is in a posterior position, using non-invasive techniques. for complications related to pregnancy and birth that are beyond the midwife's scope of practice, including surgical and instrumental deliveries, they refer their patients to physicians or surgeons. in many parts of the world, these professions work in tandem to provide care to childbearing women. in others, only the midwife is available to provide care, and in yet other countries, many women elect to utilize obstetricians primarily over midwives. many developing countries are investing money and training for midwives, sometimes by upskilling those people already practicing as traditional birth attendants. some primary care services are currently lacking, due to a shortage of funding for these resources. definition and etymology according to the definition of the international confederation of midwives, which has also been adopted by the world health organization and the international federation of gynecology and obstetrics: a midwife is a person who has successfully completed a midwifery education programme that is recognised in the country where it is located and that is based on the icm essential competencies for basic midwifery practice and the framework of the icm global standards for midwifery education; who has acquired the requisite qualifications to be registered or legally licensed to practice midwifery and use the title midwife; and who demonstrates competency in the practice of midwifery. the word derives from old english mid, "with", and wif, "woman", and thus originally meant "with-woman", that is, the woman who is with the person who is giving birth. the term "male midwife" is common parlance when referring to male gendered people who work as midwives. in english the noun midwife is gendered, and in most countries the corresponding noun and practice is historically used for women (sometimes banned for men), while in english the verb midwifery is also applied to men (e.g. havelock ellis is said to have midwifed bigamist howard hinton's aka john weldon's twins in 1883; historically assistance was done be relatives, even only husbands, while male midwifery, excluding relatives, being common in some cultures, goes back to at least the 20th century; for semelai people women also practised it up to 1980, while by 1992 some areas had only male midwives, and later most areas had only male midwifes). the older semelai word for midwife, mudem, "itself provides insight into the ritual role a midwife is expected to play. mudem also meant, and continues to mean, 'circumcisor'." scope of practice the 112 countries containing member associations of the international confederation of midwives (icm) in 2017 the midwife is recognized as a responsible and accountable professional who works in partnership with women to give necessary support during pregnancy, labor, and the postpartum period. they also provide care for the newborn and the infant; this care includes preventative measures, the promotion of normal birth, the detection of complications in mother and child, the accessing of medical care or other appropriate assistance, and the carrying out of emergency measures. the midwife has an important task in health counselling and education, not only for the woman, but also within the family and the community. this work should involve antenatal education and preparation for parenthood and may extend to the pregnant's health, sexual or reproductive health, and child care. a midwife may practice in any setting, including the home, community, hospitals, clinics, or health units. education, training, regulation and practice australia education, training and regulation the undergraduate midwifery programs are three-year full-time university programs leading to a bachelor's degree in midwifery (bachelor of midwifery) with additional one-year full-time programs leading to an honours bachelor's degree in midwifery (bachelor of midwifery (honours)). the postgraduate midwifery programs (for registered midwives) lead to master's degrees in midwifery (master in midwifery, master in midwifery (research), msc midwifery). there are also postgraduate midwifery programs (for registered nurses who wish to become midwives) leading to a bachelor's degree or equivalent qualification in midwifery (bachelor of midwifery, graduate diploma in midwifery). midwives in australia must be registered with the australian health practitioner regulation agency to practice midwifery, and use the title midwife or registered midwife. practice midwives work in a number of settings including hospitals, birthing centres, community centres and women's homes. they may be employed by health services or organisations, or self-employed as privately practising midwives. all midwives are expected to work within a defined scope of practice and conform to ongoing regulatory requirements that ensure they are safe and autonomous practitioners. professional associations/colleges australian college of midwives (acm). canada midwifery was reintroduced as a regulated profession in most of canada's ten provinces in the 1990s. prior to this legalization, some midwives had practiced in a legal "grey area" in some provinces. in 1981, a midwife in british columbia was charged with practicing without a medical license. after several decades of intensive political lobbying by midwives and consumers, fully integrated, regulated and publicly funded midwifery is now part of the health system in the provinces of british columbia (regulated since 1995), alberta (regulated since 2000, fully funded since 2009) saskatchewan (regulated since 1999), manitoba (regulated since 1997), ontario (regulated since 1991), quebec (regulated since 1999), and nova scotia (regulated since 2006), and in the northwest territories (regulated since 2003) and nunavut (regulated since 2008). in 2010, midwifery legislation was proclaimed in new brunswick and newfoundland and labrador. only prince edward island and yukon have no legislation in place for the practice of midwifery. education, training and regulation the undergraduate midwifery programs are four-year full-time university programs leading to bachelor's degrees in midwifery (b.h.sc. in midwifery, bachelor of midwifery). in british columbia, the program is offered at the university of british columbia. mount royal university in calgary, alberta offers a bachelor of midwifery program. in ontario, the midwifery education program (mep) is offered by mcmaster university and toronto metropolitan university and previously by laurentian university. in manitoba, the program is offered by the university of manitoba and previously at the university college of the north. in quebec, the program is offered at the université du québec à trois-rivières. in northern quebec and nunavut, inuit women are being educated to be midwives in their own communities. there is also a programme for aboriginal midwives in ontario. in ontario, the midwifey act exempts indigenous people from obtaining a four-year midwifery degree or registering with the college of midwives of ontario if they practice as midwife in their own community. there are also three "bridging programs" for internationally educated midwives. the international midwifery pre-registration program (impp) is a nine-month program offered by toronto metropolitan university in ontario. the internationally educated midwives bridging program (iembp) runs between 8 and 10 months at the university of british columbia. at the université du québec à trois-rivières, french-speaking internationally trained midwives may earn the certificat personnalisé en pratique sage-femme. midwives in canada must be registered, after assessment by the provincial regulatory bodies, to practice midwifery, and use the title midwife, registered midwife or, the french-language equivalent, sage-femme. practice from the original 'alternative' style of midwifery in the 1960s and 1970s, midwifery practice is offered in a variety of ways within regulated provinces: midwives offer continuity of care within small group practices, choice of birthplace, and a focus on the woman as the primary decision-maker in her maternity care. when women or their newborns experience complications, midwives work in consultation with an appropriate specialist. registered midwives have access to appropriate diagnostics like blood tests and ultrasounds and can prescribe some medications. founding principles of the canadian model of midwifery include informed choice, choice of birthplace, continuity of care from a small group of midwives and respect for the mother as the primary decision maker. midwives typically have hospital privileges, and support the woman's right to choose where she has her baby. the legal recognition of midwifery has brought midwives into the mainstream of health care with universal funding for services, hospital privileges, rights to prescribe medications commonly needed during pregnancy, birth and postpartum, and rights to order blood work and ultrasounds for their own clients and full consultation access to physicians. to protect the tenets of midwifery and support midwives to provide woman-centered care, the regulatory bodies and professional associations have legislation and standards in place to provide protection, particularly for choice of birth place, informed choice and continuity of care. all regulated midwives have malpractice insurance. any unregulated person who provides care with 'restricted acts' in regulated provinces or territories is practicing midwifery without a license and is subject to investigation and prosecution. prior to legislative changes, very few canadian women had access to midwifery care, in part because it was not funded by the health care system. legalizing midwifery has made midwifery services available to a wide and diverse population of women and in many communities, the number of available midwives does not meet the growing demand for services. midwifery services are free to women living in provinces and territories with regulated midwifery. professional associations/colleges canadian association of midwives (cam). british columbia on 16 march 1995, the bc government announced the approval of regulations that govern midwifery and establish the college of midwives of bc. in 1996, the health professional council released a draft of bylaws for the college of midwives of bc, which the cabinet approved on 13 april 1997. in 1998, midwives were officially registered with the college of midwives of bc. in bc, midwives are primary care providers for women in all stages of pregnancy, from prenatal to six weeks postpartum. midwives also care for newborns. the approximate proportion of women whose primary birth attendant was a midwife in british columbia has been evaluated. midwives in bc can deliver natural births in hospitals or homes. if a complication arises in a pregnancy, labour, birth, or postpartum, a midwife consults with a specialist such as an obstetrician or paediatrician. core competencies and restricted activities are included in the bc health professions act midwives regulation. as of april 2009, the scope of practice for midwives allows them to prescribe certain prescription drugs, use acupuncture for pain relief, assist a surgeon in a caesarean section delivery and to perform a vacuum extraction delivery. these specialized practices require additional education and certification. as of november 2015, the college of midwives of british columbia reported 247 general, 2 temporary, 46 non-practicing registrant midwives. there were 2 midwives per 100,000 people in bc in 2006. a midwife must register with the college of midwives of bc to practice. to continue licensure, midwives must maintain regular recertification in neonatal resuscitation and management of maternal emergencies, maintain the minimum volume of clinical care (40 women), participate in peer case reviews and continuing education activities. the university of british columbia (ubc) has a four-year bachelor of midwifery program. the ubc midwifery program is poised to double in size thanks to an increase in government funding. graduation of students will increase to 20 per year. in terms of professional associations, bc has both the college of midwives of bc and the midwives association of bc. france two french midwives (sages-femmes) midwives (sage-femmes, literally meaning "wise-woman" or maïeuticien/maïeuticienne) are independent practitioners, specialists in birth and women's medicine. the undergraduate midwifery programs are five-year full-time university programs (four years in midwifery schools after a first year of medical studies common with medicine, odontology and pharmacy) leading