Promoting midwifery as the standard of care for childbearing women.

• Auteur: Shah, Mary Ann

I am most grateful for this opportunity to reach my midwifery colleagues from near and far, and to call for the promotion of our beloved profession as the standard of care for the women of the world. Before proceeding, however, please indulge me as I share with you three consciousness-raising encounters I had last year.

Universal concerns of midwives

In April 2002, I was so fortunate to represent the American College of Nurse-Midwives (ACNM) at the 26th Congress of the International Confederation of Midwives (ICM). During my 12 days in Vienna, Austria, I was both enlightened and inspired by the universality of concerns shared by the ICM delegates--including those from the least developed nations. In spite of the difficult working conditions and challenges that confront so many, it was thrilling to witness the near-unanimous support of the concept of evidence-based practice and the enthusiastic endorsement of validated knowledge, skills, and behaviours as essential competencies for midwives. Very few expressed the view that 'the bar is too high ... lower it!' Rather, general agreement was reached that we must strive to make midwifery everywhere the epitome of professional excellence.

In June 2002, I gained further insights while working side-by-side with midwives from across the Americas at a conference on professional midwifery and self-regulation in San Miguel de Allende, Mexico (reported in International Midwifery 2003; 16(3): 34-35). While there, I was particularly struck by the comments of an internationally renowned physician and women's health care advocate who publicly and passionately took exception to the inference that a commitment to safe motherhood, reproductive health, and the provision of safe, competent, compassionate, and satisfying care to women is the exclusive domain of midwives. After listening to speaker after speaker allude to the 'midwifery versus the medical model of care,' he issued a provocative challenge to us, asking that we reframe the issues ha terms of humanistic vs. technologic models; and, I must agree with him. It is not that we should avoid speaking in terms of the midwifery model; but, ha so doing, we must be more inclusive and avoid offending those with whom we share a common philosophy.

In October of 2002, I was able to network with midwives from all 10 provinces of Canada at the annual meeting of the Canadian Association of Midwives (CAM) in Vancouver, British Columbia. Once again, I was impressed by...