The profession of midwifery has a very long tradition in Europe – the first textbook on obstetrics was written as early as the second century. Midwives can be employed in hospitals as well as work freelance. Since 1985, men are also allowed to learn this profession – they are then called obstetricians.
What is a midwife?
Midwives accompany and support women during pregnancy and childbirth. In addition, they also care for mothers during the postpartum period. Midwives accompany and support women during pregnancy and childbirth. In addition, they also care for mothers during the postpartum period. The prerequisite for practicing the profession is three years of training, which consists of 1,600 hours of theory and 3,000 hours of practice. Applicants must have at least a secondary school diploma and be in good health. During the theoretical part, prospective midwives are taught, among other things, anatomical, biological and physiological knowledge, the theoretical aspects of practical obstetrics, and the basics of the job. Trainees are also familiarized with laws specific to the profession, hospital documentation, newborn and infant care. The general and special theory of diseases are part of the training, as well as the theory of medicines, care of pregnant women and postnatal care. The training takes place at a midwifery school. The practical part of the training is completed in the hospital, for example in the delivery room, in gynecology and in the maternity and neonatal wards. Internships with a freelance midwife are also possible. The training is completed with the state examination.
Services and treatments
During pregnancy, the midwife may perform numerous preventive services. For example, she may determine whether a pregnancy exists and issue the maternity record. Midwives are also authorized to listen to or monitor fetal heart tones and rates. They provide advice to expectant mothers, for example, in the event of pregnancy complaints such as discomfort or nausea. They care for pregnant women in case of anxiety and preterm labor. Furthermore, midwives also conduct childbirth preparation courses. A midwife is allowed to induce and carry out a natural birth on her own. If the delivery takes place in the gynecological clinic of a hospital, a doctor must be present. This also applies if complications arise. The midwife’s duty to be present is regulated by law and only ceases to apply in emergency situations. The birth can take place in a hospital, but also in birth centers and on an outpatient basis in hospitals or medical practices. Furthermore, home births can also be performed. During the postpartum period, the midwife takes care of the baby’s navel and observes its health and development. She advises the mother on breastfeeding and on feeding and caring for the newborn. She can also be consulted on child-rearing issues and vaccinations. The midwife checks the regression of the uterus and performs regression gymnastics.
Methods of diagnosis and examination before and during childbirth
The midwife performs palpation examinations during pregnancy. By palpating the abdomen, she can check the position and growth of the fetus. Checking the cervix is done by vaginal examination as well. Midwives take swabs, examine the urine and measure the pregnant woman’s blood pressure. The heartbeat rate of the unborn baby and labor activity are also checked. To register and record them simultaneously, the midwife uses a cardiotocograph (CTG), which is also used for monitoring during delivery. Alternatively, a Pinard tube can be used to check the baby’s heart sounds. This is an obstetric stethoscope, usually made of wood, that has been used in obstetrics since the late 19th century. Furthermore, heart sounds can also be measured with a dopton, which the midwife places on the pregnant woman’s abdomen. The electronic device, which is similar to ultrasound, ensures that the sounds are transmitted to the outside. However, the midwife cannot completely replace the care provided by the gynecologist, as she is not allowed to perform ultrasound examinations or prenatal diagnostics.
What should the pregnant woman pay attention to?
Since the midwife accompanies the expectant mother during her pregnancy, a good relationship is of great importance. The pregnant woman must feel in safe hands with her. In order to find the midwife who best meets personal expectations, it is also necessary to clarify which services want to use. If there is a desire for a home birth, it is necessary to look for a midwife who offers a delivery of this type. Furthermore, the proximity to the place of residence is also decisive. Existing experiences of acquaintances can also have a positive effect on the decision. Statutory health insurance companies cover the costs of home visits by the midwife up to the eighth week after delivery. In principle, it should be clarified which additional midwife services are borne by the respective health insurance.
