The profession of midwife 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 or work freelance. Since 1985 men have also been allowed to learn this profession - they are then called Delivery assistant designated.
What is a midwife?
Midwives accompany and support women during pregnancy and childbirth. They also look after the mothers during the puerperium. A three-year training course consisting of 1,600 theory and 3,000 practical hours is a prerequisite for exercising the profession.
Applicants must have at least a secondary school diploma and be of suitable health. During the theoretical part, the prospective midwives are taught anatomical, biological and physiological knowledge, the theoretical aspects of practical obstetrics and the basics of the job. The trainees are also familiarized with job-specific laws, documentation in hospitals, and the care of newborns and infants.
The general and special pathology as well as the medicine, pregnancy care and weekly care are part of the training. 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 on the maternity and neonatal ward. Internships with a freelance midwife are also possible. The training ends with the state examination.
Services & treatments
During pregnancy, the midwife carry out numerous pension benefits. In this way, she can determine whether she is pregnant and issue the maternity card.
Midwives are also authorized to listen to or monitor the fetus's heartbeat and rate. They are there to advise the expectant mothers, for example with pregnancy problems such as malaise or nausea. They look after pregnant women with fears and contractions.
Midwives also hold birth preparation courses. A midwife is allowed to initiate and carry out a natural birth independently. If the delivery takes place in the gynecological clinic of a hospital, a doctor must be present. This also applies in the event that complications arise. The obligation to consult the midwife is regulated by law and only expires in emergency situations. The birth can take place as an inpatient in a clinic, but also in birthing centers and on an outpatient basis in hospitals or practices.
Home births can also be carried out. During the puerperium, the midwife takes care of the baby's navel and observes its health and development. She advises the mother on breastfeeding and the nutrition and care of the newborn. She can also be consulted on questions of upbringing and vaccinations. The midwife controls the regression of the uterus and performs postnatal exercises.
Diagnosis and examination methods before and during the birth
The midwife performs palpation exams during pregnancy. By feeling the abdomen, she can control the location and growth of the fetus. The examination of the cervix is also carried out by means of a vaginal examination.
Midwives take swabs, examine the urine, and measure the pregnant woman's blood pressure. The unborn baby's heart rate and labor are also checked. To register and record them at the same time, the midwife uses a cardiotocograph (CTG), which is also used for monitoring during the birth. Alternatively, a Pinard tube can be used to check the child's heartbeat. It is an obstetric stethoscope, mostly made of wood, which has been used in obstetrics since the end of the 19th century.
The heart rate can also be measured with a dop tone, which the midwife places on the pregnant woman's belly. The electronic, ultrasound-like device ensures that the sounds are transmitted to the outside world. 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 look out for?
Since the midwife the expectant mother already accompanies her 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 must also be clarified which services are to be used. If a home birth is desired, a midwife must be found who can offer this type of delivery. 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. Basically, it should be clarified which additional midwifery services are covered by the respective health insurance company.
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