What about drugs and technology?
Prenatally and during labour and birth, midwives follow best practice and provide evidence based care which results in low rates of intervention. We offer and can order the same routine tests and screens as any other obstetric care providers, including genetic testing, bloodwork, and ultrasounds. A midwifery client has all the pharmaceutical options for pain management during labour that KHSC offers, including nitrous oxide, morphine and epidural, and can choose these and continue to have midwifery care. However, midwives also offer non-pharmocological forms of labour support, such as, hydrotherapy and water immersion, position changes, emotional support and hands on comfort measures that are shown to reduce to need for medical forms of pain relief.
Midwives are able to prescribe certain medications when indicated. For example, a midwife may prescribe an antibiotic to treat a urinary tract infection in pregnancy.
Midwives use the gold standard in fetal surveillance in labour, intermittent auscultation, which involves listening to the fetal heart rate with a doppler device or a fetascope. There is a large body of evidence which indicates routine use of continous electronic fetal monitoring (EFM) leads to an increase in interventions including cesarean section. However, in certain circumstances EFM is recommended and will always be discussed with client if such circumstances arise.