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Share Pregnancies attended by midwives have less risk of ending in premature birth

Armando @armando_bastida

As societies evolve (or perhaps we should say involuciona) and people work more, eat worse, have a higher level of stress and live faster rates of premature birth increase. A premature baby has many more health risks than a full-term baby and science does not stop looking for answers or methods that help reduce these rates.

A recent study has just determined something that we could hardly believe, and is that, in addition to the factors discussed, it has been seen that when the pregnancy is followed by a midwife and when the delivery is also attended by them the risk of premature birth It is less than when the control is done by an obstetrician .

Data about the study

The study is a systematic review of more than a dozen studies with a total sample of more than 16, 000 women, conducted by the Cochrane. The researchers analyzed the data of all of them and compared the results of models of attention to pregnancy in countries where the obstetrician has maximum responsibility with models in which the voice is carried by the midwife and they saw that, in addition to decreasing the probability of Preterm deliveries are less instrumental, decreasing the use of epidural anesthesia, episiotomies and forceps or suction cups. In addition, it was found that the risk of losing the pregnancy in the first six months of gestation was much lower.

Less intervened births

To see it in data, pregnant women who were attended by midwives have a 23% lower risk of premature delivery and a 19% lower risk of losing the baby before 24 weeks of gestation . As of week 24, the risk of fetal death is the same in both groups.

The number of deliveries by cesarean section is practically the same, contrary to what one might think, and the labor of women with midwives is 30 minutes longer, probably because they have a less interventionist model of care and leave more time for childbirth evolves.

If you are wondering what is the reason for all this, how it can be that the monitoring of pregnancy by a midwife can affect the type of delivery you are going to have, tell you that the answer seems to be in the confidence of mothers in their possibilities and in the process . Obstetricians tend to control pregnancy and childbirth more and, in a way, take a little responsibility for everything to go well. The midwives, on the other hand, give the protagonism to the mother and, from the beginning, they try to give her tools and help so that she is the one who is responsible for her pregnancy and her delivery and is she who is able to do it all, with help if necessary, of course, but she alone who gives birth after all.

In addition, when the care of the pregnancy was in charge of the midwife, between 63 and 98% of the women knew the person who attended the day of delivery, while in the rest of the models this only happened in the 0 -21% of deliveries. Obviously, it is not the same to go to give birth and to find professionals that you already know and in which you trust to go to give birth and find unknown people.

But, risk pregnancies are missing

In the majority of the studies reviewed, the authors excluded women with high-risk pregnancies or addictions, as well as all births attended by non-professional or traditional "midwives" (interspersed because if they are not professionals, they are not midwives), deliveries at home or those that occurred in poor countries.

This means that, if these births were included, the results could be different (or not), and that the conclusions obtained should be limited to normal pregnancies, those that pass without complications, which are otherwise the majority.

Here in Spain I can not say what model prevails, because the pregnancies of my children were controlled by both midwives and obstetricians (each month we visited one), and when it comes to giving birth we always find unknown professionals. However, the second and third childbirths, being the second premature, were attended entirely by midwives, since, at least in the hospital to which we went, they only notify the obstetrician in the event that the delivery is complicated.

Via | Medline Plus Photo | Re-born 7 by Monica Pan (with the express permission of the author) In Babies and more | Matron or gynecologist ?, The midwife: the best option for pregnant care, "Mother of many": precious short on the work of midwives