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62-551: Since 1950, it has been a tradition that newly graduated midwives dance around the fountain. In 1888, the Society for the Beautification of Copenhagen announced a competition for a fountain on the prominent square to celebrate the upcoming silver wedding anniversary of Crown Prince Frederik (VIII) and Crown Princess Louise on 28 July 1894. The competition was won by Edvard Petersen and Vilhelm Bissen . Another entry in

124-784: A bachelor's degree or equivalent qualification in midwifery (Bachelor of Midwifery, Graduate Diploma in Midwifery). Midwives in Australia must be registered with the Australian Health Practitioner Regulation Agency to practice midwifery, and use the title midwife or registered midwife . Midwives work in a number of settings including hospitals, birthing centres, community centres and women's homes. They may be employed by health services or organisations, or self-employed as privately practising midwives. All midwives are expected to work within

186-459: A contract with a local bus union to transport women with obstetric emergencies. The drivers received training and were reimbursed for fuel by a community fund. In the event of a death police and local authorities were made aware of the arrangement, so that bus drivers would not be held liable. West Africa : Some countries in West Africa use a yellow flag as a signal to passing drivers that

248-475: A defined scope of practice and conform to ongoing regulatory requirements that ensure they are safe and autonomous practitioners. Midwifery was reintroduced as a regulated profession in most of Canada's ten provinces in the 1990s. Prior to this legalization, some midwives had practiced in a legal "grey area" in some provinces. In 1981, a midwife in British Columbia was charged with practicing without

310-543: A first year of medical studies common with Medicine, Odontology and Pharmacy) leading to an accredited master's degree in midwifery (Diplôme d'Etat de Sage-Femme). Midwives in France must be registered with the Ordre des sages-femmes to practice midwifery and use the title sage-femme . Professional associations/colleges: The undergraduate midwifery programs are four-year full-time university programs, with an internship in

372-451: A laboring woman is in distress. Willing drivers stop and transport the woman to a health facility. Uganda: UNFPA provides TBAs with solar-powered VHF-radio that connects directly to the health provider, walkie-talkies for TBAs, and ambulance services. UNFPA has reported success. UNFPA stresses the importance of both communication and transportation to improve service delivery of maternal health services. Sierra Leone: Health staff used

434-654: A means of extending health services to underserved communities in developing nations in hopes of decreasing mortality and morbidity. While the focus in the past two decades has been on training TBAs, studies on training impact has shown conflicting results in maternal outcomes with many studies showing little to no impact on high maternal mortality outcomes. As a result, there has been a shift toward skilled birth attendants, capable of averting and managing complications. TBAs have been unsuccessful in handling obstetric complications, but have contributed to successful maternal, neonatal, and child health interventions, although there

496-506: A medical license. After several decades of intensive political lobbying by midwives and consumers, fully integrated, regulated and publicly funded midwifery is now part of the health system in the provinces of British Columbia (regulated since 1995), Alberta (regulated since 2000, fully funded since 2009) Saskatchewan (regulated since 1999), Manitoba (regulated since 1997), Ontario (regulated since 1991), Quebec (regulated since 1999), and Nova Scotia (regulated since 2006), and in

558-540: A pregnancy, labour, birth, or postpartum, a midwife consults with a specialist such as an obstetrician or paediatrician. Core competencies and restricted activities are included in the BC Health Professions Act Midwives Regulation. As of April 2009, the scope of practice for midwives allows them to prescribe certain prescription drugs, use acupuncture for pain relief, assist a surgeon in a caesarean section delivery and to perform

620-833: A primary complete maternity service to childbearing women on its own responsibility. The undergraduate midwifery programmes are three-year full-time (three trimesters per year) tertiary programmes leading to a bachelor's degree in midwifery (Bachelor of Midwifery or Bachelor of Health Science (Midwifery)). These programmes are offered by Otago Polytechnic in Dunedin, Ara Institute of Canterbury (formally CPIT) in Christchurch, Waikato Institute of Technology in Hamilton and Auckland University of Technology (AUT) in Auckland. Several schools have satellite programmes such as Otago with

682-593: A programme in Southland, Wanaka, Wellington, Palmerston North, Wanganui, and Wairarapa – and AUT with student cohorts in various sites in the upper North Island. The postgraduate midwifery programmes (for registered midwives) lead to postgraduate degrees or equivalent qualifications in midwifery (Postgraduate Certificate in Midwifery, Postgraduate Diploma in Midwifery, Master of Midwifery, PhD Professional Doctorate). The Midwifery First Year of Practice Programme (MFYP)

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744-637: A shortage of funding for these resources. According to the definition of the International Confederation of Midwives , which has also been adopted by the World Health Organization and the International Federation of Gynecology and Obstetrics : A midwife is a person who has successfully completed a midwifery education programme that is recognised in the country where it is located and that

806-652: A tool for TBA integration into the healthcare system. The referral training for TBAs allows them to act as “intermediaries between the community and the formal health care system.” Training that advocates collaboration and regular involvement in clinic duties, increases the number of referrals and improves communication. The World Health Organization’s Strategies and Interventions for Obstetric Referrals: “Most maternal deaths from direct causes (such as hemorrhage, obstructed labor, infections, eclampsia, or unsafe abortions) could be prevented if women received timely care at critical moments.” On average, half of deliveries in

868-564: A two-way radio to communicate with other facilities to improve referrals and alert staff of their arrival and situation. A solar powered system worked better than a battery charged system. Communication difficulties were experienced in mountainous regions. Health centers resolved this issue by communicating to closer centers, which then communicated the message to the desired destination. In developed countries, some traditional or lay midwives are becoming increasingly vocal in support of their right to practice without formal regulation, advocating for

930-627: A vacuum extraction delivery. These specialized practices require additional education and certification. As of November 2015, the College of Midwives of British Columbia reported 247 General, 2 Temporary, 46 Non-practicing Registrant midwives. There were 2 midwives per 100,000 people in BC in 2006. A midwife must register with the College of Midwives of BC to practice. To continue licensure, midwives must maintain regular recertification in neonatal resuscitation and management of maternal emergencies, maintain

992-460: A woman who is with another woman and assists her in giving birth. The term "male midwife" is common parlance when referring to males who work as midwives. In English, the noun midwife is gendered, and in most countries, the corresponding noun and practice is historically used for women (sometimes banned for men), while in English, the verb midwifery is also applied to men (e.g. Havelock Ellis

1054-613: Is a compulsory national programme for all New Zealand registered midwifery graduates, irrespective of work setting. The New Zealand College of Midwives (the NZCOM) is contracted by the funder, Health Workforce New Zealand (HWNZ), to provide the programme nationally in accordance with the programme specification. Midwives in New Zealand must be registered with the Midwifery Council of New Zealand to practice midwifery, and use

1116-462: Is available in most hospitals. In this case, a woman's own midwife delivers the baby at the delivery room of a hospital, without intervention of an obstetrician. In all settings, midwives transfer care to an obstetrician in case of a complicated childbirth or need for emergency intervention. Apart from childbirth and immediate postpartum care, midwives are the first line of care in pregnancy control and education of mothers-to-be. Typical information that

1178-620: Is based on the ICM Essential Competencies for Basic Midwifery Practice and the framework of the ICM Global Standards for Midwifery Education; who has acquired the requisite qualifications to be registered or legally licensed to practice midwifery and use the title midwife ; and who demonstrates competency in the practice of midwifery. The word derives from Middle English mid , "with", and wif , "woman", and thus originally meant "with-woman", that is,

1240-487: Is given to mothers includes information about food, alcohol, life style, travel, hobbies, sex, etc. Some midwifery practices give additional care in the form of preconceptional care and help with fertility problems. All care by midwives is legal and it is totally reimbursed by all insurance companies. This includes prenatal care, childbirth (by midwives or obstetricians, at home or in the hospital), as well as postpartum/postnatal care for mother and baby at home. Midwifery

1302-479: Is insufficient evidence that TBA training improves peri-neonatal mortality. The key piece missing in TBA training is an adequate referral system, which allows TBAs to use their close ties with the community to link pregnant women to skilled birth attendants (SBA). The effectiveness of TBA referrals to health facilities is dependent on the healthcare system’s ability to support an increase in services provided and

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1364-542: Is not true and that the birds are indeed storks. In early 2009, as part of a classroom experiment on viral communication , slacktivism , and social media , Anders Colding-Jørgensen, a lecturer from the University of Copenhagen , created a Facebook protest group against the demolition of the Stork Fountain. In a week it managed to attract 10,000 supporters and after two weeks it had 27,000 members. However,

1426-412: Is practicing midwifery without a license and is subject to investigation and prosecution. Prior to legislative changes, very few Canadian women had access to midwifery care, in part because it was not funded by the health care system . Legalizing midwifery has made midwifery services available to a wide and diverse population of women and in many communities, the number of available midwives does not meet

1488-502: Is said to have midwifed bigamist Howard Hinton 's aka John Weldon's twins in 1883; historically, assistance was done be relatives, even only husbands, while male midwifery, excluding relatives, being common in some cultures, goes back to at least the 20th century; for Semelai people women also practised it up to 1980, while by 1992 some areas had only male midwives, and later most areas had only male midwives ). The older Semelai word for midwife, mudem , "itself provides insight into

1550-414: Is to assist women during delivery and immediately post-partum. Frequently their assistance includes helping with household chores. TBAs may not have any formal training on how to attend pregnant women. Many are highly experienced in well woman care including how to recognize and respond appropriately to complications of pregnancy . It is a matter of discussion whether the lack of education in some TBAs and

1612-538: The Northwest Territories (regulated since 2003) and Nunavut (regulated since 2008). In 2023, Midwifery is regulated in New Brunswick , Newfoundland and Labrador , Prince Edward Island and Yukon . The undergraduate midwifery programs are four-year full-time university programs leading to bachelor's degrees in midwifery (B.H.Sc. in Midwifery, Bachelor of Midwifery). In British Columbia,

1674-703: The University College of the North . In Quebec , the program is offered at the Université du Québec à Trois-Rivières . In northern Quebec and Nunavut, Inuit women are being educated to be midwives in their own communities. There is also a programme for aboriginal midwives in Ontario. In Ontario, the Midwifey Act exempts Indigenous people from obtaining a four-year midwifery degree or registering with

1736-597: The University of British Columbia . At the Université du Québec à Trois-Rivières , French-speaking internationally trained midwives may earn the Certificat personnalisé en pratique sage-femme. Midwives in Canada must be registered, after assessment by the provincial regulatory bodies, to practice midwifery, and use the title midwife , registered midwife or, the French-language equivalent, sage-femme . From

1798-717: The Canadian model of midwifery include informed choice, choice of birthplace, continuity of care from a small group of midwives and respect for the mother as the primary decision maker. Midwives typically have hospital privileges, and support the woman's right to choose where she has her baby. The legal recognition of midwifery has brought midwives into the mainstream of health care with universal funding for services, hospital privileges, rights to prescribe medications commonly needed during pregnancy, birth and postpartum, and rights to order blood work and ultrasounds for their own clients and full consultation access to physicians. To protect

1860-585: The College of Midwives of BC and the Midwives Association of BC. The qualification of midwife in the European Union is regulated by Directive 2005/36/EC . Midwives ( sage-femmes , literally meaning "wise-woman" or maïeuticien / maïeuticienne ) are independent practitioners, specialists in birth and women's medicine. The undergraduate midwifery programs are five-year full-time university programs (four years in midwifery schools after

1922-404: The College of Midwives of BC. In BC, midwives are primary care providers for women in all stages of pregnancy, from prenatal to six weeks postpartum. Midwives also care for newborns. The approximate proportion of women whose primary birth attendant was a midwife in British Columbia has been evaluated. Midwives in BC can deliver natural births in hospitals or homes. If a complication arises in

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1984-405: The College of Midwives of Ontario if they practice as midwife in their own community. There are also three "bridging programs" for internationally educated midwives. The International Midwifery Pre-registration Program (IMPP) is a nine-month program offered by Toronto Metropolitan University in Ontario. The Internationally Educated Midwives Bridging Program (IEMBP) runs between 8 and 10 months at

2046-602: The Netherlands, home birth is still a common practice, although rates have been declining during the past decades. Between 2005 and 2008, 29% of babies were delivered at home. This figure fell to 23% delivered at home between 2007 and 2010 according to Midwifery in the Netherlands, a 2012 pamphlet by The Royal Dutch Organization for Midwives. In 2014 it has dropped further to 13.4%. perined.nl/jaarboek2104.pdf. Midwives are generally organized as private practices, some of those are hospital-based. In-hospital outpatient childbirth

2108-830: The Nursing and Midwifery Board of Ireland (NMBI) to practice midwifery, and use the title midwife or registered midwife . The undergraduate midwifery programs are four-year full-time university programs leading to a bachelor's degree in midwifery (HBO-bachelor Verloskunde). There are four colleges for midwifery in the Netherlands : in Amsterdam , Groningen , Rotterdam and Maastricht . Midwives are called vroedvrouw (knowledge woman), vroedmeester (knowledge master, male), or verloskundige (deliverance experts) in Dutch. Midwives are independent specialists in physiologic birth. In

2170-542: The care of women throughout their lifespan; concentrating on being experts in what is normal and identifying conditions that need further evaluation. In most countries, midwives are recognized as skilled healthcare providers. Midwives are trained to recognize variations from the normal progress of labor and understand how to deal with deviations from normal. They may intervene in high risk situations such as breech births , twin births , using non-invasive techniques. For complications related to pregnancy and birth that are beyond

2232-454: The case fatality dropped. Uganda: Honduras : Improved roads, communication, ambulances, and increased staffing and equipment increased referrals and reduced maternal mortality. Sri Lanka : The Sri Lankan government provided three to five ambulances at each hospital. The program gave health workers the authority to organize, pay, and receive reimbursement for privately organized transportation. Nigeria : Community leaders negotiated

2294-422: The cause was purely fictitious; there was no threat of demolition and the fountain is in fact a listed monument. During the late 1960s, the fountain became a popular meetingplace for members of the protest movements. Danish folk singer Cæsar received mainstream popularity with his protest song named Storkespringvandet (Stork Fountain) about police brutality. The song's lyrics, written by Thøger Olesen, were set to

2356-423: The chances for better health outcomes among mothers and babies. There is little evidence of large-scale effectiveness of targeted intervention programmes for training TBAs, as they are rarely integrated within a general strategy for improving maternal and child care. Historically, Traditional Birth Attendants (TBA) have operated outside of the formal healthcare delivery structure. TBA training has been used as

2418-493: The competition was Thorvald Bindesbøll and Joakim Skovgaard 's Dragon Fountain , which was later erected in the City Hall Square . Peder Vilhelm Jensen-Klint proposed a fountain depicting a merry Amager farmer sitting on a cabbagehead. The fountain was inaugurated in 1894. The fountain consists of a nine-sided basin of stone. It collects water from the bronze bowl at the top and the three small cascades around

2480-585: The criteria for being accepted as a TBA by clients is experience as a mother . Many traditional midwives are also herbalists , or other traditional healers. They may or may not be integrated in the formal health care system . They sometimes serve as a bridge between the community and the formal health system, and may accompany women to health facilities for delivery. Traditional birth attendants are often older women, respected in their communities. They consider themselves as private health care practitioners who respond to requests for service. The focus of their work

2542-516: The detection of complications in mother and child, the accessing of medical care or other appropriate assistance, and the carrying out of emergency measures. The midwife has an important task in health counselling and education, not only for the woman, but also within the family and the community. This work should involve antenatal education and preparation for parenthood and may extend to the pregnant's health, sexual or reproductive health, and child care. A midwife may practice in any setting, including

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2604-582: The developing world have a skilled birth attendant present. With many deliveries outside of the health center, and an estimated 9-15% of deliveries requiring intervention, access to transportation and communication are critical to improve maternal and infant outcomes. Major contributing factors to maternal death are: “delay in recognizing danger signs, deciding to seek care, reaching care, and receiving care at health facilities”. Malawi : Communities have employed bicycle ambulances and oxcarts to transport pregnant women to health facilities. There were issues during

2666-511: The edges of the central pedestal . The pedestal is decorated with reliefs of aquatic plants; in the basin, there are frogs sitting on dock leaves , spewing jets of water. On a shelf on the pedestal stand three storks ready to take flight in each of three different directions. A common urban legend holds that the birds depicted are herons. In 2008, representatives from the Danish Ornithological Society stated that this

2728-466: The figures now stand, Mozambique is one of the few countries on track to achieve the MDG of reducing the maternal death rate by 75% by 2015. Midwifery is a regulated profession with no connection to Nursing. Midwifery is a profession with a distinct body of knowledge and its own scope of practice, code of ethics and standards of practice. The midwifery profession has knowledge, skills and abilities to provide

2790-447: The final year, leading to an honours bachelor's degree in midwifery (BSc (Hons) Midwifery). The postgraduate midwifery programs (for registered midwives) lead to master's degrees in midwifery (MSc Midwifery, MSc Midwifery Practice). There are also postgraduate midwifery programs (for registered general nurses who wish to become midwives) leading to a qualification in midwifery (Higher Diploma in Midwifery). Midwives must be registered with

2852-608: The growing demand for services. Midwifery services are free to women living in provinces and territories with regulated midwifery. On 16 March 1995, the BC government announced the approval of regulations that govern midwifery and establish the College of Midwives of BC. In 1996, the Health Professional Council released a draft of Bylaws for the College of Midwives of BC, which the Cabinet approved on 13 April 1997. In 1998, midwives were officially registered with

2914-637: The home, community, hospitals, clinics, or health units. The undergraduate midwifery programs are three-year full-time university programs leading to a bachelor's degree in midwifery (Bachelor of Midwifery) with additional one-year full-time programs leading to an honours bachelor's degree in midwifery (Bachelor of Midwifery (Honours)). The postgraduate midwifery programs (for registered midwives) lead to master's degrees in midwifery (Master in Midwifery, Master in Midwifery (Research), MSc Midwifery). There are also postgraduate midwifery programs (for registered nurses or paramedics who wish to become midwives) leading to

2976-613: The midwife's scope of practice , including surgical and instrumental deliveries, they refer their patients to physicians or surgeons. In many parts of the world, these professions work in tandem to provide care to childbearing women. In others, only the midwife is available to provide care, and in yet other countries, many women elect to use obstetricians primarily over midwives. Many developing countries are investing money and training for midwives, sometimes by upskilling those people already practicing as traditional birth attendants . Some primary care services are currently lacking, due to

3038-416: The minimum volume of clinical care (40 women), participate in peer case reviews and continuing education activities. The University of British Columbia (UBC) has a four-year Bachelor of Midwifery program. The UBC midwifery program is poised to double in size thanks to an increase in government funding. Graduation of students will increase to 20 per year. In terms of professional associations, BC has both

3100-580: The original 'alternative' style of midwifery in the 1960s and 1970s, midwifery practice is offered in a variety of ways within regulated provinces: midwives offer continuity of care within small group practices, choice of birthplace, and a focus on the woman as the primary decision-maker in her maternity care. When women or their newborns experience complications, midwives work in consultation with an appropriate specialist. Registered midwives have access to appropriate diagnostics like blood tests and ultrasounds and can prescribe some medications. Founding principles of

3162-427: The popular Scottish nursery rhyme Ally Bally Bee (Coulter's Candy). 55°40′44″N 12°34′47″E  /  55.6788°N 12.5796°E  / 55.6788; 12.5796 Midwife A midwife ( pl. : midwives ) is a health professional who cares for mothers and newborns around childbirth, a specialization known as midwifery . The education and training for a midwife concentrates extensively on

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3224-537: The program is offered at the University of British Columbia . Mount Royal University in Calgary, Alberta offers a Bachelor of Midwifery program. In Ontario, the Midwifery Education Program (MEP) is offered by McMaster University and Toronto Metropolitan University and previously by Laurentian University . In Manitoba, the program is offered by the University of Manitoba and previously at

3286-456: The rainy season. The program later added ambulances, targeted information, education, maternity waiting, and focused education activities for decision makers in the family. The maternity waiting homes were rare because they required funds collected by the community. Sierra Leone : The Ministry of Health used a radio system in conjunction with four-wheel-drive vehicles. This program has seen success. The program increased emergency referrals and

3348-466: The relationships they share with women in local communities, especially if women are unable to access skilled care . Some countries, training institutes and non-governmental agencies are initiating efforts to train TBAs in basic and emergency obstetric care, family planning, and other maternal health topics, in order to enhance the links between modern health care services and the community, and to improve

3410-422: The ritual role a midwife is expected to play. Mudem also meant, and continues to mean, 'circumcisor'." The midwife is recognized as a responsible and accountable professional who works in partnership with women to give necessary support during pregnancy, labor, and the postpartum period . They also provide care for the newborn and the infant; this care includes preventative measures, the promotion of normal birth,

3472-717: The supervision needed to support TBA integration. “Five mechanisms for TBA integration were identified: training and supervision of TBAs; collaboration skills for health workers; inclusion of TBAs in facility-based activities; systems for communication between TBAs and SBAs; and defining roles for TBAs and SBAs.” While these mechanisms are important, complementary activities also influenced TBA referral and integration success: “careful selection of TBAs; community participation; health system development; and affordability changes.” TBA’s must be provided with appropriate knowledge, easy access to health personnel, and quality and regular supervision; all three components enable training to become

3534-428: The tenets of midwifery and support midwives to provide woman-centered care, the regulatory bodies and professional associations have legislation and standards in place to provide protection, particularly for choice of birth place , informed choice and continuity of care. All regulated midwives have malpractice insurance. Any unregulated person who provides care with 'restricted acts' in regulated provinces or territories

3596-589: The title midwife . Traditional birth attendant A traditional birth attendant (TBA) , also known as a traditional midwife , community midwife or lay midwife , is a pregnancy and childbirth care provider. Traditional birth attendants provide the majority of primary maternity care in many developing countries , and may function within specific communities in developed countries . Traditional midwives provide basic health care, support and advice during and after pregnancy and childbirth, based primarily on experience and knowledge acquired informally through

3658-509: The traditions and practices of the communities where they originated. They usually work in rural, remote and other medically underserved areas. TBAs may not receive formal education and training in health care provision, and there are no specific professional requisites such as certification or licensure. A traditional birth attendant may have been formally educated and has chosen not to register. They often learn their trade through apprenticeship or are self-taught; in many communities one of

3720-451: The way many attend deliveries are risky for the mothers and their babies. Evaluating the impact of these traditional practitioners on health outcomes requires taking into consideration additional factors such as poverty, availability of health services, or institutional support. It is being increasingly recognized that TBAs may have a role to play in improving health outcomes in developing countries because of their access to communities and

3782-440: Was devastated and one in ten women were dying in childbirth. There were only 18 obstetricians for a population of 19 million. In 2004, Mozambique introduced a new health care initiative to train midwives in emergency obstetric care in an attempt to guarantee access to quality medical care during pregnancy and childbirth. The newly introduced midwives system now perform major surgeries including caesareans and hysterectomies . As

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3844-592: Was first regulated in 1868. Today midwives in Japan are regulated under the Act on Public Health Nurse, Midwife and Nurse (No. 203) established in 1948. Japanese midwives must pass a national certification exam. On 1 March 2003 the Japanese name of midwife officially converted to a gender neutral name. Still, only women can take the national midwife exam. When a 16-year civil war ended in 1992, Mozambique 's health care system

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