A midwife is a person who provides care to women during pregnancy and childbirth. While the practice of midwifery differs markedly among the midwives of the world, most focus on the natural, normal aspect of pregnancy, providing prenatal care, directing the birth procedure, and giving psychological encouragement to the woman and her family during the birth experience.
Midwifery has been a common practice worldwide at least since biblical times. Throughout the world today, midwives continue to deliver a majority of the world's babies, not only in rural isolated countries with poor access to medical care, but also in many developed countries, such as Japan and the Netherlands, where infant mortality is very low. In the United States physician-attended births have become more customary. Although a revival of midwifery began in the 1960s, especially among those interested in a natural or a more family-centered birth experience, today fewer than 5 percent of U.S. births are attended by midwives.
In general, midwives use very little hi-tech equipment in providing care during labor and birth. Many have the additional training necessary to perform safely such procedures as episiotomy (surgical widening of the vaginal opening).
Most midwives, particularly those with formal training, have an arrangement whereby a physician will be available in cases involving complications or unexpected emergencies. In addition to providing technical expertise, midwives also address the pregnant woman's emotional, social, and spiritual needs.
Midwifery training varies country to country, ranging from basic apprenticeship training to accredited degree programs for nurse-midwives, registered nurses with additional training as midwives. There are over 30 nurse-midwifery programs in the United States. Graduates who pass national certification exams gain the title "certified nurse-midwife" (CNM).
While many doctors and women prefer that a physician be on hand throughout labor and birth in case of emergency complications, recent studies of nurse-midwife attended births indicate that birth outcomes are as good and sometimes better than births of women of similar risk attended by physicians.