Sustainable Birth in Disruptive Times

Introduction -- will need to be Ch. 1Sustainable Birth Across the Globe: Solutions, Obstacles, and ChallengesKim Gutschow, Robbie Davis-Floyd, and Betty-Anne Daviss, eds. This chapter introduces the Editors' concept of sustainable birth and explores how their models of maternity care avoid the unsustainable human and financial costs of our current obstetric model of care. The Editors examine many models of sustainable birth that promote hybrid midwifery/obstetric models to improve maternal and newborn outcomes and increase provider and maternal satisfaction. They consider a continuum of care that includes more sustainable models of surrogacy, abortion, and newborn care across very different parts of the world. They illustrate how each and every chapter offers an example of evidence-based activism, in which consumers, clients, and clinicians push to change their protocols and institutional practices in ways that benefit mothers, newborns, providers, and their wider communities.

Glossary of Terms & Acronyms

SECTION 1: SUSTAINABLE BIRTH IN HIGH-RESOURCE SETTINGSThe first section describes sustainable and compassionate models of care in the US and other high-resource countries that overcome the obstacles raised by technocratic obstetric models of care. The Authors detail the principles of sustainable midwifery care; sustainable transfers of care between home and hospital settings in the US; the Dutch obstetric indications list that specifies when patients are to move between three levels of providers; an innovative model of doula care for low-income or previously incarcerated women in the US; an analysis of metrics for maternal health that have been promoted across the US after the Affordable Care Act; and a hybrid model of breech care that promotes flexible compromises between midwifery and obstetric models of care in very different high-income countries, an analysis of the well-known collaboration between midwives and obstetricians in the Netherlands, and a formula for sustainable surrogacy that contrasts case studies of surrogacy in the US and Israel.

Ch 1. Sustainable Midwifery in the US. Elizabeth Davis (Former Director of the Midwifery Education and Certification Council (MEAC))This chapter explores the key elements that make midwifery care more sustainable, cost-effective, and humanized than obstetric care. It analyzes the enduring skills that have enabled midwives to produce far better maternal and neonatal outcomes than standard obstetric care. Davis describes holistic models of midwifery education and care that are collaborative, egalitarian, flexible, and receptive to the dynamic energy of birth, as opposed to the technocratic obstetric model that is consumed with control, intervention, and hierarchies. We learn how midwives interact with their clients and key tools they use to promote holistic and transparent care. We see how midwives promote self-care, authenticity, and trust between themselves and their clients, while enhancing the birth experience and minimizing provider burnout, as is so common in the obstetric paradigm of care. Critically, the holistic midwifery model of care described in this chapter can be practiced in teams or individually, at home or in hospitals