NAPSAC publication
"The Five Standards of Birth":
Midwifery: Safe, Cost-Effective Maternity Care for All'

Excerpts from the Midwifery Chapter in "Five Standards"

by David Stewart, PhD:

...Every study published shows midwives to be safer than doctors. Every study. No exceptions. If your physician disagrees with this, challenge him or her to produce the data that supports otherwise. They won't be able to do it. Such data does not and never did exist. In a nutshell, that is the strength of the case for midwifery. It is unanimous.

...Why would doctors do relatively worse with normal cases than abnormal ones? It may have to do with the attitudes of physicians who are more likely to engage in extreme interventions with the healthy and the strong than with the sick and the weak. It appears that instead of encouraging and supporting the normality of a healthy pregnancy, as a midwife would do, doctors are inclined to abuse such advantages -- taking the presence of health as license for recklessness. These data also call into question whether anyone, even high risk women and babies, benefit from doctors. There is no evidence here that they do.

...In fact, far from reducing risk, "obstetricians' care actually provokes and adds to the dangers." *quoted from Tew and Damstra-Wijmenga, I'm not sure, but I think the reference is from her - Professor Marjorie Tew, medical statistician - book, "Safer Childbirth? A Critical History of Maternity Care, revised edition, 1995, Oxford University Press*

...Over and over again throughout history, the data show that when doctors displace midwives, outcomes get worse.

...Increasing numbers of obstetrician/gynecologist are dropping their OB practice and focusing on gynecology because of their escalating malpractice insurance cost--which is, of course, because of their escalating engagement in malpractice.
The price of malpractice insurance for midwives is minuscule compared to that for doctors. Malpractice insurance companies have to be fiscal realist. They know who is most likely to guilty of real malpractice, and they now it isn't midwives. If mounting malpractice costs reach the point to where obstetric practice is no longer profitable, physicians who deliver babies will find another source of livelihood.

...It could be that, ultimately, the rightful return of maternity care to the domain of mothers and midwives will be forced by monetary issues, instead of coming by way of a voluntary surrender of currently entrenched physicians who 'see the light', accept the scientific facts, and magnanimously respond to the ideals of what is really in the best interest of families. Among certain types of people, money always speaks louder than idealism.

...In March of 1996, the Kansas State Supreme Court rules that midwifery is a distinct profession. The high court stated that "even if the midwife does something that could be construed as medical practice, it is not medical practice. It is midwifery. An activity is not incident to the practice of medicine just because it is engaged in by the members of the medical profession."

Dr. Stewart says, "Any practitioner who attends birth with an attitude of respect for individuality, support of nature, promoting health, and the preservations of normality by little or no intervention is, by our definition, a "midwife" even though he or she may hold a degree in medical doctoring."

To get a copy of the new, fully updated 1997
"Five Standards for Safe Childbearing" by David Stewart, Ph.D send $16.95, plus $3.00 shipping to NAPSAC, Rt. 1, Box 646, Marble Hill, MO 63764-9725, USA. (make checks payable to NAPSAC International, in US funds) reprints of the Midwifery article are $4.95 each, plus $1.50 shipping, and the Home Birth Chapter is $3.95, plus $1.50 shipping. *I have no financial or any other interest in NAPSAC, except I like the work the Stewarts do!*

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Proud parents Marie Paul & Jim, Baby Girl Rita (born at home),
Faith, Martha and her son