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«The midwife is in a way the general practitioner of pregnancy“, Considers Prisca Wetzel, temporary midwife.
The human side, the medical skills required and the joy of being able to give birth to children pushed Prisca Wetzel to reorient herself towards the profession of midwife, after a first year of medicine. In addition to two or three “guards” of 12 or 24 hours per week, this young 27-year-old temporary midwife, always dynamic, multiplies the commitments to cultivate her passion.
A humanitarian mission for 6 weeks in Mali, to train locals, consolidated his enthusiasm. However, the exercise conditions were harsh, with no shower, no toilet, no electricity… “Finally, practicing a birth by candlelight and with a caver lamp hanging on the forehead is not impossible,” explains Prisca. Wetzel. The lack of medical equipment, not even to resuscitate a premature baby, complicates the task, however. But mentalities are different: there, if a baby dies at birth, it’s almost normal. People trust nature. At first, it’s difficult to accept, especially when you know that the newborn could have been saved if the birth had taken place under more favorable conditions. ”
Childbirth: let nature do it
However, the experience remains very enriching. “Seeing Malian women about to give birth arrive on the luggage rack of a moped, whereas two minutes earlier they were still working in the fields, it surprises at first!”, Laughs Prisca.
If the return was not too brutal, “because you get used to comfort very quickly”, the lesson learned from her experience remains: “I learned to be less interventionist and to work as naturally as possible.” Clearly, the triggers of convenience so that the childbirth takes place on the desired day, are far from satisfying her! “We must let nature act, especially since these triggers significantly increase the risk of cesarean section.”
A volunteer at Solidarité SIDA where she works in prevention with young people throughout the year, Prisca has also joined forces with Crips (Regional AIDS Information and Prevention Centers) to intervene in schools. The goal: to discuss with young people subjects such as the relationship with others and with oneself, contraception, STIs or unwanted pregnancies. All this while waiting to leave one day …
In 80% of cases, pregnancy and childbirth are “normal”. The midwife can therefore take care of it independently. The doctor acts as a specialist for the 20% of so-called pathological pregnancies. In these cases, the midwife is more like a medical assistant.
After the birth of the newborn, the young mother is not let go in nature! The midwife sees to the good health of the mother and the child, advises her on breastfeeding, even on the choice of a method of contraception. She can also provide postnatal care at home. If necessary, the midwife will also take care of the perineal rehabilitation of young mothers, but also of contraception and gynecological follow-up.
From the moment you choose your maternity ward (private clinic or hospital), you meet the midwives who work there. Clearly, you cannot choose it: the midwife who will do the consultation for you is the one present on the day of your visit to the maternity ward. It will be the same on the day of your delivery.
The alternative: choose a liberal midwife. This ensures the overall pregnancy monitoring, from the declaration of pregnancy to the postpartum, including of course childbirth. This makes it possible to favor continuity, listening and availability. Above all, a real relationship of trust is established between the pregnant woman and the specially chosen midwife.
The birth can then take place at home, in a birth center or in a hospital. In this case, a hospital technical platform is made available to the midwife.
During pregnancy, you are invited to consult a midwife (at the maternity ward or at her office) at the same rate as the gynecologist, namely one prenatal consultation per month and one postnatal visit. The conventional price for a maternity consultation is 23 euros. 100% is reimbursed by Social Security. Fee overruns remain rare and insignificant.
Since 2009, midwives share certain skills with gynecologists. They can provide consultations in terms of contraception (insertion of an IUD, prescription of pills, etc.) and gynecological prevention (smears, prevention of breast cancer, etc.).
What is the role of the midwife during childbirth?
From the start of labor until the hours following the birth of the newborn, the midwife assists the new mother and monitors the well-being of the baby. Traffic jams in the service oblige, it often only passes once an hour during labor (which can last 12 hours on average for a first baby). She also monitors the mother’s condition, manages her pain (epidural, massages, positions) until the time of childbirth. 80% of deliveries are accompanied by midwives alone. At birth, it is the midwife who welcomes the newborn and provides first aid. Finally, during the two hours following childbirth, she also sees to the good adaptation of the child to “aerial” life and to the absence of bleeding during delivery in the mother.
What about the men?
Despite an equivocal name, men midwives exist! The profession has been open to them since 1982. They can also call themselves a “midwife” but the name “midwife” is commonly used. And without sexism, since etymologically, “midwife” means “who possesses the knowledge of the woman”.
Midwife: a job under pressure
While the methods of exercising the profession of midwife are very varied, the working conditions are not always ideal, between on-call duty, lack of recognition, etc.
Regarding the place of practice, midwives have a choice! About 80% of them work in a hospital environment, nearly 12% prefer to work in private practice (individual or group practice). A minority choose the PMI (Maternal and Child Protection) or a supervisory and training function.
«Despite the evolution of the profession, midwives are still considered as auxiliaries to the doctor. However, in the majority of cases, they carry out the childbirth alone.“. That the selection has become more draconian (after the 1st year of medicine) and that the course extends to five years of study does not seem to have changed mentalities … Even if helping to give life remains, according to them, the most beautiful in the world.
Testimony of a mother for her midwife
A moving letter from a mother, Fleur, to the midwife, Anouk, who helped her give birth to a baby boy.
Midwife, a difficult job?
“In the hospital, the constraints are more and more difficult. While there is a great lack of midwives, maternity hospitals will soon no longer be on a human scale! This risks being to the detriment of relationships and patient support… “, explains Prisca Wetzel, midwife. A lack of recognition from midwives?