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Birth Models That Work

Robbie E. Davis-Floyd

Publication Year: 2009

This groundbreaking book takes us around the world in search of birth models that work in order to improve the standard of care for mothers and families everywhere. The contributors describe examples of maternity services from both developing countries and wealthy industrialized societies that apply the latest scientific evidence to support and facilitate normal physiological birth; deal appropriately with complications; and generate excellent birth outcomes—including psychological satisfaction for the mother. The book concludes with a description of the ideology that underlies all these working models—known internationally as the midwifery model of care.

Published by: University of California Press


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p. 1-1

Title Page, Copyright, Dedication

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pp. iii-v


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pp. vii-viii


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pp. ix-x

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pp. 1-27

Birth is one of the most powerful of all human experiences, yet it can also be one of the most disempowering. Around the world, there are examples of societies and systems that provide women with true choice, where their desires and wishes and the normal physiology of labor and birth are honored, respected, and trusted. In these places, interventions are applied solely ...


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1. The Dutch Obstetrical System: Vanguard of the Future in Maternity Care

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pp. 31-53

The German poet Heinrich Heine is reported to have said, “When the world comes to an end, I shall go to Holland, for everything there happens fifty years later.” For some, this Dutch “quaintness” explains the unusual system of obstetric care found in the Netherlands, a system where nearly one-third of births occur at home and where midwives have a degree of ...

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2. The New Zealand Maternity System: A Midwifery Renaissance

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pp. 55-87

New Zealand is a small country with a population of just over 4 million people. We live in relative geographic isolation on two main islands (with a combined land mass greater than the United Kingdom) in the Southern Pacifi c Ocean, three hours fl ight time from Australia, which is our nearest neighbor. As a nation, we see ourselves as fi ercely independent, yet we have ...

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3. The Ontario Midwifery Model of Care

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pp. 89-117

As a profession, Canadian midwifery is a latecomer of sorts, only having been officially integrated into several provincial health care systems beginning as recently as 1994. Prior to this time, Canada had no formally recognized profession of midwifery. Midwives in most Canadian provinces are now autonomous professionals who provide primary, continuous care ...

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4. Samoan Midwives' Stories: Joining Social and Professional Midwives in New Models of Birth

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pp. 119-137

This chapter challenges the assumptions, still held in many postcolonial countries, that the migration and replication of a Western model of birthing is necessarily a desirable goal. The system of maternity care left behind in the Pacific Rim as New Zealanders, Australians, French, or British colonialists moved out is at the very least disappointing. This chapter demonstrates ...


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5. The Albany Midwifery Practice

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pp. 141-158

Following the U.K. government report Changing Childbirth in 1993, a group of midwives working together and desperate for change won the setup money for a groundbreaking midwifery practice. The South East London Midwifery Group Practice (SELMGP) was inaugurated in April 1994 in Deptford, South East London. After three years of excellent outcomes and ...

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6. Small Really Is Beautiful: Tales from a Freestanding Birth Center in England

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pp. 159-186

Birth centers have evolved in many developed countries as an important alternative model to hospital-based, obstetric-led care (Rooks et al. 1989; Saunders et al. 2000; David et al. 1999). Though they are an alternative on the margins, representing just 2%–4% of births in the United Kingdom, their profi le is high in the childbirth literature. Increasingly, ...

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7. Transforming the Culture of a Maternity Service: St George Hospital, Sydney, Australia

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pp. 187-212

In this chapter we describe the process of transforming a maternity service at St George Hospital in Sydney from a traditional, medically dominated culture to one that is fl exible, woman-centered, and embracing of innovative models of continuity of midwifery care. Both of us were employed to be part of this change, Pat as the clinical midwifery consultant and Caroline as a researcher ...

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8. Maternity Homes in Japan: Reservoirs of Normal Childbirth

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pp. 213-237

Hospital birth is the norm in almost all industrialized countries, including Japan, where only 1.2% of births take place outside of a hospital. But the signifi cance of this small number is far greater than it appears, for the potential of normal births achieved in maternity homes and at home is so infl uential that it contributes to maintaining the quality of the rest of ...

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9. The Northern New Mexico Midwifery Center Model, Taos, New Mexico

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pp. 239-268

After a truly disheartening round of discussions with our local hospital’s administration and nursing staff, pediatrician Charlie Anderson took me and Tish Demmin, my midwifery partner, aside and said, “If you want family-centered care, you’re going to have to start your own birth center.” That was the winter of 1977 in Taos, New Mexico. With those words, we ...


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10. Teamwork: An Obstetrician, a Midwife, and a Doula in Brazil

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pp. 271-304

My name is Ricardo Herbert Jones, and I am an obstetrician. I live in a city in the extreme south of Brazil named Porto Alegre, in the state of Rio Grande do Sul, and I graduated from the Federal University of Rio Grande do Sul in 1985. I work in private practice; that is, women pay out-of-pocket for my services. My cesarean section rates are low, and I work on a sliding ...

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11. The CASA Hospital and Professional Midwifery School: An Education and Practice Model That Works

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pp. 305-335

The CASA maternity hospital and professional midwifery school are unique in Latin America, perhaps in the world. The Centro para los Adolescentes de San Miguel de Allende (Center for the Adolescents of San Miguel de Allende) (CASA), in the state of Guanajuato, central Mexico, has developed both birth and midwifery education models with concrete practicality and a ...

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12. Mercy in Action: Bringing Mother- and Baby-Friendly Birth Centers to the Philippines

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pp. 337-362

I studied the first 7,565 women admitted for labor and delivery in two charity birth centers that I established in the Philippines through Mercy in Action, the faith-based, nonprofit organization our family founded (see www.mercyinaction.org). The births in this study occurred between February 8, 1996 (the day the first woman delivered in our newly established ...


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13. Circles of Community: The CenteringPregnancy® Group Prenatal Care Model

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pp. 365-384

CenteringPregnancy®, a copyrighted program design, is a multifaceted model that integrates the three major components of prenatal care— health assessment, education, and support—into a unified program within a group setting. Eight to twelve women with similar gestational ages meet as a group with an obstetrical provider—midwife, physician, advanced practice ...

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14. Humanizing Childbirth to Reduce Maternal and Neonatal Mortality: A National Effort in Brazil

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pp. 385-413

In July 2006, about six months after participating in one of our seminars, Dr. José Leopoldo dos Santos, director of the Hospital Manoel Novaes, a proud presenter at a state seminar, described the current care offered to delivering women: no early admission, amniotomy only according to the partogram, no routine or liberal use of oxytocin, defi ned protocols, no ...

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15. "Orchestrating Normal": The Conduct of Midwifery in the United States

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pp. 415-440

The focus of this book is to present what is working well for birth around the world, rather than what is not. The purpose of this chapter is to provide a lens with which to examine the midwifery model of care in the United States through a synthesis of my research program about the work of midwives and studies done by other U.S. colleagues. The model I describe is ...

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pp. 441-462

In 2002 Ellen Hodnett carried out a systematic review of 137 reports on factors infl uencing women’s evaluations of their childbirth experiences. Her objective was to summarize what was known about satisfaction with childbirth, with particular attention to the roles of pain and pain relief. The reports included in Hodnett’s review included descriptive studies, randomized ...

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pp. 463-472



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pp. 473-484

Production Notes

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p. 485-485

E-ISBN-13: 9780520943339
Print-ISBN-13: 9780520258914

Page Count: 496
Publication Year: 2009

Research Areas


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Subject Headings

  • Maternal health services -- Cross-cultural studies.
  • Childbirth -- Cross-cultural studies.
  • Labor (Obstetrics) -- Cross-cultural studies.
  • Midwifery -- Cross-cultural studies.
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