Gynecologists and midwives work in a complementary manner.
The shortage of midwives affects not only the female population that lacks the attention and care of these professionals but also impacts the work of gynecologists, with whom they share a “complementary” and supportive role. On July 19, 2005, during the International Confederation of Midwives in Australia, the role of the midwife was defined as the “responsible and accountable professional who collaborates with women to provide essential support, care, and advice throughout pregnancy, childbirth, and the postpartum period,” as stated in ‘The Role of the Midwife in Primary Care’ from the Madrid Health Service (Sermas).
“They are the trained personnel responsible for monitoring and caring for pregnancies and low-risk births, specifically for healthy women,” said Medical Writing Patricia Barbero, gynecologist at 12 de Octubre University Hospital. She emphasizes the importance of having a sufficient number of midwives to ensure not only delivery care but also the identification of potential complications that women may face during their gestational period. “Without enough midwives, this monitoring will be significantly less effective and the likelihood of not identifying issues that may arise during delivery increases.”
Moreover, these are not the only procedures where midwives can operate “autonomously and independently” of gynecologists. “In most Madrid hospitals, midwives are assigned to the high-risk floor and are responsible for conducting fetal monitoring for high-risk pregnancies and identifying any warning signs,” which they will report to the gynecologist, Barbero explains.
“When there is a shortage of midwives, as we are currently experiencing because training in Spain was halted for a period, we gynecologists feel incomplete; we are missing a vital component,” she adds, referring to the interval between 1987 and 1994, during which midwifery training was interrupted due to the closure of schools in Spain that failed to meet European training standards.
José Alcolea, a gynecologist at San Juan de Dios Hospital in Córdoba, shares a similar perspective, asserting that the lack of midwives impacts daily patient care. “Midwives are specialized nurses upon whom we depend for maternal care, primary care, pregnancy monitoring, screening processes, and cancer checks (such as cytology). Due to their shortage, we are witnessing a decline in quality service and inadequate information provided to patients.“
Additionally, Alcolea notes that the remaining staff is “burdened with more work,” ultimately leading to them “trying to complete tasks to the best of their ability,” which also complicates the situation due to the increased workload. For the doctor, having midwives is “crucial; they are essential for a healthy healthcare system.” “If there is a deficit because positions are not filled, that population is genuinely underserved,” he emphasizes.
Over-informed Patients
The overabundance of information and the quest for data online also exacerbates this issue. In this age where we can access all kinds of information from our mobile devices—much of which may not be validated—women risk not receiving accurate information, and timely intervention by the appropriate professionals may be lacking.
According to Barbero, an example of this is the childbirth preparation courses for expectant mothers. “One very helpful aspect of postpartum courses is that they often explain the unique features of each hospital, the procedures, and how to navigate admission. This knowledge significantly calms women. It is evident when a woman has participated in a midwife-led childbirth preparation course compared to someone who has only read, listened, or searched for information online,” she elaborates.
For José Alcolea, the absence of scheduled childbirth preparation classes “does not inherently cause complications” for a pregnant woman. “If a woman experiences a complication during childbirth, such as placental abruption or cord prolapse, her attendance at preparation classes does not determine whether those complications will arise,” he states. However, it leads to “people being less prepared or informed” about potential complications that may occur.
Shortage of Midwives and General Nurses
The absence of midwives, while a pressing issue, also leads to another problem: general nurses performing functions that do not align with their training. “There is an attempt to make up for the lack of midwives by assigning general nurses to these roles, which is not appropriate. While general nurses can be trained briefly in the basics of childbirth and postpartum care, such skills will never truly fall within their competencies,” explains gynecologist Patricia Barbero.
As a result, a secondary issue arises: that gynecologists are assigned responsibilities they are “overqualified” for. “You place gynecologists in charge of monitoring, treating, or assisting low-risk births when their focus should be on high-risk cases and complications, which implies we are managing situations that do not require a gynecologist’s expertise,” she emphasizes.
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Gynecologists and Midwives: Collaborating for Women’s Health
The roles of gynecologists and midwives are often intertwined, each providing vital services within the healthcare system, especially concerning women’s reproductive health. However, the ongoing shortage of midwives is causing significant repercussions for both the mothers they serve and the gynecologists who collaborate with them in the care process.
The Role of Midwives in Women’s Health
The International Confederation of Midwives defines the midwife as a “responsible and accountable professional who works in association with women,” emphasizing their role in providing necessary support, care, and advice during pregnancy, childbirth, and the postpartum period. In the words of Patricia Barbero, a gynecologist at 12 de Octubre University Hospital, midwives are particularly trained for monitoring low-risk pregnancies and attending to healthy childbirths.
“Having a sufficient number of midwives is crucial to ensure effective monitoring and care throughout pregnancy,” Barbero explains. “Without adequate midwifery support, potential complications during delivery may go unnoticed.” This vital role showcases the indispensable nature of midwives in identifying complications in pregnancy and delivery processes, thereby allowing for timely intervention when needed.
Complementary Roles of Midwives and Gynecologists
Midwives perform various functions autonomously yet in conjunction with gynecologists. For instance, according to Barbero, “In most Madrid hospitals, midwives handle fetal monitoring for high-risk pregnancies and identify warning signs that necessitate a referral to a gynecologist.” This collaborative approach highlights how midwives enhance the efficiency of gynecologists’ work, particularly in high-pressure environments like labor wards.
Working alongside midwives enriches the functionality of healthcare teams. Gynecologists agree that without sufficient midwifery staffing, they experience gaps in patient care. As José Alcolea, a gynecologist at the San Juan de Dios Hospital in Córdoba, notes, “We gynecologists feel like we are lacking a crucial element when midwives are in short supply.” When midwives are absent, the pressure increases on gynecologists, leading to potential setbacks in patient care.
Implications of Midwife Shortages
The shortage of qualified midwives significantly impacts the delivery of care to mothers. Gynecologists serve many roles due to these shortages, which can overwhelm their capacity to provide specialized care effectively. Alcolea mentions, “The lack of midwives leads to the general burden of care falling onto gynecologists, affecting pregnancy monitoring, cancer screening processes, and overall maternal care.” This scenario ultimately results in poorer service to patients, emphasizing the necessity for trained midwives in every hospital.
Consequences for Patients
- Increased Workload on Gynecologists: With fewer midwives, gynecologists are often required to manage low-risk situations for which they are overqualified, detracting from their primary role of handling high-risk cases.
- Reduced Quality of Care: The impact of insufficient midwifery staff translates to diminished attention to maternal health, leading to potential oversights during childbirth.
- Overwhelmed Healthcare System: The absence of midwives leads to a backlog and more responsibilities for gynecologists, compromising the overall healthcare system’s functionality.
The Rise of Misinformation
In today’s digital age, where information is readily available at our fingertips, women often turn to the internet for advice about pregnancy and childbirth, risking exposure to incorrect and unverified data. Overinformation can lead to heightened anxiety among expectant mothers, as they may encounter conflicting advice online. Barbero stresses the importance of reliable information: “Women who participate in midwife-led childbirth preparation courses navigate their experiences with greater confidence, as these courses provide essential insights into hospital protocols and delivery processes.”
Conversely, Alcolea believes that the lack of scheduled childbirth preparation classes does not automatically indicate complications arise during the process, but it does lead to a population that is less informed about what to expect, therefore increasing stress and fear.
Impact on Nurse Roles
Another critical issue stemming from the midwife shortage is the over-reliance on general nurses to fill these gaps. This practice is not advisable; according to Barbero, “Although general nurses can be re-trained to assist with specific tasks related to childbirth and postpartum care, they lack the specialized skills and experience of trained midwives.” The reallocation of roles not only compromises patient care but also creates inefficiencies in the healthcare system.
Benefits of Collaboration Between Gynecologists and Midwives
There are numerous advantages to the partnership between midwives and gynecologists, including:
- Enhanced Patient Care: The collaborative efforts ensure that pregnant women receive comprehensive care tailored to their needs.
- Improved Identification of Risks: Midwives are often the first to recognize complications, allowing for quicker referral to gynecologists.
- Cost-Effective Healthcare: Utilizing midwives for low-risk births allows gynecologists to focus on higher-risk cases, promoting an efficient allocation of resources.
Conclusion
To ensure optimal healthcare for women, it’s essential to strengthen the workforce of midwives. Their role is crucial not only in monitoring pregnancies but also in enhancing the overall experience of childbirth. As highlighted by both Barbero and Alcolea, the future of women’s health depends on the effective collaboration between midwives and gynecologists, which can lead to improved maternal outcomes and a healthier society.
The information provided in this article is derived from expert opinions and official health regulations. For specific medical advice or concerns regarding your health, please consult your healthcare professional.