Evidence-Based Practice in Midwifery

Instructor: Danielle Haak

Danielle has a PhD in Natural Resource Sciences and a MSc in Biological Sciences

Evidence-based healthcare is becoming commonplace across the different medical disciplines. In this lesson, we'll learn how evidence-based healthcare influences how midwives develop care plans for their patients.

What is Evidence-Based Healthcare?

While Katelyn was in nursing school, she and her classmates learned about something called evidence-based practice (EBP), a model of healthcare that incorporates current best research evidence, clinical experience, and the patient's preferences and values when deciding on a course of action.

Best research evidence can come from clinical trials, controlled research experiments, case reports, expert opinion, and scientific principles, among other places. Clinical experience is something a healthcare provider gains over time, but more experienced mentors can help new nurses like Katelyn while they are first starting out. Finally, each patient will have his or her own opinions on what he or she expects from each healthcare experience.

Translating research evidence into real-world practice isn't as easy as it might originally appear. Sometimes, it takes a 'translator' to take new knowledge and figure out how it can best be applied in practice. To help assist with this translation of evidence to real-world applicability, it can help for a healthcare professional to ask a few questions. For example:

  • Does the problem outlined in this research apply to my patient?
  • Are there major differences between the patients in this study and my patient? If so, could these differences significantly affect the expected outcome of treatment?
  • Does this proposed treatment align with my patient's personal preferences?
  • Do the benefits of this approach outweigh the potential harms or costs?
  • Were the methods used in this research valid and reviewed? Did a peer review take place?

This isn't a comprehensive list of questions, but it provides an idea of the types of questions a healthcare provider must ask him or herself when incorporating evidence-based practice into patients' care.

Role of Midwives in Healthcare

While Katelyn was in school, she decided she wanted to focus her studies on becoming a midwife. Midwifery is a field of healthcare that specializes in treating women before, during, and immediately after pregnancy and labor; however, midwives also provide primary care and will sometimes treat both men and women for sexually transmitted diseases.

Midwives receive training that enables them to appropriately respond to a variety of issues that can arise during pregnancy, but they typically specialize in treating low-risk women throughout pregnancy and during normal births. A normal birth is one that occurs spontaneously and is dictated by the natural physiological response of both woman and baby during labor and birth.

In general, patients who work with midwives throughout pregnancy report higher satisfaction in their care, reduced use of unnecessary medical procedures, lower costs of care, and easier access to care. That being said, women who have higher-risk pregnancies are often directed to consult with more traditional healthcare providers during pregnancy. This is mostly because they are likely to need a different level of care than low-risk patients.

Midwives usually specialize in treating pregnant women.

Evidence-Based Practice in Midwifery

Let's look at a few examples of how evidence-based theory is applied in midwifery and how this care differs from a more traditional birthing approach.

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