Laborist noun; from Louis Weinstein, Thomas Jefferson University Hospital 1. (employment for Generation X and Y): depending on the hospital for one’s livelihood ~ income or resources 2. ( individual): doctors who work full time in the hospital, do only labor and delivery and work shifts of no more than 12 hours (from Arnold Cohen, Albert Einstein Medical Center): specialization, predictability

There’s a new doc in town. But mom probably won’t meet this obstetrician until her labor pains start.

This article poses Generation X and Y as the fall people for the economics of maternity care being in need of enhancement. If we are to believe this then we are to blame this same generation for assembly-line birth (start at induction and end your flow chart at episitiomy+forceps/vacuum or cesarean), obstetricians requiring a greater number of births in order to bill for and be able to pay for malpractice insurance (whether for poor use of interventions or mistakes made by lack of sleep) and office overhead costs and the dehumanization of birth.

Those are some heavy charges to lodge against these young people, and on behalf of the many young and older parents who have come through our birth classes we feel a need to set the record straight. Parents are searching for “care” providers. Knowledgeable, skilled and normal-birth experienced men and women who still hold a baby’s first seconds and moments in our world as being wondrous, joyful and sacred.

Parents are searching for men and women who refuse to work robotically, pushing crowds of women down a birth chute without names, identities or beliefs. Parents, who while appreciating the conveniences of technology for things such as researching information, have never stopped believing that healthcare should consist of nurturing the whole body and preserving whole health with invasive procedures as a final option. America may not rank up there with Cuba and other countries with better maternal and infant mortality outcomes but we do not believe that Americans or parents around the world prefer medical birth to normal, human birth.

The Midwives Model of Care™, defined by the Midwifery Task Force, is alive and well, although if journalistic pieces such as Division of Labor continue to make it through the editorial process it may be harder for the public to learn about it (and some might argue that the dehumanization of birth will continue to rise as a fault of the media’s integrity).

Under the Midwives Model of Care™, which is “based on the fact that pregnancy and birth are normal life processes”, quality birth care includes:

  • Monitoring the physical, psychological, and social well-being of the mother throughout the childbearing cycle
  • Providing the mother with individualized education, counseling, and prenatal care, continuous hands-on assistance during labor and delivery, and postpartum support
  • Minimizing technological interventions
  • Identifying and referring women who require obstetrical attention “The application of this woman-centered model of care has been proven to reduce the incidence of birth injury, trauma, and cesarean section.”
Across all other fields of health care there is a return to patient-led care. So we ponder what is going on behind the scenes that the medical schools churning out obstetricians feel a need to keep women and babies in the operating rooms but to pay med school bills. Here are some more links for further information on this topic: Hospitalists Review Essay; and Laborists, nocturnalists, weekendists: Will the “ists” preserve the rewards of OB practice?
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