Amicus Maternity Center: Part II

by Jan Tritten

© 2008 Midwifery Today, Inc. All rights reserved.

[Editor's note: This is an excerpt of an article which appears in Midwifery Today Issue 85, Spring 2008. View other great articles and columns in the table of contents. To read the rest of this article, order your copy of Midwifery Today Issue 85. This is part two of a two-part series on Amicus Birth Center in Trinidad. Read online part one from Midwifery Today Issue 84. We hope that this successful model can be used by others.]
Photos provided by the author

The Practice

Amicus Maternity Clinic serves mostly middle-class women, but also rich and poor, educated and uneducated clients. One thing the clients have in common is that all of them want to avoid public hospitals. The Clinic does approximately 12–14 births per month, all onsite. A midwife is present at the birth center 24 hours a day so women can come in whenever they are in labor or have a question. Venus Mark says:

Venus Mark

Birth is conducted by whomever is on duty. The care is not fragmented because the midwife who starts the birth finishes it. Women can request their choice of midwife but usually they are happy to be served by the person on duty. Most of the midwives are willing to come in at the request of a client. If a midwife starts a birth she doesn’t leave until it is completed. Sometimes all rooms are occupied but the midwife on duty can call for help if she needs it. We have added to the birth center, especially to promote privacy.

No epidurals are done with midwife births. They are like homebirths; sometimes they end up on the floor, a chair or wherever. They are women-centered. The midwives follow the lead of the mother.

At Amicus we give women enough information that they don’t have to take a childbirth education course but they can if they want. I consider time with parents an investment. They do so much better when time is spent prenatally.

After birth women can go home in 8–12 hours. Most women stay for two days, depending somewhat on what they can afford. Longer stays incur more charges. Amicus also prepares meals for clients and family, if they choose. The client’s whole family is welcome to be present during labor and the birth.

Lisa Mark

Amicus follows the basic principles of the midwifery care model. In this philosophy, pregnancy and birth are considered to be normal; the mother’s overall well-being is monitored throughout; each mother receives education and other supports; technological interventions are minimized and those with true obstetrical needs are referred to the appropriate provider. Client preferences are deferred to, in general, although evidence-based standards also guide the practice.

Other than the Midwifery Model of Care, Amicus has no general philosophy of care. Venus notes that:

Each midwife needs to have her own [philosophy of care]. In my case, mom and family tell me of their plans but if an emergency arises I may need to intervene. We always try to honor the mom’s birth plans throughout. The baby goes right up on the mom. I feel midwives should not be constrained by my philosophy. They have their own thoughts. Our only real policy is from the government on prevention of AIDS.

Women must take back their bodies [and] midwives must take the steps themselves.

Jan Tritten Jan Tritten is the founder and editor of Midwifery Today. She became a midwife in 1976 after the wonderful homebirth of one of her daughters. Her mission is to make loving midwifery care the norm for birthing women and their babies in this country and around the world. Meet Jan at our conferences around the world! [ PHOTO BY ANDREA NOLL ]   >  Editorials  Click here to read some of Jan's Midwifery Today editorials.   >  Curriculum Vitae  1947 Born in Los Angeles, California. 1965 Graduated from Placer High School in Auburn, California. 1966 Trained for one year as a psychiatric technician. Courses included basic nursing, pharmacology, microbiology, anatomy and physiology, psychology. 1966–1971 Worked at DeWitt State Hospital in Auburn, California as a psychiatric technician. 1968 Graduated from Sierra College with an Associate of Arts degree. 1970 Graduated with honors from Sacramento State College with a Bachelor of Arts degree in Social Science. 1971 Earned Lifetime California teaching credential with fifth-year program from Sacramento State College. 1972 First daughter born in a hospital. It changed my life forever. It was an unsatisfactory birth experience, but I had a wonderful postpartum experience with 2-1/2 years of breastfeeding. 1976 Second daughter born. She was born at home with a doctor who talked me into a homebirth. The difference between the two births sent me on a path to do something to help women have positive birth experiences. 1976 Began training as a midwife. Because I was raising young children and running a business, and because there were no CNM schools in my area, becoming a CNM was not within my reach. 1977 Began attending births with the Birth Co-op in Eugene while organizing courses in our community taught by CNMs, physicians, nutritionists, etc. 1978 Began a midwifery practice, New Life Care, with a partner, Chris Howard, and apprentice Monika Dunsmore. 1979 Son born at home. 1980 Did a one-year program with Marion Toepke McLean, CNM. Four of us completed the program, which was modeled after CNM curriculum at that time. She took a year off from her practice to teach us and to go to our births with us. 1982 First group of midwives certified by the Oregon Midwives Council. Our board was composed of CNMs and physicians. 1986 Slowed down practice and started Midwifery Today magazine.

Contact information for Amicus:

Amicus Maternity Centre
John & Farfan Streets
La Puerta, Diego Martin
Trinidad, West Indies
868-637-5608 Phone
868-637-7391 Fax
lisamark@tstt.net.tt

Sources:

• Midwifery Model of Care. www.cfmidwifery.org/mmoc/define.aspx. Accessed 11 Feb 2008.

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