evidence-informed midwifery
sara wickham


While many people out there are busily working on the scientific quantitative research evidence which evaluates the practice of midwifery and obstetrics, I would argue that this is only one form of evidence used by women and midwives in making decisions about birth.

I feel there are three main issues which can be addressed through the use of evidence-informed midwifery. The first of these is concerned with the fact that midwives support women making decisions. And women come to midwives because they need knowledge on which to base these decisions. The more we can generate for ourselves in the way of knowledge and understanding of women's bodies, the more we can help those women and their babies to make the decisions which are right for them. We need to become more inclusive about the forms of evidence which we seek to understand and develop and which can provide the information needed by women.

We are in danger of losing those forms of evidence and ways of knowing which are unique to women, and which may be the most relevant to the ways we work together. While some of the ideas we have may not be mainstream at present, embracing and utilising the concept of evidence-informed midwifery may be one way in which we can make them so. The question of how we can validate midwifery knowledge is one of the most exciting 'hot topics' right now.

Having worked with midwifery research for a number of years, I am aware that analysis of this research points to the very things that we do know in our hearts; that birth is a sacrament which is 'as safe as life gets'. Yet we live in a society where women are taught to distrust their bodies and the process of birth, turning instead to doctors and technology. We need to enable women to understand that, for the majority of people, even scientific research shows that home birth and midwifery are safer than the alternatives. For me, promoting evidence-informed practice is a way to ensure that more women and babies get safe, effective, loving midwifery care which empowers them as people and parents.



Midwifery Evidence and Resources

Our research Links to some of the research (and other) articles we have written about different topics
Different Ways of Knowing The part of our site which looks at other ways of knowing; art, craft, stories.
Midwifery Knowledge Our page of links to midwifery sites, many of which contain 'alternative' evidence and articles about different ways of knowing.
Intuition as Authoritative Knowledge Click on the menu on the left to see an excellent article on Intuition and Authoritative Knowledge by Robbie Davis-Floyd and Elizabeth Davis.
Midwifery Today Loads of articles written by midwives (and others) from a midwifery perspective.
Breech Birth Research Maggie Banks' critique of the Canadian Term Breech Trial - an example of the combination of an understanding of research and other evidence.




Research and Statistics on The Web



Cochrane Abstracts
A list of free abstracts on pregnancy and birth from the Cochrane Collaboration.

Birthchoice UK
Information on maternity statistics

Netting the Evidence
Lots more links!

WHO Library Database
Links to WHO articles and documents.

National Women's Health Information Center
US site containing information on women's health from a biomedical perspective.




Medical Journals Online



British Medical Journal

The Lancet

Alternative Medicine Review

Journal of Medical Internet Research


Archives of Family Medicine

Canadian Medical Association Journal

Irish Medical Journal

New England Journal of Medicine

Free Medical Journals



The whole area of evidence-informed midwifery raises far more questions than answers at present. Having established that we may need to be more inclusive of what we define as 'evidence', we need to address the issue of validity - how do we, as individual midwives, evaluate any particular form of evidence? The process that we use to evaluate research is well-understood. But how do we ensure that we are using our experiential knowledge appropriately? How can we justify using intuitive ways of knowing - not even necessarily for ourselves, or for the women we work with, but for women who have learned not to trust their feelings or for other practitioners who may choose to incorporate this into their practice?


Any thoughts?! Answers on an email!