Interview with midwife Krishinda Powers Duff

The Barcelona-based British midwife tells us about how she studied to become a midwife and her decision to work in Spain.

What is a midwife? A midwife is a person, usually but not always a woman, who is trained to care for women during pregnancy, labour, birth and after birth. She is also trained to care for newborn babies up to the age of six weeks.

Do you have to study to become a midwife? Yes, I trained in the UK, where midwifery is an integral part of the social health care system. We are university trained and also train in hospitals and in the community. On finishing our three-year degree, we graduate with a Bachelors degree in health and science, this is an honours degree, which means it requires a lot of extra work to achieve it.

British midwives and midwifery are respected all over the world, for our high standards of care and in-depth knowledge of the physiology and psychology of normal birth. We are also trained to recognise impending pathology in pregnancy and birth. We are trained to work in both hospital and home birth settings.

What are the benefits of having a midwife care for you in pregnancy as opposed to a doctor? A midwife is an expert in the normality of birth. Her role is to support you in your pregnancy, birth and postnatal experience. As well as being a medical professional, she is also a friend who helps you along the road of pregnancy and birth. Doctors are experts in illness or pathology, when it comes to pregnancy, birth and postnatal care. In the UK, if needed, midwives and doctors work together, to give women the best care. If a women becomes unwell in pregnancy or during birth or in the postnatal period, the midwife will refer her to a doctor for care. If however she is well throughout, she has no need to see anyone else but her midwife.

Are their any downfalls to having a midwife? No absolutely not, but here in Spain, private midwives are not covered by any mutua [private health insurance company] or insurance, so the woman has to pay even extra for this care. This strikes me as deeply unfair. I feel that women who pay for health insurance should be able to choose the care they feel is appropriate for them and have their insurance companies honour their choices.

I feel strongly that the type of midwifery care I offer should be available or at least partly paid for within the social security system. Women pay their taxes and should have real choices in their healthcare system. There are of course midwives in the CAP [primary health centre] system here, but their role and job is very different from that of midwives in northern Europe.

Why are you working in midwifery here in Spain? That's a big question. I had my daughter here in Barcelona nine years ago. The care I received at that time was very different from that of the care I received in the UK when I had my two other children. In reality, I was very traumatised by the experience and sought out other care options for my pregnancy. I came across the midwives of Marenostrum. Their care was very similar to the care I received in the UK. I was treated like a normal healthy woman who was simply pregnant. This was completely opposite from the treatment I received in the social care system here in Spain.

After having my baby and moving back to the UK, I decided to re-train and become a midwife. In my heart, I held the dream of returning to Spain to give other women the kind of care and support I had received at a very vulnerable time in my life.This is the reason why I am working here in Barcelona.