What is a Midwife? Is a Midwife right for You?
What is a midwife? A midwife is a professional trained to attend a woman in childbirth, by providing support and guidance during labor and delivery, as well as supervising the care of mother and child directly after birth. Today’s midwives may also provide support during the pregnancy itself.
They generally work with women experiencing normal pregnancies and deliveries, and will call on the obstetrician or other physician if complications arise during the delivery.
In midwifery, developing a sensitive relationship with the mother is of central importance, emphasizing communication, family needs, cultural values, and the personal preferences of the mother. Midwifery also emphasizes the importance of safety; studies have shown that births attended by midwives have the same success rate as those attended by physicians. In addition, midwives encourage the mother to actively participate in the labor and birth process, encouraging her not to use pain medication or invasive procedures as much as possible.
It has been shown that having a trained midwife present throughout labor and at delivery can reduce the length of labor and the need for pain medication, as well as the need for forceps or a cesarean section.
In the US, there are two recognized categories of midwives: direct entry midwives and nurse midwives. Both types maintain professional relationships with obstetricians and/or physicians in the case that complications arise.
A direct entry midwife (DEM) has usually been trained in an apprenticeship, on-the-job training, or a field that is not formal nursing. Most of their training is experience-based. DEMs usually provide support to women who are delivering at home.
A DEM can become certified from the North American Registry of Midwives, after completing certain requirements (health science pre-reqs, graduation from a midwifery education program, and baccalaureate degree) and passing the certification exam. At this time, the DEM achieves the title of “Certified Midwife” (CM), which is a recognized title in the profession.
Nurse-midwives begin their careers as registered nurses and then move into the field of midwifery by completing an accredited program. Once certified, they are conferred the title of “Certified Nurse-Midwife” (CNM).
They can dispense prescriptions, provide support in the preconception and prenatal stages of pregnancy, as well as provide guidance on after-birth care, disease prevention, and family planning, in addition to performing gynecological exams.
Both CMs and CNMs pass the same exam, which is administered by the American College of Nurse-Midwives Certification Council. In addition the ANCM was the body which developed the requirements for CMs, guaranteeing their competence and safety. CMs and CNMs are held to the same standards of practice, philosophy, and code of ethics.
If you are interested in working with a midwife, your ob-gyn or family physician should be able to give you a referral. In addition, you can call the ANCM’s 24-hr. toll-free number, which gives you the names of ANCM-certified midwives: 1-888-MIDWIFE (1-888-643-9433). You can also find this information at: www.midwife.org/find.cfm.
As you consider midwife candidates, be sure to ask questions about her education, certification, and experience and time in the field. It is also important to ask if she will attend the entire labor process, and what happens if complications arise. You will probably also want to know about her midwifery philosophy, including the role of the mother and family members in the process. Finally, be sure to ask about her fees and if she accepts insurance.
What is a midwife? A caring professional that will do everything in her power to make your pregnancy, labor, and delivery experience as personal and sensitive – and safe – as you and your family could wish.