Midwives and Pregnancy
What Is A Midwife?
A midwife is a health care practitioner who offers health services that are less intrusive and constitute a more natural approach to health practice. When it comes to pregnancy, midwives act as facilitators of a childbirth experience that is as natural as possible. However, many midwives are trained to deal with certain pregnancy and delivery complications whether independently or in collaboration with a physician. The services offered by a given midwife are often dependent on their professional experience and licensure credentials.
Types of Midwives
There are three main types of practicing midwives in the United States:
- Certified Nurse-Midwife (CNM). A certified nurse-midwife is trained in both nursing and midwifery. Certified nurse midwives are registered nurses who usually possess a bachelor's degree from an accredited educational institution along with certification from the American College of Nurse Midwives. Certified nurse midwives may work in hospitals, in a birth center setting, or provide independent homebirths, typically in collaboration with a physician.
- Certified Professional Midwife (CPM). A certified professional midwife is an individual who is trained in midwifery and whose skills and practice have been approved by the North American Registry of Midwives. CPMs generally work in birth centers or homes.
- Lay Midwife. A lay midwife is a practitioner who chooses not to become certified and may work in collaboration with a physician but does not have to be under the physician's directive. Lay midwives may have less formal training by way of apprenticeships, informal schooling, or self-study. A lay midwife focuses on homebirths and delivery at birth centers.
The Benefits of Midwifery: Why Choose A Midwife
Midwifery is becoming a popular option for women who would like to experience a natural birth, whether the birth experience takes place at home, at a birth center or at a hospital. Midwives offer very personalized care, which can start at preconception through to prenatal care, delivery, and postpartum care.
This personalized care includes the following services:
- Nutrition and exercise counseling for a healthy pregnancy
- A relaxed atmosphere as well as emotional support, encouragement, and counseling for a natural baby delivery
- Providing natural pain relief or pain medication and epidural during child birth
- Preconception counseling including a review of past medical and genetic history, immunization status, prenatal vitamins and pregnancy testing
- Complete prenatal care including gestational diabetes
- Postpartum care including breastfeeding education and check ups
A midwife can also recommend other health care practitioners, and may work in collaboration with physicians and surgeons if complications arise.
A midwife can also offer a more economical childbirth option, and many midwives treat pregnant women with lower incomes.
Studies have shown that the need for caesarian sections, mortality rates, and recovery complications are decreased amongst women who received prenatal care from a nurse midwife while pregnant. However, a hospital birth may be recommended if labor complications are expected, in order to have access to more facilities and practitioners.
Midwives and Other Services
While midwives are usually associated with childbirth, prenatal care, pregnancy, and post partum care, many nurse-midwives also provide gynecological health care to women of all ages, while maintaining the benefits of less technological intervention and a more personalized philosophy of health care practice.
Some of the gynecological services offered by a nurse-midwife include annual gynecological exams, breast exams, sexually transmitted disease (STD) testing, and pregnancy testing. Nurse midwives can also treat vaginal infections and urinary tract infections (UTIs) as well as provide PMS counseling.
A nurse-midwife can also treat issues related to menopause and osteoporosis, and in some cases provide hormone replacement therapy (HRT), perform a colposcopy or endometrial biopsy, as well as provide IUD and Implanon birth control services.
The types of services offered by a midwife generally depend on their professional history and certification along with the legal restrictions on medical practice of a given state. Check with a birth center or midwife practitioner in your area to find out about the services that may be available to you.
Learn more about the benefits of a midwife, and decide if you want to have a home birth, by chatting with other women in our pregnancy forum.