Many women interested in natural or home births choose to have a midwife as their primary care provider during pregnancy, as opposed to a doctor or traditional nurse. Midwives are devoted to facilitating natural, stress and pain-free birth experiences for women with low-risk pregnancies, and are often a service covered by maternity insurance plans.
What is a Midwife?
Traditionally, a midwife has been someone trained to aid and assist women through pregnancy and the process of giving birth. Today, that definition still holds true; however, today's midwives are usually certified via either the American College of Nurse-Midwives or the North American Midwives Registry, which assures a consistent standard of care. A midwife will charge less than a primary care physician, but is only trained to care for healthy, uncomplicated pregnancies. Women who expect complications will generally be referred to a doctor.
The History of Midwifery
Midwifery practices have been documented in both ancient Greek and Egyptian texts, and midwives appear to have been held in high esteem in the East and the Mediterranean Basin during this time. Later, in Medieval Europe, midwives were considered almost essential to childbirth, which was a deadly and dangerous undertaking for many women. By the 19th century however, most people wanted the services of a surgeon during childbirth, and midwifery fell out of favor for a time.
The Benefits of Choosing a Nurse-Midwife
A modern nurse-midwife can have a number of beneficial effects on healthy, low-risk pregnancies. At least one doctoral study has found that using a nurse-midwife can reduce maternity care costs, lower rates of morbidity for both mother and infant, reduce the need for medical intervention, and reduce the possibility of complications during recovery. Nurse-midwives are also licensed to dispense medications, just as a traditional nurse is, which can be helpful if you are using your midwife for primary prenatal care.
Types of Midwife Certification
There are several different types of midwife and midwife certification. A Certified Nurse-Midwife has training as both a nurse and a midwife, has been certified by the ACNM, and has at least a bachelor's degree from a four-year institution. A Certified Midwife has also been certified by the ACNM, but lacks nursing training. A Certified Professional Midwife has met the standards of the NAMR, while a Direct-Entry Midwife has been trained by an independent program but is not certified by either association.
When is a Midwife an Appropriate Choice?
Healthy, low-risk pregnancies comprise about 60% - 80% of all births. For these women, choosing a midwife may be a valuable decision that will save money and increase their chances of a natural, relatively comfortable birth. However, women who have reason to expect complications during pregnancy should not attempt to use a midwife or to give birth at home. In these situations, it is preferable to choose hospitalization, where your medical team can closely monitor the health of both you and your baby.
Midwifery is an ancient practice with significant benefits for modern-day women. If you're looking to save costs and have the most natural birth possible, a midwife may be able to help you achieve these goals.
Article on Midwives
A midwife is a trained and certified health care professional who provides a quality alternative to the traditional obstetrician. Although a midwife may provide contraception or gynecological services, their specialty is providing prenatal care, labor and delivery services, and postpartum care. A midwife usually offers a variety of options and seeks to eliminate or minimize unnecessary interventions. The good news for you is that in addition to providing quality health care services, midwives are also more economical on your pocketbook.
When using a midwife you should anticipate the following philosophy and practice:
Although not all midwives hold true to these completely, these are common philosophies and practices held by most midwives. The best thing to do is to ask your potential midwife about her practice.
- A continual monitoring of your physical, psychological, and overall well-being throughout your pregnancy.
- Providing you with tailored care through education, counseling, and personalized prenatal services from conception through delivery.
- Intentional efforts to minimizing unnecessary technological interventions
- Identifying and referring women who require obstetrical attention.
- Adapted from Midwives Model of Care, Midwifery Task Force, Inc.
What services do midwives provide?
The types of services you may receive from a nurse midwife depend on the specific certifications and licensure credentials. A nurse-midwife has additional credentials in nursing making the services the most comprehensive.
Although midwives provide gynecological services, the most important thing to you at this point is that their specialty is providing prenatal care with labor and delivery services. The other good news for you is that midwives often provide an a more economical option for birthing care.
What are the different types of midwives?
There are two primary credentialing entities which are the American College of Nurse Midwives (ACNM) and the North American Registry of Midwives (NARM). These programs deliver stringent education, training and testing. Here is a list of the types of midwifes and their credentials:
Certified Nurse-Midwife (CNM): an individual trained and licensed in both nursing and midwifery. Nurse-midwives possess at least a bachelor's degree from an accredited institution of higher education and are certified by the American College of Nurse Midwives.
Certified Professional Midwife (CPM): an individual trained in midwifery and meets practice standards of the North American Registry of Midwives.
Direct-Entry Midwife (DEM): an independent individual trained in midwifery through a variety of possibilities that include: self-study, apprenticeship, a midwifery school, or a college/university program.
Certified Midwife (CM): an individual trained and certified in midwifery. Certified midwives possess at least a bachelor's degree from an accredited institution of higher education and are certified by the American College of Nurse Midwives.
Where do midwives practice?
Midwives usually provide their services through a hospital, a birthing center, or in the comforts of your own home. A home birth is one of the ways to have a more economical birth because you avoid the bills associated with the hospital. Birthing centers are also much more economical than a hospital. Whether you choose to deliver at home, a birth center or in a hospital, using a midwife for your care will help reduce your expenses.
What are the reasons to use a midwife?
The reasons vary between women and families on why they elect to use a midwife. For some the main reason is economics. For others the appreciate the birthing center or at home delivery so that they experience is as natural as possible.Petter Schlenzka, a doctoral student, examined over 800,000 births to determine the differences between obstetrician care and midwifery care. From his review, he reports that there are no advantages of an obstetric hospital approach as compared to a nurse midwife setting inside or outside of the hospital. His review also noted that the following are possible benefits related to midwifery care:
- Lower maternity care costs
- Reduced mortality and morbidity related to cesarean and other interventions
- Lower intervention rates
- Fewer recovery complications2
The majority of pregnancies are low risk and eligible for midwifery care in a birthing center or at home birth. Most midwives have solid relationships with practicing obstetricians and utilize their expertise when necessary.
If complications are anticipated, it is recommended that women elect a hospital setting where there is easier access to obstetricians, perinatologists, and other experts prepared to deal with a variety of complications related to either the mother or the newborn baby.