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Midwife

Updated: Mar 15, 2023

Who is a midwife?

Midwives are healthcare providers who deal with pregnancy, childbirth, newborn care, and postpartum health. Some midwives provide routine reproductive care like pelvic exams, Pap tests, or counseling on birth control. Midwives tend to be more holistic and supportive of natural approaches to pregnancy and birth. People often choose a midwife when they know they want a nonmedicated birth or want to give birth at home.


Midwives are usually not medical physicians. They often work alongside obstetricians and gynecologists (Ob/Gyns) in a hospital or at a private clinic to ensure you have access to any care you need during your pregnancy. A midwife is recommended when your pregnancy is low-risk or if you have only mild complications.


Midwife support
Midwife support

What does a midwife do?

It depends on their credentials, certifications, schooling, and where they practice. Certified midwives and certified nurse midwives can offer the most services. Midwives who are not certified offer fewer services. You have to know if the midwife is certified to carry out the said services. You can know by asking the midwife regarding their certification and credentials.


Some of the health services a midwife may provide include
  • Prenatal appointments and routine pregnancy checkups.

  • Ultrasounds and prenatal blood tests.

  • Attending to birth and newborn care.

  • Postpartum care.

  • Educate on nutrition, lactation, fertility, and other aspects of reproductive health.

  • Birth control and family planning.

  • Pap tests and breast exams.

  • Screenings for sexually transmitted infections (STIs) and other vaginal infections and diseases.

  • A certified nurse midwife can practice at hospitals, clinics, birth centers, or your home. Midwives who are not certified are limited in where they can practice. It is best to ask your midwife what credentials they have and ask your hospital or birth center what the regulations are for midwife care.



There are different levels of certification for Midwives
  • This can give you an idea as to what to look for. Any expert would have to display their credentials and certification if they are available for consultations.

  • Certified nurse-midwives (CNMs) are registered nurses who have graduated from an accredited nurse-midwifery education program and have passed a national exam.

  • Certified midwives (CMs) are non-nurse midwives who have a bachelor's degree or higher in a health field, have completed an accredited midwifery education program, and have passed a national exam.

  • Certified professional midwives (CPMs) are non-nurse midwives who have the training and clinical experience in childbirth, including childbirth outside of the hospital, and have passed a national exam.

  • Direct-Entry Midwife (DEM): an independent individual trained in midwifery through various sources that may include apprenticeship, self-study, a midwifery school, or a college/university program.

  • Lay midwives are not certified or licensed but have apprenticed or received informal training.


Points to remember
  • If a woman has a high-risk pregnancy or if complications are anticipated, it is recommended to choose a hospital setting with more convenient access to obstetricians, perinatologists, and other professionals trained to address complications affecting either the mother or baby.


Difference between a midwife and an Obgyn
  • ObGyns and midwives differ in their training and approach to care.


  • Midwives are highly supportive and take a more natural approach to pregnancy and childbirth. Midwives view pregnancy and birth as a natural process instead of a condition that needs to be managed. They tend to be more open to nontraditional approaches to labor and delivery. People may want a midwife for a more relaxed birthing experience.


  • Midwives did not attend medical school and they cannot provide all of the same services as an Ob/Gyn. For example, Midwives cannot treat high-risk pregnancies or complications during delivery. Obstetricians can manage complications using medical or surgical interventions that are not available to midwives.


  • This does not mean ObGyns won’t offer supportive and personalized care or be open to alternative approaches to your care. If you are unsure, you should meet with both the midwife and ob-gyn to see who fits your personality and your desires for pregnancy and delivery. It is important to talk and ask your queries, sometimes you just know in your first meeting without the need for questions, and sometimes you may not feel comfortable even after several meetings. It is never too late to change, and do not hesitate to change your provider.


Is it mandatory to choose a midwife?

It’s a personal preference. Some people prefer midwives, and others prefer Ob/Gyns. A midwife is typically only recommended for low-risk pregnancies. A midwife might be for you if you have a low-risk, routine pregnancy and if you desire a more personalized relationship with your provider. If you have a health condition that could complicate your pregnancy or delivery, close collaboration between your midwife and obstetrician is ideal.


What is the difference between a doula and a midwife?

A doula is a person who has training in the support of labor and birth. They can help you manage contractions, get you ice water to sip on, suggest new labor positions and act as your cheerleader. They have no medical training. The care they provide is emotional and informational, not medical.


What can midwives not do?
  • Midwives cannot medicate you or prescribe medications.

  • Midwives can’t perform c-sections, but they can assist in them.

  • Some midwives can prescribe epidurals, but midwives can’t give epidurals.

  • Midwives typically are not trained to perform surgeries.


Questions to ask while choosing a midwife
  • What type of certification does the midwife have?

  • Is the midwife licensed by the state?

  • Is the midwife affiliated with a medical practice, hospital, or birthing center?

  • Does this midwife have a good reputation?

  • What type of experience does the midwife have and in what settings (hospitals, birthing centers, home births)?

  • What is the midwife's general approach to pregnancy care and delivery?

  • How does the midwife manage pain during delivery?

  • What percentage of the midwife's patients have episiotomies and under what circumstances are they performed?

  • Under what circumstances would the midwife recommend certain medical interventions, such as inducing labor or ordering an epidural or C-section?

  • What is the midwife's emergency backup plan for an out-of-hospital birth?

  • Does the midwife listen to me and explain things clearly?

  • Is my spouse or partner comfortable with the midwife?

  • Who covers for the midwife when they are not available?

  • If another midwife or doula will also attend my delivery, can I meet them beforehand?

  • Does the midwife consult with an OB and can I meet them?

  • Does the doctor provide backup in case of complications or emergencies?

  • Is the office location convenient?

  • How are emergencies and after-hour calls handled?

  • Does my insurance cover the midwife's services?


Resources

Midwives


Midwife


What is a Midwife?


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