The term midwife reflects a philosophy of care–one that is directed toward women and their individual reproductive needs. A midwife usually offers a variety of options and seeks to eliminate or minimize unnecessary interventions.This philosophy is represented by the Midwives Model of Care.
The midwives model of care is based on the belief that pregnancy and birth are normal life processes. The midwives model of care includes:
- Monitoring the physical, psychological, and social well-being of the mother throughout the childbearing cycle
- Providing the mother with individualized education, counseling, and prenatal care, continuous hands-on assistance during labor and delivery, and postpartum support
- Minimizing technological interventions
- Identifying and referring women who require obstetrical attention1
What is a midwife?
A midwife is a health care professional who provides an array of health care services for women that can include medical histories and gynecological examinations, contraceptive counseling, prescriptions, and labor and delivery care. Providing expert care during labor, delivery, and after birth is a specialty of midwives that makes them unique.
What services do midwives provide?
The services of a midwife depend on the certification and licensing credentials obtained and the practice restrictions of each state. Because of the additional licensure in nursing, a nurse-midwife can offer the most comprehensive array of health care services to women.
These services include: annual gynecological exams, family planning and preconception care, prenatal care, labor and delivery support, newborn care, and menopausal management. Midwives generally provide reproductive education in fertility, nutrition and exercise, contraception, pregnancy health, breastfeeding, and quality infant care. Midwives often function as a quality economical option for birthing care. Find a local midwife.
What are the different types of midwives?
Midwives are qualified health care providers who go through comprehensive training and examinations for certification. Certification is offered by the American College of Nurse Midwives (ACNM) and the North American Registry of Midwives (NARM). The practice and credentials related to midwifery differ throughout the United States. Below is a brief description of each of type of midwife:
- 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 who meets practice standards of the North American Registry of Midwives.
- Direct-Entry Midwife (DEM): an independent individual trained in midwifery through a variety of sources that can 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.
- Lay Midwife: an individual who is not certified or licensed as a midwife but has been trained informally through self-study or apprenticeship.
- Find a Local Midwife
Where do midwives practice?
Midwives believe in facilitating a natural childbirth as much as possible. Accordingly, it is common to receive care from a midwife in a private and comfortable birthing center or in your own home. Because of their professionalism and expertise, midwives are often part of a labor and delivery team associated with the local hospital. You can choose to use the services of a midwife whether you elect to give birth at home, a birthing center, or at a hospital.
What are the benefits of using a midwife?
One of the main reasons that women elect to use a midwife is to experience childbirth as naturally as possible.
Available options is another benefit associated with having a midwife. Midwives often offer payment plans, sliding fees, and are willing to accept most insurance plans including Medicaid.
According to the doctoral research conducted by Peter Schlenzka, the choice of using a nurse-midwife and natural delivery can result in the following benefits:
- Lower maternity care costs
- Reduced mortality and morbidity related to cesarean and other interventions
- Lower intervention rates
- Fewer recovery complications2
Electing to use a nurse-midwife is appropriate for low risk pregnancies which constitute 60 to 80% of all pregnancies. In Schlenzka’s review of over 800,000 births, he reports there are no advantages of a standard obstetric hospital approach over a nurse-midwife setting inside or outside of the hospital.
What are the concerns related to using a midwife?
Low risk pregnancies make up 60 to 80% of all pregnancies. This means that between 20 to 40% of pregnancies could have potential complications. There are times when either the mother or the baby will require medical interventions that are outside the scope of services offered by a midwife. Midwives routinely consult with obstetricians, perinatologists, and other healthcare professionals and will refer women to appropriate medical professionals if complications arise.
If complications are anticipated, it is recommended that women elect a hospital setting with more convenient access to obstetricians, perinatologists, and other professionals trained to deal with complications affecting either the mother or baby.
For more information on Midwives:
You may find the following books helpful.
- Active Birth
- Janet Balaskas
- Giving Birth
- Catherine Taylor
- Ina Mays guide to Childbirth
- Ina May Gaskin
Your purchase supports the American Pregnancy Association.
Compiled using information from the following sources:
1Collaborative statement created by Midwives Alliance of North America, the North American Registry of Midwives, the Midwifery Education Accreditation Council and Citizens for Midwifery.
2Schlenzka, Peter, “Safety of Alternative Approaches to Childbirth,” Department of Social Work and Sociology, Ferrum College, 1999.
Pregnancy, Childbirth and the Newborn: The Complete Guide. Simkin, Penny, et al, Ch. 1.
American College of Nurse-Midwives, http://www.midwife.org/