What is a Midwife?
Most midwives in the United States are health care providers who offer services to women of all ages and stages of life. With their advanced education and their focus on research and partnering with women, they are among the most modern, forward-thinking health professions in the United States today.
With all the changes happening in health care, the midwifery approach to caring for women has never been more important. Today’s woman expects the best care. She expects her provider to understand and value her individual needs. She wants a provider who will partner with her to make health decisions.
Midwives focus on what is most important to each woman’s unique situation and values and often work with other members of the health care team. It’s time to think about whether a midwife might be the right choice for you.
When considering a health care provider who will best meet your needs, keep in mind that many midwives focus not only on maternity care, but also on the full range of a woman’s health needs. Certified nurse-midwives (CNMs) and certified midwives (CMs) provide care starting with a woman’s first period until after menopause, plus all the important health events in between, such as:
CNMs and CMs are independent health care providers. They also work with other members of the health care team, such as physicians and nurses, to provide the highest quality care. They work in a variety of settings, such as hospitals, medical offices, clinics, birth centers, and homes. They provide general health care services, gynecology care, family planning, as well as maternity care (before, during, and after childbirth). They are covered by most insurances.
Types of Midwives
Midwives are dedicated to providing you with the personalized health care experience you deserve. When looking for a midwife who will best meet your needs, it is important to understand the different options available to you in the United States.
Certified Nurse-Midwife (CNM®)
CNMs are registered nurses with graduate education in midwifery. They have graduated from a nurse-midwifery education program accredited by the Accreditation Commission for Midwifery Education (ACME). This education includes a university degree as well as hands-on clinical training by practicing CNMs. They also have passed the national certification exam of the American Midwifery Certification Board (AMCB). CNMs provide general women’s health care throughout a woman’s lifespan. These services include general health check-ups and physical exams; pregnancy, birth, and postpartum care; well woman gynecologic care; and treatment of sexually transmitted infections. CNMs are able to prescribe a full range of substances, medications, and treatments, including pain control medications. CNMs work in many different settings, such as hospitals, health centers, private practices, birth centers, and homes. Most midwives in the United States are CNMs.
Certified Midwife (CM®)
CMs are midwives with a bachelor’s degree in a field other than nursing who have graduated from a graduate-level midwifery education program accredited by ACME. The midwifery education program for CMs includes health-related skills and training in addition to midwifery education, which is the same as that of CNMs. Like CNMs, they have passed the national certification exam of the AMCB. CMs provide the same services as CNMs, practice in the same settings, and receive the same preparation as CNMs to safely prescribe a full range of substances, medications, and treatments, including pain control medications.
Certified Professional Midwife (CPM)
CPMs prepare for a national certification exam administered by the North American Registry of Midwives (NARM) in different ways. There are two primary pathways for CPM education with differing requirements: apprenticeship training alone or an accredited formal education program. The health care services provided by CPMs are not as broad as those of CNMs and CMs. CPMs provide pregnancy, birth, and postpartum care for women outside of the hospital—often in birth centers and homes. CPMs are not able to prescribe most medications.
Other midwives who are not certified by AMCB or NARM may be practicing in some states. These midwives may or may not have formal education and have not passed a national certification exam. They may or may not be licensed. Their services are usually focused on pregnancy and birth, and they are unable to prescribe most medications.
For more details about the different kinds of midwives in the United States, please visit the American College of Nurse-Midwives.
Learn More about Midwives
As you think about your options, take the time to learn more about your choices. What do you want most out of your health care experience? What do you value? Midwives have the education and experience to tailor your health care plan based on current research and what you value most in your care.
Our Role as Midwives
Unfortunately, many people don’t really know what role midwives play in women’s health care in the United States today. The truth is that midwives approach health care using science and evidence. They base their expert, personalized service for women and newborns on their education and experience. In fact, certified-nurse midwives (CNMs) and certified midwives (CMs) can offer services beyond maternity care, including women’s and general health care services from the teenage years through adulthood and into the elder years.
A Midwife’s Approach to Health Care
When seeking a partner for your women’s health care, it’s important to understand how different kinds of providers will have a different approach to care. Midwives are skilled in creating a health care experience that is tailored to your personal preferences and health care needs. They will work with you to decide on important decisions such as where and how you want to give birth or how you want to approach your changing needs as you move into menopause.
Birth Settings & Midwives#
Using a midwife will give you access to professionals who practice in hospitals, clinics, medical offices, free-standing birth centers and/or private settings (such as a private practice or your home). Many midwives practice in more than one setting, such as hospitals and physician’s offices, and often work closely with other health care providers to offer you a wide range of services. We encourage you to identify a provider in your area that can work with you to meet your health care goals.
Click here to learn more about your options for where to give birth.
The health care system in the United States tends to approach pregnancy in terms of what might go wrong. This is a different approach than in other developed countries, and it often leads to the use of tests and procedures in pregnancy and birth that are not needed. Midwives view pregnancy and birth as normal life events that are best protected through education and support. Midwives use medical procedures only when there is a specific concern for the health of the mother or baby.
Many women are not aware that for a low-risk, healthy pregnancy (which most are), common childbirth procedures like labor induction or cesarean section are not usually needed. Unfortunately, too many women enter labor not knowing they have choices about whether or not to accept these procedures and how to avoid them. No matter which health care provider you select, it’s important to know about the procedures that may be offered to you during childbirth.
Your midwife is an expert at recognizing and taking action in an emergency if necessary. However, most situations are not emergencies. There is time to work with your midwife to understand your choices and consider the options available to meet your personal needs. As your partner in care, your midwife will provide you with information and resources so you can make informed decisions. This shared approach to decision making and partnering in planning your care is a key aspect of your midwife’s approach to health care.
Whether you plan to give birth in the hospital, at a free-standing birth center, or at home, your midwife will have a plan of action for handling any problems that require attention from additional health care providers.
Why Choose a Midwife?
In our society, many health care services are offered as one-size-fits-all. Choosing a midwife offers you a chance for expert personalized care based on research and evidence. Midwifery care does not rely on providing a specific set of childbirth procedures or practices for all women. Instead, midwives tailor care to meet the wants and needs of each woman and her baby. In this way, midwives maintain the best conditions possible for a safe and healthy outcome for all involved.
Here is what women are saying about using a midwife for their care:
“When I became pregnant with my first child, my sister-in-law, an OB/GYN, suggested that I see a midwife. She so highly praised the midwives in her practice that it seemed like the natural choice for us. My midwife approached pregnancy as a normal process and provided a sense of calm empowerment to me throughout. I am certain that her patience and wisdom saved us from needing undesired medical procedures and helped us have the birth experience that was important to us. She will always have a special place in our lives and hearts.”
“Within a matter of weeks after finding out I was pregnant, I chose to see a group of certified nurse-midwives who attended births at a birth center as well as a nearby hospital. I am so grateful that I had a full range of choices for navigating labor and birth and a care provider I could trust to guide me through the difficult patches without giving up my values and wishes. I’ll continue visiting my midwife for my gynecologic care and without a doubt will return for my next birth.”
“To say that I love my midwife is nothing short of an understatement. She unselfishly gave me the support and encouragement that I needed to confidently obtain a wonderful natural healthy birth for my daughter. After having been through a very difficult birth with my first child as a direct result of multiple unnecessary medical procedures, I knew that there had to be a better way to experience birth. She helped me see it through to the very end; through every tear and drop of sweat she stood with me, all the while saying, ‘“You can do this!’”
The above quotes are from women who received midwifery care and shared their stories with the American College of Nurse-Midwives on www.teammidwife.org.
Adapted from the ACNM website, http://midwife.org
Image courtesy of Victor Habbick at FreeDigitalPhotos.net