Midwifery, one of the world’s oldest professions

You might have seen that last week was National Midwifery Week, but many people don’t know what benefits midwives brings to the birth world. So, we wanted to post a primer on the various types of midwives and what they can provide. As an expecting parent or someone thinking about having kiddos one day, we know the pool of advice can be deep. There’s a whole slew of information out there that can feel overwhelming. At Mina, we like to dig in, research and weigh all the options.

Understanding your options when it comes to the different aspects of how to bring your sweet, beautiful baby into this world is important. It’s common to pour hours into researching the kind of car we’re going to purchase, or obsess over consumer reports to determine which vacuum does the best job, but often research around birth options is overlooked. In the US, we simply tend to go to the hospital closest to our home.

Evidence is mounting that where and how you decide to give birth greatly affects you and your baby’s experience and outcomes. And your first birth experience can significantly affect future births.

So to help you understand your options, we’re breaking down the types of midwives and providing an overview of the midwifery care model.

 

What is a midwife?

A midwife is a person that’s trained specifically for prenatal care, labor, birth and after baby’s arrival. They are healthcare professionals and experts on all things pregnancy and birth. They can provide care in a hospital, birth center, or at home. They may also offer family planning services and can provide annual exams (even basic well-person care — you don’t have to be pregnant!).

Midwifery care typically leans toward 1) physiological birth (birthing person-led, with freedom of movement, and limited interventions such as episiotomy, epidural or medication) and 2) evidence-based birth (birth care that is based on the most up to date evidence for best care during birth). There are different types of education and certification for a midwife.

 

Certified Nurse Midwife (CNM)

A Certified Nurse Midwife is a registered nurse that has graduated from an accredited program and passed the American Midwifery Certification Board exam. All 50 states allow CNMs to practice. Certified Nurse Midwives primarily work in hospitals and free-standing birth centers. Their scope of practice is similar to a medical doctor. They can provide general well-person care (like annual physicals and general health), as well as care throughout pregnancy and birth. Contrary to popular belief, midwives can prescribe medication and even work with patients who are planning to get an epidural. Midwives are generally with their patients throughout active labor, as well as delivery.

 

Certified Midwife (CM)

A Certified Midwife is not an RN but does have a bachelor’s degree in a health field and has completed an accredited midwifery program as well as passed the National Certification Exam in Midwifery. There are few states that allow a CM to practice.

 

Certified Professional Midwife (CPM)

A Certified Professional Midwife is not an RN but has experience and training in childbirth, including out-of-hospital settings. These midwives have passed a national midwifery exam and have usually spent time apprenticing with a practicing midwife. There are few states that allow a CM to practice.

How is the Midwifery care model different than Obstetrician (OB or Ob-Gyn) care?

An obstetrician is a medical doctor who has completed medical school as well as a residency in obstetrics (pregnancy and postpartum care) and often gynecology (general female reproductive health). They typically work out of hospitals, however there are some that work out of birth centers as well. Obstetricians/Ob-Gyns take a more conventional medical approach toward childbirth.

Do Midwives and Obstetricians/Ob-Gyns work together?

Yes, absolutely! Ob-Gyns provide comprehensive care throughout pregnancy and typically join the birthing team after active labor during the second stage (pushing). If complications arise that require immediate medical interventions, an obstetrician can be called in at any time to assist a midwife birth team. They can perform cesarean births and other complicated operations that can occur such as with placenta accreta, or retained placenta, where the placenta needs to be surgically removed.

Birth options include:

  • Hospital with an OB/Ob-Gyn
  • Hospital with Certified Nurse Midwife
  • Hospital with an OB/Ob-Gyn and Certified Nurse Midwife
  • Hospital with a Family Practice physician
  • Hospital with a Family Practice physician and Certified Nurse Midwife
  • Freestanding birth center with a Certified Nurse Midwife or Certified Professional Midwife
  • Home birth with a Certified Professional Midwife or Certified Nurse Midwife

So, in summary…

The biggest difference between midwives and OBs/Ob-Gyns, in general, are the style of care and approach to childbirth. While these descriptions are broad generalities, and care can vary from one specific provider to the next, they can provide a starting point to research what may be the best fit for you family. It’s important to understand your options and what provider and birthplace aligns with your desires. The way you choose to bring your baby into this world is 100% YOUR CHOICE. It’s a beautiful time of life, and meeting your little one face-to-face should be an amazing experience. This article is simply meant to provide a snapshot of the kinds of care available, and to help aim you in the direction that is best for you, your baby, and your family.

 

Help Us, Help Families.

Did you know that the doors you walk through on the day you give birth can greatly affect the experience you have during and after birth? Some birthplaces are more family-led, baby-friendly places, and some tend toward more medicalized birth experiences. It also can be a determining factor in the chances of having an unplanned cesarean birth. Some hospitals and providers simply are more prone to lean that way if delay or complication arise.

We love babies, and know that sometimes a surgical birth may be the healthiest way for you to meet your little one. BUT the frequency of unnecessary cesarean births is high in our nation (which can bring more complications, especially if it isn’t medically necessary). Knowing your hospital’s record and those of your provider (and their associated provider group that may share on-call shifts), as well as what style of care your provider and hospital provides, is important so you can be prepared and make informed decisions.

We’re creating an amazing, grassroots way to look at birthplaces. It’s a way to help growing families determine where they want to give birth to their little ones, based on the reviews from other families. It’s also a place where you can share the experiences you’ve had with providers and birthplaces. If you’re new to the birth world, taking a minute to read through the places listed on our site may help in your future birth experience. If you’ve already had a birth experience, writing a review of birthplace(s) and provider(s) with which you’ve had an experience can greatly help other expecting parents find a place to meet all their wants and needs.

We know families deserve the very best, and we want to help provide that for you; gleaning wisdom from others is one of the best ways we can think of to achieve that goal. Please help us in that endeavor.

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