What is a Midwife?
Pregnancy, birth, and parenting are accompanied by their fair share of unknowns, but there is one thing that is guaranteed – you will be faced with choices to make! Being educated and informed about what your options are often results in a sense of empowerment and confidence in the choices you make. Before you exercise your ability to choose between adorable baby outfits, wraps, and ring slings, you may want to think about who you choose to guide you through the birth process.
A midwife is a professional who has been trained to assist women in childbirth. Midwives have been around for hundreds of years as women would assist other women giving birth. We have come a long way from then as there are now associations, governing and licensing bodies, and educational requirements put in place for midwives. If you are thinking that a woman can decide to be a midwife and start delivering babies the next day, think again! Midwifery training typically takes three years of schooling, as well as time spent observing and assisting births. It is important to note that there are generally two different types of midwives: nurse midwives (CNM) and certified professional midwives or direct-entry midwives (CPM).
Nurse midwives, as expected by the name, are registered nurses who have done additional training to become a midwife. They mostly work in hospital settings and are specifically trained for in-hospital births. A small percentage of nurse midwives work in birthing centers and an even smaller percentage assist women birthing at home. Because they are registered nurses, some nurse midwives can administer and prescribe drugs and in some states, nurse midwives work in agreement with a physician in their hospital. Although they are not trained surgeons like an OB, they do have a plethora of tools available in the hospital setting to assist with birth.
Certified professional midwives, which can also be known as licensed midwives or direct-entry midwives do not typically have a nursing background. They complete three years of schooling focused solely on midwifery and are trained for out-of-hospital births, whether that be in a birthing center or at home. These midwives operate from the mindset that birth is a normal, physiological process and less is more when it comes to intervening with such a powerful, natural experience. Now, if you think a midwife shows up to a birth empty handed, think again! Midwives can be equipped with oxygen, anti-hemorrhagic medication, and/or herbs. In addition, they are trained in neonatal resuscitation and have a handful of techniques for a laboring woman to cope with pain, including hydrotherapy, massage, TENS units, positioning, and breathwork.
In the process of deciding what type of care you want throughout this process, it is important to ask yourself a number of questions:
What do you want your birth to be like?
Do you want your provider to be someone you know?
Do you want more individualized care?
Do you want your family to be involved in the birth?
Do you have any health conditions or obstetric history that may complicate your pregnancy?
A breech baby, twins, vaginal births after cesareans, insulin dependent diabetes, high blood pressure, and pre-term deliveries are a few examples of situations when a midwife may transfer your care to a hospital setting, or provide concurrent care with a medical provider depending on the state you live in and what their scope of practice entails.
One of the cornerstones of the midwifery model of care and something that sets certified professional midwives apart is continuity of care. A licensed midwife provides extensive prenatal care, is there for labor and birth, provides newborn care, and postpartum care for mom. Rather than one check-up at 6 weeks, some midwives provide 4-6 postpartum visits to check on mom and baby. There is no guessing as to who will be on call or if it will be a familiar face when you go into labor. Midwives are also very well connected in their communities, often working with and referring to herbalists, functional medicine practitioners, lactation consultants, chiropractors, and nutritionists. Midwifery care is also very family-centered. Mom, partners, and children can be a part of the prenatal visits, they can listen to the baby’s heartbeat, and be there to welcome baby into the world when the day comes for your family to expand.
It is important to note, that although nurse midwives, professional midwives and OBs are all highly trained when it comes to childbirth, they may come with a different mindset, toolset, and setting. Choose a provider who aligns with your values and that you feel will make the best decisions when it comes to what tools to use. It is just as important for a provider to know which tools are necessary as it is to know which tools are not necessary! It is also vital to make sure you feel listened to and informed when it comes to your care throughout the motherhood transition so that you can always make decisions out of love rather than fear.
For more information, check out Episode 97 of the BIRTHFIT Podcast with CPM Cathy Rude of Katy Birth Center.
Dr. Morgan ObersteinBIRTHFIT Union City @birthfitunioncity