What is a Midwife?

The Advantages of a Midwife

The word “midwife” means “with woman”. Midwives have attended women at birth since the beginning of time. In the United States, Certified Nurse-Midwives (CNMs) and Certified Midwives (CMs) have been attending women through pregnancy, birth, and other normal stages of life since the early 1900s. It wasn’t until the last century that physicians became the more prevalent providers of obstetrical care in the U.S., but that trend is reversing. In recent years, midwifery has regained its popularity, having always been popular in most other countries of the world. Currently, more women are seeking midwifery care in order to receive the personalized care midwives provide. Nurse-midwives attended over 11% of all vaginal births in the U.S. in the past year, doubling in recent decades.

The majority of midwives are either CNMs or CMs. Still, a variety of titles are used to label midwifery practice, so it can be confusing for consumers who want to determine just what qualifications their midwife has earned. Certified Nurse-Midwives are registered nurses who have completed graduate-level training in midwifery and who have passed the national certification exam of the American College of Nurse Midwives. A Certified Midwife or Certified Professional Midwife (CPM) is a direct-entry midwifery practitioner who has met all the certification standards set by the North American Registry of Midwives (NARM).

What distinguishes a CPM from a CNM? CPMs usually attend out-of-hospital births and are trained via a competency-based model of education rather than the nursing educational background of the CNM. Certified Nurse-Midwives practice in hospitals, birth centers, or at home, and are licensed by the State Board of Nursing to practice in Illinois. CNMs are reimbursed by private insurances, HMOs and public aid in the same process as physicians. Licensure for CPMs to practice in Illinois is pending in the Illinois legislature as of this writing, and therefore CPMs cannot yet practice legally in Illinois.

CNMs practice the independent management of woman’s health care including pregnancy, labor, birth, and the postpartum, as well as family planning and gynecologic care throughout the lifecycle. At your visit with a midwife, she or he will take a complete family and personal medical history, and give you a thorough and gentle examination. She may do a pap smear or write prescriptions as needed. She can follow your prenatal care, attend your labor and birth, and see you postpartum. Nurse-midwives have a 24 hour-a-day, seven days-a-week network of agreement with a physician for collaboration and referral as needed.

Why choose a midwife for your pregnancy care?

Midwives focus on the natural process of labor and birth. Midwives practice a philosophy of care that focuses on the individual needs of each woman, empowers her to actively participate in her health care, and minimizes unnecessary intervention. A woman can search for a midwife practice that best suits her personal wishes for her birth by browsing the website of the American College of Nurse-Midwives.

How do you choose a midwife for your women’s health care?

When searching for a provider to attend you at your pregnancy and birth: be an informed consumer! Seek recommendations from childbirth educators or doulas who have worked with different midwives and physicians. Browse websites and read reviews. Make an appointment to interview your prospective provider and bring a list of your questions and concerns. Ask about birth statistics such as cesarean section rate, frequency of patients using epidurals or medication, management of overdue pregnancies and induction of labor. Ask about use of fetal monitors and Ivs …shop around! Birth is one of the single most important events in your life, and you want to find someone you can trust completely. Make an appointment prior to your pregnancy if possible and initiate care for a preventive health care visit (pap smear or pre-conception counseling).

What is right for you?

Midwives believe that every woman has within her the inner strength and wisdom to assist her throughout her life, and that each woman gains strength and wisdom from the women who surround her and support her. Your midwife will help you, and help the people you have chosen to be with you, to attain the birth experience you are hoping for…. that is the essence of the practice of midwifery.

Editorial provided by Gayle Riedmann, CNM, President of West Suburban Midwife Associates, Ltd in Oak Park, IL.

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