Certified nurse midwives are individuals educated in the fields of nursing and midwifery. They typically hold a Bachelor’s degree in Nursing and a Master’s degree in nursing with a focus in midwifery. Most of certified nurse midwives, or CNMs, have experience as labor and delivery nurses, who have spent time observing and managing women in labor while calling the doctor for the delivery.
The popularity of CNMs is rising. In 2005, CNMs were responsible for 10% of our country’s deliveries!
Despite their rising popularity, myths abound regarding CNMs, what they do, and what their qualifications are. These myths persist even within the medical community. Following are a few of these myths with the reality behind them.
96% of CNM deliveries occur in hospitals.
We can and do order pain medicine upon patient request, and on rare occasions recommend it. We will educate you regarding the risks and benefits of the various pain relief methods and leave the decision to you.
We perform annual gynecologic exams, prescribe birth control, and treat minor infections.
While obstetricians are experts in treating pathology, midwives are experts in normal. We are also experts in the prevention of problems and the maintenance of good health. In fact, in many European countries-ones with much better maternal and infant mortality and morbidity rates than here in the US-most pregnant women see midwives, and only women with problem pregnancies go to obstetricians.
If a woman has a preexisting medical condition such as hypertension or diabetes, she needs to be under a physician’s care. However, many “high risk” pregnancies can be managed by a midwife with physician consultation. For example, women over 35 years of age are typically labeled as high risk. More diagnostic testing is generally recommended, and if this testing is normal, she can see a midwife for her pregnancy and birth. Another example is VBAC (vaginal birth after cesarean). While a physician consultation is needed, the pregnancy and birth can be managed by a midwife. Additionally, midwife managed VBACs have a higher vaginal delivery success rate.
A nice experience and a healthy baby are not mutually exclusive. In fact, many studies have shown that women under the care of CNMs have a lower incidence of preterm birth, low birth weight, and cesarean section. These favorable ouitcomes persist even after controlling for the fact that CNMs work with low risk patients. Also, some of these studies are with patient populations that are socioeconomically at risk; for example, teen mothers and lower income mothers.
In summary, midwives are licensed and certified professionals who are qualified to care for women experiencing normal pregnancies as well as women wanting gynecologic care. Problems and complications are handled via a collaborative relationship with a physician.
In addition to providing safe care, midwives generally have longer appointment times and more personal relationships with their patients. We ask about lifestyle factors and address your emotional needs. We want to know how your pregnancy is impacting you and are interested in helping you make the transition to motherhood in a safe and satisfying manner. While to some this is “nice”, we believe that it is an important component of our care.
If you want to be an active participant in your care, to have a healthy baby, AND to have a pregnancy and birth that give you confidence, consider a midwife!