Midwives
A Long History and a Modern Choice
Most
people have heard of midwives, but their usual image is often a far cry
from the modern choice. Fictionalized accounts of midwives have not helped
to clarify the issue. Most people think of old grannies in aprons showing
up at a home delivery in the midnight hours advising dad to boil water
and tear sheets. This is far from the truth.
Worldwide, the vast majority of pregnancies and births are attended by
midwives with excellent outcomes. In Japan, a large industrialized country,
midwives outnumber obstetricians 200 to 1! Care is provided for all pregnant
women by the midwife with the physician attending to the high risk cases.
In the United States, however, with centralized health care an average
of only ten percent of deliveries are attended by midwives. Amazingly,
outcomes for babies born in Japan are much better than in the U.S. The
World Health Organization (WHO) believes that one of the reasons for the
better outcome is the reliance on midwifery care for the majority of women.
Most midwives are women and have achieved extensive education in well woman care (gynecology), pregnancy, labor and delivery, newborn evaluation, and breastfeeding. Midwives use a variety of styles of care, from traditional medical to herbs, nutrition, homeopathy, acupressure, and more. Their skill is in sculpting your care to your individual needs.
So, why a midwife? Most importantly, midwives trust birth yet are skilled to quickly and safely recognize the rare need for true medical intervention. Trusting in you and your ability to birth normally and naturally is significant. Trust breeds calm and allows labor to progress with minimal intervention. Midwives strongly believe that pregnancy and birth belong to you. This leaves your midwife available for you as a resource to help teach and reinforce your good intuition about what is right for you and your family.
The certified nurse-midwife is also part of a team working in collaboration with an obstetrician/gynecologist, pediatrician, or perinatologists as necessary. If a complication or difficulty arises, her physician consultant is available twenty-four hours a day to assist in your care. Whether you have chosen a cozy birth center labor and delivery with no medication surrounded by your family and friends or a hospital birth with plans for an epidural for pain management, your choices are respected by your midwife.
Midwives are a modern and excellent choice. Certified nurse-midwives
(CNM) generally have a bachelor’s degree in nursing (BSN) and graduate
training in midwifery. Certified by the American College of Nurse Midwives’
Certification Council, the CNM participates in continuing education courses
and conferences, keeping current with new trends in obstetrical care and
practice. The Certified Nurse-Midwife generally provides delivery care
in the hospital or birth center setting. While not as numerous, there
are CNMs who attend home births in some areas of the country.
There is another group of midwives in Connecticut that practice solely
in the homebirth setting. They have varying degrees of educational experience
and backgrounds. As of now, there is no licensure in Connecticut for this
group of practitioners. They may be called Certified Professional Midwives
(CPM), lay midwives, spiritual midwives, or homebirth midwives. For those
who choose this option, it is especially important to ask questions that
specifically address the midwive’s experience with labor and birth,
education, and back-up arrangements (in the event of emergency), and fees.
Care provided by a CNM is generally billable to insurance, both private and Medicaid. Birth center and hospital births are both covered by participating insurance plans. Home birth may or may not be covered depending upon plan and provider.
A true advantage to midwifery care today in the U.S. is that many clients start with a midwife for pregnancy care and then continue receiving their well woman care with the same midwifery practice. Because the CNM is able to write prescriptions, order laboratory tests, mammograms and ultrasounds, a woman need not look for another care provider when she is done having children or needs a gynecology visit for an annual exam or for a problem. Aside from trusting birth, midwives trust women and really listen throughout your lifetime.