Published on June 20th, 2024
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You’ve made it – from getting off birth control to conception, your due date is rapidly approaching. As you schedule appointment after appointment to assemble your pregnancy healthcare dream team, you may wonder: what is a midwife?
Midwives are highly-trained medical professionals. But, in contrast to most obstetricians, who mainly focus on your physical health during the stages of pregnancy, midwives take a holistic and individualized approach to your care.
Their mission isn’t merely to help you stay healthy while pregnant—it’s to help you stay whole.
No matter what your ideal birth plan is (or even if you have no clue what yours is yet), a certified nurse midwife can be a valuable source of knowledge, care, and compassion. Learn more about what a midwife can do for you and how to pick the right one for your personal pregnancy journey.
What is a midwife and what do they do?
In Old English, “midwife” literally translates to “with woman”—which sums up their role in healthcare perfectly.
The care you receive from a nurse midwife is highly individualized due to the unique and unpredictable nature of pregnancy, but most midwives follow the Midwives Model of Care, which includes:
- Educating, counseling, and assisting you before, during, and after you give birth
- Nurturing your physical, mental, emotional, and social health during your pregnancy
- Using as few medical intervention methods as possible (e.g. forceps, surgery, or pain medication)
- Recognizing when you need specialized care from an obstetrician
The Midwives Model of Care has historically reduced the frequency of assisted and medicated births. With a midwife, you’re less likely to:
- Be induced into labor
- Need a cesarean section (C-section)
- Use epidurals or other pain medications
- Experience severe perineal tears
Above all, midwives believe that giving birth should be a ceremony that prioritizes the well-being of the parent and child—in all senses of the word. If you share this view, having a midwife may be right for you.
The History of Midwifery and Natural Birth Practices
Midwifery has a long, topsy-turvy history in the U.S., as well as in other countries.
Up until the beginnings of obstetrics in the 19th century, midwives were essential women’s health providers for pregnant women and their communities as a whole. Midwives acquired their skills through apprenticeships and were taught to value and treat all aspects of pregnancy, not just the physical.
Then, as Western medicine developed, doctors fought to move births from the home into hospitals. In the early 20th century, some doctors went as far as to advocate for abolishing midwife practices, a move which has rightfully been called out for its bigotry.
Now, midwives are steadily re-gaining popularity each year. In fact, in 2020, about 12% of U.S. births were attended by midwives—a sharp uptick from the mere 1.1% in 1980.
If you’re interested in natural birth practices and the holistic benefits of a midwife’s care, you’re not alone. So, what else can you expect?
Benefits of Choosing a Midwife for Your Pregnancy Journey
Midwives offer individualized services that other healthcare providers can’t always accommodate.
Depending on your needs, they can provide:
- Childbirth and/or parenting classes
- Ultrasounds and other prenatal monitoring
- Labor and delivery assistance
- Gynecological services
- Nutrition and lactation guidance
- Postpartum care and support
Remember, when it comes to choosing a midwife, the key word is “choice.” You have the power to choose:
- Whether or not you want a midwife
- Who your midwife (or midwives) will be
- How integral your midwife will be to your overall care
Personalized Care and Support
A midwife’s care is tailored specifically to each patient; after all, no two pregnancies are the same, even for the same parent.
In addition to the care described above, midwives can also help you design the most essential and individualized aspect of your labor and delivery prep: your birth plan.
Your midwife can help you understand what your birthing preferences are, including:
- Where you want to give birth (and your ideal conditions for the room)
- What pain medications you want to use, if any
- How much coaching you want to receive while in labor
After you’ve created your birth plan, it’s your midwife’s duty to see that your wishes are granted (like your own pregnancy genie). Of course, complications and surprises can arise and turn your original plan on its head. But luckily, midwives are also experts at rolling with the punches.
Lifelong Services
Midwives are also trained to offer general reproductive care, similar to a gynecologist.
In particular, they can:
- Conduct pelvic and breast exams
- Perform Pap smears, STI screenings, and other vaginal disease tests
- Provide birth control and family planning options
This is why many people seek out midwifery services for both preconception care and long after giving birth. Midwives create strong, emotional bonds with their patients—and that care doesn’t start and end with pregnancy.
How to Select the Right Midwife for You
Once you’ve decided that you’d like to have a midwife, it’s time to start your search!
The first thing to consider is what type of midwife you’d like, as not all midwives have the same educational backgrounds or specialties. Here are your main options:
- Certified nurse-midwife (CNM) – These highly qualified midwives are also certified as nurses, which means they may be able to diagnose health conditions and prescribe medications. To become a CNM, one must complete a graduate-level nurse-midwife program and be certified by the American Midwifery Certification Board.
- Certified midwife (CM) – Certified midwives have the same midwife training and certification as CNMs, but they aren’t certified nurses.
- Certified professional midwife (CPM) – A CPM is certified to practice midwifery by the North American Registry of Midwives (NARM). Instead of earning a graduate degree, CPMs either complete an accredited midwife apprenticeship or a midwifery program.
- Direct-entry midwife (DEM) – DEMs are non-nurses who typically provide midwife services in homes and birthing centers. The education and licensing requirements for DEMs vary by state.
- Lay midwife – Lay midwives don’t have any formal licenses or certifications to practice, so they only offer at-home services. They often gain their midwifery skills through apprenticeships or self-study.
So, to discover your perfect midwife match, you may also want to decide where you’d like to give birth. And you have options there, too!
Considerations for Home Birth vs. Hospital Birth
An overwhelming majority of people give birth in hospitals: in the U.S., it’s over 98%. But you may be able to give birth just as easily from the comfort of your own home, too. In fact, most midwives are specially trained to help you do it.
Besides home births and hospital births, you can also choose to deliver your baby at a freestanding or in-hospital birth center. Here are the benefits of each:
- Hospitals – Hospitals are most equipped to assist with complicated or high-risk pregnancies. They have the technology and the trained physicians necessary to intervene during labor or delivery if needed. There’s also a much smaller chance that you’ll need to be moved to another location during labor due to complications. Make sure you know what to pack in your hospital bag to make the process go as smoothly as possible.
- Homes – Giving birth at home is a valid and advantageous option for uncomplicated pregnancies. You can receive extremely personable, attentive care from midwives and other care team members, and you don’t have to worry about transporting you and your baby home—you’ll already be there!
- Birth centers – Birth centers have a homier atmosphere than hospitals and mainly offer midwifery care. If you’re apprehensive about home births but still want personalized midwifery care, a birth center may be for you. Note that the level of care will vary between birth centers, specifically between freestanding and in-hospital centers.
Remember, there’s no right or wrong choice for where you give birth or who helps you. Rather, you can make the choice that best aligns with your birthing wishes and needs.
Integrating Midwifery Care with Your Healthcare Team
The goal of your entire healthcare team—from your obstetricians and gynecologists to your nurses and midwives—is to keep you and your baby safe over the course of your pregnancy. Constant communication and collaboration are essential to staying healthy and avoiding risks.
This is particularly important if your pregnancy is nonroutine (e.g. if you’re having twins) or if you’re at a higher risk due to pre-existing health conditions such as:
- High blood pressure
- Diabetes
- Seizure disorders
- A history of higher-risk pregnancies
Midwives are very skilled at assisting with low-risk pregnancies, but they can’t do everything a certified physician can, like perform cesarean sections or administer epidurals. However, midwives are trained to identify if or when you need any interventions and can refer you to those who can help.
Collaborating with Doctors and Specialists
As knowledgeable and compassionate as your midwife will be, pregnancy care is not a one-person show. Other essential members of your care team can include:
- Nurses
- Nutritionists
- Doulas
- Childbirth specialists
- Physical therapists
What doulas do compared to midwives can be a bit confusing, but If anything, know that midwives embody the idea that you deserve the best and most comprehensive care possible. If they see that you need help they can’t provide, they’ll be the first to tell you.
Discover the Sex of Your Baby Early with SneakPeek
Whether or not you want the care of a midwife, know that you have the choice to make your pregnancy a personal, fulfilling experience—no matter what that means for you.
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At SneakPeek, our commitment is to provide accurate, up-to-date, and reliable information to empower our readers. Our content is thoroughly researched, reviewed by medical experts, and fact-checked to ensure its credibility. We prioritize the well-being and education of our readers, and our editorial policy adheres to the highest standards of integrity and accuracy in all our articles.
This post has been reviewed for accuracy by:
Sarah Cacia, currently leading as the Director of Business Development at Gateway Genomics, parent company of SneakPeek, brings an impressive blend of bioengineering expertise and clinical business acumen. Her extensive experience, marked by roles at renowned institutions like Genentech and UC San Diego's Cardiac Mechanics Research Group, underpins her deep understanding of biotechnology and clinical research. A UC San Diego alumna with a Bachelor of Science in Bioengineering: BioSystems, Sarah's rich professional background empowers her to provide authoritative insights into the cutting-edge developments in the field.
Sources:
- Oregon Health and Science University. A Brief History of Midwifery in America. https://www.ohsu.edu/womens-health/brief-history-midwifery-america
- National Association of Certified Professional Midwives. Midwives Model of Care©. https://www.nacpm.org/midwives-model-of-care
- Cleveland Clinic. Midwife. https://my.clevelandclinic.org/health/articles/22648-midwife
- GraduateNursingEDU.org. What is a Midwife? https://www.graduatenursingedu.org/careers/certified-nurse-midwife/what-is-a-midwife/
- National Partnership for Women & Families. Your Options. https://nationalpartnership.org/childbirthconnection/healthy-pregnancy/choosing-a-place-of-birth/your-options/
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