The term midwife reflects a philosophy of care that is directed toward women and their individual reproductive needs. A midwife usually offers a variety of options and seeks to eliminate or minimize unnecessary interventions. This philosophy is represented by the Midwives Model of Care.

The Midwives Model of Care is based on the belief that pregnancy and birth are normal life processes.

• “Monitoring the physical, psychological, and social well-being of the mother throughout the childbearing cycle
• Providing the mother with individualized education, counseling, and prenatal care, continuous hands-on assistance during labor and delivery, and postpartum support
• Minimizing technological interventions
• Identifying and referring women who require obstetrical attention.”¹

What is a midwife?

A midwife is a health care professional who provides an array of health care services for women including gynecological examinations, contraceptive counseling, prescriptions, and labor and delivery care. Providing expert care during labor and delivery, and after birth is a specialty that makes midwives unique.

What services do midwives provide?

The services of a midwife depend on the certification and licensing credentials obtained and the practice restrictions of each state. Because of the additional licensure in nursing, a nurse-midwife can offer the most comprehensive array of health care services to women.

These services include annual gynecological exams, family planning and preconception care, prenatal care, labor and delivery support, newborn care, and menopausal management. Midwives generally provide reproductive education in fertility, nutrition, exercise, contraception, pregnancy health, breastfeeding, and quality infant care.

Midwives often function as both a quality and economical option for birthing care.

What are the different types of midwives?

Midwives are qualified health care providers who receive comprehensive training and must pass an examination to become certified. Certification is offered by the American College of Nurse Midwives (ACNM) and the North American Registry of Midwives (NARM).

The practice and credentials related to midwifery differ throughout the United States.

Below is a brief description of each of type of midwife:

• Certified Nurse-Midwife (CNM): a midwife trained and licensed in nursing and midwifery. Nurse-midwives must have at least a bachelor’s degree from an accredited institution. They are also certified by the American College of Nurse Midwives.
• Certified Midwife (CM): an individual trained and certified in midwifery. Certified midwives must have at least a bachelor’s degree from an accredited institution. They are also certified by the American College of Nurse Midwives.
• Certified Professional Midwife (CPM): an individual who is trained in midwifery and meets  standards of the North American Registry of Midwives. Multiple educational backgrounds are recognized to become a CPM.
• Direct-Entry Midwife (DEM): an independent individual trained in midwifery through various sources that may include apprenticeship, self-study, a midwifery school, or a college/university program.
• Lay Midwife: an individual who is not certified or licensed as a midwife but has received informal training through self-study or apprenticeship.

Where do midwives practice?

Midwives believe in facilitating a natural childbirth as much as possible. Accordingly, it is common to receive care from a midwife in a private and comfortable birthing center or in your own home. Because of their professionalism and expertise, midwives are often part of a labor and delivery team associated with a local hospital.

You can choose to use the services of a midwife whether you elect to give birth at home, a birthing center, or at a hospital.

What are the benefits of using a midwife?

One of the main reasons women decide to use a midwife is to experience childbirth as naturally as possible. An additional benefit of having a midwife is their various payment options. Midwives often offer payment plans and sliding fees, and are willing to accept most insurance plans including Medicaid.

According to the American College of Nurse Midwives, benefits of receiving midwifery care include:

• Decreased risk of needing a cesarean
• Reduced rates of labor induction and augmentation
• Reduced use of regional anesthesia
• Decreased infant mortality rates
• Decreased risk of preterm birth
• Decreased third and fourth degree perineal tears
• Lower costs for both clients and insurers
• Increased chances of having a positive start to breastfeeding
• Increased satisfaction with quality of care ^2,3

What are the concerns related to using a midwife?

There are cases in which either the mother or the baby will require medical interventions that are outside the scope of services offered by a midwife.

Midwives routinely consult with obstetricians, perinatologists, and other healthcare professionals, and will refer women to appropriate medical professionals if complications arise.

If a woman has a high-risk pregnancy and/or if complications are anticipated, it is recommended to choose a hospital setting with more convenient access to obstetricians, perinatologists, and other professionals trained to address complications affecting either the mother or baby.

www.americanpregnancy.org