Q: I‘m considering switching from my OB/GYN to a midwife. What should I know about midwifery care?
A: Midwifery care has a rich history and has undergone a substantial transformation over the past century. It emphasizes client-centered care with a low-intervention approach, fostering collaboration between the midwife and low-risk individuals. Midwives often provide longer appointment times, allowing for in-depth discussions, education and the development of a professional, trusting relationship.
Midwifery care is diverse, ranging from hospital-based to home-birth settings, depending on the midwife’s qualifications and comfort level. If your current care isn’t meeting your expectations, it’s OK to switch providers to one who better aligns with your values. You can make this change at any time, though availability of the new provider may be a factor.
Q: I like the idea of a natural childbirth, but I’m scared of the unknown, if things get complicated. Is a home birth safe?
A: The unknown can feel uneasy at times, and it’s great to acknowledge those feelings. Home birth is considered safe for those who are low risk. We identify low-risk individuals through discussion and review of our client’s health history. It is also important to remember that midwives are trained to watch for signs and symptoms throughout pregnancy, labor, birth and within the postpartum period. If a client’s risk elevates, there may be a need for increased monitoring and/or transfer of care to another provider, if the condition falls outside the midwife’s scope of practice.
Q: What are the different types of midwives? I’ve seen some with certifications and others without. Can you explain the differences?
A: Each midwife’s role within the birthing community is unique and valuable. Together, we have a significant impact on many people’s lives. Understanding their credentials helps clarify their scope of practice, education and training.
- Certified Nurse-Midwives: CNMs are nurse practitioners with a master’s degree in nursing. They’ve passed a national midwifery board exam (AMCB) and are qualified to care for individuals throughout their reproductive lifespan, prescribe medications and practice in both hospitals and out-of-hospital settings. Their scope is the broadest among midwives.
- Certified Professional Midwives: CPMs have a midwifery certification and have passed a national exam (NARM). They provide care primarily during pregnancy and postpartum and are trained to use life-saving medications and equipment. They practice in out-of-hospital settings.
- Licensed Direct Entry Midwives: LDMs are CPMs who have taken additional steps to become licensed in their state. Licensing requirements vary by state.
- Traditional/Community/Lay Midwives: These midwives have not undergone formal school training or board exams. Their education is usually self-taught or through apprenticeships. They practice in out-of-hospital settings and have the narrowest scope of practice.
Q: My partner and I recently learned the good news that we’re expecting! I’ve always dreamed of a home birth, but my partner is anxious about it. How can we learn more about the process and what’s expected of him?
A: It’s important to have an open and honest conversation about each of your hopes and concerns for this pregnancy and birth. I recommend scheduling a consultation with the midwife you’re interested in. This gives your partner and you the chance to ask specific questions and gain a clear understanding of the process, helping you make an informed decision for your family.
In addition, consider taking a childbirth education course or hiring a doula. Childbirth education covers all the details of labor, birth, postpartum and newborn care for both you and your partner. A doula provides emotional, physical and informational support throughout pregnancy, labor, birth and even in the postpartum period.
This article appears in BendNest Winter 2024.
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