Some common questions I receive from pregnant patients deal with midwives: "Who are they? What do they do? Do I need one?"
Midwives attend about 8% of births nationally. There are two general categories of midwives: those who deliver babies in hospitals and those who attend homebirths. In select areas throughout the country there are also independent birthing centers where midwives deliver children.
Certified Nurse Midwives (CNMs) are nurses - usually with backgrounds in labor and delivery - who attend additional training and certification in birthing babies. They also have training in non-medical comfort measures for laboring women, and may recommend position changes, massage and pressure points, and breathing strategies, as well as the use of water (hot and cold). They can order narcotic pain relievers and epidurals and are usually in and out of the room throughout labor, checking on women every one to two hours up until transition. CNMs work under physician oversight and attend low-risk pregnancies. If complications arise an obstetrician is called for a consultation. CNMs do not perform cesarean sections.
Traditional Midwives, also known as Licensed Midwives or Lay Midwives, attend homebirths and birthing center births. Nationally, about 1% of births occur at home with midwives. Traditional Midwives are generally trained through years of apprenticeship with another Traditional Midwife, as well as licensed by the state if available. They "labor sit" with the woman, with continuous contact during labor, birth, and postnatally. They are well trained in the natural process of labor, usually offering more types of non-medical comfort measures than CNMs. They are trained to recognize complications and recommend transportation to the hospital if needed. Homebirth midwives do not provide medical interventions and cannot administer medications or drugs, although some states now allow homebirth midwives to carry Pitocin and oxygen tanks.
When deciding if a midwife is the right choice, I ask women if they have a low-risk pregnancy and a desire for increased access to non-medical pain relief strategies. If so, then exploring midwifery care is a great option. I usually recommend that women spend some time interviewing a few different care providers and find someone they trust and with whom they have good rapport.
Here are four things that will help you find the midwife who is right for you:
- Ask questions about the standard of care, intervention rates, c-section rates, and numbers of non-medicated births.
- Take a birthing class and spend time thinking about what type of birth you envision.
- Create a birth plan (a short document with your birth preferences) and show it to the providers you interview.
- Most importantly, find someone who will listen and respect your choices around birth.
Digg
StumbleUpon
Facebook
Delicious