What is a Midwife in 2018?
I am always saddened to discover that in 2018 many people do not know or understand what a midwife is or does! The term itself mid….wife means with…women. I became a midwife over 30 years ago because I wanted to make a difference for women wherever they chose to birth their baby. At that time I was working at a large urban hospital with residents, obstetricians, and one midwife. The difference between the births that the midwife did and everyone else was so moving to me that I chose to follow her path. Much has changed in the past three decades, but the principals of midwifery have not. Our commitment to support the mother and family unit, to encourage a woman to trust her own instincts and birth in whatever position/location that feels right for her while being surrounded by the people important to her has not.
Today, there are over 12,000 women and a few men who are midwives in the United States. Certified Nurse Midwives (CNMs) are the most common type, but there are also Certified Midwives (CMs). Both CNM’s and CM’s have graduate level midwifery degrees, have passed a national certification exam, and can prescribe medications and treatments. About 95% of the births done by midwives occur in hospitals, but another 5% safely birth at home or in birth centers.
Although midwives are best known for their role in pregnancy and birth, we also provide care for women from puberty through menopause. This can include routine gynecological care, birth control, and yearly visits after menopause. Many women become so attached to their midwife that they follow the same person through all the stages of their life. I always say that once you see a midwife you will be sold on the difference in your care.
Often I am asked to explain what the difference in birthing with a midwife vs a doctor might be. Many people think it means they cannot have an epidural or drugs, which is not the case. During pregnancy, my goal is to assist the mother in feeling healthy on all levels, physically, emotionally, mentally, and spiritually. There is so much more to birth than just the size of the baby and the mother’s pelvis. A woman's emotions, needs, past experiences, etc. are all major players in the birth process. I seek to educate her about her body, nutrition, exercise, and to understand her desires for the birth. I am there to support her in birthing in whatever way she feels is right for her. It is her birth, and I while I cannot control the course of labor, I can control that she feel supported during the process. I believe that the only way to manage labor is to be present with the woman during the entire process. Pushing with a midwife can be different in that we encourage you to push in any position that works for you. We limit interventions to necessary medical problems, and rarely will cut an episiotomy.
Although most birth is normal, we recognize that sometimes there is intervention needed in the form of C/Section. I am grateful to work with a group of five Ob-Gyn’s and four other Certified Nurse-Midwives. Just as there is always a midwife from our group on call, there is also a obstetrician available if we need them. In this way our patients are always cared for by members of our group that they have met before labor.
Suzanne Arms wrote this in the 70’s and I have strived in my 30 years of practice to practice with this philosophy.
“Childbirth is an experience in a woman’s life that holds the power to transform her Forever. Passing through these powerful gates –Each in her own way-Remembering All the generations of mothers Who walk with her She is alone- Yet not alone.”