Expelling the myths of the midwife

When I was pregnant with my second son, I was discussing with a family member my decision to go to a midwife for my prenatal care and birth. “You need to see a doctor – someone educated – and deliver in a hospital. You're high risk,” she said skeptically. 

As we talked more I got the distinct feeling that she had a vision of me delivering in the woods, with a witch doctor attending my birth.  Sadly, many people share this view of midwives. 

Part of the problem is that there is a bit of an identity crisis within the profession. Certified nurse midwives, certified professional midwives, and lay midwives all fall under the title of midwife, though our training, education, and licensing are vastly different. For the purpose of this blog when I refer to midwives, I'm referring to certified nurse midwives or certified midwives.

Even with these distinctions, my own patients are sometimes confused about exactly what I am able to do as a midwife. Many are unaware that I can diagnose and treat medical problems, as well as prescribe most any medication.  Some pregnant patients tell me that they don't feel comfortable birthing at home or without the option for pain medication, so they need to see a physician.  Many people ask when I will become a doctor, whereas some assume that I am anti-physician.  The word midwife means “with woman.”  This is the goal of midwifery, to be with women through all the stages of their lives. 

I am a midwife.  I am an advance practice nurse with a graduate degree in nursing. I'm not a physician, nor will I ever be one. I don't do surgery, but I do catch (deliver) babies in a hospital. 

Many midwives do offer home births or work in freestanding birth centers, if the pregnancy is low-risk. I care for pregnant women and provide gynecologic services to women from adolescence through menopause and beyond.  I provide STD testing, contraceptive counseling, some primary care and health promotion. 

Sometimes there is talk within the medical community comparing midwives and doctors as if they are competing forces. This should not be. Midwives often work in collaboration with physicians. For example, I can care for a high-risk pregnancy but will coordinate the plan of care with my back-up doctor. If a birth becomes complicated, I can call on my collaborating physician to assist me. There is plenty of need and space for both physicians and midwives in modern health care. In an ideal situation, collaboration between midwives and doctors enhances the care provided by each. 

So why choose a midwife? What makes us so special? I cannot speak for all midwives, but I tend to take a more holistic approach to health care. I like to spend time getting to know my patients and including the whole family in prenatal care.  My focus is education and prevention, as well as health promotion and wellness. I advocate for my patients and try to give them choices in their care whenever possible. I have a belief that birth is natural and safe until proven otherwise; however, I would never deny a laboring mother pain medication. The hardest part of my job is often keeping my hands off, doing nothing and waiting.

If you're thinking of seeing a midwife, becoming a midwife or have any questions about the profession, you can email me here.

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