Lily Bastian CNM MSN
Midwifery Clinical Practice Advisor, American College of Nurse-Midwives
Pregnancy is an exciting time and there is a lot to prepare for your new arrival. As the healthcare landscape in the United States changes due to COVID-19, you’re likely considering all your options in relation to prenatal care and where you want to deliver your baby. Midwifery may have crossed your mind, but it might be an unfamiliar avenue. Maybe you have heard stories but still don’t have a clear picture of what to expect.
“What is a midwife?”
Midwife means, “with woman.” Midwives promote normal physiological birth, supporting a woman’s own innate body processes to give birth. Midwives are often integrated into their communities and bring a unique perspective on how to provide care while keeping the whole person in mind.
Certified Nurse-Midwives (CNMs) and Certified Midwives (CMs) are educated in graduate-level accredited midwifery programs. CNMs and CMs pass a national certification exam to receive the professional designation of CNM (if they have an active RN at the time of the exam) or CM. CNMs are licensed to practice in all 50 states and D.C., and CMs are licensed to practice in eight states: Delaware, Hawaii, Maine, New Jersey, New York, Oklahoma, Virginia and Rhode Island. Certified Professional Midwives have two pathways to national certification: apprenticeships or accredited programs which lead to a certificate, associate, bachelor or master’s degree. CPMs are licensed to practice in 34 states and DC.
Midwives provide a full range of primary care services from adolescence through post-menopause and everything in between, including primary care, gynecology, family planning, pre-conception, pregnancy, childbirth, postpartum, and normal newborn services. You will find them working in clinics, birth centers, hospitals, and home settings. They specialize in low-risk pregnancies and if complications arise in pregnancy or birth, they are educated to identify abnormal occurrences and collaborate with other health professionals to assure safety.
“Why a midwife?”
Midwives provide evidence-based, individualized care, continuous partnerships, and therapeutic use of human presence and skillful communication. Research shows that midwifery improves birth outcomes, including increased rates of spontaneous labor, vaginal birth, and breastfeeding. Midwifery care results in lower rates of unnecessary interventions. Many women that use midwifery care report higher rates of satisfaction with their overall healthcare experience.
There is currently a maternal healthcare crisis in the United States, with women experiencing high rates of maternal death and injury from pregnancy-related complications. These rates are higher among people of color. Midwives and their philosophy of care are key to changing these statistics. Evidence-based research shows better health outcomes for patients who receive care from providers who look like them. As such, there is also a need to diversify the midwifery profession to address this growing health crisis. Midwives provide an impactful solution to geographic areas that experience a shortage of maternity providers as they are poised to meet the needs of communities.
Making the choice
When deciding who will provide your prenatal care, it is important to know yourself, what you are comfortable with, and what concerns you. Where will you feel most relaxed receiving care and delivering your baby? Be sure to collect information on what is available in your area; your decision will be impacted by your location, insurance coverage, and other logistics.
If you are feeling wary about going to a hospital during the pandemic, you may explore if there is an option in your state to have a home birth or birth center birth with a midwife. Midwives are the experts in normal pregnancies and the American College of Nurse-Midwives has a vision to ensure a midwife for every woman.