While most pregnant women in the U.S. give birth while under the care of an obstetrician (OB), a growing number are choosing to seek prenatal care and deliver their babies with a midwife rather than a doctor. According to the American College of Nurse Midwives, the number of births attended by midwives has steadily increased over the past decade. In 2014 (the latest year for which there are statistics), midwives attended 8 percent of all hospital births, an 11 percent increase since 2005. The percentage of out-of-hospital births attended by midwives also increased from 28 percent in 2005 to 31 percent in 2014.
“Women may choose a midwife if they desire a more ‘natural’; approach to their pregnancy care, labor and delivery experience,” says Kelly Kasper, MD, an obstetrician/gynecologist at Indiana University Health. Here’s what else you need to know about midwives:
Midwives may offer more options in terms of where and how you give birth.
One advantage to using a midwife is that a woman may choose to have her baby in a birthing center or even in her own home, rather than in the hospital. In addition, a midwife offers women a more “hands-off” approach, meaning little or no pain medicine and limited monitoring, says Dr. Kasper. Midwives are generally present throughout the entire labor and delivery period.
They’re formally trained and certified.
A big misconception is that midwives have no formal education, says Dr. Kasper. But in the U.S., Certified Nurse Midwives have a master’s or doctorate degree in nursing and are required to pass a national certification exam. Midwives offer the same standard tests as doctors do, although their appointments tend to be longer (usually about 45 minutes).
Dr. Kasper says another misconception is that midwives cannot care for a high-risk pregnancy. “Midwives can provide health care in a high-risk pregnancy,” she says. “Most often these midwives will work closely with an OB and deliver their patients at a hospital.” However, if there’s a good chance that you’ll need a C-section, she says, you’re better off being seen by an OB since midwives don’t do C-sections.
Midwives aren’t the same as doulas.
While both midwives and doulas help women through labor and delivery, their roles are very different, says Dr. Kasper. “A midwife is a health care provider while a doula is more of a childbirth coach,” she says. Midwives can conduct physical exams, suture up tears after delivery and care for the newborn baby, for instance. “A doula isn’t qualified to provide prenatal care or deliver babies, but can add extra services, such as helping you with techniques to manage pain during labor and even providing support and help during the first few weeks of your baby’s life.”
They do more than deliver babies.
“While many people think that midwives only focus on pregnancy and birth, they’re qualified to care for women through pregnancy, birth, postpartum and beyond,” says Dr. Kasper. They can care for teen girls through menopausal women, provide general health check-ups, screenings, vaccination, treatment for STIs, provide birth control, as well as many other services.
If you’re interested in seeing a midwife, Dr. Kasper recommends asking physicians, nurses and trusted friends for recommendations, and then interviewing a few before you make your choice. You can also search the American College of Nurse-Midwives website at www.midwife.org/find-a-midwife.
-- By Patricia Scanlon