Midwifery: What Is A Midwife And What Exactly Does A Midwife Do?

Midwives have been supporting families during pregnancy, labor, and birth for centuries. The practice of midwifery in the modern era dates to the 18th and 19th centuries when licensed midwives became an integral part of healthcare practices, providing prenatal, childbirth and postpartum care. Midwifery services focus on not just physical health needs but also the emotional, social, and mental well-being of the patient. Despite it being an important role in modern healthcare, many people are still unaware of what a midwife does or uncertain about the safety of midwifery. Even sothere has been an increased demand for midwives offering patient-centered care which is based on trust and understanding recently, leading to greater awareness and recognition of midwifery services around the world.

So, What Is A Midwife & What Do Midwives Do?

A midwife is an experienced healthcare professional trained to provide care to women during pregnancy, childbirth, and the postpartum period. Midwives are knowledgeable in promoting natural childbirth while also being prepared to recognize and manage complications. They work with women to create a birth plan that meets their individual needs and preferences, offering support and guidance throughout the entire process. The 4 main types of midwives include CNMs (Certified Nurse Midwives), CMs (Certified Midwives), CPMs (Certified Professional Midwives) and Unlicensed or Lay Midwives. With a history stretching back to ancient times and modern midwifery dating back 100s of years, midwifery has now been an established profession in the United States for over a century offering many advantages for pregnant women and their families.

IMG-20230928-WA0027 (1)
Midwives Malki Schuler, Alicia Gagnon, Judy Ribner & Ruchi Cohen

The Role of a Midwife

Midwives are incredibly important in the journey of pregnancy and childbirth. They offer skilled, comprehensive care, providing emotional and physical support to moms-to-be before, during and after childbirth. A midwife’s role is essential in fostering safe pregnancies, reducing interventions during childbirth, and facilitating appropriately informed decision making for the health of both mother and baby throughout the entire process.

Pre-pregnancy & prenatal care

Midwives are highly involved in pre-pregnancy care, providing counseling and education to prospective mothers on how to establish healthy habits before conception. From nutrition tips to advice on avoiding harmful substances, midwives can provide comprehensive guidance that increases the likelihood of a healthy & successful pregnancy.

Midwives also provide prenatal care, assessing any potential risks or complications that could arise during pregnancy. They provide guidance on regular pregnancy concerns and any other challenges that may arise. Midwives will often offer emotional support for expecting mothers, reassuring them about the process of childbirth and alleviating any fears, anxieties or worries they may have.

Birth

Midwives  are competent providers who can manage the labor and delivery process. They provide a personal and intimate journey for the pregnant mother, honoring her unique experience and choices. 

They are trained to provide physiologic and evidence based care such as intermittent fetal monitoring, encouraging movement during labor as well as suggesting positions that minimize tearing during childbirth. They care for mom and baby in a safe and loving way.

Postpartum & newborn care

A midwife’s role in postpartum and newborn care is invaluable. Typically, midwives provide essential postpartum check-ups to mothers and babies in the home, usually 24-48 hours after the birth. During these visits, midwives can monitor mom and baby for the normal adaptations that occur after childbirth. They conduct screening tests such as CCHD and newborn screening and provide breastfeeding support. They file birth certificates with the correct authorities. At the six week visit, midwives can offer contraceptive choices and HPV screening.

Midwives also offer emotional support for new mothers dealing with postpartum depression or other difficult feelings that come with caring for a newborn. They are on hand to help guide families through caring for their baby, sleep patterns and advice on infant care. If necessary, midwives will refer any additional support requirements to appropriate services.

Certified Nurse Midwives (CNMs)

Certified nurse midwives (CNMs) are healthcare providers, certified by the American Midwifery Certification Board, that have gone through nursing school & completed a graduate degree in midwifery. CNMs specialize in reproductive health and provide both general care as well as ordering lab tests, prescribing medication, and diagnosing conditions. CNMs are allowed to practice in all 50 states and they can work in hospitals, birth centers or attend at-home births.

Their training includes anatomy, physiology, obstetrics, and medical decision-making within the standards of care set out by the medical community’s protocols. CNMs spend more time with laboring women than doctors providing individual attention and support leading up to, during and after delivery.

Certified Midwives (CMs)

Certified midwives (CMs) are specialized non-nurse midwives with an educational background in a health-related field, specifically an accredited midwifery education program and the passing of a national exam. Paths to becoming a CM vary but typically involve obtaining a bachelor’s degree or higher, as well as being permitted to practice lawfully in only a small number of states across America. CMs hold graduate degrees in midwifery yet have not necessarily completed nursing school programs. CMs carry certification from the American Midwifery Certification Board.

Midwifery Education & Training

Midwives possess a specialized knowledge and understanding of reproductive health, labor, and postpartum care, which are acquired through comprehensive midwifery education and training programs. Depending on the specific midwifery specialty one wishes to pursue, there may be additional requirements in addition to the core competencies. Regardless of the type of midwifery program chosen, they all incorporate both theoretical learning and practical clinical experience.

Academic requirements

For those interested in becoming a midwife, there are certain academic requirements needed. For Certified Nurse Midwives specifically, it’s typically required to begin with earning a bachelor’s degree in nursing or similar field accompanied by an accredited midwifery program from the Accreditation Commission for Midwifery Education (ACME).

Education and training for midwives includes a comprehensive curriculum. Areas of instruction include anatomy and physiology, pharmacology, newborn care, and reproductive health.

Clinical training

Getting hands-on experience is an important part of midwifery education & training. Midwifery students must gain abilities in clinical settings under supervising midwives and healthcare professionals so that they can gain practical talent and understanding. Clinical training may happen in different settings, such as hospitals, birthing centers, and home birth practices.

Midwifery clinical training equips students with the skills necessary to become certified midwives. Students learn how to provide prenatal care, assist in labor and delivery, and manage complications such as pre-eclampsia or postpartum hemorrhage.

Certification & licensing

Midwives must become certified and licensed to practice in the United States. The American Midwifery Certification Board administers certification exams for midwives-in-training, which cover topics such as completing an accredited program, logging clinical hours, and demonstrating competency in providing care.

After getting certified, midwives must apply for licensing from their state of residence.

Why Someone Might Choose A Midwife Over A Doctor

Whether it is personalized care or lower intervention rates, midwifery care offers numerous advantages when compared to traditional obstetric care. Midwifery care is increasingly become a preferred choice for pregnant women who want comprehensive and holistic healthcare during the entire pregnancy and childbirth process. Some of the benefits of choosing a midwife as your healthcare provider include access to individualized care, reduced risk of medical interventions and increased chances of having a natural birth experience.

Personalized care

When it comes to pregnancy and childbirth, midwives prioritize personalized care. They get to know their patients on a deep level to understand their unique needs and preferences. They developing an individualized care plan tailored to a woman’s needs, beliefs, and values .  Midwives strive to create an exceptional experience for each person they serve. This emphasis on personalized care can lead to a more positive and empowering childbirth experience for mothers-to-be.

Lower rates of interventions

Midwifery care has been found to be associated with decreased interventions in childbirth, such as a reduction in epidurals, c-section, and inductions. This is because midwives focus on encouraging physiologic labor and reducing interventions. Midwives encourage breathing and relaxation techniques, massage, hydrotherapy and unrestricted movement during labor.

Lower healthcare costs

Midwifery care results in lower healthcare costs than receiving obstetric care from a hospital. This is partly because midwives typically provide their services in home or birth center settings and are focused on preventing health issues such as gestational diabetes or preeclampsia. With nutritional counseling and education, midwives help women avoid expensive medical interventions.

Improved maternal and fetal outcomes

Research has demonstrated that pregnant women obtaining midwifery care tend to experience better maternal and infant outcomes. These women are less likely to endure preterm labor, have babies with low birth weight, or have an infant die soon after delivery. Furthermore, women receiving midwife support have better breastfeeding rates. Breastfeeding has advantageous health benefits both for mothers and their children.

Cultural Competence in Midwifery

Midwives are at the forefront of providing culturally competent and personalized care for women and families. Through understanding and respecting the values, beliefs, and practices of those they serve, midwives can bridge any gaps in healthcare disparities that may exist. By increasing cultural competence in midwifery, maternal and fetal outcomes can be improved as a result.

Challenges & Controversies in Midwifery

Despite its increasing recognition and acceptance, midwifery care unfortunately still faces many challenges and controversies. These can impede the capacity of midwives to provide safe and effective care to women and babies. To ensure midwifery can be seen as an increasingly viable option for childbirth and reproductive health, it’s important that these obstacles are addressed and overcome.

Legal and regulatory issues

Midwives must operate within a legal framework that covers their practice. This can include everything from licensing, educational prerequisites and limitations on clinical autonomy. As regulations vary from place to place, the roles and responsibilities of midwives differ according to location. Issues regarding scope of practice and physician involvement often raise debates among healthcare providers, making the legal and regulatory environment surrounding midwifery a point of contention.

Collaboration with physicians

Midwives often have to collaborate with Obstetricians, and not all physicians acknowledge midwives’ contribution to care. As midwives provide an alternate source of care, they may be seen as potential competitors which can make teamwork difficult. Open communication between practitioners is vital for optimal outcomes for women and babies. It’s essential for midwives and medical physicians to foster a trusting partnership of collaboration based on mutual respect.

Public perception and misconceptions

Midwifery has unfortunately dealt with  negative public perception and false misconceptions. This has led to resistance from members of the medical community and a limiting of access to midwifery care. To facilitate better midwifery practice, it’s important to strengthen the collaboration between midwives and physicians. Increased communication and public education initiatives can help dispel any misunderstandings or stigmas. This step is necessary to create better opportunities for patients and practitioners and to protect individuals’ reproductive health rights.

Resources

  1. American College of Nurse-Midwives. (2022). Essential Facts About Midwives.
  2. American College of Nurse-Midwives. (2021). Midwifery Linked to Better Birth Outcomes.
  3. American Pregnancy Association. (n.d.). Midwives.
  4. American College of Nurse-Midwives. (2017). Comparison Chart of Certified Nurse-Midwives, Certified Midwives, and Certified Professional Midwives.
  5. American College of Nurse-Midwives. (2015). Midwifery Education Trends Report.
  6. Midwives Alliance of North America. (n.d.). State by State.
  7. American College of Obstetricians and Gynecologists. (2018). Joint Statement of Practice Relations between Obstetrician-Gynecologists and Certified Nurse-Midwives/Certified Midwives.
  8. “Scope of Practice for Midwives.” Georgetown University School of Nursing & Health Studies, 2021.
  9. “Midwifery.” Encyclopedia Britannica, Encyclopedia Britannica, Inc., 6 Nov. 2020.
  10. “Become a Midwife.” American College of Nurse-Midwives

NYC & Long Island Homebirth Midwifery  Holistic Midwifery NY Logo

Though birthing at home is not for everyone, the rate of home birth satisfaction is high – much higher than the satisfaction rate for hospital births.

Giving birth at home is a gift for you and your family.

At Holistic Midwifery NY, located in NYC and Long Island, we believe that where you decide to give birth is one of the most important decisions you’ll ever make. We’ll be with you every step of the way.

For a deeper dive into everything homebirth, please see the Resources section of our website, Resources – Holistic Midwifery NY.

Call us today for your free consultation

We’re standing by ready to answer any questions you have.

×