What is a certified nurse-midwife?

The definition of the word “midwife” actually means “with woman”, but a majority of the time when you ask someone if they know what a midwife is, they say “no”. A few others will usually come up with some really original ideas of what they think a midwife is and does. Like “No, I don’t know what it means, I thought it meant you were the doctor’s “middle” wife”. It’s unfortunate that there is such a poor understanding of what a midwife is and does. Well, a certified nurse midwife is a professional health care provider, usually a registered nurse who has graduated from one of the advanced programs accredited by the American College of Nurse Midwives (ACNM). A CNM must also pass a national certification exam and meet strict requirements set by individual state health agencies. CNMs may be found in a variety of health settings; county clinics, private obstetrical offices, hospitals, birth centers and many others. Nurse-midwives provide prenatal, postpartum, and well women care. They are probably best known for attending women in labor and supporting them as they deliver their babies. Midwives apply their philosophy of care in any setting they may be employed in.

Midwives have been with women throughout a lifetime, teaching and answering questions about diet, exercise, personal hygiene, sleep and how to maintain a healthy lifestyle and pregnancy. They can provide preconception counseling, family planning services, gynecological care, annual pelvic and breast examinations, Pap tests and screening and treatment for infections. They may also care for older women, pre and post menopausal.

A Nurse Midwife’s philosophy of care provides women with special skills so that they will be able to understand their own unique physical, emotional and spiritual needs. Nurse-midwifery care focuses on maintaining health and encouraging women to make informed decisions about their health care. Midwives take the time to listen and talk with you. They encourage your empowerment. In support of midwifery care, numerous studies have demonstrated that women who are cared for by midwives can expect the same level of safety as they would get from a physician.

Why choose a certified nurse-midwife?

Most women who seek out care provided by a midwife are looking for an alternative to the traditional medical management provided by most obstetricians. Midwives look at pregnancy as a normal process, something that is supposed to happen naturally, not as a disease or condition that needs to be managed. Midwives are patient; they let things happen naturally. They listen to the women they care for; a woman’s body will tell her what to do if she knows how to listen to it. The midwife will teach her how to listen to her body which will assist her in identifying her own needs and the needs of her baby. The midwife will then encourage her to take control of her pregnancy by making informed choices for herself and her baby. Then the midwife sits back and watches with guidance (and minimal intervention) as the woman proceeds through her pregnancy and in the end successfully gives birth to her baby. Most midwives feel honored and privileged to be able to share this very intimate time in a woman’s life, with her.
You can choose a certified nurse-midwife to care for you during your pregnancy as long as you are healthy and you do not have any serious or chronic medical problems such as; high blood pressure, epilepsy, heart disease or diabetes.

At your first visit the midwife will take a thorough medical history, answer any questions you have, perform a physical exam, order blood tests, and provide you with an estimated date when your baby may be born. Your midwife may recommend some tests that she does not do herself, such as a formal diagnostic US or amniocentesis. Arrangements will be made for you to receive these tests if indicated.

If complications should arise during your pregnancy the midwife may refer you to an obstetrician or a perinatologist. In some cases the midwife may be able to co-manage your care with the physician she collaborates with. Conditions that may arise that would require such management include pre-eclampsia, diabetes, multiple gestation (twins, triplets, etc), and a malpresentation (breech). Midwives can independently manage healthy women who have healthy pregnancies and babies.

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