Choosing a Midwife: Midwives and Midwifery

A midwife is a person who delivers babies. She will follow the mother throughout the gestation period, caring for her health and the health of the baby. When it is time for the birth the midwife may have the laboring mom come to a birth center, or the midwife may travel to the woman's home to assist in a home birth.

Midwives have been in existence for thousands of years. As a profession, they have delivered more healthy babies that Ob-gyns ever thought of. As caregivers they are hard to beat.

A midwife is trained in the science of birth. There are as many different methods of midwifery and midwifery training as there are midwives. More and more, midwives are an option women want for their birth.

The midwife has a tendency to consider your wishes more than an obstetrician will. SInce most midwives are women they also tend to be more sympathetic to your discomforts, pain, and complaints. You have the opportunuty to spend more time with them and so develop a close relationship.

Most people enjoy these positive aspects of a midwife, and once they have experienced birth with amidwife attending do not wish to do it any other way.

Up until the 1900s midwives delivered more babies in the United States than doctors. With medical care changing drastically in the early part of the 20th century the shift was made to doctors and by the hygiene-driven 1940s it was considered unclean and unsafe to give birth anywhere other than a sterile hospital.

The number of C-sections, induction, pitocin, and complicated births increased dramatically. Doctors routinely put the birthing mother under anesthesia, slowing down healthy labor and delivery. The father was not allowed in the delivery room where medical staff reigned supreme. The baby was whisked away to a nursery, satiated with sugar water, and had a pacifier stuck into it's mouth before the father could finish passing out cigars.

That trend began to change with the back to nature Hippy Movement in the late sixties. By the 1980s Dad was welcomed in the delivery room, and births were being done without medications. However midwives were still shunned and doctors still did a lot of unnecessary procedures. It was in the 1990s that midwifery began to come out of the shadows and again be an acceptable alternative to conventional birth. With skyrocketing hospital costs and difficult insurance plans the average $2,500.00 charged by a midwife was a lot easier to pay for than the close to $10,000.00 charged at a hospital.

The challenge was that midwifery was not, and is not, legal in all states. Some insurance plans pay for it and others do not. One of the biggest challenges is the perception that birth is a complicated process which only obstetricians can understand.

A midwife is able to do nearly everything that a normal pregnancy and healthy delivery require.

At the first appointment she (there are some male midwives but we will refer to all midwives as "she" in this article for clarity) will do a pregnancy test, blood workup, and exam. She will take your personal history and talk to you about your desires and expectations of your pregnancy and birth. You will be weighed and your blood pressure taken. Many midwives will suggest dietary outlines and herbal supplements to insure a healthy baby.

You will be scheduled to see her monthly until the last few months of your pregnancy. At each appointment she will do an exam, check weight and blood pressure and listen for a heartbeat. She will sit and answer questions and discuss your pregnancy with you at length. One of the nicest things about a midwife is the time that they invest in each patient, rather than hurrying the mom-to-be out the door. She will discuss your birth plan, whether you plan to deliver at her birth center or at your home, and what to expect during the birth. She may discuss options like water birth, any religious preferences you may have, and other things specific to your situation.

If there is a problem or concern at any point your midwife will discuss this with you and then discuss your options. She may refer you to an obstetrician at that point for the good of your baby. A midwife cannot do surgery, administer anesthetics, or prescribe medications. If you will ultimately need these things she will refer you to an obstetrician.

At the birth the midwife will usually bring an assistant. She will be working with you and your husband during labor and delivery to make it the easiest and best experience possible. She will suggest different birth positions depending on the position of the baby. When the baby is born she will lay it on your chest and deal with the afterbirth.

Usually at this point the midwife will lead you to an herbal bath. You will soak in fragrant and healing herbs while the midwife and her assistant clean up your room, change your sheets, and possibly even cook you a meal! She will observe you for awhile to make sure all is well and then leave. The midwife will leave a list of things to watch for, and more than likely she will be back to check on you in a couple of days.

What is the difference between the two?

Simply, the certified nurse midwife has usually attended nursing school and has a degree. She will also attended a nurse midwifery school and have a midwife's degree. While this makes some people feel better, others feel that it gives them a tendency to be more like a doctor and less like a midwife. Certified nurse midwives are more likely to be legal in the state you are in.

A Lay Midwife, or Direct Entry Midwife generally gets hands on training. She goes through a midwifery program and then apprentices to a working midwife for a period of time. There are specialized exams that she must pass. Often she will continue to work with the midwife until she is experienced enough to be ready to go on to her own practice. This type of midwifery is illegal in some states, although it is practiced extensively throughout the United States. There is a movement to make this alternative health care available to parents in all states.

Using a midwife is sometimes a controversial choice. Family members may have opinions, friends may have opinions, and even people you work with may have opinions that you would rather not hear. It is a safe alternative for most women. If it is something you want, do not let anyone dissuade you from it.