If you are pregnant and seeking an alternative to having an OB/GYN manage your birth, you may be wondering what role a midwife plays in childbirth. The profession of midwifery has been around for centuries, though it has evolved quite a bit from its roots in ancient history. Simply put, a midwife is a trained professional who assists a woman with prenatal care, attends the birth of the baby, and assists with postpartum care of both mother and child. Midwives usually emphasize natural childbirth using non-invasive techniques to assist the mother with giving birth.
But within that broad definition, there are several different types of midwives, with differing levels of certification and education. The following is a brief overview of the two different levels of midwifery care currently available in the United States:
Nurse-midwives are individuals who have completed a course of study that allows them to practice as both nurses and midwives. Depending upon the state they live in, these midwives can be certified as advanced-practice nurses, midwives, or nurse-midwives. These professionals can prescribe medications in all 50 states, and can also provide gynelogical care for all women, regardless of age. They assist with births in any setting, including hospitals, clinics, birthing centers, and with home births. In order to become a nurse-midwife, the practitioner must obtain formal study from an insitution accredited by the American College of Nurse-Midwives. After obtaining an education, the practitioner must then pass a certification exam given by the American Midwifery Certification Board.
Direct-entry midwives are practitioners who are educated in midwifery but are not licensed to practice as medical nurses. Practitioners may become educated through self-study, apprenticeships, a midwifery school, or a college or university program that does not include a nursing program. Under this category, three separate types of midwives fall. A certified professional midwife (CPM) is one who has been licensed by the North American Registry of Midwives to provide the midwife model of care. A licensed midwife is one who has become licensed to practice within the regulations of her state. A lay midwife is one who has learned the fundamentals of midwifery care through informal routes, such as self-study and apprenticeship.
Although these two levels of midwifery care differ, the overall guiding principles of midwifery care are the same:
- to help ensure the well-being of the mother throughout her pregnancy
- to provide education and counseling to the mother during prenatal care, to assist continuously throughout the labor process, and to follow-up with postpartum care for mother and child
- to minimize technological intervention in the hopes of ensuring a natural childbirth
- to recognize at-risk pregnancies and other cases that require the assistance of an OB/GYN
If you are intrigues by the idea of having a midwife assist you throughout your pregnancy, you may want to check with the American College of Nurse-Midwives to see what kind of midwifery care is available in your area. Midwives are generally in favor of non-traditional birthing methods, such as a water birth. So if you are interested in exploring your options for a non-traditional or natural birth, you should consult with a midwife for further information.Sarah Baker is a documentary filmmaker and writer currently living in New Bern, NC. Her first book, Lucky Stars: Janet Gaynor and Charles Farrell, will be published December 2009. Read more about her.