What is a Nurse Midwife?

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Midwives of the Past

Midwives have been around since the dawn of time. The earliest definition of midwife was simply someone who assisted in childbirth. Midwives were women who were called to help other women in the daunting task of child labor and birth. There was a time when childbirth was considered a natural part of being a woman. It wasn’t a medical event. It was a rite of passage. There were no trained doctors or hospitals for childbirth.

Although formal training for midwives began in 1715, many women believed childbirth wasn’t a subject to be discussed with men. At that time, girls weren’t taught to read, so many women were illiterate. Formal education was nearly impossible.

By the 19th and 20th centuries, as doctors became more formally trained and as anesthesia became more widely used, middle-class families turned to the medical community for help in childbirth. By 1900, physicians were used for about half of the nation’s births. Midwives were for families who could not afford a doctor. As our economy became stronger, and more people joined to ranks of the upper and middle classes, there was a sense of “prestige” that accompanied the choice of delivering with a doctor.

By 1920, doctors believed that “normal” deliveries were indeed rare and convinced the public that medical interventions should be made during every childbirth event to prevent possible defects and death. In the decades that followed, childbirth became a medical event, rather than a natural process, and the idea of safe childbirth anywhere outside of a hospital was ludicrous in the minds of the American people. Interestingly, maternal mortality rates didn’t decline. Between 1900 and 1930, the maternal mortality rate was 600 to 700 deaths per 100,000 births.

The feminist movement of the 1970s brought a shift in the attitudes about childbirth. Feminists expressed concern about the medical interventions in what they believed to be the natural process of childbirth. There became an increasing demand for midwives and the support they brought to women who wanted to experience a natural childbirth.

We’re seeing much of that same sentiment today with the demand for organic foods and natural remedies for life’s ailments. There is a longing to return to simpler days of less industrialized food and health care. Although the midwife has always been a part of some corners of society, she is being called out of the shadows to meet the demands of women to make labor and childbirth natural events again.

Midwives of the Present

Each state has its own laws about licensing midwives. Most require a midwife to go through some sort of formal training, and many require nursing school. Today, nurse-midwives strive to meet the physical, emotional, and social needs of their patients. They offer health care to women before, during, and after childbirth. Their focus is on helping women with normal pregnancies prepare for childbirth, monitoring the progress of the pre-born baby, postpartum care, family planning and routine gynecological care. Nurse-midwives partner with their patients to help them make decisions about diet & nutrition, exercise, and maintaining a healthy lifestyle. They believe that pregnancy and childbirth are natural processes and that most women are able to deliver healthy babies without intervention.

Nurse-midwives are trained in modern obstetrics and gynecology, nursing and midwifery. Many have worked as maternity nurses in hospitals. Where nurse-midwives deliver babies varies from state to state. Some are available as an option in the same hospitals where doctors deliver babies. Some have their own clinics, called birthing centers. Some come to your home so you can deliver there. Nurse-midwives work with physicians when something about the pregnancy varies from normal. They are trained to know when to refer a patient to a doctor for more advanced care.

Choosing a Midwife

It’s important to interview your chosen midwife to understand what she brings to the birth experience and what you can expect. It’s also important to understand the differences between the different types of midwives.

A Certified Nurse-Midwife (CNM) 

A CNM are licensed and trained as a registered nurse in midwifery. As a registered nurse, she has labor, delivery, postpartum or neonatal experience. They are usually licensed through their state and have a Master’s Degree. CNMs are allowed to practice in all states and deliver in home, birth centers or hospitals. They can provide care from the first menstrual cycle through menopause. Nevada doesn’t require any physician oversight and allow CNMs to write prescriptions and carry prescription medications to births.

A Certified Professional Midwife (CPM)

A CPM licensed and trained in midwifery only. CPMs don’t necessarily go to school, but can get their training through apprenticeships. Their licensure is through a portfolio evaluation process. They’re only required to have a high school diploma and although they can practice in most states, Nevada does not license CPMs. CPMs cannot attend deliveries in hospitals, nor can they write or carry prescriptions in Nevada.

A Certified Midwife (CM)

A CM licensed and trained in midwifery only. They’re required to obtain a Bachelor’s of Science from an accredited college or university and a graduate degree from an accredited midwifery education program. They can attend hospital and out of hospital births, but they cannot write prescriptions or carry prescription medications to births. Although CMs can practice in some states, Nevada does not license them.

Childbirth is a natural process and most women don’t need medical intervention. Working with an experienced midwife by your side allows you to enjoy a natural birth experience without worry and fear. If you would like to find out more you can submit our online contact form here.