Pregnancy

Is a Midwife Right for You? Here’s What to Consider

written by KATHERINE BALLESTA-ROSEN
reasons to use a midwife"
reasons to use a midwife
Source: Canva
Source: Canva

As the mothers and leaders, partners and friends, and movers and shakers of the world, if there’s one thing we all count on, it’s access to quality women’s healthcare. Wellness and healthcare help us show up as our best selves, whether it’s for a well-woman exam, pregnancy, breast health, or something else. More and more, women are feeling inspired to choose a midwife to receive this care.    

The origins of midwifery go way back (even the Bible mentions it!). Before medical schools and professional accreditations, midwives were reliable women in the community who made sure other women were being taken care of. If you were expecting a baby, had gynecological needs, or just needed care, it was a midwife by your side. 

No wonder today’s women are looking at reasons to consider using a midwife. It’s a seemingly timeless profession made up of heartfelt providers. Sure, there’s no denying that currently, OB-GYNs make up the majority of women’s healthcare practitioners (especially in the U.S.). Yet even in some countries today, it’s still midwives who attend most births compared to obstetrical providers.

So, if you’ve been wondering if a midwife is right for you, you’re in luck. We’ve done the research, spoken to an expert, and can help you decide. (Spoiler alert, midwives do far more than pregnancy-related healthcare!) Keep reading to discover reasons to consider using a midwife, how their services different from an OB-GYN, and more!

Meet the Expert

Kathlyn Albert, DNP, RN, CNM, FNP-BC

As the Clinical Assistant Professor and Director of Marquette University’s Nurse-Midwifery Program, Dr. Albert has accumulated years of dedicated experience practicing nurse-midwifery care and expertly educating others in the field.

 

What is a midwife?

To better understand the complete scope of what a midwife does, we spoke with Dr. Kathlyn Albert, D.N.P., RN, CNM, FNP-BC. She is a certified nurse-midwife and the director of the Marquette University School of Nursing’s nurse-midwifery program. Given she’s grounded at the intersection of nursing and midwifery, she defined a midwife from the vantage point of being certified as a nurse-midwife (CNM). “A nurse-midwife is a health care provider trained to provide holistic health care to individuals from adolescence throughout the lifespan. They are considered primary care providers,” Dr. Albert described. Meanwhile, a certified midwife (CM) is quite similar but is not a registered nurse.

If you thought midwives were solely for pregnancy care and delivering babies, you’re not alone. Dr. Albert clarified, “They [do] spend a lot of time caring for individuals during pregnancy, the labor/birth process, and the postpartum periods. They can also care for newborns up to 28 days of age.”

So yes, midwives tend to be largely associated with providing pregnancy-related healthcare. Nevertheless, it’s also important to value them for the full extent of services they can offer. For instance, there are many people choosing to use a CNM or CM as their primary healthcare provider. This includes gynecological care and general well-being, from a first period through menopause and beyond. It’s an entirely personal choice.

Can men be midwives?

Absolutely! Though it’s much less common, there is a growing body of men choosing to develop a career as a midwife. This is especially true in countries where midwives are the only birthing support available for pregnancy care. As far as male midwives in the U.S. go, according to the American Midwifery Certification Board’s (AMCB) 2021 demographic report, 0.3 percent of the respondents surveyed identified as male.

Are they still referred to as midwives? Yep. Since technically speaking “midwife” means “with woman,” you’re officially referred to as a midwife no matter your gender. In fact, the midwifery model of care prides itself on embracing gender fluidity. It’s one of the many reasons to consider using a midwife—you’ll find out more about it below.

What’s the difference between a midwife and OB-GYN?

Midwives and OB-GYNs (obstetrician-gynecologists) overlap on key features. They support pregnancy, delivery, and postpartum health, as well as gynecological, menopausal, and overall wellness-related care. On the other hand, midwives and OB-GYNs also have their distinctions. With midwives, though they have extensive training and abilities in the areas previously mentioned, “We are not trained physicians, and therefore aren’t trained to perform surgical procedures like C-sections,” explained Dr. Albert. Indeed, one of the major differences is educational background and training. 

Both providers are very highly skilled trained professionals. They have dedicated an admirable number of years to education and training around women’s health. Midwives are either registered nurses with a master’s or doctorate degree in nursing (CNM) or have achieved a postgraduate degree in midwifery (CM). All midwives have been certified by the American Midwifery Certification Board. OB-GYNs are medical doctors (MDs), having completed medical school, residency, and a fellowship. They can further obtain certification from the American Board of Obstetrics and Gynecology for an added distinguishing credential, too.

Since midwives aren’t surgically trained for C-section births, Dr. Albert highlighted, “We care for primarily low-risk individuals, and if/when high-risk status occurs, we can collaborate with our OB-GYN counterparts as needed.” That’s because OB-GYNs are equipped to manage high-risk pregnancies or complications that might arise (i.e., preeclampsia or a history of miscarriage). Overall, however, the key takeaway is that both midwives and OB-GYNs are experts in the field of women’s health. When it comes to pregnancy, giving birth, and your total wellness, their number one priority is your (and your baby’s) health and safety. 

Is using a midwife safe?

Questioning safety often prevents people from looking further into the reasons to consider using a midwife. When we asked Dr. Albert how she would address those who doubt the safety and credibility of using a midwife, she responded, “Years of evidence show that midwives provide safe, competent care to individuals.” Many have elected midwifery care for their pregnancies, gynecological support, and other women’s health-related care. When they do, Dr. Albert confirmed they have reported high satisfaction with the healthcare they receive.   

“Years of evidence show that midwives provide safe, competent care to individuals.”

At this point, you might feel confident about using a midwife for your general wellness. But, it’s understandable to feel added hesitation about safety when pregnancy and childbirth enter the equation. As extra reassurance, Dr. Albert shared, “Midwives are trained for emergent situations. That being said, one should always have a backup plan in case emergencies arise that they aren’t capable of handling alone.” Actually, this type of emergency planning would take place whether you’re working with a midwife or obstetrical provider. 

reasons to consider using a midwife
Source: Canva

When isn’t it advisable to use a midwife?

Deciding how you would like to approach aspects like your health or pregnancy journey are empowering choices. First and foremost, if you have reservations about using a midwife, honor them. Or, perhaps you have your heart set on using a midwife but just want the green light you’re OK to do so. Dr. Albert advised that it’s best not to seek midwifery care “when a person is considered very high risk, either due to certain health conditions, or pregnancy-related conditions.” For pregnancy-related care or otherwise, you might have circumstances that will be better handled by an OB-GYN or other healthcare provider who specializes in exactly what you need. 

Can you still use a midwife if you want/need an epidural or C-section?  

Midwives do tend to take holistic approaches to pregnancy and birth. It’s one of the main reasons to consider using a midwife. Still, if you were counting on an epidural for pain management during labor, you’re in luck. Dr. Albert affirmed that epidurals definitely remain a possibility. She specified that it’s the location of the delivery that might be restrictive.

For example, let’s say you’re planning for a home birth or one at a free-standing birth center. In those cases, epidurals and other interventions aren’t available the way they would be in a hospital. The best thing to do? Talk with your (potential) midwife about your intentions of having an epidural available or not. Then, you can decide on a plan from there.

As for C-sections, as Dr. Albert noted above, midwives are not trained to perform them. But like with epidurals, that doesn’t mean you have to miss out on midwifery care if it’s something you were looking forward to. Dr. Albert elaborated, “If a patient is set for a planned C-section, that is not something a midwife can do alone. However, many midwives are first assists (assistants to physicians) who perform the actual surgery.” So while you’ll give birth in the hospital if you’re having a C-section, and it will be handled by multiple providers, you can still count on your midwife to be a part of your pregnancy process up through your delivery. 

Benefits of midwives

Hopefully, no matter who you’re evaluating (and ultimately selecting) to manage your wellness and/or pregnancy, you have the peace of mind that you’re truly in good hands. For many women, a midwife’s specialties can completely provide this standard of care. Here are positive reasons to consider using a midwife: 

Minimal interventions

Midwives are less likely to jump to prescribing medications and recommending medical procedures as initial courses of action when addressing your healthcare needs. For instance, if you’re hoping for a childbirth experience free of pain medications, an episiotomy, C-section, etc., midwives are a great option. This is refreshing considering C-section rates have only continued to rise over the past years. The increase isn’t necessarily due to an uptick in medically imperative C-section orders or truly contemplated elective C-sections, but simply because they’re more nudged by physicians

Dr. Albert underscored, “Midwives have been shown to have lower rates of interventions and higher rates of vaginal births than physician counterparts.” That’s not to say various types of supportive interventions won’t be available to you if things don’t go as expected, your preferences change, or you require them in the first place.

Coordinated care

When you’re working with a midwife, they’re usually ready to be as integrated as possible with your other care providers. This isn’t always the case when it’s the other way around. Certain providers can be under the impression they’re your one and only, so to speak. It’s as though they feel insulted when you involve others alongside their care. 

During pregnancy, specifically, it’s quite common to use a midwife alongside the support of an OB-GYN, particularly around labor and delivery. Midwives are fully prepared to collaborate with an obstetrical provider to ensure the safest birthing experience possible. If getting the best of all worlds for your care team sounds like a dream come true, a midwife will certainly be able to coordinate their place on it. 

Flexibility

Regarding pregnancy and giving birth, midwives offer tons of flexibility around details like where and how you’ll give birth. For example, a midwife can facilitate your delivery in a birth center, at home, in a hospital, etc. A lot of times, people don’t even realize that midwives are associated with hospitals, assuming it’s only OB-GYNs. Dr. Albert pointed out, “Oftentimes, midwives provide prenatal care in a clinic-type setting, with delivery occurring in the hospital. However, at times, clinics are situated inside hospitals as well.” 

Besides delivery setting, midwives adapt to who and what comes into play as your pregnancy develops and when labor arrives. They can encourage things like involving a doula, navigating a water birth, or trying hypnobirthing. Essentially, a midwife will be happy to figure out ways to incorporate any unique approaches you’d like to explore as you prepare to bring your tiny human into the world!

reasons to consider using a midwife
Source: Canva

Holistic approach

If there’s something midwives are celebrated for, it’s their commitment to taking a holistic approach to your healthcare. They’ll make a point to prioritize your emotional well-being as much as your physical health. In general, they have a wonderful extent of minimally-invasive methods and resources they can propose for taking care of both. 

When thinking about your care within the context of having a baby, they won’t singularly focus on pregnancy basics during check-ups. They’ll want to direct care around a complete picture of your wellness and personal goals. A midwife will be open to discussing your fertility, approaches to contraception (or smoothly getting off birth control) or trying to conceive, patterns of nutrition and exercise, details for a birth plan, strategies for breastfeeding, and quality infant care. Fundamentally, they treat the whole person, not just the pregnancy or gynecological consideration she presents with.  

Relationship building

If having a meaningful connection with your provider is important to you, your odds with a midwife are high. It’s one of the primary reasons to consider using a midwife. Dr. Albert emphasized, “Midwives tend to spend a lot of time with their patients… we build relationships with individuals that can last a lifetime.” If you’ve experienced visits with a doctor who has been so pressed for time they barely have a chance to address all your questions, you can empathize with how precious this is. It doesn’t mean midwives are less busy or in low demand—sufficient patient time is just foundational to their work. 

“Midwives tend to spend a lot of time with their patients…we build relationships with individuals that can last a lifetime.”

Besides being relationship-oriented, they are usually also well-versed in birth justice, gender and sexual fluidity, cultural sensitivity, and other vital parts of our individual identities. You should be able to totally trust your midwife to give you the nonjudgmental and careful listening you deserve. 

How to find the right midwife

For anyone seeking a midwife for health and/or pregnancy care, Dr. Albert suggests spending time doing your research. It’s as simple as even starting with a search like “midwives near me.” Many midwives have their bios available online, and there may be third-party reviews as well. The American College of Nurse-Midwives also has a directory where you can select things like your location, type of care, and setting, and they’ll generate a list for you. All of this can lend you confident reasons to consider using a midwife.

Once you start narrowing down options, Dr. Albert encourages, “Meet them! Oftentimes, a midwife might be willing to have a 1:1 consult to see if it is a right fit.” You can express what you hope to achieve by working with a midwife. You can also decide if their practices are in tune with what you have in mind. If you’re seeking care for the duration of your pregnancy, she recommended clarifying what your birthing desires are and if you’re considered low-risk. 

If and when the stars align and you encounter your perfect midwife, there’s much to look forward to. We asked Dr. Albert to share what she loves about being a midwife. She replied, “The positive relationship between provider and patient makes the job very rewarding, along with the positive impact we can make on individual health.” Without access to quality women’s health, how can we embrace the life we live and dream of? A midwife’s attentive and thoughtful care could make all the difference.

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