Midwives have been helping women through their pregnancies for generations. Long ago, there wasn't much choice - true medical doctors weren't always available. Today, they offer expectant mothers an alternative to doctors delivering their babies.
For some mothers it may be a matter of "natural birth," for others it may be a financial decision. Whatever the reason, it's up to you to make the right choice for you and your baby.
What They Do
Midwives specialize in reproductive health - practically everything involved with pregnancies. Midwives provide help with:
- Prenatal care, such as proper nutrition
- Physical examinations
- Delivering the baby
- Post-delivery issues, like breastfeeding
This is by no means a complete list of things midwives do before, during and after pregnancies. Each midwife may offer different services, and often state laws control what they can and can't do for their patients.
Types, Education & License
There are a few different types of midwives, and the type usually depends on the required level of education and certification. Also, the names may vary from state to state, but in general, a:
- Certified Nurse-Midwife (CNM) is a trained, licensed nurse with at least a bachelor’s degree and certification from the American College of Nurse Midwives (ACNM)
- Certified Professional Midwife (CPM) is trained in midwifery and meets the educational requirements of the North American Registry of Midwives (NARM)
- Certified Midwife (CM): has at least a bachelor’s degree and certification from ACNM
Not all states recognize all types of midwives. For example, Ohio recognizes only CNMs.
Also, many states have additional training and license requirements. California, for example, requires licensing from state agencies. In New York, midwives must pass additional examinations before they can practice. And most states require additional licensing before midwives can prescribe medications.
Still Things Go Wrong
Despite training and licensing, sometimes things go wrong. A New Hampshire midwife is under fire for malpractice. One mother claims she contracted an infection because of the midwife's improper care. Another claims the midwife caused her baby to suffer permanent brain damage.
New Hampshire authorities are investigating the complaints. The midwife surrendered her license and suspended her practice, too. Meanwhile, several patients have filed medical malpractice lawsuits against the midwife.
What You Can Do
Maybe you're thinking of using a midwife because you want a natural birthing experience, either at home or a special birthing center that's different than the typical, impersonal hospital room. Maybe you want the personalized and ongoing care offered by a midwife.
Or, maybe you like the financial aspects of having a midwife. Most midwives can bill Medicare, and can offer flexible payment plans most doctors and hospitals can't.
Whatever the reason, take some steps to make sure you and your baby are well-cared for:
- Determine your pregnancy risk level. Midwives mostly handle low risk pregnancies where there's very little chance of complications. High risk pregnancies, such as the mother has a medical condition or the fetus is improperly positioned, are best handled by a medical doctor in a hospital
- Talk to more than one midwife before making a decision. Ask friends, family and your doctor for recommendations
- Ask any midwife for references from past patients and contact as many of those references as possible
- Make sure a midwife has the education and license required by your state. Yes, there are midwives out there who don't have formal educations or licenses. Your state's health department or medical board should be able to help
- Ask the midwives you're talking to for the names of the doctors they work with if your state requires midwives to work under a doctor's supervision
- Request that your midwife would voluntarily work with a doctor as a back-up in case of a medical emergency
- Use the midwife, but consider giving birth at a hospital where there's always a doctor on call, other trained staff and the necessary equipment to handle an emergency - unlike most birth centers and certainly your home
- Contact your state's health department or medical board immediately if you experience a problem with a midwife
It's an exciting time, and perhaps a bit worrisome, too. You want your baby to be healthy and strong. Making a good decision about using a midwife to help with your pregnancy is an important step. Take some time to research so you make the right decision for you, your family and your baby.
Questions for Your Attorney
- Can a mother get into legal trouble for hiring an unlicensed midwife?
- Is a midwife's license good in any state?
- Do midwives have to carry any type of insurance?