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Midwife FAQs

"It's not just the making of babies, but the making of mothers that midwives see as the miracle of birth." - Barbara Katz Rothman, Sociologist, Author of The Tentative Pregnancy

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FAQs and answers were culminated from various sources on the web. Source notation will be listed as appropriate.

What is a midwife?
A midwife is a trained professional with special expertise in supporting women to maintain a healthy pregnancy birth, offering expert individualized care, education, counseling and support to a woman and her newborn throughout the childbearing cycle.

A midwife works with each woman and her family to identify their unique physical, social and emotional needs. When the care required is outside the midwife's scope of practice or expertise, the woman is referred to other health care providers for additional consultation or care. Obstetricians tend to focus on the pathology of pregnancy and birth, including everything that 'might go wrong', midwives focus on the normalcy and focus on all the wonderful things that are going 'right'.

The Midwives Alliance of North America, the North American Registry of Midwives, the Midwifery Education Accreditation Council and Citizens for Midwifery agreed on a short definition of what "midwifery care" means. However, just because a person is a midwife does not guarantee that they provide this kind of care; consumers looking for a midwife should ask questions to determine if a prospective caregiver will be able to provide the kind of care they seek. (Citizens for Midwifery)

What is the difference between a CNM, CPM and a DM?
A CNM, certified nurse midwife goes to nursing school and is a registered nurse as well as being trained to be a midwife. They are licensed by their state or province and most of the time work in hospitals along side OBs.

A CPM, certified professional midwife is not a registered nurse but has most likely done professional training through a certification program. Some CPMs are licensed by their states or provinces.

DMs or direct-entry midwives, also known as lay midwives, usually have been trained with an extensive apprenticeship under the direction and guidance of experienced midwives.  Their focus is on 'experience' as compared to certification.  Many midwives who have been practicing for decades, commonly referred to as Granny Midwives, are considered DMs or LMs. Some DMs are licensed by their states or provinces and may also have had some professional training in school or in a certification program.

What should I know when choosing a midwife?
Here are some suggested questions you should ask when interviewing a midwife:

  • Why did you choose midwifery as your path?
  • Are you licensed or certified? What is your training?
  • How long have you been practicing?
  • How many births have you attended? How many of those were you the primary midwife for the mom?
  • Do you have partners/apprentices I need to meet? Who will be at the birth?
  • How much time do you spend with your clients prenatally?
  • What insurance do you take? Do you have payment plans?
  • How much time do you spend with your clients during labor and postpartum?
  • Do you encourage women to eat during labor? Will you encourage me to labor in whatever position I want?
  • Do you attend water births?
  • Do you have a relationship with a physician who will take care of me if I need to go to the hospital, or have special tests done? Do I meet him/her prenatally?
  • What would make my pregnancy high risk? Do you handle any of these complications?
  • What is your transport rate? For what reasons do you transport? Where do you transport to?
  • How many of those transports go on to have cesareans?
  • What is your episiotomy rate?
  • What equipment do you use for prenatal care and for the birth?

(Woman Care Midwifery)

What Equipment Do Midwives Bring to a Birth?
Though individual midwifery practices are different throughout the country and whereas many midwives practice under politically harsh conditions, generally speaking your midwife should have these items available to her when she comes for your delivery.

Most Important:

  • Doppler and a fetoscope
  • Medication to control hemorrhage: Pitocin, Methergine (IM, oral)
  • Oxygen tank(s) and gauge(s) with adult and pediatric masks, cannulas, tubing
  • Suction devices, such as delee traps
  • Instruments: scissors, hemostats, needle holders, etc.

Important:

  • Blood pressure cuff/stethoscope for an adult
  • Ambu bags, adult and infant with a variety of sizes of infant masks
  • Amnihooks
  • Suturing equipment
  • Catheterization equipment
  • IV equipment
  • Baby scale, tape measure

Extra items that a midwife may carry:

  • Pulse oximeter
  • Newborn blood pressure cuff
  • Airways, infant and adult
  • ET tubes 2.0-4.0
  • Laryngoscopes: adult and infant
  • Medications such as Vitamin K, eye ointment, lidocaine
  • Tubes for the laboratory examination of cord blood
  • Herbs for labor
  • Miscellaneous items, such as a mirror, flashlight
  • Extra birth supplies: sterile/non sterile gloves, Betadine, sterile and non sterile gauze pads, K-Y jelly, bulb syringe, cord clamps, alcohol pads, perineal oil, ammonia amps
    (dear-midwife.com, Anne Sommers, Licensed Midwife)

What if complications occur?
Most complications in labor are detected by our frequent monitoring and therefore, the midwife will be able to transport you to a hospital before it becomes an emergency situation.
(Beth Overton, CPM, Gentle Beginnings)

For the rare occurrence of a complication requiring medical assistance, [midwives] have emergency equipment that is brought to your birth to stabilize mother and baby for transfer to the nearest hospital. However, despite the inherent risks associated with birth, true emergency complications are very rare, and most are prevented or handled safely at your home by the midwife. 
(West Texas Birth Services)

Where do prenatal visits take place?
Most midwives will make prenatal visits in your home. Some have offices that you can go to for check ups. Ask your midwife (or potential midwife) where she/he does prenatals.