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Midwives have a long tradition of taking care of women throughout pregnancy and the birth of their babies. Prior to 1900, midwives delivered almost all babies born in the United States. The growth of hospitals and formalized medical education programs around that time shifted the responsibilities of caring for pregnancy and childbirth to physicians. More recently, there has been a resurgence of interest in midwifery in America and across the world.  For example, the Duchess of Cambridge, Kate Middleton chose to have two midwives deliver her baby with a team of physicians standing by in the event that complications arose. More and more, pregnant women are asking the question “Is a midwife right for me?” Midwives are healthcare providers that care for women throughout the lifespan and especially enjoy assisting women with the transition into motherhood including pregnancy and birth. A certified nurse-midwife (CNM) is an advanced practice nurse who has specialized education and training in both nursing and midwifery. In addition, CNMs can prescribe medications, offer family planning counseling and contraception management, perform annual physical exams, order labwork, and provide menopausal support and basic primary care to healthy women.

Why might I choose a nurse-midwife to care for me?
The word midwife means “with woman”. Midwives are experts in normal birth and view pregnancy as a customary physical and mental transition in which a woman can improve her health and prepare to become a mother. CNMs emphasize education, health promotion, disease prevention and partnership between the client and health care provider. You can make your very first prenatal appointment with a midwife and she will continue to care for you until after the birth of your baby.

Do I still receive the same prenatal testing and ultrasounds during my pregnancy that are typically ordered by a physician?
Yes, during your pregnancy you will have the option to have any or all of the routine screening tests to make sure that your pregnancy is on the right track.

Does using a nurse-midwife mean I cannot have any pain relievers during childbirth?
Midwives specialize in caring for women who choose to forgo pain medication but nurse-midwives who practice in the hospital are able to order pain medications and/or epidural analgesia for women who choose them.

How much involvement does a midwife have in the birthing process?
The midwife may be present throughout the process of labor, during pushing and the birth, and available in the immediate postpartum period to assist with breastfeeding.

Will my support team be allowed to participate?
Midwives actively encourage the assistance of family, friends and doulas to support the mother during the labor and birth process.

Where will my labor and delivery take place?
Although some nurse-midwives offer the option to give birth out of the hospital, the majority in the U.S. assist women with giving birth in the hospital. At St. David’s Medical Center we can offer various things to help you during your labor such as childbirth education and coping skills, prenatal classes, birth balls, large showers, remote telemetry fetal monitoring that allow you to move around in labor, and supportive nursing staff who desire to help you achieve your goals.

What are some medical conditions that may preclude me from having a midwife?
There are varying circumstances that necessitate care from a physician. Some of these arise prior to or during pregnancy, some during the birth and some during the postpartum time. Some examples include chronic health conditions like high blood pressure or diabetes, preterm birth, twins, a baby being breech or known problems with the placenta. These are just a few examples and your healthcare provider will be able to tell you if your pregnancy requires collaboration with or transfer of care to a physician. Even in these situations, it can be possible for the midwife to remain involved in your care.

St. David’s Medical Center is pleased to offer a nurse-midwife service for appropriate pregnant patients, to optimize both the holistic birth experience and the goal of a safe and healthy childbirth.  For those who are interested, please contact us at 512-544-4226.

Aspen Green, Certified Nurse Midwife
St. David’s Medical Center

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