Midwifery may be one of the oldest medical professions in the world—researchers uncovered traces of the practice as far back as the Paleolithic era (40,000 B.C.E.). Cultures worldwide have practiced some form of midwifery, assisting and supporting childbirth, for centuries. But what does a midwife do, exactly? We sat down with one of our Certified Nurse Midwives, Olivia May, CNM, to dissect the role of a midwife and answer your most pressing questions about these dedicated healthcare professionals.
What is a midwife?
Midwives are healthcare professionals who primarily work in pregnancy, childbirth, newborn, and postpartum care. They tend to work closely with expectant parents, providing more one-on-one support through pregnancy and the days and weeks following labor and delivery. Midwives usually handle non-complicated births, meaning those that are low-risk or have mild complications. Some also provide routine gynecological care, such as annual well-woman exams and birth control counseling. Midwives are experienced, care-centered providers who strive to offer a holistic labor and delivery experience.
Certified nurse midwife meaning
Midwifery is a robust field; there are different types of midwives with different training and certifications, and requirements vary for each state. Most midwives fall under one of two categories: nurses who received additional midwifery training or direct-entry midwives who are only trained in midwifery. Certified Nurse-Midwives (CNMs) and Certified Midwives (CMs) are highly trained healthcare professionals who receive accreditation from an overseeing agency. CNMs are nurses with a graduate-level nurse-midwife certification, “[for] CNMs, we go through nursing school first and then Midwifery school,” May shares.
CMs are non-nurses with a graduate-level midwifery degree from a program accredited by the Accreditation Commission for Midwifery Education (ACME). Both CMs and CNMs are certified by the American Midwifery Certification Board (AMCB). CNMs and CMs provide the same level of care, but only CNMs are licensed for independent practice in all states.
Midwife Questions: An FAQ with a CNM
Despite the popularity of midwifery in other countries (2/3rds of live births in the UK are with a midwife), it’s not as common to work with a midwife in the U.S. However, interest in midwifery is growing. Recently, the rate of live births attended by a midwife has increased from 8% in 2018 to 12% in 2021. And with good reason: “We actually know that midwives can improve perinatal outcomes,” says May. Research shows that first-time mothers who give birth with a midwife on their care team are 74% less likely to have their labor induced. Below, we dive deeper into what midwives do and how they support labor, delivery, and beyond.
What does a midwife do?
Nurse midwives, or CNMs, facilitate the safe delivery of babies in low-risk or “normal” births. May shares, “Midwives are safe, and part of that safety is knowing what’s within our scope and what’s not within our scope; our training is evidence-based, and we work to support the physiological aspect of birth.” This usually includes prenatal care, one-on-one counseling, education, and hands-on assistance during labor.
What education or certification does a midwife have?
The education and training a midwife undergoes depend on the type of midwife. As a CNM, May is both a nurse and a midwife: “We go through nursing school first and then midwifery school, which is usually 2-3 years, followed by clinical rotations.” May continued her training with a fellowship, which isn’t required but can be part of further education or gaining a specialty.
Can midwives deliver in hospitals?
“Midwives operate in all settings where birth happens,” says May. This can be a hospital setting, a birth center, or a home birth. Some people may think that you can only work with a midwife if you have a home birth, but that’s not true. One key difference, May shares, is that midwives in hospital settings are CNMs. “All of the midwives in hospitals are nurses. We have our RN, and then we have advanced specialty in the practice of midwifery.”
Can a midwife give epidurals?
Another common misconception is that if you work with a midwife, you must have a natural birth. Per May, that’s not always the case: “It varies state by state, but in Arizona, midwives have prescriptive authority, which means they can prescribe medication, and you can have an epidural; it happens quite frequently.” However, midwives do not place the epidural.
How do Midwives, Doulas and ObGyns work together?
Some people may confuse doulas and midwives, but they are different. “Doulas provide emotional, informational, and physical support; they are not clinical providers, whereas midwives are healthcare providers,” says May. That doesn’t mean they can’t and don’t work together. Quite the opposite, according to May: “Midwives and doulas can both be part of a strong care team.” ObGyns can also be part of that team and are often on hand if there are complications or just to assist. You can have a midwife and an ObGyn; it depends on several factors, but it’s not entirely out of the realm of possibility.
The relationship between all three professions is highly collaborative. They work as a unit to ensure a safe delivery and healthy mother and baby.
Can midwives perform c-sections?
One scenario where ObGyns and midwives collaborate very closely is a c-section. Midwives do not perform c-sections, though they may still assist or attend during the surgery. “There are some midwives who can do ‘first assist,’ which means they can provide direct assistance to the ObGyn,” May says. Midwives may also accompany their patients to the operating room for emotional support. May emphasizes that the vast majority of c-sections are planned in advance, so they work with the entire care team to make a plan that supports the mother and baby.
Midwives & Routine Women’s Health Care (13:12)
Although midwives generally work in labor and delivery, did you know you can also work with a midwife for routine care? May shares, “We [midwives] do full-scope reproductive care; if it’s gynecological-related, we can see you.” Other services midwives provide include:
- Annual well-woman exams and pap smears
- STI screening
- Menopause support
- Pelvic pain
- Birth control counseling
Per May, midwives refer patients to an ObGyn for follow-up if anything abnormal arises during routine care.
Accessible, exceptional midwife care in Tucson
Midwives are highly trained professionals with a wealth of knowledge and experience in reproductive care. At Genesis, we work with several CNMs to provide outstanding, safe and compassionate care. Contact us to request an appointment today.
Olivia May, CNM, is a certified nurse midwife practicing at Northwest ObGyn in Tucson, Oro Valley and Sahuarita. She earned her MSN in Nurse-Midwifery at Vanderbilt University School of Nursing. She continued her training as a midwifery fellow at Holy Family Birth Center in the Rio Grande Valley, Texas. She is certified by the American Midwifery Certification Board.
